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Sample records for left upper eyelid

  1. Graves upper eyelid retraction.

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    Cruz, Antonio Augusto Velasco; Ribeiro, Sara F T; Garcia, Denny M; Akaishi, Patricia Mitiko; Pinto, Carolina T

    2013-01-01

    Graves upper eyelid retraction (GUER) is the most common and characteristic sign of Graves orbitopathy. Despite being well recognized since the 19th century, GUER is still a subject of controversy. We review GUER, including historical aspects, diagnosis, methods of measurements, ocular surface abnormalities, etiology, and medical and surgical treatments. There is no consensus about the mechanisms of its etiology or the best surgical correction. There is a need for quantitative studies on the effects of GUER on lid movements. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. A giant upper eyelid ossifying pilomatrixoma

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    Rizvi Syed

    2008-01-01

    Full Text Available Pilomatrixoma of the eyelid is extremely rare in middle age and rarely develops into a large tumor. A 45-year-old female developed a painless, progressive swelling (3.0 cm x 2.0 cm of the left upper eyelid over a period of two years. Overlying skin was normal in color and texture. A differential diagnosis of dermoid, epidermoid cyst, chalazion and basal cell carcinoma was made. An excisional biopsy was performed. A diagnosis of pilomatrixoma was made on histopathological features (dystrophic calcification of matrix with keratin and foreign body granulomatous reaction, basaloid cells and shadow cells/ghost cells. It also comprises ossification apart from the usual calcification. This is a report of an unusually large ossifying pilomatrixoma in left upper eyelid of a middle-aged woman. The patient should be followed up at regular intervals to rule out any recurrence or malignant transformation.

  3. The sigmoid upper eyelid blepharoplasty: redefining beauty.

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    Fezza, John P

    2012-01-01

    A youthful female upper eyelid contour includes a concave medial portion of the upper eyelid along with a fuller, convex lateral eyelid. The skin in the lateral eyelid is tight without hooding. This is a sigmoid shape in 3-dimensional terms. With aging, fatty herniation medially along with redundant, hooded, ptotic lateral skin creates the exact opposite eyelid curve. The sigmoid blepharoplasty is a novel surgical technique that recreates a youthful upper eyelid. A retrospective chart review of 142 female patients who underwent the sigmoid blepharoplasty was conducted. To recreate a youthful eyelid in 3 dimensions, the medial eyelid concavity is achieved by removing a strip of medial orbicularis oculi muscle along with selective medial fat removal. Excess skin and hooding is removed, and fat grafts from the medial eyelid are placed laterally below the muscle to achieve a fullness and tight skin. All patients achieved a pleasant, rejuvenated upper eyelid as assessed by photographs and chart records. The sigmoid blepharoplasty restored a youthful eyelid appearance by recreating a concave medial eyelid and fuller lateral eyelid. There were no infections, and fat grafts took uniformly. The sigmoid upper eyelid blepharoplasty technique recreates a truly youthful eyelid with novel eyelid concepts. The surgery is safe and reproducible, and consistent results are achievable.

  4. Updates on upper eyelid blepharoplasty

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    Kasturi Bhattacharjee

    2017-01-01

    Full Text Available The human face is composed of small functional and cosmetic units, of which the eyes and periocular region constitute the main point of focus in routine face-to-face interactions. This dynamic region plays a pivotal role in the expression of mood, emotion, and character, thus making it the most relevant component of the facial esthetic and functional unit. Any change in the periocular unit leads to facial imbalance and functional disharmony, leading both the young and the elderly to seek consultation, thus making blepharoplasty the surgical procedure of choice for both cosmetic and functional amelioration. The applied anatomy, indications of upper eyelid blepharoplasty, preoperative workup, surgical procedure, postoperative care, and complications would be discussed in detail in this review article.

  5. Upper Eyelid Silicone Oil Migration After Sutureless 23-Gauge Vitrectomy

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    Alireza Dehghani

    2017-01-01

    Full Text Available To report a case of upper eyelid swelling and ptosis caused by silicone oil migration in a patient after sutureless 23-gauge pars plana vitrectomy and silicone oil injection. A 36-year-old female was referred to eye clinic with total retinal detachment (RD and superotemporal giant dialysis secondary to trauma in the left eye. Transconjunctival sutureless 23-gauge pars plana vitrectomy and intraocular silicone oil (1300 centistokes injection were performed. After about 5 months, she came back with the left upper eyelid and periorbital swelling. Palpation of the eyelid revealed soft and mobile subcutaneous small lumps that were not attached to the skin. Computed tomography scan of the orbit showed an 11 mm × 8 mm soft tissue density mass in lateral aspect of the left orbit. Transcutaneously surgical exploration was performed. The patient was seen after 1 week postoperatively and there was a significant improvement of the ptosis. Eyelid swelling and ptosis caused by silicone oil migration after RD surgery are very rare and this is one of the few reports in literature.

  6. Total upper and lower eyelid reconstruction using deltopectoral flap

    OpenAIRE

    Gujjalanavar, Rajendra Suresh; Girish, A. C

    2013-01-01

    Total upper and lower eyelid unilateral full thickness reconstruction is a surgical challenge. A case of right orbital haemangioma with unilateral complete defect of total upper and lower eyelids with right orbital exenteration is reported, together with the surgical technique of reconstruction. Patient was a 24-year-old female who underwent right orbital exenteration with total upper and lower eyelid excision for orbital haemangioma presented after 3 weeks of the above procedure. In the firs...

  7. Congenital upper eyelids ectropion in Down’s syndrome

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    Corredor-Osorio, Rafael

    2017-02-01

    Full Text Available Congenital bilateral ectropion of the upper eyelids is a rare, benign condition reported in ophthalmic literature. It is more frequently associated with Down’s syndrome, ichthyosis, and sporadic cases in newborns from black population. We report three cases of congenital bilateral upper eyelid ectropion associated with Down’s syndrome. Management of these patients usually requires medial and lateral canthoplasties, full-thickness pentagonal resection of the upper eyelids and placement of skin grafts. We present herein the evolution of one of these patients and we will discuss the mechanism of the eyelid ectropion and its treatment.

  8. Congenital eversion of upper eyelids: Case report and management

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    Maheshwari Rajat

    2006-01-01

    Full Text Available Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down′s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of congenital bilateral severe upper eyelid eversion in a normal infant, born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching.

  9. The effect of upper eyelid blepharoplasty on eyelid and brow position.

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    Nakra, Tanuj; Modjtahedi, Sara; Vrcek, Ivan; Mancini, Ronald; Saulny, Stan; Goldberg, Robert A

    2016-12-01

    This article evaluates the effect of upper eyelid blepharoplasty on eyelid margin position and brow height. This study is a retrospective analysis of patients who underwent upper eyelid blepharoplasty without concurrent blepharoptosis repair or brow surgery. The medical records of the participants were retrospectively reviewed and an established image analysis software was used to quantify the upper margin reflex distance (MRD1) as well as brow height using high quality standardized clinical photographs. A total of 19 patients (38 eyelids and brows) met the inclusion criteria. The mean preoperative MRD1 was 2.8 mm, and the mean post-operative MRD1 was 3.5 mm, revealing an increase of MRD1 from upper blepharoplasty alone of 0.7 mm (p = 0.0001). The mean preoperative brow position was 17.5 mm above the pupil, and the mean post-operative position was 17.4 mm, for an average change of position of -0.2 mm (p = 0.39) following upper eyelid blepharoplasty. Upper eyelid blepharoplasty without ptosis surgery results in a statistically significant increase in MRD1. Brow position does not demonstrate a statistically significant change in patients who undergo upper eyelid blepharoplasty for simple dermatochalasis.

  10. Total upper and lower eyelid reconstruction using deltopectoral flap

    Science.gov (United States)

    Gujjalanavar, Rajendra Suresh; Girish, A. C

    2013-01-01

    Total upper and lower eyelid unilateral full thickness reconstruction is a surgical challenge. A case of right orbital haemangioma with unilateral complete defect of total upper and lower eyelids with right orbital exenteration is reported, together with the surgical technique of reconstruction. Patient was a 24-year-old female who underwent right orbital exenteration with total upper and lower eyelid excision for orbital haemangioma presented after 3 weeks of the above procedure. In the first stage split thickness skin grafting is used to resurface orbital cavity raw area followed by staged reconstruction of total upper and lower eyelid reconstruction using pedicle deltopectoral flap. This reconstruction provided stable eyelid reconstruction to retain ocular prosthesis with concealed and minimal donor area. After reconstruction patient underwent rehabilitation with ocular prosthesis, now the patient is satisfied with cosmetically acceptable results. PMID:24459354

  11. Total upper and lower eyelid reconstruction using deltopectoral flap

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    Rajendra Suresh Gujjalanavar

    2013-01-01

    Full Text Available Total upper and lower eyelid unilateral full thickness reconstruction is a surgical challenge. A case of right orbital haemangioma with unilateral complete defect of total upper and lower eyelids with right orbital exenteration is reported, together with the surgical technique of reconstruction. Patient was a 24-year-old female who underwent right orbital exenteration with total upper and lower eyelid excision for orbital haemangioma presented after 3 weeks of the above procedure. In the first stage split thickness skin grafting is used to resurface orbital cavity raw area followed by staged reconstruction of total upper and lower eyelid reconstruction using pedicle deltopectoral flap. This reconstruction provided stable eyelid reconstruction to retain ocular prosthesis with concealed and minimal donor area. After reconstruction patient underwent rehabilitation with ocular prosthesis, now the patient is satisfied with cosmetically acceptable results.

  12. Total upper and lower eyelid reconstruction using deltopectoral flap.

    Science.gov (United States)

    Gujjalanavar, Rajendra Suresh; Girish, A C

    2013-09-01

    Total upper and lower eyelid unilateral full thickness reconstruction is a surgical challenge. A case of right orbital haemangioma with unilateral complete defect of total upper and lower eyelids with right orbital exenteration is reported, together with the surgical technique of reconstruction. Patient was a 24-year-old female who underwent right orbital exenteration with total upper and lower eyelid excision for orbital haemangioma presented after 3 weeks of the above procedure. In the first stage split thickness skin grafting is used to resurface orbital cavity raw area followed by staged reconstruction of total upper and lower eyelid reconstruction using pedicle deltopectoral flap. This reconstruction provided stable eyelid reconstruction to retain ocular prosthesis with concealed and minimal donor area. After reconstruction patient underwent rehabilitation with ocular prosthesis, now the patient is satisfied with cosmetically acceptable results.

  13. A modified posterior approach for upper eyelid retraction.

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    Looi, Audrey L G; Sharma, Basant; Dolman, Peter J

    2006-01-01

    To describe and review a graded technique for lowering the upper eyelid from a posterior approach, recessing or resecting Müller muscle and levator aponeurosis but leaving a central pillar of Müller muscle intact, occasionally including a temporal tarsorrhaphy or superior tarsal strip where needed, and performing tissue dissection with a hot-wire cautery instrument. A 10-year retrospective chart review was performed. Where follow-up was less than 6 months, telephone interviews were conducted to assess patient satisfaction with the procedure. Statistical analysis was performed using an unpaired t test. Ninety-nine patients (161 eyelids, 62 bilateral and 37 unilateral) with a mean age of 47 years (range, 21-82 years) were studied. The mean follow-up period was 61 months. The mean preoperative and postoperative margin reflex distances (MRD1) were 7.3 mm (range, 4.5-10 mm) and 4.3 mm (range, 2-7 mm), respectively. Eighty-nine percent (144/161 eyelids) achieved the target result of an MRD1 of 4 +/- 1 mm after one procedure. Fifteen eyelids (9% of operated eyelids) required a second procedure, and in this group, 2 (13% of the reoperated eyelids) underwent a third procedure. Although bilateral cases were more likely to achieve symmetry (p = 0.0071), 90% of either unilateral or bilateral cases achieved a postoperative MRD1 of 4 +/- 1 mm. Both mild (MRD1 of 5-7 mm) and severe (MRD1 > 7 mm) cases of eyelid retraction achieved similar operative outcomes. In the first 6 months after surgery, complications included undercorrection (8 eyelids), overcorrection (2 eyelids), and pyogenic granuloma (2 eyelids). None had a flattened upper eyelid contour. Late recurrence of retraction was seen in 9 eyelids. Mean operative time was 16 minutes per eyelid. This technique of lowering the retracted upper eyelid is effective even in severe cases of eyelid retraction. Minimal complications were encountered, and upper eyelid contours were well preserved. The use of hot-wire cautery

  14. Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler.

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    Mancini, Ronald; Khadavi, Nicole M; Goldberg, Robert Alan

    2011-01-01

    To evaluate the efficacy of hyaluronic acid gel fillers as a nonsurgical alternative for the management of upper eyelid margin asymmetry in cases of relative retraction. This is a retrospective study of 8 patients with upper eyelid margin asymmetry relating to relative upper eyelid retraction treated with hyaluronic acid gel injection to affect upper eyelid lowering. Digital photographs were used to quantitatively assess outcomes by comparing pretreatment and posttreatment differences between marginal reflex distance (MRD1) in the right and left eyelids. Image J was used for photographic analysis, and Student paired t test was performed. Eight patients (2 male; mean age, 50.9 years; range, 30-69 years) were injected with hylauronic acid gel in the upper eyelid. The etiology of upper eyelid margin asymmetry included Graves eyelid retraction (n = 3), asymmetry following reconstructive surgery (n = 1) and aesthetic surgery (n = 1), contralateral Horner syndrome (n = 1), Bell palsy (n = 1), and contralateral involutional ptosis (n = 1). The average volume injected in the upper eyelid was 0.2 ml (range, 0.1-0.4 ml). One of 8 patients was injected bilaterally. Average follow-up was 5.7 months (range, 2-12 months). Two of 8 patients requested repeat injection within a 6-month period for undercorrection. No overcorrections were noted, and no patient requested reversal with hyaluronidase. There was a statistically significant improvement in symmetry with mean pretreatment MRD1 difference of 1.53 mm (range, 0.78-3.36 mm) and mean posttreatment MRD1 difference of 0.70 mm (range, 0.02-2.03 mm), p = 0.007. At 4 to 8 months' follow-up, 8 of 8 demonstrated persistent improvement in asymmetry with statistically significant reduction in MRD1 difference when compared with pretreatment with average follow-up MRD1 difference of 0.74 mm (range, 0.11-1.65 mm), p = 0.018. This pilot study suggests that upper eyelid injection with hylauronic acid gel filler may be an effective nonsurgical

  15. Botulinum toxin type a for dysthyroid upper eyelid retraction.

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    Morgenstern, K E; Evanchan, J; Foster, J A; Cahill, K V; Burns, J A; Holck, D E E; Perry, J D; Wulc, A E

    2004-05-01

    To evaluate the safety and efficacy of botulinum toxin type A for treatment of eyelid retraction resulting from thyroid eye disease (TED) during the inflammatory phase of the condition. In this prospective, nonrandomized case series, 18 patients with inflammatory eyelid retraction caused by active TED received botulinum toxin type A injection (10, 5, or 2.5 U) for treatment of upper eyelid retraction. Botulinum toxin type A (Allergan, Irvine, CA, U.S.A.) was injected transconjunctivally just above the superior tarsal border in the elevator complex of the upper eyelid. Seventeen of 18 patients (94%) demonstrated a reduced marginal reflex distance (MRD1) after botulinum toxin injection. The average change in MRD1 of the treated eyelid after injection was -2.35 mm (range, 0 to -8.0 mm). Of the 27 eyelids injected, 33% had a 0- to 1-mm drop in eyelid height, 30% had a 1.5- to 2-mm decrease, 22% had a 2.5- to 3-mm decrease, and 15% had a greater than 3-mm decrease in eyelid height. None of the treated eyelids were noted to increase in height. One patient showed no alteration inafter treatment. One patient had clinically MRD1 significant ptosis and one patient reported worsening of preexisting diplopia after injection. Three patients undergoing unilateral injection had relative contralateral eyelid elevation. All untoward effects resolved spontaneously without sequelae. : Botulinum toxin type A may be used in the inflammatory stage of thyroid eye disease to improve upper eyelid retraction. Individual response to treatment is variable, but this modality should be considered as a temporizing measure until stability for surgery is reached.

  16. Advanced Upper Eyelid Sebaceous Gland Carcinoma with Deep Orbital Extension

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    Rizvi SAR

    2010-03-01

    Full Text Available Sebaceous gland carcinomas (SGC are highly malignant lid tumors which originate from meibomian glands and rarely from the gland of Zeis, sebaceous gland of caruncle, eyebrows and periocular skin. In many cases correct diagnosis of SGC is delayed because of its ability to masquerade as a variety of other ocular conditions.A forty year old male presented with a left upper eyelid swelling with an ulcerated wound on its nasal aspect. A differential diagnosis of sebaceous gland carcinoma or preseptal cellulitis was made. Contrast enhanced computed tomography showed an ill defined soft tissue density mass in the left orbit encasing the whole of the optic nerve. A total exentration was performed. A diagnosis of meibomian gland carcinoma was confirmed on histopathology.This is a report of an advanced sebaceous gland carcinoma with deep orbital extension. An early diagnosis and appropriate treatment may decrease the long term morbidity and extend the survival rate of such patients.

