Bilateral upper lid coloboma at Bugando Medical Centre: A case report

Abstract

This is a rare case of bilateral upper eyelid coloboma in a neonate managed with early primary surgical correction.
A three-day-old term neonate weighing 3 kilograms was referred from primary health facility to Bugando Medical Center, a tertiary referral hospital in Mwanza, Tanzania, following a spontaneous vaginal delivery. Ophthalmological examination revealed bilateral upper eyelid colobomas with exposure keratopathy with dryness and loss of luster. Systemic physical examination did not reveal any associated congenital anomalies such as craniofacial deformities, polydactyly, ear abnormalities, genital anomalies, or choanal atresia. On the first day post-admission, the patient underwent successful surgical repair via primary closure of the eyelid defects.
Frost sutures were applied bilaterally to protect the cornea, and a good Bell’s phenomenon was observed postoperatively. We conclude that prompt recognition and early surgical repair of eyelid colobomas are critical in preventing serious complications such as exposure keratopathy, corneal ulceration, xerosis, and permanent vision loss. This case highlights the importance of early intervention, even in resource-limited settings, and underscores the need for comprehensive systemic evaluation to rule out syndromic associations.