Microstomia is a small mouth (micro- a combining form meaning small + -stomia a combining form meaning mouth = (abnormally) "small mouth" in Greek.) Congenital
It is a feature of many craniofacial syndromes, including Freeman–Sheldon syndrome and Sheldon-Hall syndromes (or distal arthrogryposis multiplex congenita). It may present with whistling-face feature, as well, as in Freeman-Sheldon syndrome. In this syndrome, it impairs alimentation and may require repeated oral surgeries (called commissurotomy) to improve function. Acquired
Microstomia can occur as a result of scarring due to many conditions. It is seen as complication of facial burns. It can also be a feature of systemic scleroderma. References


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Cause
Diagnosis
Prompt diagnosis is critical, since the sudden blindness in the one eye is often followed, within days, by similar sudden blindness in the second eye. Treatment may prevent further damage (see below). Any patient diagnosed with non-arteritic AION over the age of 50 must be asked about the constitutional symptoms mentioned above. Furthermore, AION patients over the age of 75 should often be blood tested regardless. Treatment
AAION requires urgent and critical intervention with a very long course of corticosteroids to prevent further damage. While this treatment is in itself problematic, non-treatment leads to bilateral blindness and strokes.There is much research currently underway looking at ways to protect the nerve (neuroprotection) or even regenerate new fibers within the optic nerve. References
Myron Yanoff et al., Ophthalmology, 2nd ed. (C.V. Mosby, 2004), chapt. 191. UpToDate article "Clinical manifestations and diagnosis of giant cell (temporal) arteritis"

External links
The Use of Botulinum Toxin in a Case of Acquired Periodic Alternating Nystagmus