  17. Congenital Upper Eyelid Coloboma: Clinical and Surgical Management.

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    Ortega Molina, José María; Mora Horna, Eduardo Ramón; Salgado Miranda, Andrés David; Rubio, Rosa; Solans Pérez de Larraya, Ana; Salcedo Casillas, Guillermo

    2015-01-01

    Purpose. The goal was to describe our experience in the surgical management and treatment of four patients with congenital upper eyelid colobomas. Methods. A descriptive, observational, retrospective study was performed including patients with congenital eyelid colobomas referred to Asociación para Evitar la Ceguera en México I.A.P. "Dr. Luis Sánchez Bulnes" between 2004 and 2014 and assessed by the Oculoplastics and Orbit Service. Results. The four cases required surgical treatment of the eyelid defects before one year of age and their evolution was monitored from the time of referral to the present day. One of the patients needed a second surgical procedure to repair the eyelid defect and correct the strabismus. Conclusions. Eyelid colobomas are a potential threat to vision at an early age, which requires close monitoring of the visual development of patients.

  18. Response to phenylephrine testing in upper eyelids with ptosis.

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    Grace Lee, N; Lin, Li-Wei; Mehta, Sonia; Freitag, Suzanne K

    2015-01-01

    To evaluate the response of ptotic upper eyelids to topical phenylephrine 10%. The medical records of patients referred for ptosis evaluation over an 18-month period were retrospectively reviewed. Seventy-seven ptotic upper eyelids with aponeurotic dehiscence in 47 patients were given 1 drop of 10% phenylephrine. Margin-to-reflex distance 1 (MRD1) and levator excursion were recorded and photography of lid height was performed both pre- and 5 minutes post-phenylephrine testing. A total of 77 ptotic upper eyelids of 47 patients were included. In 22% of lids, phenylephrine testing produced no response; in 18%, lid elevation of 0.5-1 mm; in 35%, elevation of 1.5-2 mm; and in 25%, elevation of > 2 mm. Subgroup analyses revealed a higher proportion of response in cases of mild to moderate ptosis compared with cases of severe ptosis. The amount of levator function in these cases of aponeurotic dehiscence did not correlate with the amount of response to phenylephrine. A majority of ptotic eyelids, regardless of levator function, responded to topical phenylephrine, which has been demonstrated to be necessary for successful Müller's muscle resection ptosis repair. While the severity of ptosis was linked to eyelid response to phenylephrine, the degree of levator function did not appear to affect an eyelid's response to phenylephrine. In this study cohort, phenylephrine was shown to stimulate Müller's muscle contraction independently of levator function.

  19. Congenital upper eyelid coloboma with ipsilateral eyebrow hypoplasia

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    Vulović Dejan

    2012-01-01

    Full Text Available Introduction. Coloboma is a Greek word, which describes the defect of all layers of the organ, and it can be congenital or as the result of an injury, operation, or some disease. Congenital upper eyelid coloboma is a rare anomaly, with the unknown incidence. The size of the defect is different, but it always involves all layers of the eyelid. This malformation is more frequent at the upper eyelid, and unilaterally, at the junction of the medial two thirds. Sometimes, it can also involve the eye, and may be a component of many syndromes (Goldenhar, Fraser, Manitoba, CHARGE, Cat eye. Case report. We are describing the case of the upper eyelid coloboma with the rare eyebrow anomaly at the three-month old girl, and the result of reconstruction. The baby was treated conservatively with lubricants and overnight patching. Pentagonal excision of the defect was performed in general anesthesia. Three layers of the eyelid were prepared: the skin, muscle and tarsoconjunctival layer. Because of orbicularis muscle malposition, reinsertion and reposition of the muscle fibres were performed. Then, lateral canthotomy was made and the suture of three layers of the eyelid. Catgut suture 7-0 was used for the conjunctiva and muscle. Nylon 6-0 was used for skin suture. Z-plasty was done on the upper part of the pentagonal excision in order to reduce skin tension at the suture line. The operation lasted about 60 minutes and the hospitalization three days. The occlusive dressing was applied for two days. The stitches were removed after seven days. The postoperative swelling of the upper and lower eyelid disappeared in five days. There were no complications in the postoperative period. Conclusion. The main principle of the treatment of eyelid coloboma is surgical reconstruction of all layers of the eyelid, in optimal period, using different surgical methods, which depends on the size of the defect. An early diagnosis is of the greatest importance, as well as the

  20. Myocutaneous pedicle flap combined with a free skin graft for upper eyelid reconstruction

    DEFF Research Database (Denmark)

    Toft, Peter B

    2010-01-01

    Repair of large upper eyelid defects can be accomplished by both 1-stage and 2-stage techniques some of which are complicated and time consuming. I here present a simple 1-stage technique for upper eyelid reconstruction....

  1. Double-bridged flap procedure for nonmarginal, full-thickness, upper eyelid reconstruction.

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    Dutton, Jonathan J; Fowler, Amy M

    2007-01-01

    To describe the technique and results of double-bridged flap reconstruction of full-thickness upper eyelid defects that spares the upper eyelid margin. The surgical technique is described and illustrated in 2 patients who underwent this procedure. The 2 patients presented in this study achieved excellent functional and cosmetic results following the procedure. One patient subsequently underwent a frontalis sling procedure to correct residual ptosis. Double-bridged flap reconstruction of the upper eyelid that spares the eyelid margin can provide excellent functional and cosmetic results, particularly in cases of nonmarginal eyelid tumor excision, severe upper eyelid scarring, and severe cicatricial retraction.

  2. Effect of Low-Concentration, Nonmydriatic Selective Alpha-Adrenergic Agonist Eyedrops on Upper Eyelid Position.

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    Mendonça, Taís B; Lummertz, Atauíne P; Bocaccio, Francisco J L; Procianoy, Fernando

    2017-02-01

    Ptosis after botulinum toxin injection is a disturbing complication. Decongestant and antiglaucoma eyedrops are frequently prescribed for temporary improvement of eyelid ptosis. Although frequently cited on informal communications, the effect of these drugs on eyelid position has never been compared in a formal study. To measure the effect of low-concentration, nonmydriatic selective alpha agonist eyedrops on upper eyelid position. This nonrandomized clinical trial enrolled 20 healthy subjects aged 18 to 50 years. The upper margin-reflex distance (MRD1) was measured before, 30, 60, and 120 minutes after administration of 1 drop of brimonidine 0.2%, phenylephrine 0.12%, or naphazoline 0.05% to the left eye. There was no statistically significant difference in mean MRD1 between the brimonidine and phenylephrine groups when comparing baseline to all other study time points. After administration of naphazoline 0.05%, MRD1 had a mean increase of 0.56 ± 0.11 mm (p upper eyelid ptosis in selected patients.

  3. Upper Eyelid and Pupillary Effects of Topical Dilute Epinephrine.

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    Garcia, Giancarlo A; Ngai, Philip; Vemuri, Swapna; Tao, Jeremiah P

    Adrenergic medications may elevate the upper eyelid and dilate the pupil. The effects of topical phenylephrine on Müller's muscle have been well described. Dilute epinephrine (DE) is a sympathomimetic agent commonly administered in blepharoptosis surgery, and has been shown to elevate the upper eyelid margin when injected subcutaneously. The effects of DE applied topically to the eye, whether intentional or inadvertent during surgery have not been characterized. The purpose of this investigation was to quantify and compare the effects of topical DE and phenylephrine on upper eyelid position and pupil size. Prospective, nonrandomized trial of 41 adults without (n = 25, 25 eyes) and with ptosis (n = 16, 16 eyes). Upper eyelid margin reflex distance (MRD1) and pupil diameter were primary measures and pupil reactivity to light was a secondary measure. MRD1 and pupil diameter were recorded at baseline and at 30-second intervals for 5 minutes after administration of topical 1% lidocaine with epinephrine 1:100,000 (DE). After a washout period of >24 hours, the same measurements were recorded after administration of topical phenylephrine 2.5%. No statistically significant difference was observed between mean baseline and postexposure MRD1 after application of topical DE (p = 0.181). In contrast, a mean increase in MRD1 of 0.51 ± 0.09 mm (effect size 0.33) was observed after exposure to phenylephrine 2.5% (p MRD1 was significantly greater for phenylephrine compared with DE (p < 0.001, analysis of covariance). Mean pupil diameter increased 0.29 ± 0.09 mm (effect size 0.48) in response to DE and 0.27 ± 0.11 mm (effect size 0.41) after application of phenylephrine (p = 0.004 and p = 0.001, respectively). All pupils maintained a constrictive response to light. Although DE is similar to topical phenylephrine in causing mydriasis, it did not have a similar effect on elevating the upper eyelid. These findings may have implications on intraoperative assessment

  4. The success rate of TED upper eyelid retraction reoperations.

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    Golan, Shani; Rootman, Dan B; Goldberg, Robert A

    2016-12-01

    Although reoperation rates for upper lid retraction surgery for thyroid eye disease (TED) typically range between 8% and 23%, there is little literature describing the outcomes of these second operations. In this retrospective observational cohort study, all patients that underwent surgery for upper eyelid retraction over a 14-year period at a single institution were included. Cases were included if a second eyelid retraction surgery was performed during the study period. Success of surgery was defined as a marginal reflex distance (MRD1) of 2.5 to 4.5 mm in each eye and less than 1 mm difference in MRD1 between the eyes. Overcorrection and undercorrection were defined as above and below these bounds, respectively. 72 eyes in 49 patients were included in the study. The mean age was 56.6 (±11.5) years. By definition, all patients had at least 1 lid lengthening surgery for upper eyelid retraction, and at least 1 subsequent surgery. For this second surgery, 61 eyes (85%) underwent retraction surgery and 11 eyes (15%) underwent ptosis surgery. After this second operation, 31% were undercorrected and 33% were overcorrected. A third surgery was performed in 19 eyes (25%), 12 had surgery for residual retraction and 7 for ptosis. After the third operation 10% of eyes were under corrected and 11% were over corrected. Four patients underwent a fourth surgery: one for retraction and three for ptosis. Success was noted in 35% after the second surgery and 44% after the third. Surgical success in eyelid retraction surgery increases from a second to a third consecutive surgery, and residual asymmetry was roughly equally distributed between over- and undercorrection.

  5. Pre- and postoperative quantitative analysis of contour abnormalities in Graves upper eyelid retraction.

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    Ribeiro, Sara F T; Milbratz, Gherusa H; Garcia, Denny M; Devoto, Martin; Guilherme Neto, H; Mörschbächer, Ricardo; Pereira, Filipe J; Cruz, Antonio A V

    2012-01-01

    One of the most common problems of the surgical management of Graves upper eyelid retraction is the occurrence of eyelid contour abnormalities. In the present study, the postoperative contour of a large sample of eyelids of patients with Graves orbitopathy was measured. The postoperative upper eyelid contour of 62 eyes of 43 patients with Graves orbitopathy was subjectively classified by 3 experienced surgeons in 3 categories: poor, fair, and good. The shape of the eyelid contours in each category was then measured with a recently developed custom-made software by measuring multiple midpupil eyelid distances each 15° along the palpebral fissure. The upper eyelid contour of 60 normal subjects was also quantified as a control group. The mean ratio between the sum of the lateral and medial midpupil eyelid distances (lateral/medial ratio) was 1.10 ± 0.11 standard deviation in controls and 1.15 ± 0.13 standard deviation in patients. Postoperatively, the mean midpupil eyelid distance at 90° was 4.16 ± 1.13 mm standard deviation. The distribution lateral/medial ratios of the eyelids judged as having good contours was similar to the distribution of the controls with a modal value centered on the interval between 1.0 and 1.10. The distribution of lateral/medial ratios of the eyelids judged as having poor contour was bimodal, with eyelids with low and high lateral/medial ratios. Low lateral/medial ratios occurred when there was a lateral overcorrection, giving the eyelid a flat or a medial ptosis appearance. High lateral/medial ratios were due to a central or medial overcorrection or a lateral peak maintenance. Postoperative upper eyelid contour abnormalities can be quantified by comparing the sum of multiple midpupil eyelid distances of the lateral and medial sectors of the eyelid. Low and high lateral/medial ratios are anomalous and judged as unpleasant.

  6. A NEGLECTED CASE OF EXTENSIVE RECURRENT SEBACEOUS CARCINOMA OF THE LEFT EYELIDS AND MANAGEMENT

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    Srinivasa Rao

    2015-06-01

    Full Text Available INTRODUCTION: Sebaceous gland tumor of the eyelids may arise from the meibomian glands, glands of Zeis or glands associated with the caruncle. They are included in the list of tumors of the epidermal appendages, so - called adnexal skin structures. Sebaceous gland carcinoma 1 (SGC might be the second most common lid malignancy after basal cell carcinoma (BCC. Its multifocal origin and pagetoid spread give it a unique place among eyelid malignancies. Sebaceous gland s are located in the periocular skin, caruncle, and eyebrow skin follicles. The tumor is a very rare, slow growing, and commonly found in elderly population with female predisposition. Mean age at diagnosis is mid - sixties; however, the tumor has been repor ted in children as young as 3.5 years old . It is rare in Caucasians and common in oriental Asiatics. SGC most commonly arises from the meibomian glands 2 anterior to the gray line, occasionally from the glands of Zeis or Moll, and from sebaceous glands in c aruncle 3 ; however, the cell of origin may not be certain in 50 – 60% of cases . 3 In contrast to basal cell carcinoma (BCC or squamous cell carcinoma (SCC, SGC is two to three times more common in upper eyelid due to more number of meibomian glands 4 there . PRESENTATION OF CASES: In the department of ophthalmology, G.S.L medical college, Rajahmundry, we came across a 52 years old female with recurrent swelling of left ey e lid from past 4 years.

  7. The Effect of Upper Aging Blepharoplasty on Upper and Lower Eyelid Position.

    Science.gov (United States)

    Park, Jinhwan; Choi, Boyoon; Baek, Sehyun

    2018-02-07

    Change in eyelid position after upper blepharoplasty is an important factor that can affect postoperative patient satisfaction. However, no one has investigated eyelid changes during follow-up for upper eyelid surgery. Thus, the purpose of this study was to investigate position changes in the upper and lower eyelids during the follow-up period after upper blepharoplasty in Korean. The authors retrospectively reviewed the clinical records of patients who underwent upper blepharoplasty for uncomplicated upper eyelid dermatochalasis. Digital photographs were taken preoperatively, immediately after surgery, and at 1 week postoperative, 1 month postoperative, and 3 months postoperative. Our main-effect variables were marginal reflex distance (MRD) 1 and 2 and palpebral fissure height (PFH), which were measured from digital photographs using ImageJ software. We enrolled 180 eyes from 90 patients (M: 35 and F: 55) with a mean age of 63.8 ± 10.3 years. The eyelid measurements (MRD1, MRD2, PFH) taken preoperatively, immediately after surgery, and 1 week, 1 month, and 3 months postoperative were, respectively: MRD1 (mm): 2.56 ± 1.08, 1.91 ± 0.86, 2.21 ± 1.02, 2.66 ± 1.01, 2.75 ± 0.99; MRD2 (mm): 4.91 ± 0.93, 4.62 ± 0.87, 4.68 ± 0.90, 4.87 ± 0.86, 4.91 ± 0.83; and PFH (mm): 7.48 ± 1.64, 6.53 ± 1.46, 6.89 ± 1.53, 7.52 ± 1.51, 7.65 ± 1.49. All postoperative measurements for MRD1 and PFH were significantly different from the preoperative measurement, except for measurements taken 1 month postoperative. MRD2 measurements differed significantly from the preoperative measurements immediately after surgery and 1 week postoperative. Among age, preoperative PFH, and amount of skin-muscle resection, only preoperative PFH significantly affected PFH changes immediately after surgery and at 3 months postoperative (OR 0.636, 95% CI 0.478-0.847, OR 0.506, 95% CI 0.386-0.663). All eyelid measurements (MRD1, MRD2, and PFH) decreased 1 week postoperatively from values

  8. [The treatment of upper eyelid sulcus using the expanded polytetrafluoroethylene implanted in orbit].

    Science.gov (United States)

    Xu, Zhou; Min, Wei; Zheyuan, Yu; Jieneng, Wu

    2015-07-01

    To explore the feasibility of the treatment of upper eyelid sulcus using the expanded polytetrafluoroethylene implanted in orbit. From July 2009 to April 2011, a total of 16 patients with upper eyelid sulcus were treated for recreating youthful periorbital appearance. To correct this kind of clinical characteristic, expanded polytetrafluoroethylene with different size were used as the orbital implant to restore the orbital contents and reinforce the bony support. upper eyelid sulcus was reversed effectively. With average 2.5 year follow up, upper eyelid sulcus of 16 cases was reversed effectively. No postoperative complication related to globe or affected normal physical function was found. The technique of orbital implantation with Expanded Polytetrafluoroethylene is beneficial for the treatment of the upper eyelid sulcus.

  9. A randomised double-blinded crossover study comparing pain during anaesthetising the eyelids in upper blepharoplasty : First versus second eyelid and lidocaine versus prilocaine

    NARCIS (Netherlands)

    Pool, Shariselle M. W.; Struys, Michel M. R. F.; van der Lei, Berend

    Aim: The aim of this study was to investigate whether infiltration of the upper eyelid skin is less painful with prilocaine than with lidocaine. Methods: In 40 consecutive patients scheduled for bilateral upper blepharoplasty, one upper eyelid was anaesthetised with lidocaine with epinephrine and

  10. Symmetry of Upper Eyelid Contour After Unilateral Blepharoptosis Repair With a Single-strip Frontalis Suspension Technique.

