Humans are able to see the world through a pair of eyes. Some may need to use glasses or contact lenses to get better eyesight and clear ones. Those who experience visual problems would ask a doctor if they find that going to an optometrist would not help improve their eye vision. There are many conditions that can affect how a normal eye looks and functions. Some of these diseases may affect a person since they are a child. One of them is fundus coloboma.
Let us break down what is fundus and coloboma first. Fundus describes the inside of the eye, specifically the back surface. Coloboma, according to the Greek language, means defect. Thus, fundus coloboma means a problem with the parts of the eyeball, specifically the back wall of the eye. This back wall of the eye consists of retina or optic nerve. In other words, fundus coloboma may affect the optic nerve (nerve that connects to the brain) or retina (layer of nerve) which is associated which plays an important role in eye vision.
Coloboma in general may not only affect the fundus. It may affect many other parts of the eyes such as the eyelid, iris (coloured part of the eyes) and lens (clear part of the eyes). It is estimated that coloboma affects 1 in 10 000 people. Due to the fact that coloboma may not always affect eye vision or cause eyes to seem bulging outwards, only some people are likely to be diagnosed such as those with fundus coloboma.
Colobomas are considered as congenital defects in most cases. This means that the defect is developed even before the person is born. When the baby is still in the womb, the eyes with its cup-shaped, zipped close along the bottom. Any disruption to this process will cause problems to the tissue of the eye parts, leading to missing parts. Colobomas itself may be presented on its own or may be associated with many other congenital problems. For example, some people with colobomas may have problems with congenital problems of CHARGE syndrome, cat-eye syndrome or Edwards syndrome. This means that colobomas may be inherited or occur spontaneously without any history of family members with the same condition.
Most cases of retinal colobomas are located at the bottom of the eye. In such a case, it would not cause vision problems. However, large colobomas or colobomas that are directly located at the optic nerve or central retina, may experience severe vision problems. This includes prolonged poor vision, nystagmus (repetitive uncontrolled eye movement), strabismus (crossed eyes) and small eyes size. Fundus colobomas are a condition that needs continuous observation by an ophthalmologist. The issue with fundus coloboma is that it may goes unnoticed unless it already causes poor eye vision. The only way that fundus coloboma can be seen or detected is through complete eye examination, especially through ophthalmoscopy.
Do you know how ophthalmoscopy examination is done? Ophthalmoscope is a tool the size of a flashlight. This instrument has different sizes of tiny lenses which can be adjusted by healthcare providers to get a close view of the internal back of the eye. This test works by shining the light through the pupil (opening at the centre of the iris). Ophthalmoscopy is also known as fundoscopy. Due to the fact that fundus coloboma affects children in most cases, this test is usually done by paediatric ophthalmologists as they expertise in examining children with eye problems.
You may wonder why fundus coloboma needs extra care from their doctor. The issues that can arise from fundus coloboma are its complications. Complications that are serious ones are the possible occurrence for retinal detachment. Retinal detachment can cause a person to lose vision. Apart from retinal detachment, presence of abnormal blood vessels may appear along the fundus area. These blood vessels can be considered as brittle and weak. If these blood vessels bleed, it may also cause vision loss.
There is no cure for coloboma. Treatment provided is typically to improve eye vision. This includes low vision aids, glasses and contact lenses. Certain cases might benefit from eye patch or eye drops to prevent lazy eyes (amblyopia). To avoid risk for retinal detachment or eye with signs of retinal detachment, surgery may be done to keep the back of the eye safe. This can preserve eye vision.
It can be concluded that fundus coloboma is part of the general coloboma which is caused by the problem during eye development. It can be hereditary and spontaneous. Fundus coloboma may be presented as a disease on its own or be linked with another congenital anomaly. The best way to know coloboma is to get the child checked by a doctor, specifically paediatrics ophthalmologists. Treatment is aimed to preserve eye vision and treatment provided will depend on the severity. Doctors may do further tests to check for possible congenital problems associated so that constructive treatment and holistic approach can be given to the child.
