Isolated upper eyelid coloboma with visual loss: Single-stage tenzel flap repair

Congenital upper eyelid coloboma may threaten vision through exposure keratopathy and scarring.1,2 A 6-year-old boy presented with an isolated, medial, full-thickness upper lid defect involving about half the margin Fig. 1. Systemic and ophthalmic examinations showed no syndromic association. The left eye demonstrated lagophthalmos, corneal exposure, and opacity consistent with visual loss. Reconstruction used a lateral semicircular Tenzel myocutaneous flap after canthotomy and cantholysis.3 Layered closure restored tarsal support, orbicularis continuity, and skin integrity. Postoperative recovery was uneventful. Topical lubricants and antibiotic ointment were used for 1 week. Follow-up showed complete eyelid closure, preservation of the corneal surface, and stable cosmetic symmetry at 12 months Fig. 2. The Tenzel flap permits tension-free closure and preserves contour in medium upper lid defects, consistent with prior reports.3,4 Early diagnosis and timely repair help prevent ulceration and amblyopia in congenital upper lid coloboma.5,6Figure 1: Preoperative view showing a medial full-thickness upper eyelid defect with lagophthalmos and exposure keratopathyFigure 2: One-year postoperative view after Tenzel flap showing complete closure, clear corneal surface, and good symmetryEthics statement This study was conducted in accordance with institutional and ethical standards. Authors’ contributions The author performed all aspects of the study, including concept, design, definition of intellectual content, literature search, clinical studies, data collection, data analysis, statistical analysis, manuscript preparation, manuscript editing, and manuscript review. Declaration of patient consent The author certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in this journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.