FND3 patients exhibited severe frontonasal hypoplasia, microphthalmia, and cleft lip and palate (Uz et al., 2010; Pini et al., 2020), whereas FND1 and FND2 patients displayed milder but distinctive midfacial defects including hypertelorism with ptosis or blepharophimosis, depressed nasal bridge with absent or bifid nasal tip, cleft nasal alae, midline notching of the upper lip, and cranium bifidum (Kayserili et al., 2009; Twigg et al., 2009; Farlie et al., 2016). Here, ALX4 is linked to microphthalmia.