Buphthalmos Definition, Reason, Symptoms, Treatment & Prevention

Buphthalmos Definition, Reason, Symptoms, Treatment & Prevention


Buphthalmos is a term used to describe the condition where the eyeball is enlarged. This condition is often found in children from birth to the age of three. Another term that can be used to describe this condition is ox eye or cow’s eye. Buphthalmos can be found in one or both eyes. In about 75 percent of cases, eyeball enlargement can be found in both eyes.

Under normal conditions, the average diameter of the cornea at birth is less than 10.5 millimeters. Enlargement of the eyeball, which can be assessed from the diameter of the corneoscleral junction, which exceeds 12 millimeters can be a marker of Buphthalmos.

The condition of Buphthalmos is generally present from birth. Unfortunately, this condition is often not realized until the child grows older. Even though this condition can cause blindness in about 10 percent of cases and impaired vision in about 50 percent of cases.

Buphthalmos Symptom

Some of the signs and symptoms of Buphthalmos that can be encountered include:

  • Epiphora (watery eyes)
  • Photophobia (sensitivity to light)
  • Blepharospasm (spasm or tense contractions of the eyelids)
  • Redness of the conjunctiva of the eye
  • Corneal enlargement and corneal clouding
  • Impaired vision

Buphthalmos Reason

Buphthalmos is commonly caused by congenital glaucoma. This disorder can be found in 1 in 10,000 births. Congenital glaucoma is an increase in eye pressure found in the first year of a child’s life.

The causes of congenital glaucoma are not fully understood. There are several theories put forward by experts. Among other things, due to the presence of a membrane or membrane that covers the anterior chamber angle or the front chamber of the eye (called Barkan’s membrane), there is an obstruction in the trabecular meshwork (spongy tissue at the base of the cornea which serves as a kind of pipe), and disturbances in the development of the anterior chamber in the uterus. All of these things can cause resistance to the outflow of fluid in the eye, thereby increasing eye pressure. This high pressure causes enlargement of the eyeball (Buphthalmos).

In most cases, congenital glaucoma occurs sporadically. However, in some cases this condition can be inherited in an autosomal recessive manner or due to a genetic problem. Therefore, inter-relative marriage can increase the risk of Buphthalmos.


Buphthalmos can be diagnosed by looking at the clinical condition of the patient. However, several tests can also be carried out to support the diagnosis, such as:

  • Visual function check
  • Corneal diameter examination: results above 12.5 millimeters often indicate an abnormality, especially if there is asymmetry between the two eyes
  • Check eyeball pressure (possibly pediatric patients need to be anesthetized)
  • Biomicroscopy or slit lamp examination
  • Ophthalmoscopy examination
  • And several other forms of inspection

Buphthalmos Treatment

Treatment is focused on reducing excess eye pressure and also dealing with complications that may arise. For example refractive disorders and amblyopia.

Often, lowering the pressure in the eyeball needs to be done by means of surgery, such as geniotomy and trabeculotomy. Surgery is expected to expedite the flow of fluid in the eye ( aqueous humor ) so that it can reduce eye pressure.

Treatment with drugs is generally given in conjunction with surgery. Drugs that may be given include carbonic anhydrase inhibitors, beta-blockers, and prostaglandin analogues. Re-examination of the effect of treatment should be done within 1-2 weeks after use.

It is also necessary to evaluate the possibility of complications, such as myopia, astigmatism, corneal scarring, and lens dislocation. All of these things can cause visual disturbances.

The prognosis for Buphthalmos is highly age-dependent. Glaucoma that is present at birth is generally difficult to treat and often causes blindness in up to 50 percent of cases. On the other hand, glaucoma that is not detected and treated, causing an enlarged cornea of ​​14 millimeters also has a poor prognosis.

Often, a good prognosis is found in glaucoma detected when the child is 3–12 months old. At that age, generally 80–90% of cases produce good eye pressure control after surgery.


Because the causes of Buphthalmos are not widely known and are often found at birth, there is no effective way to prevent it. Observation of the baby’s eyeballs from birth and routine control to the pediatrician can help identify problems as early as possible. Prompt treatment will also prevent the problem from becoming serious.

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