    Science.gov (United States)

    Akaishi, Patricia; Galindo-Ferreiro, Alicia; Cruz, Antonio A V

    2018-01-10

    To analyze the upper eyelid contour of patients with unilateral congenital ptosis who underwent single-strip frontalis suspension. The authors compared the upper eyelid shape of the right and left eyes of 10 patients who underwent unilateral frontalis suspension with a single strip of autogenous fascia. At a mean postoperative time of 10.1 ± 4.01 months, the image J software was used to measure the ratio between the nasal and temporal areas of the upper half of the palpebral fissure. The midpupil upper eyelid distance (MRD1) was also measured on the photos with the same software. The nonparametric Wilcoxon signed-rank test was used to compare the data. Postoperative MRD1 ranged from 2.5 to 4.7 mm (median = 3.8) on the affected side. The MRD1 for nonoperated eyelid ranged from 1.8 to 5.0 mm (median = 3.5). On the operated side, the temporal areas ranged from 50.3 to 85.7 mm (median 65.2) and nasal areas ranged from 41.5 to 72.3 (the median was 60.1). In the contralateral, nonoperated palpebral fissures, the temporal areas ranged from 42.7 to 94.3 mm (median = 54.5) and the nasal areas ranged from 36.8 to 86.1 mm (median 52.3). The T/N ratio distributions were almost identical between groups, ranging from 0.9 to 1.2 (median = 1.1) in the operated eyes and from 0.9 to 1.3 (median = 1.1) in the fellow eyes. In autogenous fascia frontalis suspension procedures, the upper eyelid contour of the ptotic eyelids can be adequately normalized with a single area of traction on the tarsal plate.

  11. Reconstructive Surgery of the Upper Eyelid Using the Residual Tarsus after Excision of Sebaceous Gland Carcinoma

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    Tatsuya Yunoki

    2016-12-01

    Full Text Available Purpose: To report a successful eyelid reconstruction performed using the residual tarsus after excision of a sebaceous gland carcinoma. Case Report: An 86-year-old woman presented with a sebaceous gland carcinoma of the upper eyelid margin. After excision of the tumor, she underwent reconstructive surgery of the superior eyelid performed using the residual tarsus. Because the tumor was localized on the upper lid margin, a tarsus of about 4–5 mm in height remained after the excision; we therefore used the residual tarsus to reconstruct the upper eyelid. No functional or cosmetic problems arose as a result of this method. Conclusions: Reconstructive surgery of the upper eyelid using the residual tarsus may be a viable option provided that surgeons can ensure a sufficient safety margin, and that more than 4 mm of the tarsus remains.

  12. Correction of Sunken Upper Eyelids by Anchoring the Central Fat Pad to the Medial Fat Pad during Upper Blepharoplasty

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    Myeong Su Jeon

    2015-07-01

    Full Text Available BackgroundMany methods have been proposed for the correction of sunken upper eyelids. These methods include surgical treatments, such as micro-fat, dermofat, or fascia-fat grafts, or the use of alloplastic materials. Here, we present our experience of sunken upper eyelid correction involving the simple addition of anchoring the central fat pad to the medial fat pad during upper blepharoplasty.MethodsWe performed 74 cases of upper blepharoplasty with sunken upper eyelid correction between October 2013 and September 2014. The lateral portion of the central fat pad was partially dissected to facilitate anchoring. The medial fat pad was gently exposed and then pulled out to facilitate anchoring. After the rotation of the dissected lateral portion of the central fat pad by 180° to the medial side, it was anchored spreading to the medial fat pad. Photographs taken at 6 months postoperatively were presented to three physicians for objective assessment. Of the 74 patients, 54 patients followed at 6 months postoperatively were included in this retrospective, objective assessment.ResultsSunken eyelids were effectively corrected in 51 of the 54 patients, but 3 had minimal effect because preaponeurotic fat pads had been removed during previous upper blepharoplasty. In addition to correcting sunken eyelids, lateral bulging was corrected and a better definition of the lateral portion of upper lid creases was obtained.ConclusionsAnchoring the central fat pad to the medial fat pad provides an effective means of correcting sunken upper eyelids during upper blepharoplasty.

  13. Local Anesthesia for Surgical Procedures of the Upper Eyelid Using Filling Cannula: Our Technique

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    Maria Trapasso, MD

    2014-05-01

    Full Text Available Summary: Sometimes, after local anesthetic injection for surgical procedures of the upper eyelid, it is possible to observe superficial preseptal hematomas or excessive lid swelling that may distort the tissues and obscure surgical landmarks. We present a technique to perform local anesthesia of the upper eyelids, using a 27-gauge needle and a 26-gauge filling cannula, that may decrease the incidence of hematomas and bruising.

  14. A Promising Modified Procedure for Upper Eyelid Retraction-Associated Graves’ Ophthalmopathy: Transconjunctival Lateral Levator Aponeurectomy

    OpenAIRE

    KHATAVI, Fatima; NASROLLAHI, Kobra; ZANDI, Alireza; PANAHI, Maryam; MORTAZAVI, Mahshid; POURAZIZI, Mohsen; RANJBAR-OMIDI, Behzad

    2017-01-01

    Upper eyelid retraction is a characteristic feature of thyroid eye disease, including Graves’ orbitopathy. In this study, a new surgical technique for correction of lid retraction secondary to Graves’ orbitopathy is described. Sixteen eyelids of patients older than 18 years old underwent surgical correction for moderate to severe lid retraction secondary to Graves’ orbitopathy. In this procedure, levator aponeurectomy was performed via a transconjunctival approach. Upper marginal reflex dista...

  15. Discoid Lupus Erythematosus Presenting as Upper Eyelid Edema and Erythema

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    Abbas Darjani

    2017-09-01

    Full Text Available Discoid Lupus Erythematosus (DLE is an autoimmune disorder that usually occurs on sun exposed areas of head and neck. Infrequently it could be presented by palpebral involvement and rarely unilateral upper eye lid edema and erythema have been reported as the sole manifestation of DLE. We describe a 38-year-old woman with chronic left upper eye lid edema and erythema from one year ago which was induced by steroid injection for left eyebrow alopecia. Histopathologic and direct immunofluorescent studies were made on palpebral skin tissue and confirmed DLE diagnosis. Antinuclear antibody (ANA titer was 1/160 with speckled pattern. She was treated by oral hydroxychloroquine (400 mg daily with moderate improvement after three months. We should think about DLE in cases with chronic upper eye lid edema and erythema. The aim of this case report is to emphasize that ophthalmologist and dermatologists should be aware of different presentations of DLE in the periorbital area to prevent misdiagnosis.

  16. Association of Involutional Lower Eyelid Entropion with Reduced Upper Eyelid Position Relative to the Corneal Light Reflex: Quantification of Facial Asymmetry.

    Science.gov (United States)

    Phelps, Paul O; Wladis, Edward J; Meyer, Dale R

    2018-01-16

    To investigate the association between upper eyelid position relative to the corneal light reflex (MRD1) and to delineate an association between eyelid height and involutional lower eyelid entropion. Retrospective study of patients presenting for entropion repair to an academic ophthalmic plastic surgery service. A total of 111 patients were included in the study; 95 had unilateral involutional lower eyelid entropion, and 16 had bilateral lower eyelid entropion. Patients with a history of previous eyelid surgery, trauma, upper eyelid entropion, or cicatricial changes were excluded from the study. Of the 95 patients with unilateral involutional lower eyelid entropion, 45 (47.4%) had a lesser MRD1 on the side ipsilateral to the involutional lower eyelid entropion. In this unilateral group, the mean MRD1 (± standard deviation) on the ipsilateral to the involutional lower eyelid entropion was 2.9 (±1.2) mm, while the mean MRD1 on the contralateral side was 3.3 (±1.0) mm. This difference was 0.4 mm and was statistically significant (p MRD1 ≤ 2.0 mm) was 24 of 95 (25.3%) in the unilateral involutional entropion group and was even higher in the bilateral involutional lower eyelid entropion group, with 7 of 16 (43.8%) patients exhibiting bilateral blepharoptosis. Patients presenting with involutional lower eyelid entropion tend to have a relatively reduced MRD1 on the ipsilateral (affected) side. When both lower eyelids are affected by involutional entropion, the reduced MRD1 tends to be more pronounced.

  17. Migration of Intraocular Silicone Oil from the Vitreous Cavity into the Upper Eyelid Causing Ptosis

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    Yuzo Deguchi

    2014-07-01

    Full Text Available Introduction: To report a case in which intraocular silicone oil migrated into the upper eyelid and caused ptosis. Methods: A 65-year-old woman presented with proliferative vitreoretinopathy in the right eye. Vitrectomies, injection of silicone oil and encircling were performed. Two months after the last operation, swelling of her right eyelid occurred. Result: Magnetic resonance imaging revealed moisture in the palpebral fat tissue. We incised the bulbar conjunctiva and confirmed silicone oil leakage from the vitreous cavity through the scleral button hole of the encircling suture. Postoperatively, the right upper eyelid swelling decreased. Histopathologically, dense macrophage infiltration was seen in the palpebral tissues. Conclusions: We report a rare case with a postoperative complication caused by silicone oil. In cases with swelling of the eyelid and decreased silicon oil in the vitreous cavity postoperatively, clinicians should consider the possibility of silicone oil leakage.

  18. Extrusion of hydrogel exoplant into upper eyelid 16 years after a scleral buckle procedure

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    Chirag P Shah

    2011-01-01

    Full Text Available Sixteen years after scleral buckle surgery with a hydrogel episcleral exoplant, a 43-year-old woman presented with progressive binocular diplopia, ptosis, and an expanding mass in her upper eyelid. She underwent surgical removal of the hydrogel exoplant through an anterior approach. The exoplant proved to be friable, fragmented, and encapsulated in a fibrous tissue; the exoplant was removed in its entirety. Postoperatively, the eyelid mass resolved, while her diplopia and ptosis improved slightly.

  19. Contour Symmetry of the Upper Eyelid Following Bilateral Conjunctival-Müller's Muscle Resection.

    Science.gov (United States)

    Golbert, Marcelo; Pereira, Filipe Jose; Garcia, Denny M; Cruz, Antonio A V

    2017-03-01

    Conjunctiva-Müller muscle resection (CMMR) is a simple, effective, and predictable procedure for internal treatment of ptosis. The authors determined contour symmetry of the upper eyelid following bilateral CMMR. Thirty control participants (ie, without ptosis) and 44 patients with acquired bilateral blepharoptosis who underwent CMMR were evaluated in a prospective study. To assess symmetry of lid contour, distances from midpupil to the upper eyelid (ie, MPLDs) were determined radially at intervals of 15° (total, 180°) along the palpebral fissure, and MPLDs at each angle were compared for right and left eyes. For control participants, the mean marginal reflex distance (MRD1; ie, MPLD at 90°) ± standard error (SE) was 4.05 mm ± 0.75 mm, and small contour asymmetries (MRD1 was 2.56 ± 0.1 mm, and mean medial and lateral lid asymmetries (14.3% ± 8.4% and 16.7% ± 9.7%, respectively) were significantly higher than those of controls. Medial and lateral asymmetries correlated significantly with the extent of ptosis and were more pronounced laterally than medially. One month after CMMR, the lateral-medial discrepancy in lid asymmetry was resolved, and mean medial and lateral MPLDs (9.9% ± 7.5% and 8.5% ± 5.3%, respectively) were similar to those of controls. For patients with involutional ptosis, CMMR enables elevation of the lid margin and correction of contour anomalies. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  20. EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS

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    Nagaraju

    2015-02-01

    Full Text Available INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is based on available levator function and also other factors like etiology, severity, Bell’s phenomenon etc. If such varied procedure s are performed in a group of patients based on standard criteria and results are evaluated systematically we can determine what works best for a given patient . AIM : Evaluation of outcome of various surgical procedures for upper eyelid ptosis . METHODOLOGY : 25 eyelids of 20 patients who presented to a tertiary centre in south India with complaint of drooping of upper lid were considered. All subjects underwent complete ocular examination corrected visual acuity and detailed ptosis evaluation with particular emphasis on measurement of levator muscle function, MRD1 (margin reflex distance - 1, palpebral fissure width in different gazes and margin crease distance. The effect of various factors like MRD1, MCD, levator function were assessed, the amount of correction required and appropriate surgical procedure was chosen. Surgical procedure of Levator resection, frontalis sling operation, anterior levator aponeurosis advancement, o r other ptosis correction procedures under appropriate anaesthesia were performed. Post - operative evaluation in terms of visual acuity, MRD, Interpalpebral fissure height, lid symmetry, lagophthalmos and complications (if any was done. RESULTS : Levator muscle resection was done in 28% of eyelids, frontal sling surgery in 60% of eyelids, Levator muscle plication in 8% eyelids and levator muscle disinsertion with frontal sling surgery in 4% eyes. Undercorrection was seen in about 44% of eyelids in varying degrees. 56% of the eyes had optimal correction. Symmetric correction was achieved in 76% of eyelids. CONCLUSION: The influence of various preoperative factors on the

  1. Melanoma of the conjunctiva located in the upper eyelid

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    Andre Afonso Nimtz Rodrigues

    2016-04-01

    Full Text Available Melanoma of the conjunctiva (MC is a tumor that can affect the next bulbar conjunctiva to the limbus, conjunctiva, eyelid, forniceal in plica or caruncles region, which may originate from melanosis areas acquired primary with atypia, conjunctival nevus areas, and no local lesions. Clinically it presents itself as a mass or a high pigmented conjunctival lesion. This Study aimed at describing a case of conjunctival melanoma multifocal from preexisting pigmented nevus. Histopathological diagnosis and staging of early conjunctival lesion is extremely important to designate the management of patients.

  2. Total Upper Eyelid Reconstruction with Modified Cutler-Beard Procedure Using Autogenous Auricular Cartilage.

    Science.gov (United States)

    Mandal, Salil Kumar; Fleming, James Christian; Reddy, Shilpa Gillella; Fowler, Brian T

    2016-08-01

    Malignant tumour in upper lid is a surgical challenge to oculoplastic surgeon. Full thickness defect created after removal of large tumour promptly treated with modified cutler beard procedure using autogenous auricular cartilage. Surgical procedure is two staged: In first stage, removal of the tumour followed by full thickness flap repaired; In second stage, opening the closed lid with lid margin repair. Post-operatively, there is good anatomical, functional and cosmetic restoration of the eyelid similar to the other eye. To evaluate the efficacy of the modified Cutler-Beard procedure using autogenous ear cartilage for tarsal plate reconstruction in the repair of 70-100% upper eyelid defects. This is a prospective, interventional case series of 16 patients over a period of three years. Patients with upper eyelid defects, secondary to removal of tumour, greater than or equal to 70% were included. Of these patients, those with lymph node involvement, distant metastasis, lower eyelid involvement, corneal infiltration or intra-orbital extension were excluded. FNAC was done in all the cases. Created defect was measured in mm (length and width) and later expressed in percentage. Pre and Post-operative measurement of Levator Palpebrae Superioris (LPS) was done. Pre and Post-operative measurement of Margin to Reflex Distance (MRD1) were also noted. Upper eyelid recreation was successful in all patients without complications. Pre-operative LPS action ranged from 0-4 mm, while post-operative LPS action was 12-14 mm. Pre-operative MRD1 ranged from -4 millimeters to -1 mm, while post-operative MRD1 was +3 to +4 millimeters. The follow-up period ranged from six months to two years. Every patient had a successful upper eyelid reconstruction. The modified Cutler-Beard procedure using an autogenous auricular cartilage graft is an effective procedure for repair of large upper eyelid defects, with acceptable functional and cosmetic results. Furthermore, it is particularly useful in

  3. Modified Full Thickness Graded Blepharotomy for Upper Eyelid Retraction Associated With Thyroid Eye Disease in East Asians.

