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17th November, 2015

SUPPLEMENTAL NOTES

 

The grading scale used in the UK is as follows:

 

Lends no support

Lends limited support

Lends moderate support

Lends support

Lends strong support

Lends powerful support

 

 

The expert has informed us that the grading "Lends powerful support" is given out extremely rarely. This would be for cases that are unique. Take, for example, Gorbachev's birthmark. This level of certainty is exceedingly rare.

 

In the expert's own words;

 

Powerful Support is only really used when:

 

 

a.       There is an identifying feature that can be seen clearly, in detail and can be accurately compared to a control sample. For example a detailed tattoo or a birth mark or scar (Gorbie mark).

 

 

b.      It can be used in the reverse also, such as, when a birth mark scar or similar is clearly seen  and the control sample does not have any features similar Powerful support that it is not……

 

 

The full comments from the optometrist who was consulted by the expert for this report are as follow:

 

I've really focused on the better resolution image because it's much easier to make an assessment. I agree that the cornea of the right eye (left in the pic, it's an optometrist thing) is smaller than the left eye.

 

 

This can't be explained by trauma causing blow out fracture or ptosis (droopy lid) or microphthalmia (a smaller eye) because this would affect the position of the lids which appear equal.

 

Megalocornea or large cornea is not likely as this is usually a bilateral condition.

I have ruled out the possibility of part of the cornea being covered by a mass such as a pterigium because an uneven edge would be visible.

 

Congenital glaucoma can cause the appearance of a large cornea but this will also produce corneal haze which I think would be visible in the picture. If anything the left eye looks clearer than the right.

 

This leaves microcornea, a congenital corneal anomaly of autosomal dominant inheritance. This is classified as a corneal diameter of 10mm or less which you might be able to measure.

 

Systemic associations include fatal alcohol, Turner, Ehlers-Danlos, Weill-Marchesani, Waardenburg, Nance-Horan and Cornelia de Lane syndromes.

 

I don't know the prevalence of microcornea but I can tell you that it is rare.