Cryptophthalmos is a condition that results in failure of eyelid formation. It is divided into three types: The complete variety, the incomplete variety, and the symblepharon variety. The complete variety is the most common type. The eyelids do not form and the eyelid skin grows continuously from the forehead to the cheek, covering the underlying globe. The globe is usually abnormal.
The incomplete variety presents with facial skin fusing to the medial aspect of the globe with no eyelid structures in that area. The lateral eyelid is present and normal.
Finally, the congenital symblepharon variety presents with fusion of the upper eyelid skin to the superior portion of the globe. The eyelid in this area is absent. There may be a small amount of normal eyelid laterally.
Cryptophthalmos is often bilateral and symmetric. Autosomal recessive and autosomal dominant inheritance have been reported. The globe is often abnormal, resulting in poor visual prognosis.
Cryptophthalmos is associated with many other congenital anomalies, including mental retardation, nasal anomalies, ear anomalies, cleft lip and palate, irregular dentition, genitourinary abnormalities, cardiac malformations, meningoencephalocele, abnormal hairline, umbilical hernia, anal atresia, ankyloglossia, laryngeal atresia, and syndactyly.
There are syndromes associated with cryptophthalmos and these include: Fraser's syndrome, cryptophthalmos-syndactyly syndrome, malformative syndrome with cryptophthalmos, and cryptophthalmos syndrome.
Treatment of cryptophthalmos is aimed at reconstructing the eyelids and allowing for visual development. The eyelids can be reconstructed with oral mucous membrane grafts in combination with local myocutaneous or eyelid sharing grafts. The underlying globe must also be reconstructed and may require mucous membrane grafts to the globe as well as corneal surgery in an attempt to allow the development of vision.