    Science.gov (United States)

    Lee, Joonsik; Lee, Hwa; Park, Minsoo; Baek, Sehyun

    2016-12-01

    To evaluate the functional and cosmetic outcomes of modified full thickness graded blepharotomy when used for East Asian patients with upper eyelid retraction of thyroid eye disease (TED). Medical records of each patient who underwent modified full-thickness blepharotomy at Korea University Guro Hospitals from January 2009 to February 2014 to correct upper eyelid retraction resulting from TED were retrospectively reviewed. Modified full-thickness graded blepharotomies were performed on 22 eyelids of 18 patients. The most common preoperative upper eyelid retraction-associated symptom was asymmetry of the upper eyelid (14 patients, 77.7%) followed by discomfort (10 patients, 55.5%), photophobia (5 patients, 27.7%), and epiphora (4 patients, 22.2%). Most preoperative symptoms improved after blepharotomy (Table 1). Preoperatively, upper eyelid retraction (MRD1; midpupil marginal reflex distance) ranged from 2.3 mm to 6.8 mm (mean, 5.23 ± 0.89) in 22 lids; postoperatively, lid retraction significantly decreased to 3.26 ± 1.23 mm (P = 0.03 by independent t test) (Table 2). Lid retraction was divided into 3 groups according to severity; a severe group (5 eyelids, 27.7%), a moderate group (14 eyelids, 63.6%), and a mild group (3 eyelids, 13.6%). The MRD1 improved regardless of severity (P = 0.03 in the severe group, P = 0.02 in the moderate group, and P = 0.04 in the mild group by independent t test). The MRD1 improvement did not differ significantly among groups (P = 0.08 by Pearson χ t test). At 6 months postoperatively, the midpupil marginal reflex distance was the perfect height in 13 of 22 lids (59.0%), with a mean reduction of 3 mm, whereas 7 of 22 eyelids (31.8%) were at acceptable height and 2 eyelids (9.0%) showed failure. Overall, 18 eyelids (90.9%) exhibited objectively satisfactory results (perfect or acceptable) at 6 months after surgery (Table 3). Modified graded full thickness eyelid blepharotomy is a reliable and safe method for upper eyelid lengthening

  4. Nylon Hang Back Sutures in the Repair of Secondary Ptosis Following Overcorrected Dysthyroid Upper Eyelid Retraction.

    Science.gov (United States)

    Shah-Desai, Sabrina; Azarbod, Parham; Szamocki, Sonia; Rose, Geoffrey E

    2016-01-01

    Repair of blepharoptosis secondary to surgical overcorrection of thyroid related primary upper eyelid retraction (secondary ptosis) can be unpredictable. This study describes the long-term results of "hang-back" nylon sutures, for an anterior approach surgical repair of secondary ptosis. This was a retrospective consecutive case note review of patients referred with secondary ptosis (after prior upper eyelid lowering for thyroid eye disease), under the care of a single surgeon at Moorfields Eye Hospital & subsequently at Barking Havering Redbridge University Hospitals NHS Trust (SSD). In accordance with hospital trust policy, this audit was registered and all patient data was anonymized, ethical approval was not required. Patients with secondary ptosis underwent surgery under local anesthesia through an upper eyelid skin-crease incision. The anterior portion of the levator muscle was freed from all scar tissues and its action re-established on the superior part of the upper tarsal plate, using two 6-0 nylon hang-back sutures placed centrally and medially. The margin reflex distance 1 (MRD1), skin crease height, eyelid contour, symmetry of eyelid position (difference in margin reflex distance 1 <1 mm in both eyes) and degree of lagophthalmos were assessed from clinical notes preoperative and postoperatively at 1, 3, and 12 months. Surgery was undertaken in 14 eyelids in 13 patients (3 males; 23%), with 9/14 (65%) eyelids having undergone attempted repair of ptosis prior to referral; in 7 of the 8 (88%) eyelids with previous failed ptosis repair, the referring surgeon had used soluble hang-back sutures. As compared with an average preoperative margin reflex distance 1 of 0.9 mm (median 1, range: -1 to 2 mm), the average margin reflex distance 1 at 3 months was 3.0 mm (median 3, range: 2.5-4 mm; p < 0.0001) and 2.8 mm at 12-month follow up (median 3, range: 2-4mm; p < 0.0001). The upper eyelid central skin crease height changed from a preoperative mean of 9.8 mm

  5. Sebaceous carcinoma of right upper eyelid: case report and literature review

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    Shruti Singh

    2013-12-01

    Full Text Available Sebaceous gland carcinoma is a rare fast growing cutaneous cancer. It is derived from the adenxal epithelium of sebaceous glands. Sebaceous carcinomas are generally divided into those occurring in periocular or extraocular locations. Ocular sebaceous carcinomas occur most commonly in upper eye lid, in the elderly with a predilection for females and Asian populations. Due to its clinical resemblance with chalazion or other chronic inflammatory conditions, there is a delay in diagnosis. Due to its rarity, we present a case of sebaceous carcinoma of right upper eyelid in a 65-year-old female.----------------------------------------------Cite this article as:Singh S, Kaur S, Mohan A, Goyal S. Sebaceous carcinoma of right upper eyelid: case report and literature review. Int J Cancer Ther Oncol 2013; 1(2:01022.DOI: http://dx.doi.org/10.14319/ijcto.0102.2

  6. Correction of Sunken Upper-Eyelid Deformity in Young Asians by Minimally-Invasive Double-Eyelid Procedure and Simultaneous Orbital Fat Pad Repositioning: A One-Year Follow-up Study of 250 Cases.

    Science.gov (United States)

    Chen, Chen-Chia; Chen, Sheng-Ni; Huang, Chien-Lin

    2015-05-01

    Double-eyelid procedure to construct a supratarsal fold is the most common aesthetic surgery in young Asian adults. More complex surgical procedures, such as fat grafting or filler injection, are often indicated during traditional, long-incision, double-eyelid procedures to achieve better aesthetic results for patients with hollowness of the upper eyelids. The authors sought to determine the efficacy of minimally-invasive double-eyelid procedures with concurrent repositioning of the orbital fat pads to correct sunken upper eyelids in young Asian adults. The study included 250 patients treated between June 2008 and July 2103. Preoperatively, all patients complained of upper-eyelid hollowness and had positive findings on a lower-eyelid compression test. All patients underwent a minimally-invasive double-eyelid procedure plus repositioning of orbital fat. After the minimum follow-up period of 1 year, the overall patient satisfaction rate was 76%. The relapse rate was 10% within the first year, and the complication rate was 8%. This minimally-invasive combination procedure may be an option for young Asian adults who have single upper eyelids and sunken eyes. The surgery resulted in a natural double eyelid and more youthful orbital appearance in the majority of patients in this study. Proper patient selection and evaluation, including lower eyelid compression testing, are essential to achieve long-term correction. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  7. Tarsal platform show after upper eyelid blepharoplasty with or without brassiere sutures

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    Marisa Novaes de Figueiredo

    Full Text Available ABSTRACT Purpose: Increased tarsal platform show (TPS and decreased brow fat span (BFS are associated with favorable results in women undergoing cosmetic blepharoplasty. We conducted a study to evaluate the efficacy of upper blepharoplasty with or without a technique (brassiere sutures to increase TPS and decrease BFS. Methods: This is a prospective, randomized, comparative, case series study of 100 eyelids (50 consecutive women patients treated with cosmetic upper blepharoplasty performed by a single surgeon. Patients were randomized to receive traditional upper blepharoplasty with a single running suture skin closure versus orbicularis oculi muscle fixation to the periosteum (brassiere sutures prior to skin closure. Data on patient age, duration of follow-up, complications, and treatment were analyzed. The mean TPS, mean BFS, and mean TPS/BFS ratio were measured at three anatomic landmarks before and after surgery. Results: Fifty-six eyelids (28 patients were treated with traditional single suture blepharoplasty, and 44 eyelids (22 patients had brassiere sutures. In both groups, paired t-tests indicate significant differences between preoperative and postoperative evaluations (p0.05. Conclusions: Brassiere sutures during upper blepharoplasty and traditional blepharoplasty were associated with postoperative increase in TPS, decrease in BFS, and increase in TPS/BFS, without statistically significant differences between these surgeries.

  8. Analysis of Lid Contour in Thyroid Eye Disease With Upper and Lower Eyelid Retraction Using Multiple Radial Midpupil Lid Distances.

    Science.gov (United States)

    Kang, Dongwan; Lee, Joonsik; Park, Jinhwan; Lee, Hwa; Park, Minsoo; Baek, Sehyun

    2016-01-01

    The aim of this study was to analyze upper and lower eyelid contours in adult patients with thyroid eye disease (TED) and normal adults using a software program that measures multiple radial midpupil lid distance (MPLD). Analysis targeted 61 eyes from 61 normal adults who had never undergone eyelid surgery or ophthalmic surgery and 63 eyes from 63 patients with TED. Digital pictures of primary gaze were analyzed using custom software. Conventional MPLD (90°, 270°) and 12 oblique MPLDs were collected every 15° across the temporal (105°, 120°, 135°, 150°, 165°, 180°) and nasal (75°, 60°, 45°, 30°, 15°, 0°) sectors of the upper eyelid. For lower eyelid contours, 9 oblique MLPDs in the temporal sector (255°, 240°, 225°, 210°, 195°) and nasal sector (285°, 300°, 315°, 330°) of the lower eyelid were analyzed. From all angles, the MPLD of patients with TED was larger than that of the control group. The mean difference between the 2 groups was larger for the upper eyelid (0° ∼ 180°) than the lower eyelid (195° ∼ 330°). When comparing symmetry by dividing into each angle, the ratio of 90°/270° (MRD1/MRD2) demonstrated greater in patients with TED (P = 0.000). Temporal/nasal eyelid contour symmetry in the upper eyelid, investigated using the distance ratio of the nasal sector/temporal sector (15°/165°, 30°/150°, 45°/135°, 60°/120°, 75°/105°), was significantly smaller in patients with TED (P < 0.05). However, there was no significant difference between the 2 groups regarding temporal/nasal eyelid contour symmetry of the lower eyelid (330°/210°, 315°/225°, 300°/240°, 285°/255°). Radial MPLD is effective for analyzing eyelid contour. In our study, lateral flare of upper lid retraction and flat appearance of lower lid retraction were distinct characteristics in patients with TED. Consideration of eyelid contour in patients with TED may improve corrective surgery for eyelid retraction.

  9. A Promising Modified Procedure for Upper Eyelid Retraction-Associated Graves’ Ophthalmopathy: Transconjunctival Lateral Levator Aponeurectomy

    Science.gov (United States)

    KHATAVI, Fatima; NASROLLAHI, Kobra; ZANDI, Alireza; PANAHI, Maryam; MORTAZAVI, Mahshid; POURAZIZI, Mohsen; RANJBAR-OMIDI, Behzad

    2017-01-01

    Upper eyelid retraction is a characteristic feature of thyroid eye disease, including Graves’ orbitopathy. In this study, a new surgical technique for correction of lid retraction secondary to Graves’ orbitopathy is described. Sixteen eyelids of patients older than 18 years old underwent surgical correction for moderate to severe lid retraction secondary to Graves’ orbitopathy. In this procedure, levator aponeurectomy was performed via a transconjunctival approach. Upper marginal reflex distance (MRD1) was measured before the surgery and at 1 week, 3 months, and 6 months after the surgery. MRD1 was reduced significantly from preoperatively (mean: 7.84 mm) to 1 week after the surgery (mean: 3.59 mm) (P MRD1 was 5.09 mm and 5.10 mm, respectively, showing that lid retraction was improved significantly (P < 0.001). Lateral levator aponeurectomy via the transconjunctival approach is a simple, scar-less, quick procedure that has optimal stable outcome. PMID:29367934

  10. A Promising Modified Procedure for Upper Eyelid Retraction-Associated Graves' Ophthalmopathy: Transconjunctival Lateral Levator Aponeurectomy.

    Science.gov (United States)

    Khatavi, Fatima; Nasrollahi, Kobra; Zandi, Alireza; Panahi, Maryam; Mortazavi, Mahshid; Pourazizi, Mohsen; Ranjbar-Omidi, Behzad

    2017-01-01

    Upper eyelid retraction is a characteristic feature of thyroid eye disease, including Graves' orbitopathy. In this study, a new surgical technique for correction of lid retraction secondary to Graves' orbitopathy is described. Sixteen eyelids of patients older than 18 years old underwent surgical correction for moderate to severe lid retraction secondary to Graves' orbitopathy. In this procedure, levator aponeurectomy was performed via a transconjunctival approach. Upper marginal reflex distance (MRD1) was measured before the surgery and at 1 week, 3 months, and 6 months after the surgery. MRD1 was reduced significantly from preoperatively (mean: 7.84 mm) to 1 week after the surgery (mean: 3.59 mm) (P MRD1 was 5.09 mm and 5.10 mm, respectively, showing that lid retraction was improved significantly (P < 0.001). Lateral levator aponeurectomy via the transconjunctival approach is a simple, scar-less, quick procedure that has optimal stable outcome.

  11. Relation of the Vector Force Needed to Lift the Upper Eyelids and the Degree of Exophthalmos.

    Science.gov (United States)

    Hwang, Kun; Kim, Joo Ho; Kim, Hun; Hwang, Se Won

    2015-07-01

    The aim of this study was to determine the relation of the vector force needed to lift the upper eyelids and the degree of exophthalmos (EX). In the 109 magnetic resonance imaging films, the degree of EX (the shortest distance from the cornea to the line connecting both lateral orbital rims), the anterior angle (θ, an angle formed from the lower margin of the upper eyelid-superior transverse ligament (STL)--with a parallel line connecting the supraorbital rim and the infraorbital rim in the sagittal film), the length from the STL to the upper eyelid margin (levator length [LL]), the thickness of the STL (WT), and the thickness the of levator palpebrae (LT) were measured.The average EX was 14.5 ± 2.35  mm. The average θ was 33.84 ± 2.15 degrees. The vector force needed to lift the upper eyelids (cos θ) was 0.83. The average LL was 21.0 ± 1.54  mm. The average WT was 1.07 ± 0.22  mm. The average LT was 1.69 ± 0.30  mm. There was a significant positive relationship between the EX and age (P = 0.022). The EX in those younger than 20 years (12.8 ± 2.06) was significantly lesser than that of the other age groups. There was no significant relationship between the EX and cos θ. However, there was a significant positive relationship between the EX and the LL. There was a significant positive relationship between LL and LT, and between LL and WT.The farther the eyeball protrudes, the longer the LL is needed. The longer the LL is, the thicker the levator muscle and STL.

  12. The expression and comparison of healthy and ptotic upper eyelid contours using a polynomial mathematical function.

    Science.gov (United States)

    Mocan, Mehmet C; Ilhan, Hacer; Gurcay, Hasmet; Dikmetas, Ozlem; Karabulut, Erdem; Erdener, Ugur; Irkec, Murat

    2014-06-01

    To derive a mathematical expression for the healthy upper eyelid (UE) contour and to use this expression to differentiate the normal UE curve from its abnormal configuration in the setting of blepharoptosis. The study was designed as a cross-sectional study. Fifty healthy subjects (26M/24F) and 50 patients with blepharoptosis (28M/22F) with a margin-reflex distance (MRD1) of ≤2.5 mm were recruited. A polynomial interpolation was used to approximate UE curve. The polynomial coefficients were calculated from digital eyelid images of all participants using a set of operator defined points along the UE curve. Coefficients up to the fourth-order polynomial, iris area covered by the UE, iris area covered by the lower eyelid and total iris area covered by both the upper and the lower eyelids were defined using the polynomial function and used in statistical comparisons. The t-test, Mann-Whitney U test and the Spearman's correlation test were used for statistical comparisons. The mathematical expression derived from the data of 50 healthy subjects aged 24.1 ± 2.6 years was defined as y = 22.0915 + (-1.3213)x + 0.0318x(2 )+ (-0.0005x)(3). The fifth and the consecutive coefficients were <0.00001 in all cases and were not included in the polynomial function. None of the first fourth-order coefficients of the equation were found to be significantly different in male versus female subjects. In normal subjects, the percentage of the iris area covered by upper and lower lids was 6.46 ± 5.17% and 0.66% ± 1.62%, respectively. All coefficients and mean iris area covered by the UE were significantly different between healthy and ptotic eyelids. The healthy and abnormal eyelid contour can be defined and differentiated using a polynomial mathematical function.

  13. Reconstruction of large upper eyelid defects with a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft

    DEFF Research Database (Denmark)

    Toft, Peter B

    2016-01-01

    PURPOSE: To review and present the results of a one-step method employing a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft for reconstruction of large upper eyelid defects after tumour surgery. METHODS: This was a retrospective case-series of 8 patients who underwent...... was reconstructed with a laterally based myocutaneous pedicle flap in 7 patients, leaving a raw surface under the brow which was covered with a free skin graft. In 1 patient with little skin left under the brow, the anterior lamella was reconstructed with a bi-pedicle orbicularis muscle flap together with a free...... excision to avoid eye discomfort. CONCLUSION: Large upper eyelid defects can be reconstructed with a free tarsal plate graft and a laterally based myocutaneous pedicle flap in combination with a free skin graft. Two-step procedures can probably be avoided in most cases....

  14. Bilateral corneal injury after face-paint application to upper eyelids.

    Science.gov (United States)

    Ho, Derek Kwun-Hong; Ramessur, Ravi; Webber, Sue

    2017-05-10

    A 40-year-old woman with no known medical conditions or allergies presented with severely painful, watery eyes and blurred vision. She reported topical application of face-paint onto both upper eyelids prior to attending a Halloween party. She subsequently noticed a burning sensation, epiphora and misty vision within a few hours. On examination, bilateral large corneal epithelial defects were highlighted with fluorescein dye under cobalt-blue light. Antibiotic ointment, mydriatic and sodium ascorbate 10% eye-drops were given, and patient was advised to keep the eyelids shut to promote healing. No corneal defects were visible by day 4 and the patient was discharged with vision recovering to normal levels. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. "Pseudo-pseudochalazion": giant chalazion mimicking eyelid neoplasm.

    Science.gov (United States)

    Koo, Lily; Hatton, Mark P; Rubin, Peter A D

    2005-09-01

    A 33-year-old man presented with a solid lesion encompassing the entire left upper eyelid. Multiple biopsies revealed lipogranuloma consistent with chalazion. The induration resolved after multiple triamcinolone injections. This is the only case report to our knowledge of a chalazion that involved the entire upper eyelid.

