Eyes have been “hidden” b...

A 48-year-old woman complained that both of her eyes have been “hidden” behind the upper eyelids since she was born. She did not have a family history of ocular or systemic abnormalities. However, the ophthalmological examination revealed that both eyes were fixed in a highly superomedial position. The micro corners were covered almost entirely by the upper eyelids, even when she opened her eyes.

The right cornea was entirely covered by the upper eyelid, while a small part of the inferior left cornea could be seen. The corneal diameters were approximately 5mm with corneal opacification and pannus formation, as shown in the figure. The forced duction test was positive for severe restrictions in extraocular motility. 

Orbital computed tomography CT demonstrated a deviation in and elongation of the eyeball, superior displacement of the lateral rectus muscle (LR), an attenuated inferior rectus muscle (IR) and inferotemporal herniation of the globe through the muscle cone. Based on the diagnosis, an appropriate operation was performed. Postoperatively, the primary position improved, and the patient had a satisfactory correction.