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Congenital Abnormalities

Interactive App



Inter-canthal, internal
Inter-canthal, external
Palpebral oppening
Use an appropriate Vernier..
Express values in percentiles for sex and age.
Difficult in the newborn.
Before measuring the inter-pupilar distance rule-out strabismus with a pencil-light, observing if the reflex is in the same position in both eye globes.
For more information about measurement go to:
1. Dolfus H, Verloes A, Dysmorphology and the orbital region: A practical clinical approach, Survey of ophthalmology, Volume 49, Number 6, Nov-Dic 2004. Pubmed 15530943[uid].
2. Hall BD, Graham JM Jr, Cassidy SB, Opitz JM, Elements of morphology: Standard terminology for the periorbital region, Am J Med Genet A, 2009 Jan; 149A (1):29-39. Pubmed 19125427 [uid].
3. Kulkarni ML, Rajendran NK, Sangam DK, Inner canthal, outer canthal and inter pupillary distance in newborns, Indian Pediatr. 1992 Jun;29(6):759-63.
Evaluate the position of the photographic flash reflection.
Photo 3 shows that there is no strabismus but that the right eye is slanted downward.
In Photo 4 the right medial sclera is covered by a telecanthus, simulating a convergent strabismus, but the reflection observed at the same location in both irises proves that no strabismus exists.
Photo 5 shows hypertelorism, the medial sclera on both sides is uncovered and the reflection observed at the internal quadrants of both eyes shows a coexisting convergent strabismus.



Photo 1. Synophthalmia-cyclopia: 1 iris. 2. Cyclopia with 2 irises. 3. Ocular hypotelorism 4. Telecantus 5. Ocular hypertelorism.