  16. Shrinking upper and lower eyelid skin with a novel radiofrequency tip.

    Science.gov (United States)

    Carruthers, Jean; Carruthers, Alastair

    2007-07-01

    Many subjects wish to have tightening of eyelid skin but are reluctant to undergo aesthetic blepharoplasty surgery. We wanted to perform a small pilot study to test the efficacy and safety of a 0.25-cm(2) monopolar radiofrequency tip in a prospective noncomparative study as a novel nonsurgical method to safely tighten upper and lower eyelid skin in subjects of differing ethnicity and sex. Twenty adult subjects were enrolled in this prospective pilot study. All received symmetrical monopolar radiofrequency treatments in multiple passes to the pretarsal, preseptal, and lateral orbital skin. All subjects wore a protective plastic haptic contact lens to protect their vision during the radiofrequency treatment. (Haptic contact lenses fit over the entire anterior surface of the globe from superior to inferior and medial to lateral fornix. The purpose of using such a large contact lens was to protect the globe itself from radiofrequency energy.) Standardized color digital photography with eyes both open and closed was taken on each visit. Treatment efficacy was evaluated by both the expert observer and the subject at each visit. RESULTS At 6-month follow-up, according to the expert observer, 26 upper lids (87%) showed 25% or more tightening. Twenty lower lids (67%) showed 25% or more tightening. Two subjects (3.33%) had 51% to 75% upper lid tightening at 6 months. There were no adverse events beyond one subject with minimal corneal epithelial punctate defects on the treatment day. These resolved over several hours. The use of this new tip was shown to be safe. Effectiveness at shrinking eyelid skin was at best mild to moderate.

  17. Müller's muscle-conjunctival resection for upper eyelid ptosis: correlation between amount of resected tissue and outcome.

    Science.gov (United States)

    Zauberman, Noa Avni; Koval, Tal; Kinori, Micki; Matani, Adham; Rosner, Mordechai; Ben-Simon, Guy Jonathan

    2013-04-01

    To explore the relationship between the amount of resected Müller's muscle-conjunctiva (MMCR) and clinical outcome in patients undergoing upper eyelid ptosis surgery. 49 patients underwent 87 MMCR surgeries. The total areas of the specimen and of MM were measured in pixels. The average percentage of muscle tissue in relation to total excised tissue was 21%. Intraoperative MMC tissue measurements and postoperative improvement in eyelid position (delta marginal reflex distance 1 (MRD1)) were positively correlated (R=0.427, p=0.09). There was a weak correlation between total areas measured on the histological slides and the intraoperative MMCR values (R=0.3, p=0.057). Total histological areas did not correlate with the delta change in eyelid position or with the amount and percentage of resected muscle tissue and the extent of improvement in eyelid position (delta MRD1) or final eyelid position (postoperative MRD1). Post-MMCR improvement in eyelid positions did not correlate with the percentage of MM in the excised tissue. We believe that the mechanism responsible for surgical outcome is plication or scarring of the posterior lamella and not the amount of resected MM. More lift in eyelid position can be anticipated when more tissue is excised by MMCR, and not when more muscle is excised.

  18. The role of the orbicularis oculi muscle and the eyelid crease in optimizing results in aesthetic upper blepharoplasty: a new look at the surgical treatment of mild upper eyelid fissure and fold asymmetries.

    Science.gov (United States)

    Fagien, Steven

    2010-02-01

    One of the most common aesthetic and rejuvenative facial plastic surgical procedures performed is upper blepharoplasty. The traditional approaches to this procedure have been conceptually related to the removal of apparent "excess" tissue to enhance the visibility of the pretarsal region and reduce the upper eyelid irregularities and changes that occur with age. Many times, surgery has been performed both bilaterally and similarly on each side without extensive preoperative planning irrespective of the patient presentation and has commonly incorporated the removal of skin, orbicularis oculi muscle, and upper periorbital fat. The orbicularis oculi muscle is excised for a variety of reasons and has, in general, not been considered as an important component that mandates preservation or a potential means with which to further enhance outcomes by manipulation. If upper eyelid ptosis is also present, it may be treated by traditional methods of blepharoptosis repair. Despite this, patients are more often generally pleased with the obvious improvements after surgery with these traditional surgical procedures, yet the changes do not necessarily approach the youthful configuration in some individuals, the asymmetries that they had presented with may persist, and changes might occur that were not anticipated that may detract from the overall aesthetic result. A simple yet comprehensive approach to upper blepharoplasty that considers both the youthful or desired appearance and the management of upper eyelid asymmetries by preservation or selective treatment of the orbicularis oculi muscle and placement of the upper eyelid crease to improve aesthetic outcomes is presented in this article.

  19. A patient with diplopia and upper eyelid edema: a case report

    Directory of Open Access Journals (Sweden)

    Igor Šivec Trampuž

    2017-11-01

    Full Text Available Idiopathic orbital inflammatory disease, previously referred to as orbital pseudotumor, is a nonneoplastic, non-infective disease. The inflammatory process can involve one or more orbital sof tissues; extraocular muscles, tear gland, scleralorepiscleral tissue or orbital fat. Orbital myositis typically presents itself with a sudden onset of restricted ocular motility, diplopia, congestive proptosis, eyelid ptosis, periocular swelling and conjunctival hyperemia. A thorough workup is essential for ruling out other entities. This report presents a case of a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. Afer initial ophthalmologic workup and ultrasound an orbital mass was suspected. Te MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression were observed. In two years of follow-up visits no recurrence was noted. Isolated superior oblique muscle myositis is extremely rare. This is one of eleven cases documented between 1988 and 2015.   This case report presents a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. After initial ophthalmologic workup and ultrasound an orbital mass was suspected. The MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression was observed. In two years of follow-up visits no recurrence was noted. Isolated superior oblique muscle myositis is extremely rare. This is one of eleven documented cases between 1988 and 2015.

  20. The effect of upper blepharoplasty on eyelid position when performed concomitantly with Müller muscle-conjunctival resection.

    Science.gov (United States)

    Brown, M S; Putterman, A M

    2000-03-01

    To determine the effect on eyelid elevation of excising excess skin, orbicularis oculi muscle, and herniated orbital fat and reconstructing the upper eyelid crease (blepharoplasty) concomitant with a Müller muscle-conjunctival resection. The charts of 202 patients who had undergone Müller muscle-conjunctival resection during an 8-year interval were reviewed. Three hundred forty-five eyelids were divided into two groups. Group 1 (n = 162) underwent a Müller muscle-conjunctival resection only, and group 2 (n = 183) had this procedure combined with excision of skin, orbicularis muscle, and herniated orbital fat with upper eyelid crease reconstruction. Each group was divided into three subgroups based on the amount of Müller muscle-conjunctival resection. Subgroup A had resection less than 7.75 mm; subgroup B, resection of 7.75 to 8.75 mm; and subgroup C, resection greater than 8.75 mm. The change in margin reflex distance-1 (MRD1) measurements of the upper eyelid levels (postoperative MRD1 minus preoperative MRD1) were calculated and compared between groups. The mean (+/- standard deviation) change in MRD1 was, respectively, 2.3 +/-1.0 mm and 1.9+/-1.0 mm for groups 1A and 2A; 3.1+/-1.3 mm and 2.1+/-1.2 mm for groups 1B and 2B; and 3.4+/-1.2 mm and 2.8+/-1.3 for groups 1C and 2C. Blepharoplasty performed concomitant with a Müller muscle-conjunctival resection reduced the anticipated postoperative eyelid elevation by as much as 1 mm. Surgeons who perform these procedures together should be aware that a larger Müller muscle-conjunctival resection may be required to obtain the desired increase in eyelid height postoperatively.

  1. Current Trends in Upper and Lower Eyelid Blepharoplasty Among American Society of Ophthalmic Plastic and Reconstructive Surgery Members.

    Science.gov (United States)

    Kossler, Andrea L; Peng, Grace L; Yoo, Donald B; Azizzadeh, Babak; Massry, Guy G

    To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members. An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery. Practice patterns for both aesthetic and functional blepharoplasty are assessed. Thirty-four percent (161/472) of American Society of Ophthalmic Plastic and Reconstructive Surgery members polled responded to the survey. Members perform an average of 196 upper eyelid, 46 lower eyelid, and 53 four-eyelid blepharoplasty procedures per year, with 70% of cases being functional and 30% purely aesthetic. Most members prefer monitored care (71%) to local (21%) or general (8%) anesthesia. Eighty-nine percent of surgeons use topical antibiotics after surgery, erythromycin being the most common (51%). Fourteen percent of members use postoperative oral antibiotics, with cephalexin (81%) being most common. In upper eyelid blepharoplasty, orbicularis muscle is excised by 86% of respondents. Orbital fat is excised, when deemed appropriate, in 97% of cases, with nasal fat excised most commonly (88%). Less commonly, fat repositioning (36%) and adjunctive fat grafting (33%) are performed. In lower eyelid blepharoplasty, surgeons report using one or more of the following approaches: transconjunctival (96%), transcutaneous (82%), and both transconjunctival and transcutaneous (51%). Common adjunctive procedures include orbital fat excision (99%), fat repositioning (80%), and lateral canthal suspension (96%). Less common adjunctive procedures include laser skin resurfacing (36%) and chemical peels (29%). This report outlines contemporary practice patterns among active American Society of Ophthalmic Plastic and

  2. Localization and Retrieval of an Eyelid Metallic Foreign Body With an Oscillating Magnet and High-Resolution Ultrasonography.

    Science.gov (United States)

    Yoo, Sylvia H; Rootman, Dan B; Goh, Alice; Savar, Aaron; Goldberg, Robert A

    2016-01-01

    A patient was found to have a metallic foreign body in the left anterior orbit on CT imaging, but the foreign body was not evident on clinical examination. On high-resolution ultrasonography, an object was identified in the left upper eyelid; however, the typical shadow with metallic foreign bodies was not seen. A high-power oscillating magnet was then applied to the eyelid, which revealed a subcutaneous metallic foreign body in the left upper eyelid. When used in conjunction, the high-resolution ultrasound and oscillating magnet successfully localized and facilitated retrieval of the metallic foreign body from the left upper eyelid.

  3. Morgellons Disease Presenting As an Eyelid Lesion.

    Science.gov (United States)

    Sandhu, Rasanamar K; Steele, Eric A

    2016-01-01

    Morgellons disease is characterized by complaints of uncomfortable skin sensations and fibers emanating from nonhealing skin lesions. Morgellons disease is well-known in the dermatology and psychiatry literature, where it is typically considered a subtype of delusional parasitosis, but it has not yet been described in the ophthalmology literature. A patient with self-reported Morgellons disease is presented, who was referred for evaluation of left lower eyelid ectropion. She reported that her skin was infested with fibers that were "trying to get down into the eyelid." On examination, she had ectropion of the left lower eyelid, broken cilia, and an ulcerated left upper eyelid lesion concerning for carcinoma. Biopsy of the lesion was consistent with excoriation. Treatment of her ectropion was deferred out of concern for wound dehiscence, given the patient's aggressive excoriation behavior. This case is presented to make the ophthalmologist aware of this disorder and to highlight the appropriate clinical management.

  4. Giant hanging melanoma of the eyelid skin

    Directory of Open Access Journals (Sweden)

    Pai Radha

    2008-01-01

    Full Text Available Cutaneous melanoma of the eyelid is a rare entity. We present a 53-year-old male who had a nevus on the left upper eyelid skin since childhood, which transformed into a huge ulcerated hanging mass in the same region. Excision of the mass was done and histopathology confirmed the diagnosis of nodular malignant melanoma. A small preauricular lymph node showed metastatic melanoma on fine needle aspiration cytology.

  5. Investigation into surface interaction between the contact lens, the upper eyelid and cornea using optical coherence tomography

    Science.gov (United States)

    Morecroft, R.; Carré, M. J.; Lewis, R.; Mylon, P.; Matcher, S. J.; Toomey, P.; Goff, J. E.; Maiti, R.

    2017-02-01

    Background and Aim: Over 50% of the total 125 million contact lens users complain of discomforts due to contact lenses. The aim of the project is to understand the effect of contact lenses on the morphological parameters of cornea and eyelid surfaces. Methods and results: Five volunteers were recruited for this study (3 soft contact lens users and 2 non-users). The volunteers were imaged using a slit lamp and Optical Coherence Tomography (OCT) before and after a period of 6-7 hours. There was a significant increase in epidermal thickness of the eyelid for contact lens users compared to non-users. In addition, the upper eyelid roughness for contact lens users and non-users increased significantly. This might be due to deposition of particles from the eyelid during the wiping process. Conclusions: Contact lens usage does affect the morphological parameters of eyelid. OCT is a powerful tool to measure these morphological changes in the eye. However, more volunteers must be recruited to get a better understanding of these changes.

  6. IgG4-related disease mimicking chalazion in the upper eyelid with skin manifestations on the trunk.

    Science.gov (United States)

    Leivo, Tiina; Koskenmies, Sari; Uusitalo, Marita; Tynninen, Olli

    2015-08-01

    IgG4-related disease is a recently defined inflammatory process characterized by IgG4-bearing plasma cells in the involved tissues. The most common sites of involvement are the pancreas, hepatobiliary tract, salivary glands, lymph nodes, retroperitoneum and orbit, especially the lacrimal glands. Other ocular or ocular adnexal sites are rare. To our knowledge, there is one reported case of a conjunctival involvement. We describe a patient, who had an IgG4-RD mimicking chalazion in the upper eyelid, confined to the tarsus, with multiple skin lesions on the trunk. This is a case report of a 55-year-old female. A 55-year-old female presented with an upper eyelid lesion, which was clinically diagnosed as chalazion and drained three times. Histopathological diagnoses were chalazion and inflammation with mixed cells, respectively. Additionally, the patient had had skin nodules on the trunk for several years. Finally, after a third recurrence, the tarsal eyelid lesion was completely excised. The tarsal pathology specimen showed 85 IgG4 positive plasma cells per HPF and the IgG4/IgG ratio was 0.64, suggesting a probable IgG4-related disease. The re-examined skin lesions resembled histologically the eyelid lesion. It is essential to be aware of IgG4-related disease, including in recurrent chalazia.

  7. Hyaluronic acid gel injection for upper eyelid retraction in thyroid eye disease: functional and dynamic high-resolution ultrasound evaluation.

    Science.gov (United States)

    Kohn, Jocelyne C; Rootman, Daniel B; Liu, Wenjing; Goh, Alice S; Hwang, Catherine J; Goldberg, Robert A

    2014-01-01

    The goal of this study is to determine the functional and dynamic effects of hyaluronic acid (HA) gel injection into the levator plane for improving upper eyelid retraction in patients with thyroid eye disease (TED). This is a prospective, non-randomized study of consecutive patients with symptomatic unilateral upper eyelid retraction in the setting of active and inactive TED. Study participants underwent HA gel injection subconjunctivally into the levator plane and were examined before injection, 1 to 3 months after injection, and at the clinician's discretion thereafter. At each of the time points, high-resolution ultrasound imaging and clinical photographs were taken, and the marginal reflex distance 1 (MRD1) was measured. Eight patients (4 in the active stage of TED, 4 in the inactive stage of TED) were injected on average with 0.45 ml of HA gel. The average baseline MRD1 was 5.6 mm prior to HA injection, 4.6 mm at the first follow up after injection, and 5 mm at the final follow up after injection. HA was localized ultrasonographically to multiple anatomical locations and changed in morphology over time but not in anatomical location. All patients demonstrated increased fluidity of eyelid excursion on dynamic ultrasound after HA injection. There were no vision-threatening complications in this study. Despite variability in the HA gel distribution and long-term conformational changes on ultrasound examination, HA injection may be an effective and minimally invasive method to improve upper eyelid position for patients with mild eyelid retraction in both the active and inactive stages of TED.

  8. Spontaneous upper eyelid ecchymosis: A rare presenting sign for frontal sinus mucocele.

    Science.gov (United States)

    Mehta, Amy A; Wagner, Lilly H; Blace, Nancy

    2017-06-01

    Paranasal sinus mucoceles are benign lesions that commonly present with orbital signs due to their anatomic proximity. We are reporting a case of bilateral frontal sinus mucocele presenting with spontaneous eyelid ecchymosis. To our knowledge this is the first case report of eyelid ecchymosis as the initial sign of this condition. In addition, our patient lacked commonly described symptoms such as diplopia or pain. This report highlights the importance of including frontal sinus mucocele in the differential diagnosis of spontaneous periorbital ecchymosis.

  9. Anaplastic hemangiopericytoma of eyelid: An unusual location

    Directory of Open Access Journals (Sweden)

    Pradeep Ventrapati

    2017-01-01

    Full Text Available Hemangiopericytomas (HPCs are rare soft tissue tumors. The eyelid is a very uncommon site for these tumors, and an anaplastic variant of HPC in the eyelid has not been reported before. A 44-year-old male presented with complaints of slowly progressive, painless swelling on the inner aspect of the left upper eyelid for 9 months. He underwent local excision of the swelling and histopathology revealed a WHO Grade III anaplastic HPC. Whole body 18 F-fluorodeoxyglucose positron emission tomography-computed tomography done postoperatively did not show any evidence of local or distant disease. The patient was planned for adjuvant radiotherapy of 60 Gy in 30 fractions over 6 weeks in view of high grade of histopathology and doubtful margins. He is disease free at the time of the last follow-up. To the best of our knowledge, this is the first case of anaplastic HPC of eyelid being reported in English literature.

  10. Hidradenocarcinoma eccrinale syringomatodes of the eyelid--case of a rare malignancy.

    Science.gov (United States)

    Karolina, Ziaja; Arkadiusz, Pogrzebielski; Jolanta, Orłowska-Heitzman; Bozena, Romanowska-Dixon

    2010-01-01

    Presentation of a case of very rare malignant tumor of eccrine sweat glands in the eyelid. A 44 years old man with a tumor of the upper left eyelid is presented. Sweat gland carcinomas are rare malignant tumors of the skin adnexa. Diagnosis of these carcinomas is difficult due to their infrequency.

