Staphyloma

Staphyloma is a rare eye disorder. It develops when your cornea and sclera stretch and thin, so your eye bulges (outpouches). Your cornea is the clear front of your eye. Your sclera is the white of your eye, which wraps around your eye. Some people are born with the condition (congenital staphyloma). But eye injuries or eye diseases, like severe nearsightedness (pathologic myopia) or glaucoma, can also cause staphyloma.

Types of staphylomas

The two types of staphylomas (pronounced “sta-fuh-LOW-muh”) are:

• Anterior staphyloma: This type affects your cornea and sclera at the front of your eye. This condition causes symptoms that you or others can see. You can be born with this type, but most people develop it during their lifetime.
• Posterior staphyloma: This is when the sclera at the back of your eye thins and bulges. You won’t see the bulge. But an eye doctor may do tests that show the changes. This type most often happens at birth.

Symptoms of staphyloma

Staphyloma symptoms include:

• An enlarged eye
• Noticeable bulging or outpouching at the front of your eye
• Blue or black tinge in your sclera when your sclera thins and exposes the tissue underneath
• Eye pain and eye strain
• Loss of vision

Babies born with staphyloma have noticeable symptoms at birth. Acquired staphyloma — when the condition happens after you’re born — may not cause symptoms right away. In some cases, you may learn you have this condition when eye tests show changes in the back of your eyes.

Staphyloma causes

The two condition types have different causes:

• Anterior staphyloma: Eye injuries and eye infections, like keratitis, are common causes.
• Posterior staphyloma: Most people with posterior staphyloma are born with the disease. But severe nearsightedness also often leads to posterior staphyloma.

Complications

Anterior staphyloma can cause eye bulges that change your appearance. The change may make you feel self-conscious and lead to social isolation.

Posterior staphyloma can cause blindness if the condition changes the structure of your eyes. Changes in your eye structure can cause choroidal neovascularization or damage your optic nerve. Choroidal neovascularization is when new blood vessels in your choroid cause inflammation and scarring.

Risk factors

The following issues may increase your risk:

• Age, because your cornea and sclera weaken as you get older
• Severe nearsightedness
• Work or other activities that increase the chance you’ll have an eye injury

How doctors diagnose staphyloma

An eye doctor will ask about your symptoms, including any vision issues. They may ask about your health history, including current eye issues and any past infections. They’ll diagnose staphyloma based on imaging tests, including:

• CT scan
• Optical coherence tomography (OCT)
• 3D MRI

How is it treated?

There isn’t a specific treatment for staphyloma. Your treatment will depend on factors like the cause and the part of your eye the condition affects. Your eye doctor will recommend potential treatment based on your situation. For example, they may:

• Do active surveillance: Acquired staphyloma symptoms slowly get worse. Your eye care specialist may recommend frequent check-ups to monitor your situation.
• Treat underlying issues: Eye injuries, infections and eye diseases, like severe nearsightedness or glaucoma, can cause staphyloma. Treating the underlying condition may keep staphyloma from worsening.
• Recommend a cornea transplant: You may have this procedure if you have congenital staphyloma that affects your cornea(s).
• Remove your eye: Your eye care specialist may recommend surgery to remove the affected eye.

When should I seek care?

Contact an eye care specialist if your eye bulges, has a blue or black spot or your vision seems to be getting worse.

What can I expect if I have this condition?

That depends on why you have staphyloma. If you were born with it, you may have surgery to remove the affected eye. Sometimes, this condition develops but doesn’t get worse. In that case, you may have frequent check-ups so your eye doctor can watch for changes that could affect your vision.