Ophthalmic Considerations in Cleft Lip and Palate Patients

Abstract

Cleft lip and palate (CL and P) represents the second most frequently occurring congenital deformity after clubfoot deformity. CL and P could be associated with many other structural abnormalities of the adjacent vital structures of the face. In this study, an attempt was made to identify the abnormalities of the ocular structures seen in patients with isolated CL and P as well as in those with syndromic CL and P. Of the 322 patients with cleft lip and palate screened, 27 (8.3%) had ocular abnormalities. Totally 47 ocular defects were identified in 27 patients. Abnormalities of the eyelid were the commonest accounting for 22% of the total defects (11/47), which includes symblepharon, ectropion, lid colobomas, euryblepharon and ptosis. Second commonest abnormality was squint 8/47 (17%) followed by orbital defects 8/47 (17%) (Telecanthus and Hypertelorism). Abnormalities of the nasolacrimal apparatus 3/47 (6%), refractive errors 7/47 (15%), dermoids 4/47 (6%), cataract 2/47 (4%) and retinal colobomas 2/47 (4%) constituted the rest. Thus, children with cleft lip and palate should be assessed as soon as possible after birth by a multidisciplinary team involving the Pediatrician, Ophthalmologist and specialists from Maxillofacial, ENT and Plastic surgery. The medical problems in this group of children are global and therefore, should not be looked at in isolation.

Characterization of Subtle Brain Abnormalities in a Mouse Model of Hedgehog Pathway Antagonist-Induced Cleft Lip and Palate

“…Moreover, a slight but significant increase in interocular distance was found in each of the cyclopamine-exposed groups with clefts. While HPE is typically associated with reduced interocular distance [35] , clinical populations with non-syndromic OFCs have been described as hyperteloric or as having normal interocular distance [46] .…”

Refractive Errors and Strabismus In Patients with Orofacial Clefts

“…In the study by Anchlia et al [3] Previously published case reports describe ocular abnormalities in patients with orofacial clefts, resulting from the abnormal fusion of the embryonic optic fissures, such as ocular coloboma, ectopia lentis, ectopia pupillae, and bilateral optic disc pit with maculopathy [4,6]. These changes were observed in patients with CL/CLP without systemic or neurological involvement, excluding syndromic associations.…”

“…Children with these disorders usually require multidisciplinary care from birth to adulthood and they have a greater morbidity and mortality throughout their lives than unaffected individuals [1]. Medical assistance to these patients generally involves plastic surgery, maxillofacial surgery, otolaryngology, and genetics, among others [3]. Ophthalmological evaluation plays an important role in this context, as visual changes are recognized in this group of patients.…”

Loss of Wiz Function Affects Methylation Pattern in Palate Development and Leads to Cleft Palate

“…On top of these findings, other observed phenotypes of E18.5 Wiz –/– embryos such as cleft eyelids may be connected to the cleft palate phenotype as they share a similar developmental program, which consists of directional tissue growth followed by tissue fusion. Different types of eyelid defects were found among patients with cleft palate diagnosis ( Anchlia et al, 2011 ). Similarly, shorter snout in mouse embryo may indicate more general alteration in growth dynamic of orofacial area, which can result in cleft phenotypes.…”