  11. Orthodontic intervention of an impacted upper left central incisor due ...

    African Journals Online (AJOL)

    A fixed orthodontic appliance was used to facilitate traction and correction of malalignement of the impacted upper left central incisor.Treatment outcome: Successful removal of the odontoma, full exposure of the crown of upper left central incisor and good alignment on the arch were achieved. Crowding on the upper and ...

  12. Reconstructions of eyelid defects

    Directory of Open Access Journals (Sweden)

    Nirmala Subramanian

    2011-01-01

    Full Text Available Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

  13. Dimensões palpebrais antes e após blefaroplastia superior: avaliação quantitativa Eyelid measures before and after upper blepharoplasty: quantitative evaluation

    Directory of Open Access Journals (Sweden)

    Silvana Artioli Schellini

    2005-02-01

    Full Text Available OBJETIVO: Quantificar, usando o sistema de imagem digital, medidas palpebrais antes e após a cirurgia de blefaroplastia superior. MÉTODOS: Foram avaliadas 18 pálpebras de 9 pacientes atendidas no HC da FMB - UNESP, com idade entre 40 a 75 anos, do sexo feminino, portadoras de dermatocálase. Foram obtidas fotografias das pacientes antes e após 60 dias da blefaroplastia da pálpebra superior. As imagens foram transferidas para um computador e analisadas pelo programa Scion Image Frame Grabber. Os parâmetros avaliados foram: a altura da fenda palpebral em posição primária do olhar, altura do sulco palpebral superior e o ângulo palpebral lateral antes e depois de 60 dias da realização da cirurgia de blefaroplastia superior. RESULTADOS: Após a cirurgia, houve aumento da altura da fenda palpebral e do sulco palpebral superior. Contudo, o ângulo palpebral lateral não se alterou. CONCLUSÃO: A posição palpebral se altera após a blefaroplastia e o processamento de imagens digitais possibilita quantificar estas alterações, mensurando os resultados obtidos com a cirurgia.PURPOSE: To evaluate eyelid measures before and after upper blepharoplasty surgery using a digital image system. METHODS: Eighteen eyelids of 9 patients with dermatochalasis were evaluated at the Hospital das Clínicas de Botucatu - UNESP regarding eyelid measures before and after upper blepharoplasty. All patients were female, aged between 40 and 75 years. The images were acquired by a photographic camera, transferred to a computer and then analyzed by the Scion Image Frame Grabber program. The evaluated parameters were upper eyelid position in primary gaze position, upper palpebral sulcus and lateral eyelid angle. The measures were obtained before and after 60 days of upper dermatochalasis surgery. RESULTS: After the surgery, there was an increase of upper eyelid position and upper palpebral sulcus; the lateral palpebral angle did not show any alteration. CONCLUSION

  14. Benign Eyelid Lesions: Six Months Study

    Directory of Open Access Journals (Sweden)

    E Abbasi Shavvazi

    2013-04-01

    Full Text Available Introduction: Benign eyelid lesions are classified to infectious, inflammatory and tumoral lesions. The various number of these lesions is due to unique eyelid anatomical structure. Some lesions are simple and do not need any treatment but sometimes patients refer to ophthalmologists due to beauty or problems such as pain, swelling. The aim of our study is to investigate and compare the relative frequency of benign eyelid lesions in Shahid Sadoughi eye clinic as well as the private offices. Methods: This cross sectional six month study was done on 247 patients who referred to Shahid Sadoughi eye clinic and the private offices in 2011. They were examined by direct observation and slit lamp regardless of the cause. The information was gleaned by a questionnaire and the research data was analyzed by SPSS (ver.16. Results: we studied 247 patients including 84(34% male and 163(6% female. The mean age of the patients was 42.7 years. 60.2% of lesions were in upper lid and 39.8% were in lower lid. 51.2% of lesions were in right eye and 48.8% were in left eye. The most common eyelid lesions were papilloma (32.9% nevus (21.9% and chalazion (14.1% respectively. Conclusion: Papilloma, nevus and chalazion are respectively the most common lesion in men and women. Benign lesions were more common in women located more in upper lid, though there was no statistically difference between right and left lid.

  15. Solitary eyelid schwannoma

    Directory of Open Access Journals (Sweden)

    Renu M Magdum

    2014-01-01

    Full Text Available Schwannomas are rare benign tumors arising from Schwann cells of peripheral nerves that form the neural sheath. While there have been reports of such tumors in the orbit, solitary schwannomas arising from the eyelids are very rare. There are reports of schwannomas being erroneously diagnosed as chalazion, inclusion cysts or even eyelid malignancy. We are reporting a case of a 20-year-old female who presented with a painless, non-tender, slow-growing mass in the upper eyelid of the right eye. The external appearance of the mass was suggestive of an implantation cyst of the eyelid and it could be completely excised as it had a well-defined capsule. Histopathological examination showed characteristic hypercellular and hypocellular areas with fusiform nuclei that tended to form palisades. The purpose of reporting this case of schwannoma in a young female is to recommend the inclusion of this entity as a differential diagnosis of well-defined lid tumors.

  16. Pilomatricoma of the eyelid

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    Tasleem Arif

    2018-02-01

    Full Text Available Pilomatricoma is an uncommon benign tumor considered to be harmatoma of hair matrix. Here we present a case of 27 year old male patient who had solitary swelling over the right upper eyelid. On the basis of clinical and histopathological background, the diagnosis of pilomatricoma was made.

  17. Eyelid Growths

    Science.gov (United States)

    ... of the Eyelids and Tears Blepharitis Blepharospasm Canaliculitis Chalazion and Stye (Hordeolum) Dacryocystitis Dacryostenosis Entropion and Ectropion ... mimic other eye disorders (such as blepharitis and chalazion ), so a doctor usually biopsies any growths that ...

  18. Eyelid lift

    Science.gov (United States)

    ... Editorial team. Eyelid Disorders Read more Plastic and Cosmetic Surgery Read more Skin Aging Read more A.D. ... must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get ...

  19. [Mucinous sweat gland carcinoma of the eyelid].

    Science.gov (United States)

    Müller, P L; Herwig, M C; Holz, F G; Loeffler, K U

    2016-09-01

    A 52-year-old patient presented with a painless nodular tumor of the upper left eyelid, which was first noticed 6 months prior to the initial presentation. The histopathological and immunohistochemical examination of the excised tumor revealed a mucinous sweat gland carcinoma. This very rare neoplasm (1/150,000 skin lesions) is located within the ocular adnexa in 40 % of cases. If completely excised the prognosis is usually good; however, due to the histological similarity to metastases of an adenocarcinoma, a hitherto unknown primary tumor at another site should be excluded.

  20. Endocrine mucin-producing sweat gland carcinoma of the eyelid.

    Science.gov (United States)

    Mehta, Sonia; Thiagalingam, Sureka; Zembowicz, Artur; Hatton, Mark P

    2008-01-01

    A 70-year-old woman was examined for a 4-mm bluish nodule in the left upper eyelid. The lesion was excised and pathology showed it to be endocrine mucin-producing sweat gland carcinoma with positive margins. She underwent Mohs surgery and reconstruction of the resulting defect. Clinicians should be aware of this entity given its association with invasive mucinous adenocarcinoma, a locally aggressive tumor with metastatic potential.

  1. Eyelid bump

    Science.gov (United States)

    ... It appears as a red, swollen bump that looks like a pimple. It is often tender to the touch. Causes A stye is caused by a blockage of one of the oil glands in the eyelids. This allows bacteria to grow inside the blocked gland. Styes are ...

  2. Outcomes of levator advancement and Müller muscle-conjunctiva resection for the repair of upper eyelid ptosis.

    Science.gov (United States)

    Thomas, G N; Chan, J; Sundar, G; Amrith, S

    2017-02-01

    Both the Müller muscle-conjunctiva resection (MMCR) and levator advancement (LA) procedures can be used to manage ptosis in patients with good levator function. The aim of this article is to evaluate the efficacy and cosmetic outcomes of the two procedures. The clinical records of 29 consecutive eyelids of 26 patients undergoing MMCR and 30 eyelids of 23 patients undergoing LA were analysed. Eleven (42%) in the LA group and 9 (39%) in the MMCR group were male. The preoperative eyelid measurements were significantly different in the LA compared to the MMCR groups, in terms of palpebral aperture (PA) (6.3 vs 7.4, p = 0.01), marginal reflex distance 1 (MRD1) (-0.1 vs 1.5, p MRD1 1 month post-surgery was slightly less in the LA group compared to the MMCR group (2.6 vs 3.18 mm, p = 0.047) but not significantly different at months 3 and 6. The final change in MRD1 was significantly higher in the LA group (2.93 vs 1.76, p = 0.004). The MMCR group had a lower incidence of lid contour abnormalities (0% vs 20%, p = 0.01) and overcorrection (0% vs 13%, p = 0.04). There was no statistically significant difference in the rates of undercorrection in either group. Both the MMCR as well as LA procedures are effective for mild to moderate ptosis in patients with good levator function. Patients undergoing MMCR had higher success rates, better preservation of the natural lid contour, and a lower incidence of overcorrection than patients undergoing LA.

  3. PROSE scleral lens: a novel aid for staged eyelid reconstruction.

    Science.gov (United States)

    Samimi, David B; Chiu, Gloria B; Burnstine, Michael A

    2014-01-01

    A 50-year-old man presented with a papillomatous tarsoconjunctival tumor involving the medial two-thirds of the left upper eyelid. Office biopsy revealed papillary squamous cell carcinoma (SCCA). Rapid tumor growth with caruncular and forniceal conjunctival involvement continued, despite a trial of weekly interferon-α2b intralesional injection therapy. Surgical excision with clear margins resulted in a large upper eyelid defect. The suspicion for recurrence remained, given the aggressive nature of the tumor. A temporary prosthetic replacement of the ocular surface ecosystem (PROSE) scleral lens was fit for preservation of the ocular surface and visual function during a 1-month observation period. No evidence of recurrence was noted, and the eyelid defect was successfully reconstructed with a Cutler-Beard procedure. Local disease was controlled; unfortunately, metastatic disease was found in the ipsilateral parotid gland 1 year later. Aggressive surgical removal is recommended in interferon-α2b nonresponsive SCCA tumors. The PROSE scleral contact lens may serve as a useful adjunct for the maintenance of a healthy ocular surface and visual function during delayed eyelid defect repair.

  4. Reconstrucción total del párpado superior mediante colgajo frontal Whole repair made in the upper eyelid using a frontal flap

    Directory of Open Access Journals (Sweden)

    Yamilé León Rodríguez

    2009-12-01

    Full Text Available Los pacientes que han sido sometidos a resecciones quirúrgicas por cáncer, que han sufrido lesiones por quemaduras de espesor total o traumas avulsivos con pérdida extensa de tejidos que engloban la totalidad del párpado superior, acuden con relativa frecuencia a consulta por presentar la cornea expuesta, y dicha exposición resulta en ulceraciones, cicatriz y ceguera. En estos pacientes se observa una gran insatisfacción por el inconveniente que representa no poder usar una prótesis ocular y algo no menos importante, el gran defecto estético. Se presenta el caso de un paciente del sexo masculino, de 30 años de edad, que sufrió múltiples lesiones por el estallido de un artefacto explosivo, con pérdida total del párpado superior derecho y enucleación ocular. Se le realizó reconstrucción palpebral total mediante el colgajo dermograso frontal y se obtuvieron buenos resultados estéticos.Patients underwent to surgical resections from cancer and whole thickness burn lesions or avulsion traumata with an extent loss of tissues which shape the upper eyelid, came with a relative frequency to consultation due to corneal exposition and this exposition resulting in ulcerations, scar, and blindness. These patients are very unsatisfied because they can not use of an ocular prosthesis, and something less important, the big aesthetic defect. Authors present the case of a male patient aged 30 with multiple lesions from explosion of an explosive artifact with loss of right upper eyelid and ocular enucleation. A total palpebral reconstruction was performed using a frontal dermal fatty flap with good aesthetic results.

  5. Eyelid Retraction in Isolated Unilateral Congenital Blepharoptosis

    OpenAIRE

    Michael S. Salman; Michael S. Salman; Ian H. Clark; Ian H. Clark

    2017-01-01

    Isolated unilateral congenital ptosis is encountered relatively infrequently in clinical practice. It typically consists of a unilateral droopy eyelid, weak levator palpebrae superioris muscle function, lid lag, and an absent upper lid crease with no other abnormalities on examination. We present a four-and-a-half-year-old girl with isolated and mild unilateral congenital ptosis who unexpectedly demonstrated a static upper eyelid on downgaze in conjunction with a well-formed upper lid skin cr...

  6. Periocular and anterior orbital necrosis after upper eyelid gold weight loading: operation-related or self-inflicted?

    Directory of Open Access Journals (Sweden)

    Schwartz R

    2014-04-01

    Full Text Available Roy Schwartz,1 Ran Ben Cnaan,1 Ophir Schein,2 Michael Giladi,3 Michal Raz,4 Igal Leibovitch11Oculoplastic and Orbital Institute, Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 2Department of Plastic Surgery, Assaf Harofeh Medical Center, Tzrifin, Israel; 3Infectious Disease Unit, 4Pathology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelAbstract: A 44-year-old woman, who had undergone gold-weight implantation due to facial palsy and lagophthalmos, arrived at the ophthalmology ward with eyelid swelling and erythema, which rapidly deteriorated under intravenous antibiotics to a necrotic process involving the periocular tissues, the eye, and the anterior orbit. Despite prompt removal of the gold weight, the patient's ocular and systemic condition continued to deteriorate, necessitating evisceration and debridement of necrotic tissue. Cultures showed growth of Staphylococcus epidermidis, Staphylococcus capitis, Candida glabrata, and Candida albicans, and histopathology demonstrated an acute nonspecific necrotizing panophthalmitis. Later on, the patient was admitted to a plastic surgery ward with recurrent severe burns of her thigh, which were highly suggestive of being self-induced, raising the possibility of self-induced damage.Keywords: evisceration, factitious disorder, lagophthalmos

  7. Cutaneous lupus erythematosus manifesting as unilateral eyelid erythema and swelling

    Directory of Open Access Journals (Sweden)

    Yi-Fang Wu

    2012-03-01

    Full Text Available Unilateral eyelid involvement, as the only manifestation of discoid lupus erythematosus (DLE, is very rare. Here, we report the case of a 41-year-old woman who presented with erythema and swelling of her left upper eyelid, which was initially misdiagnosed as cutaneous lymphoid hyperplasia. She had initially received radiotherapy at another institute for treatment. Our examinations established the diagnosis of DLE, and direct immunofluorescence confirmed this diagnosis. The skin lesion improved after treatment with topical steroids and oral hydroxycholoroquine.

  8. [Simple rules for orientation in transcutaneous ptosis surgery--a contribution to the surgical anatomy or: how not to get lost in the upper eyelid].

    Science.gov (United States)

    Schaudig, U; Schumacher, S

    2012-01-01

    Surgical preparation in the upper eyelid follows well defined anatomic structures. Nevertheless, even an experienced surgeon can loose orientation in the presence of fatty degeneration, oedema or bleeding. Some simple rules can help to stay oriented and identify the landmarks. The preaponeurotic fat has a distinct colour, structure and texture and is a landmark for the levator muscle lying underneath it. This defines a first simple rule: it is not preaponeurotic fat if it does not look like preaponeurotic fat. The orbital septum may weaken and allow orbital fat to prolapse, but it stays firmly attached at the upper orbital rim. A second simple rule therefore adresses its identification: if a structure does not move with inferior tension, it cannot be muscle or fat (it must be septum). Identifying the landmarks preaponeurotic fat, orbital septum and tarsus will facilitate anatomic correlation and surgical preparation. In summary: Rule No. 1--If it does not look like preaponeurotic fat, then it isn't. Rule No. 2--If it does not move with traction, it is neither muscle nor fat (but probably septum). Rule No. 3--If things get confusing, stop and consider rules 1 and 2. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Defect of the Eyelids.

    Science.gov (United States)

    Lu, Guanning Nina; Pelton, Ron W; Humphrey, Clinton D; Kriet, John David

    2017-08-01

    Eyelid defects disrupt the complex natural form and function of the eyelids and present a surgical challenge. Detailed knowledge of eyelid anatomy is essential in evaluating a defect and composing a reconstructive plan. Numerous reconstructive techniques have been described, including primary closure, grafting, and a variety of local flaps. This article describes an updated reconstructive ladder for eyelid defects that can be used in various permutations to solve most eyelid defects. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Mechanical Blepharoptosis and Eyelid Swelling Caused by Silicone Oil

    Directory of Open Access Journals (Sweden)

    Thabit A. Mustafa

    2009-01-01

    Full Text Available The purpose of this article is to report a case of upper eyelid mechanical ptosis caused by silicone oil migration in a Jordanian patient after pars plana vitrectomy and intraocular silicone oil injection. A 20-year-old male patient was referred to the oculoplastic clinic for the management of a left upper eyelid swelling and complete ptosis that developed 12 years after pars plana vitrectomy and silicone oil placement for retinal detachment secondary to perforating eye injury. Eye examination showed upper eyelid swelling and a complete ptosis induced by the weight of inflammatory tissue and silicone oil, as proved by histopathologic examination. We presumed that silicone oil had leaked through the pars plana vitrectomy ports or through a subtle traumatic perforation of the posterior segment, which might have been aggravated by increased intra-ocular pressure postoperatively. In conclusion, mechanical ptosis caused by silicone oil migration after retinal detachment surgery is rare and this is one of the few reports in the literature.

