The relationship between soft tissue anomalies around the orbit and globe and astigmatic refractive errors: a preliminary report.

Corneoscleral limbal masses were created in ten rabbit eyes and upper eyelid colobomas were produced in an additional ten eyes. The resultant changes in corneal curvature were recorded over a one-month period using streak retinoscopy and photokeratometry. By these methods, we have determined that forces at or near the corneoscleral limbus can produce changes in the corneal curvature that lead to refractive errors primarily of the astigmatic variety. There is a shift of the axis of astigmatism towards the meridian 90 degrees away from the external force or an increase of astigmatism along the meridian where the force was exerted. In this study, corneal curvature changed significantly in the coloboma and epibulbar mass groups when compared to the control group. This study supported a causal relationship between soft tissue anomalies and astigmatic refractive errors seen clinically in certain syndromes, such as Goldenhar and mandibulo-facial dysostosis. These findings suggest that patients observed with periorbital soft tissue defects may be at risk for the development of unilateral anisometropic refractive errors and secondary amblyopia. Recognition of this entity is essential in order that adequate therapy can be instituted at an early age.