A 5-day-old-newborn with a large right upper eyelid coloboma

On initial examination, the patient was found to have a right preauricular skin appendage, visual acuity of light perception in both eyes, a small right eye temporal limbal dermoid, and a right upper eyelid coloboma that involved approximately 70%–80% of the upper eyelid. There was near total exposure of the right corneal surface, with trace inferior punctate epithelial erosions but no epithelial defect. Anterior and posterior segment examinations were normal. Aggressive surface lubrication was initiated, and the patient was followed closely. At 2 weeks’ follow-up the patient developed a small right inferior corneal ulcer. Topical antibiotics were initiated, and the patient was scheduled for surgical repair (Figure 1).