  11. Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

    Directory of Open Access Journals (Sweden)

    Apostolakis Efstratios

    2006-09-01

    Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

  12. Blepharoplasty (Eyelid Surgery)

    Science.gov (United States)

    ... lid blepharoplasty is almost always done just for cosmetic reasons. Risks Possible risks of eyelid surgery include: Infection and bleeding Dry, irritated eyes Difficulty closing your eyes or other eyelid problems Noticeable scarring Injury to eye muscles Skin discoloration ...

  13. Isolated neurofibroma of the eyelid mimicking recurrent chalazion.

    Science.gov (United States)

    Pai, H Vijaya; Abbagani, Surabhi; Jaishankar, Padma Priya

    2018-03-01

    Neurofibroma is a peripheral nerve sheath tumor which is seen in neurofibromatosis type 1 and is characterized by various ophthalmic manifestations. Solitary neurofibroma of the eyelid is rare. We report a case of a 53-year-old female patient who presented with a painless swelling in the left upper lid of 4 years' duration. She had undergone surgery for the same lesion twice. The lesion was excised and histopathological examination revealed a solitary neurofibroma. She did not have any other features of generalized neurofibromatosis.

  14. Isolated neurofibroma of the eyelid mimicking recurrent chalazion

    Directory of Open Access Journals (Sweden)

    H Vijaya Pai

    2018-01-01

    Full Text Available Neurofibroma is a peripheral nerve sheath tumor which is seen in neurofibromatosis type 1 and is characterized by various ophthalmic manifestations. Solitary neurofibroma of the eyelid is rare. We report a case of a 53-year-old female patient who presented with a painless swelling in the left upper lid of 4 years' duration. She had undergone surgery for the same lesion twice. The lesion was excised and histopathological examination revealed a solitary neurofibroma. She did not have any other features of generalized neurofibromatosis.

  15. Eyelid Squamous Cell Carcinoma in a Dog

    Directory of Open Access Journals (Sweden)

    Chang-hyun Song1§, Sae-kwang Ku2§, Hwan-soo Jang3, Eun-young Kye, Sung-ho Yun, Kwang-ho Jang and Young-sam Kwon*

    2012-06-01

    Full Text Available A 10-year-old, female, Yorkshire Terrier was presented with a left lower eyelid mass. No other abnormality was detected on affected eye in a general eye examination. The mass was surgically removed and histologically diagnosed as a squamous cell carcinoma. The advancement flap used in this case may be an appropriate therapeutic choice for eyelid squamous cell carcinoma in dogs.

  16. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    International Nuclear Information System (INIS)

    Oguz, Berna; Haliloglu, Mithat; Alan, Serdar; Ozcelik, Ugur

    2009-01-01

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  17. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Berna; Haliloglu, Mithat [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Alan, Serdar; Ozcelik, Ugur [Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara (Turkey)

    2009-09-15

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  18. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion.

    Science.gov (United States)

    Onesti, Maria Giuseppina; Troccola, Antonietta; Maruccia, Michele; Conversi, Andrea; Scuderi, Gianluca

    2013-01-01

    Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion.

  19. The Measurement of Palpebral Fissure Height Using the Intersection Angle (the Réal Angle) Between the Meeting Points of the Upper Eyelid and the Edge of the Cornea.

    Science.gov (United States)

    Lee, Hun Joo; Kim, Soo Shin

    2017-06-01

    We evaluated a new palpebral fissure height measurement to evaluate medial, lateral, and overall ptosis. We photographed 250 Koreans (44 males, 206 females) and evaluated their Réal 1 angle (angle between the meeting points of the upper eyelid and the corneal edge), Réal 2 angle (angle between the meeting point of the upper eyelid, medial corneal edge and a vertical line through the center of the pupil), Réal 3 angle (angle between the meeting point of the upper eyelid, lateral corneal edge and a vertical line through the center of the pupil), and Réal 4 angle (Réal 2-Réal 3). Angles were compared between sexes and age groups. We then evaluated the Réal angles of 13 Korean actresses. Mean age was 31.85 ± 14.60 years; Réal 1 was 129.01° ± 14.23°, Réal 2 was 68.20° ± 7.49°, Réal 3 was 60.80° ± 9.65°. There was no significant difference between the sexes in Réal 1, Réal 2, and Réal 3 angles. Réal 1 increased with age, and Réal 4 decreased with age. All Réal angles were significantly different between age groups. The actresses' mean age was 30.66 ± 8.01 years; Réal 1 was 102.84° ± 10.16°, Réal 2 was 57.87° ± 6.10°, and Réal 3 was 44.97° ± 8.74°. This simple measurement of palpebral fissure height using Réal angles consistently evaluated the amount of medial, lateral, and general ptosis. For average Korean eyes, the lateral portion of the upper eyelid is slightly higher than the medial portion; however, this lateral portion droops with age. Korean actresses have vertically higher eyes than average Korean women. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  20. Eyelid Retraction in Isolated Unilateral Congenital Blepharoptosis

    Directory of Open Access Journals (Sweden)

    Michael S. Salman

    2017-05-01

    Full Text Available Isolated unilateral congenital ptosis is encountered relatively infrequently in clinical practice. It typically consists of a unilateral droopy eyelid, weak levator palpebrae superioris muscle function, lid lag, and an absent upper lid crease with no other abnormalities on examination. We present a four-and-a-half-year-old girl with isolated and mild unilateral congenital ptosis who unexpectedly demonstrated a static upper eyelid on downgaze in conjunction with a well-formed upper lid skin crease. We attribute this uncommon sign in congenital ptosis to stiffness and presumed fibrosis of the levator muscle. Examining the function of the eyelids in all directions of gaze is important in patients with abnormalities of lid position, since additional useful information can be gleaned about the status of the levator muscle including, aberrant regeneration or fibrosis.

  1. Subclavian flap aortoplasty and preservation of left upper extremity circulation using an interposition graft.

    Science.gov (United States)

    Zarrabi, Khalil; Ghaffarpasand, Fariborz; Zamiri, Nima; Ostovan, Mohammad Ali

    2012-05-01

    To introduce a surgical technique to maintain left upper limb blood flow after subclavian flap aortoplasty (SFA). Five patients (9 to 23 months of age) with a diagnosis of long-segment aortic coarctation underwent conventional SFA. A Gore-tex graft was interposed between the stump and the proximal descending aorta to maintain perfusion of subclavian artery. All patients had a patent Gore-tex graft and normal blood flow of the subclavian artery and left upper limb. One patient expired and four others were discharged with a mean follow-up of 48 months. On follow-up all patients had normal development of the left upper limb and no signs of limb ischemia. Echo findings revealed normal arch flow with normal flow in the Gore-tex graft and left upper extremity. Interposing a Gore-tex graft between the subclavian artery stump and proximal descending aorta concomitant with SFA can be safely performed in infants with long-segment aortic coarctation, with preservation of left upper extremity circulation. © 2012 Wiley Periodicals, Inc.

  2. Combined eyelid and strabismus surgery: examining conventional surgical wisdom.

    Science.gov (United States)

    McCracken, Michael S; del Prado, Jonathan D; Granet, David B; Levi, Leah; Kikkawa, Don O

    2008-01-01

    To determine whether satisfactory results of both eyelid surgery and strabismus surgery can be obtained when these procedures are performed in the same setting in selected patients. Nine patients (16 eyelids) who had undergone surgery in the same setting for eyelid malposition and strabismus of the horizontal rectus muscles, with or without concurrent vertical rectus muscle surgery, were retrospectively reviewed. Eyelid malposition surgery success was defined as a postoperative margin reflex distance (MRD1) within 1 mm of the target. Strabismus surgery success was defined as a postoperative deviation within 8 prism diopters of orthophoria or a decrease in binocular diplopia if the patient had a less than 8 prism diopters deviation in primary gaze preoperatively. Eyelid retraction repair was performed on 13 upper eyelids, levator advancement was performed on 2 eyelids, and frontalis suspension was performed on 1 eyelid. Four patients underwent bilateral medial rectus recession and the remaining 5 patients received varying strabismus surgery. Four patients received adjustable sutures. Mean follow-up was 11 months. Postoperatively, 13 of 16 eyelids (81%) achieved an MRD1 within 1 mm of the target. Eight of 9 patients (89%) demonstrated satisfactory strabismus correction. Combined eyelid malposition and strabismus surgery can be successfully performed in selected cases, particularly when the strabismus surgery involves the horizontal rectus muscles. Combined surgery is not recommended in cases that do not involve the horizontal rectus muscles.

  3. Treatment of Extensive Eyelid Molluscum Contagiosum with Physical Expression Alone in an Immunocompetent Child

    Directory of Open Access Journals (Sweden)

    Gamze Öztürk Karabulut

    2014-03-01

    Full Text Available Molluscum contagiosum is a common viral skin infection in children with dome-shaped umbilicated nodules. Diagnosis is based on clinical appearance. An eight-year-old child presented to our clinic with multiple molluscum contagiosum nodules on the right lower and upper eyelid and one small papule on the left upper eyelid. Only a couple of lesions were squeezed with expression of cheesy material from the center of the lesions. In the follow-up period, beside resolution of the squeezed lesions, all other lesions disappeared spontaneously and no new lesion was observed in the following one year. This method is costless, neither needs a chemical agent nor results in scarring, so can be the first choice of treatment. (Turk J Ophthalmol 2014; 44:158-60

  4. Recurrent sebaceous gland carcinoma of eyelid previously diagnosed as basal cell carcinoma: case report.

    Science.gov (United States)

    Kan, Li-Wei; Leu, Yi-Shing; Tzen, Chi-Yuan; Wu, Chien-Hsiu

    2011-01-01

    Sebaceous gland carcinoma (SGC) of the eyelid is a highly malignant neoplasm that arises from the meibomian glands, glands of Zeis, and sebaceous glands of the skin. The characteristics of this disease are high recurrence rate, significant metastatic potential, and notable mortality rate, which are quite different from basal cell carcinoma (BCC). We report the case of a 37-year-old woman with the history of left lower eyelid BCC (diagnosed 9 years ago), who had left parotid lymph nodes metastases and local recurrence twice. The chief complaint during visit was a left upper eyelid swelling mass noted for 3 months. She received salvage ablation surgery later. The final pathologic report is SGC. The diagnosis corresponds to the clinical presentation of this patient at last. The delay between initial examination and final diagnosis in this patient is about 9 years, but operation and concurrent chemotherapy and radiotherapy were performed after left parotid lymph nodes metastasis was noted. Although there was still local recurrence after concurrent chemotherapy and radiotherapy, the patient is still alive without distant metastasis. In this article, we would discuss the differences of the pathologic characters, treatment, and prognosis between SGC and BCC. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  5. Oriental eyelids. Anatomic difference and surgical consideration.

    Science.gov (United States)

    Liu, D; Hsu, W M

    1986-01-01

    Fashions change with time and beauty standards differ in different cultures. In recent years, there has been an increase in the number of immigrants to the United States from the Orient. The creation of an upper eyelid crease has been for the past several decades the most popular cosmetic procedure in many Asian countries. In order to perform this procedure to the satisfaction of an Oriental patient, the surgeon must know what the patient perceives as beautiful and the anatomic differences between the Oriental and the Occidental eyelids. In this paper with data collected from over 3,600 patients, we are presenting important statistics that enables the surgeon to understand better the Oriental mind and facilitate communications. The anatomic difference in the upper eyelid is also discussed.

  6. Eyelid verrucous carcinoma.

    Science.gov (United States)

    Monescillo, J; Mencía-Gutiérrez, E; Gutiérrez-Díaz, E; Santos-Bríz, A; Rodríguez-Peralto, J L

    2002-01-01

    To report a case of verrucous carcinoma (VC) that presented as an eyelid mass on the right eye. A 66-year-old man developed a slow-growing eyelid lesion on the lateral canthus of the right eye. The tumor was firm, well-defined, sessile, acuminate, and exuded foul-smelling fluid. Excisional biopsy revealed a VC. The patient remains asymptomatic. VCs are extremely rare eyelid tumors. This clinicopathological entity is a low-grade variant of squamous cell carcinoma that occurs mainly in the intraoral, genitogluteal, and plantar areas. A role of human papillomavirus (HPV) in these tumors has been recently identified. VCs characteristically show locally aggresive growth. This is the second case reported in the literature on the eyelid. VC should be considered in the differential diagnosis of eyelid tumors.

  7. TYPES, CAUSES AND TREATMENT OF EYELID TRAUMA

    Directory of Open Access Journals (Sweden)

    Mateja Naji

    2004-05-01

    Full Text Available Background. Eyelid trauma is a common cause of visit to the ophthalmologist, but there are just a few recent epidemiological studies. Purpose of our study was to analyse eyelid injuries according to the mechanism of injury, causes of eyelid injuries and different types of treatment.Methods. A retrospective review of data from patients who received surgical treatment for eyelid injuries at the Ophthalmology Department, Maribor General Hospital in 2000 and 2001 was carried out. Eyelid injuries were divided into a minor trauma with patients treated as outpatients and major trauma patients who needed hospital treatment. According to the mechanism of injury eyelid injuries were divided into a blunt trauma, sharp trauma and combination of both. They according to the localisation injuries were divided into injuries of upper lid, lower lid and both lids at the same time. We looked for causes of eyelid injuries, accompanying injuries and different types of treatment of eyelid injuries.Results. Out of 295 patients 239 were men (81% and 56 were women (19%. 27 patients (9% suffered major trauma and needed hospitalisation while 268 suffered minor trauma and they were treated as outpatients (91%. Blunt trauma was present in 195 cases (66%, sharp trauma was present in 40 cases (14% and in 60 cases (20% the injury was combination of sharp and blunt trauma. The most common causes were sudden falls in 89 cases (30%, followed by violence in 85 cases (29%. 215 patients (73% clinically showed injury of upper lid, 46 patients (16% showed injury of the lower lid and in 34 cases (11% both lids were injured. Accompanying injury of the eyeball was present in 138 patients (47% and face injuries in 17 patients (6%.251 patients (85% needed skin sutures, 6 patients (2% needed skin and subcutaneous tissue suturing, lid margin was treated in 33 cases (11% and canaliculus was treated in 5 cases (2%.Conclusions. Results of our study showed that eyelid injuries were more frequent

  8. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    International Nuclear Information System (INIS)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun

    2017-01-01

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location

  9. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2017-08-15

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location.

  10. Lymphoma of the eyelid

    DEFF Research Database (Denmark)

    Svendsen, Frederik Holm; Heegaard, Steffen

    2017-01-01

    lymphomatoid papulosis has a female predominance. Signs of B-cell and T-cell lymphomas are tumor and swelling of the eyelid. Ulceration and erythema occur frequently among patients with T-cell lymphoma. Radiotherapy with or without surgery is the treatment of choice for low-grade, solitary lymphomas, whereas......Lymphoma of the eyelid constitutes 5% of ocular adnexal lymphoma. In previously published cases, 56% of lymphomas of the eyelid are of B-cell origin and 44% are of T-cell origin. The most frequent B-cell lymphomas are extranodal marginal zone lymphoma (27 cases-14%) and diffuse large B...

  11. Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

    International Nuclear Information System (INIS)

    Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

    1996-01-01

    To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

  12. Topiramate-Induced Persistent Eyelid Myokymia

    Directory of Open Access Journals (Sweden)

    Mohammadrasoul Khalkhali

    2016-01-01

    Full Text Available Background. Topiramate (TPM is a psychotropic drug, which is used mainly as an antiepileptic drug and now over the years is used for a wider range of indications, including migraine prophylaxis and binge eating disorders. Although ocular side effects of Topiramate have been frequently reported, neuroophthalmologic manifestations such as myokymia are rarely reported. Case Presentation. This case report presents a case of a 47-year-old woman who had begun TPM for binge eating problem. She developed unilateral long standing lower eyelid twitching, which progressed to upper eyelid and eyebrow at the same side. The patient was not a smoker or excessive alcohol or caffeine abuser. Increasing the resting time and changing life style made no significant changes in her eyelid twitching. There was no definite evidence by neuroimaging and clinical or laboratory evaluations causing eyelid myokymia. The symptoms resolved with discontinuation of TPM. Conclusion. Although eyelid myokymia is a benign and self-limited condition, it sometimes becomes a source of distress in chronic long standing cases. Physicians should be aware of the neuroophthalmologic side effects of this drug.

