Yesterday, a parent brought in a 3-year-old girl with an atrophied left eye since childhood and said upon entering the clinic: “Doctor, please help my child get a movable prosthetic eye! Looking at the child’s small eye that had failed to develop and grow since childhood atrophy, the collapsed and drooping eyelid, and the narrow orbit, I knew this was another case that had been delayed. I learned from the medical history that the parents had brought the child to the hospital a few months after birth, but the doctor did not even do an examination, and said that they would come back when they grew up to install a prosthetic eye, leaving the parents in anxiety until now. Congenital ocular atrophy is caused by intrauterine infections, congenital developmental disorders, or certain special conditions such as proliferative vitreous lesions or intraocular tumors, so that after birth the eye atrophies and no longer grows, and leads to ipsilateral orbital facial developmental disorders. For a child with congenital ocular atrophy, a consultation should be made early after birth, preferably within 3 months of birth, and for the first visit, the doctor should give high priority and perform a detailed related examination. First, the examination should clarify the cause of the atrophy and exclude the possibility of intraocular tumors, because the atrophy of the eye secondary to congenital retinoblast may later deteriorate and may be life-threatening; second, to clarify whether there is residual vision in the affected eye, especially for a child with bilateral eye developmental disorders, even if it is faint light, may be able to improve through treatment and obtain better useful vision; we have a child with congenital microphthalmia We have a child with congenital microphthalmia, who initially had less than one foot of distance index vision, and now has been trained with glasses and the child is able to perform normal daily life. Most importantly, we also need the initial exam to determine if the healthy eye is truly “healthy” and if there is a latent risk of blindness as well! This is why the responsibility of the first-time doctor is so important! A “come back when you’re older” not only risks missing the diagnosis, but also delays a great cosmetic opportunity! If the orbit is not stimulated to grow during this period, it will easily lead to lifelong deformed small orbits and narrow conjunctival sacs, making it difficult to achieve satisfactory cosmetic results because even if plastic surgery is performed in the future, it will not be able to fit into the right size. The correct method should be to insert the supporting prosthetic eye piece as early as possible, and after the orbital conjunctival sac has expanded to a certain degree, implant the prosthetic eye table according to the size of the orbit at an early stage, and replace the prosthetic eye piece on time, which will not only achieve satisfactory cosmetic results, but also avoid facial asymmetric changes caused by the orbital development deformity. Therefore, with congenital eye disease, it is always better to do your best to improve the prognosis rather than leaving irreparable regrets!