Ocular Aspects of Craniofacial Disorders

Craniofacial disorders may comprise various entities such as clefting anomalies, tumors (e.g., fibrous dysplasia), orbito-facio-cranial trauma, and the craniosynostoses. Each may have significant ocular involvement, but the focus of my discussion is the craniosynostoses. Craniosynostosis is the premature closure of one or more cranial sutures, which may be associated with systemic features or an isolated finding.1 When a suture closes prematurely, growth of the skull continues parallel to the suture, but is arrested or retarded perpendicular to it (see Figure 1). This results in an irregular shape of the skull. Previously, patients with suture synostosis were described as having a particular shaped head such as plagiocephaly, brachycephaly, or scaphocephaly. These are now better described in terms of the sutures involved, e.g.,