A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure Keratopathy

Diprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are presented. A male infant who was born at 33 weeks of gestation to a nonconsanguineous 42-year-old mother and 47-year-old father was examined for orbital abnormalities. The infant had a large head, 2 faces, and 4 eyes, of which 2 were placed laterally and 2 were fused in the midline. In the laterally placed eyes, the pupils were unresponsive to light, and the optic discs were hypoplastic. In the fused eyes, the lower and upper eyelids were also fused, horizontally wide, vertically short, and immobile, resulting in a progressive exposure keratopathy. On the 33rd day of life, a modified total tarsorrhaphy was performed with the use of inhalational mask anesthesia. The patient died due to pneumonia and septicemia on the 45th day of life. Accepted for publication August 14, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Bulent Yazici, M.D., Izmir Yolu Senyurt Is Merk, no: 87/4, 16110 Bursa, Turkey. E-mail: byazici@uludag.edu.tr © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.