Clinical Study Scleral Lenses in the treatment of Neurotrophic

CLINICAL STUDY
Mini-scleral Lenses in the Treatment of Neurotrophic
Keratopathy Secondary to Möbius or Möbius-like Syndrome
abduction. It is also associated with
other cranial nerve palsies, orofacial
dysmorphism (congenital malforma-
tions of the face and/or mouth), and
limb or axial malformations. 2 Limb
anomalies (hypoplasia) can range from
mere syndactyly of the digits (webbed
fingers or toes) to the absence of a
limb. The craniofacial deformities vary
even more and can include:
micrognathism (undersized jaw), tongue
malformations, facial and oral clefts,
oligodontism (miss-ing teeth) and
cranial nerve palsies. 1 The presence of
cranial nerve palsies is required to make
the diagnosis of Möbius syndrome. 1
Patients may be
BY ELISE G. KRAMER OD
& LANGIS MICHAUD, OD, MSc, FAAO
& VANESSA BACHIR, OD
Introduction
M
öbius or Möbius-like syndrome is
a disease within a group
of syndromes known as “terminal
transverse defects with orofacial
malformations”. 1 The condition was
originally recognized by Von Graefe in
1880 and later, more extensively
described by Moebius in 1888. 2 It is
characterized by a unilateral or bilat-
eral, nonprogressive congenital facial
palsy with impairments of ocular
Elise G. Kramer, OD
Langis Michaud,
OD, MSc, FAAO (Dipl)
Associate Professor,
École d’optométrie-
Université de Montréal
Vanessa Bachir, OD
ABSTRACT
Objective: This case report aims to explore the use of
large diameter rigid gas permeable lenses (LDRGP)
for the treatment of ocular and visual complications in
a young patient presenting with neurotrophic corneas. Objectif : Cette étude de cas vise à explorer l'utilisation de
Methods: After a comprehensive eye exam and specific Méthodes : Après un examen de la vue complet et des tests
testing for contact lens fitting, LDRGP lenses were fitted with spécialisés pour l’adaptation en lentilles cornéennes, des lentilles
success and dispensed. RESULTS. Prescribed contact LDRGP ont été adaptées avec succès et livrées. RÉSULTATS. Les
lenses helped the patient achieve optimal visual correction lentilles prescrites ont aidé la patiente à atteindre une correction
(6/6) as well as ocular protection for the cornea. visuelle optimale (6/6) et ont protégé la surface oculaire.
Conclusion: Neurotrophic keratopathy is a challenging Conclusion : La kératite neurotrophique est une condition difficile
condition due to its impact on ocular health and vision. LDRGP à gérer a cause de son impact sur la santé oculaire et la vision.
offer a unique way of addressing many issues raised in this case La correction avec des lentilles LDRGP offre une solution unique
report such as corneal healing and visual restoration. This lens aux nombreux défis soulevés dans ce rapport tels que la
modality may be considered for any other case involving cicatrisation de la cornée et la restauration visuelle. Ce type de
abnormal corneal tissue healing and reduced visual acuity. lentille peut être envisagé afin de solutionner les cas de guérison
Key words: large diameter rigid gas permeable lenses
(LDRGP), Möbius syndrome, neurotrophic keratopathy
lentilles de grand diamètre rigides perméables aux gaz (LDRGP)
afin de traiter les complications oculaires et visuelles d’une jeune
patiente présentant un problème de kératite neurotrophique.
anormale de la cornée avec baisse d’acuité visuelle.
Mots clés : kératite neurotrophique, lentilles de grand diamètre
rigides perméables aux gaz (LDRGP), Syndrome de Möbius
C a n a d i a n J o u r n a l
o f
O p t o m e t r y | R e v u e
c a n a d i e n n e d
’ o p t o m é t r i e
V ol 75 | N o 2 2013
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