  13. Entrópio congênito primário da pálpebra superior Congenital primary entropion of the upper eyelid

    Directory of Open Access Journals (Sweden)

    Taliana Freitas Bernardes

    2009-02-01

    Full Text Available O entrópio congênito primário da pálpebra superior é mais raro que o da pálpebra inferior. O diagnóstico no neonato, apesar de ser difícil, é imprescindível. O seu reconhecimento precoce exige a correção cirúrgica imediata, pois essa é uma condição que não melhora espontaneamente, podendo levar a úlceras de córnea com nefastas conseqüências para a visão. Várias técnicas cirúrgicas têm sido descritas para correção da deformidade. Na análise e comparação dos dados do pré, per e pós-operatório do presente caso com os descritos na literatura, é enfatizada a importância da retração da lamela posterior da pálpebra no mecanismo etiopatogênico. Com o tempo de seguimento de 34 meses, os autores apresentam o resultado e descrevem o procedimento realizado, que consistiu no deslocamento do músculo orbicular pré-tarsal e da aponeurose do músculo elevador da pálpebra superior para a área pré-septal após terem sido desinseridos da face anterior do tarso.The primary congenital entropion of the superior eyelid is more infrequent than the one of the inferior eyelid. The premature diagnosis of this deformity in newborns, although difficult, is very necessary because implies an immediate surgical correction as it is a condition that does not recover spontaneously even leading to corneal ulceration with disastrous consequences for the vision. Many surgical techniques have been described to correct this malformation. The analysis and confrontation of the pre, per and postoperative data of the current case with the ones present in the literature emphasizes the importance of the retraction of the eyelid's posterior lamella in the etiopathogenesis mechanism. With the follow-up period of 34 months the authors present the results and describe the procedure taken, which consisted in the transplantation of the pretarsal orbicular muscle and of the aponeurosis of the levator muscle for the preseptal region after being removed

  14. Case report 373: Diametaphyseal chrondroblastoma of the upper portion of the left femur

    Energy Technology Data Exchange (ETDEWEB)

    Sotelo-Avila, C.; Sundaram, M.; Graviss, E.R.; Kyriakos, M.; Tayob, A.A.

    1986-06-01

    In summary, a case has been presented of a chondroblastoma of the diametaphysis of the upper end of the left femur in an 11-year-old girl. Despite its atypical location, the tumor proved to be a characteristic chondroblastoma on microscopic examination. The literature was reviewed comprehensively and it was noted that 12 examples of chondroblastoma arising outside an epiphysis (or apophysis) were noted. (orig./SHA).

  15. Spitz nevus arising in the eyelid of a teenager.

    Science.gov (United States)

    Shields, Patrick W; Jakobiec, Frederick A; Stagner, Anna M; Yoon, Michael K

    2016-01-01

    A 16-year-old boy developed over a 2-month interval a lightly pigmented left upper eyelid lesion measuring 1.5 mm in greatest diameter that, when excised, microscopically was hypercellular and composed almost exclusively of nonpigmented epithelioid cells that created florid, large intraepidermal junctional nests and sheets and nests of subepidermal cells. The diagnosis was a Spitz nevus. HMB-45, MART-1, and microphthalmia-associated transcription factor were all positive and established the melanocytic nature of the benign tumor. The Ki-67 proliferation index (5%) and 2 mitoses/mm(2) were both low; p16 protein was immunohistochemically identified in the nevoid cells. We review the clinical, histopathologic, and other immunohistochemical features of this entity and provide a brief differential diagnosis (including separation from a Spitzoid melanoma). This is only the third eyelid Spitz nevus reported in the literature and is the most fully characterized immunohistochemically. At their present stage of development, contemporary immunohistochemical biomarkers, while providing supplemental information, nonetheless remain less than definitive in terms of reliably distinguishing benign from malignant Spitz lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Eyelid nonbullous impetigo

    Directory of Open Access Journals (Sweden)

    Rafael Corredor-Osorio

    2016-07-01

    Full Text Available We report an unusual case of nonbullous impetigo of the eyelid. A 21-year-old woman had a painless eruptions right eyelid and around nostril. Clinical examination revealed eyelid nonbullous impetigo. The patient was otherwise healthy. Any minor trauma or skin problems there were not founded. Staphylococcus aureus was isolated from the lesions. Complete resolution was achieved with oral cephalexin an ointment tobramycin. Impetigo nonbullous occurs commonly on the face of children but it might be developed in healthy adults even those was not necessary evidenced previous trauma or dermal infiltrate with pus or any other active cutaneous injury as this case is demonstrated. The treatment of impetigo around the eye included a careful examination of the segment anterior and the application de topical measures with oral and topical antibiotics. The case is being reported in view of its rarity and unusual location.

  17. Melkersson-Rosenthal Syndrome Presenting as Chronic Eyelid Swelling.

    Science.gov (United States)

    Kondratiev, Svetlana; Heher, Katrinka; Baker, Brad J; Laver, Nora V

    2010-03-09

    Melkersson-Rosenthal Syndrome (MRS) is a rare disorder characterized by orofacial edema, facial palsy, and fissured tongue. A 64-year-old man presented with a fissured tongue and persistent chronic right upper eyelid edema of 15 years duration. The diagnostic biopsy revealed non-necrotizing granulomatous inflammation adjacent to blood and lymphatic vessels. Characteristic granulomas with focal occlusion of dilated lymphatic channels were present. Special stains for fungi, acid-fast microorganisms and bacteria were negative. Ptosis due to a mechanical effect of the persistent eyelid edema required surgical treatment including debulking and advancement of the levator muscle. At 6 months after surgery the patient showed symmetrical eyelid position without edema. The case demonstrates an uncommon presentation of Melkersson-Rosenthal syndrome with prominent upper eyelid edema and lingua plicata, which was initially misdiagnosed. The clinical findings coupled with the characteristic granulomatous lymphangitis present in the biopsy are crucial for a definite diagnosis. Copyright 2010, SLACK Incorporated.

  18. Malignant melanoma of the eyelid in a red squirrel (Sciurus vulgaris orientis).

    Science.gov (United States)

    Fukui, Daisuke; Bando, Gen; Kosuge, Masao; Yamaguchi, Masanori; Shibahara, Tomoyuki; Kadota, Koichi

    2002-03-01

    A 6-year-old male red squirrel (Sciurus vulgaris orientis) developed bilateral tumors of upper and lower eyelids. The tumors in the left lid recurred despite surgical removal. Necropsy revealed metastasis to the lung. The neoplastic cells were epithelioid and highly pleomorphic, and only a few cells contained melanin granules. Occasionally melanoma cells were immunoreactive for S100, neuron-specific enolase and vimentin, and a small number of cells for cytokeratin. Ultrastructurally, the presence of premelanosomes was confirmed in the cytoplasm. Possible presence of cytokeratin-positive neoplastic melanocytes should be taken into account when differentiating a nonpigmented epithelioid melanoma from other tumors such as anaplastic carcinomas.

  19. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  20. Trichilemmal Cyst of the Eyelid: Masquerading as Recurrent Chalazion

    OpenAIRE

    Meena, Manju; Mittal, Ruchi; Saha, Debarati

    2012-01-01

    A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis...

  1. Effects of chalazia on corneal astigmatism : Large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism.

    Science.gov (United States)

    Jin, Ki Won; Shin, Young Joo; Hyon, Joon Young

    2017-03-31

    A chalazion is a common eyelid disease that causes eye morbidity due to inflammation and cosmetic disfigurement. Corneal topographic changes are important factors in corneal refractive surgery, intraocular lens power calculations for cataract surgery, and visual acuity assessments. However, the effects of chalazia on corneal astigmatism have not been thoroughly investigated. The changes in corneal astigmatism according to chalazion size and location is necessary for better outcome of ocular surgery. The aim of this study is to evaluate changes in corneal astigmatism according to chalazion size and location. In this cross-sectional study, a total of 44 eyes from 33 patients were included in the chalazion group and 70 eyes from 46 patients comprised the control group. Chalazia were classified according to location and size. An autokeratorefractometer (KR8100, Topcon; Japan) and a Galilei™ dual-Scheimpflug analyzer (Ziemer Group; Port, Switzerland) were utilized to evaluate corneal changes. Oblique astigmatism was greater in the chalazion group compared with the control group (p chalazion group (p chalazion group, whole area group, and large-sized chalazion group (p Chalazion should be treated before corneal topography is performed preoperatively and before the diagnosis of corneal diseases.

  2. A 64-year-old woman with a left upper-lung field lobulated mass.

    Science.gov (United States)

    De Dios, Jose Angelo; Javaid, Adnan; Mesologites, Thalia; Lahiri, Bimalin

    2011-04-01

    Pulmonary mucinous cystic neoplasia (PMCN) is an uncommon primary lung malignancy. Approximately 80 cases have been reported in the literature. We describe a case and review the literature on this malignancy. Our patient was asymptomatic and presented with a left upper-lung field lobulated mass. Primary PMCN is a spectrum of mucinous cystic lesions that should be considered as a separate lung tumor entity due to its unique morphologic features and its distinct clinical behavior. Prognosis is generally better than other more common lung malignancies.

  3. Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives.

    Science.gov (United States)

    Suzuki, Natsuko; Suzuki, Keisuke; Mizuno, Tomofumi; Kato, Yukari; Suga, Norihiro; Yoshino, Masabumi; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2016-01-01

    A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being well-controlled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.

  4. Lymphoma of the Eyelid

    DEFF Research Database (Denmark)

    Svendsen, Frederik Holm; Rasmussen, Peter Kristian; Coupland, Sarah E.

    2017-01-01

    . The cases included primary and secondary lymphomas affecting the eyelid. Overall survival, disease-specific survival (DSS), and progression-free survival were the primary endpoints. Results Eighty-six patients were included. Mean age was 63 years and 47 (55%) were male. Non-Hodgkin B-cell lymphomas......Purpose To document subtype-specific clinical features of lymphoma of the eyelid, and their effect on patient outcome. Design Retrospective observational case series. Methods Patient data were collected from 7 international eye cancer centers from January 1, 1980 through December 31, 2015...... constituted 83% (n = 71) and T-cell lymphomas constituted 17% (n = 15). The most common subtypes were extranodal marginal-zone lymphoma (EMZL) (37% [n = 32]), follicular lymphoma (FL) (23% [n = 20]), diffuse large B-cell lymphoma (DLBCL) (10% [n = 9]), mantle cell lymphoma (MCL) (8% [n = 7]), and mycosis...

  5. Anthrax of the eyelids.

    Science.gov (United States)

    Amraoui, A.; Tabbara, K. F.; Zaghloul, K.

    1992-01-01

    Anthrax is a disease caused by Bacillus anthracis. The disease affects primarily herbivores including sheep, cattle, horses, and other domestic animals. Humans may rarely be affected. We examined one male and two female patients with a localised itchy erythematous papule of the eyelid. A necrotising ulcer formed in each of the three cases resulting in a black lesion. Scraping in each case showed Gram positive rods and culture grew Bacillus anthracis. All three patients responded to the intravenous administration of penicillin G, and the lesion resolved leaving scars in two cases. Anthrax is a rare disease but should be considered in the differential diagnosis of ulcers or pustules of the eyelids. Images PMID:1486081

  6. [The aging eyelid].

    Science.gov (United States)

    Press, U P

    2010-01-01

    Surgery of the aging eyelid makes great demands on the oculoplastic surgeon regarding preoperative diagnostics as well as choosing the ideal surgical method. This is not only important regarding reconstructive anatomic function but also for aesthetic aspects. This paper gives a résumé of modern diagnostics and therapy of the involutional syndrome of the eyelid. Treating ptosis of the eyebrow, blepharoplasty, blepharoptosis as well as malposition of the lower lid such as ectropion and entropion not only has an impact on the visual system but also on the individual facial features. Considering and treating this makes the highest demands on the oculoplastic surgeon to consider and treat the above problens in order to achieve ideal results. (c)Georg Thieme Verlag KG Stuttgart New York.

  7. Radiotherapy for eyelid cancer

    International Nuclear Information System (INIS)

    Saika, Kazumi

    2001-01-01

    Some studies on radiotherapy for eyelid cancer have been reported, but the optimal radiation doses for different histological types and tumor sizes have not been detailed. So I studied the optimal radiation doses in radiotherapy for eyelid cancer. The patients were fourteen and histological diagnoses were made on the basis of biopsies or surgery before radiotherapy. Surgical cut margins were positive in 10 cases. In 5 of these cases, tumors were visible. There were 9 sebaceous adenocarcinomas (SAC), 4 squamous cell carcinomas (SCC), and 1 basal cell carcinoma (BCC). In 13 of 14 cases, radiation was applied to eyelids in which tumor-surgical cut margin distances were 3 mm or less. The eyeballs were covered with lead or tungsten shields, and the eyelids were irradiated with a total dose of 50 to 66.6 Gy. In 5 cases, radiation was applied prophylactically for ipsilateral pre-auricle lymph node areas. 11 of 13 cases were locally controlled. I gave greater radiation doses for SAC than for SCC or BCC. I also gave greater doses for in visible tumors than for invisible ones. In the acute phase dermatitis, inflammation of the cornea, conjunctivitis, etc. occurred but they were mild. Later reactions were decreased cilia, dry eye, inflammation of cornea, conjunctivitis, discomfort of the scar, etc. Cataracts were also seen, but they were of senile origen. Because 81.8% of the tumors were controlled, this radiation method was useful with salvage therapies to select an optimal radiation dose according to the differences among histological types and tumor sizes. 60% of visible tumors were also controlled so I think that radical therapy using radiation alone is possible. (author)

  8. [Ecthyma gangrenosum of the eyelid after chickenpox].

    Science.gov (United States)

    Ouédraogo, M-S; Korsaga Somé, N; Tapsoba, G-P; Ouédraogo, A-N; Sondo, K-A; Inouss, I-A; Sanou, M-L; Konsem, T; Sakandé, J; Barro Traoré, F; Niamba, P; Traoré, A

    2016-10-01

    Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox. Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability. There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. [Chalazion mimicking an eyelid tumor].

    Science.gov (United States)

    D'hermies, F; Fayet, B; Meyer, A; Morel, X; Halhal, M; Elmaleh, C; Azan, F; Behar-Cohen, F; Renard, G

    2004-02-01

    A 3-year-old girl had a tumor growing for a month on the superior right eyelid, attached on the free margin of the eyelid and partially necrotic. A surgical excision was performed under general anesthesia. The histopathological study found an inflammatory lesion with epithelioid and giant cells, evidence of a granuloma, suggesting the diagnosis of chalazion. This case shows the various clinical presentations of this common and benign disease of the eyelid.

  10. Paragonimus kellicotti Presenting With Hemoptysis and a Left Upper Lobe Mass.

    Science.gov (United States)

    Horn, Christopher B; Patel, Nikhil R; Hawasli, Jennifer A; Edwards, Melanie A

    2016-11-01

    A 46-year-old man presented to the thoracic surgery clinic with a 6-month history of cough and hemoptysis refractory to treatment. Examination of specimens from repeated biopsies was nondiagnostic, so the patient underwent video-assisted thoracoscopic left upper lobe wedge resection. Pathologic examination revealed Paragonimus organisms, and the patient was prescribed praziquantel, with resolution of his symptoms. Although Paragonimus infections are common in Asia, they are rare in the United States despite P kellicotti being endemic. Clinicians should have a high index of suspicion for patients presenting with unusual lung symptoms in endemic areas to avoid prolonged evaluations with potentially unnecessary diagnostic modalities. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Prostaglandin-Associated Periorbital Lipodystrophy in Cosmetic Eyelid Surgery: A Novel Cause of Facial Asymmetry.

    Science.gov (United States)

    Eftekhari, Kian; Mifflin, Mark D; Anderson, Richard L

    2016-03-01

    A 70-year-old woman presented to our practice with profound ptosis of the left upper eyelid and notable asymmetry of the periocular area. On examination, she was noted to have significant atrophy of the periocular tissues on the left side, with lower eyelid retraction. These features were present but less severe on the right side. Upon further questioning, she stated that she had cataract surgery on the left side that was complicated by a high intraocular pressure and required subsequent secondary surgery. She had taken a prostaglandin eyedrop for many months after her cataract surgery to keep the eye pressure low. Recently, a newly recognized adverse effect of prostaglandin eyedrops has been described in the ophthalmic literature in which patients develop periorbital lipodystrophy. This case emphasizes that this may occur unilaterally in patients taking the eyedrop in only one eye, and should be recognized prior to considering functional and aesthetic surgery of the periocular area. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  12. Total Reconstruction of Lower Eyelid in a Post-traumatic Patient ...

    African Journals Online (AJOL)

    different for upper and lower lids, as the functionality of the two lids differ. There are numerous methods of reconstruction of the eyelids. In this article, we describe a case of posttraumatic reconstruction of lower eyelid and periorbital area using a modification of the Fricke's flap. CASE REPORT AND SURGICAL. TECHNIQUE.

  13. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

    Directory of Open Access Journals (Sweden)

    A. Novo Torres

    2006-09-01

    y por tanto la recuperación es mas rápida; posibilita también la cirugía de rescate en caso de correcciones insuficientes y evita el problema de sobrecorrección con exceso de resección de tejido conjuntival. En resumen se trata de una modificación quirúrgica que facilita la técnica, disminuye las complicaciones postoperatorias, mejora la recuperación y evita la sensación de cuerpo extraño intraocular de una resección conjuntivalBlepharoptosis is the abnormally low of the top eyelid during the direct look. Best results are obtained by resection or advance of the elevator muscle or aponeurosis, whenever the elevator has a suitable function. We present a modification to the Blaskovics´s technique for correction of moderate blepharoptosis, with good function of the elevator muscle. We present a serie of 10 cases where we used a variant of Blaskovics’s technique of resection of the elevator for surgical correction of ptosis. Seven were bilateral cases and 3 unilateral ones. In all the cases the elevator function was between 4 and 8 mm and ptosis was major than 4mm with visual field decrease in the direct look. Surgical technique included a cutaneous horizontal incision of Blepharoplasty, wide exhibition of elevator muscle and aponeurosis, respecting orbicular fatty bags and separating it from the palpebral conjunctive. In all the cases correction of the ptosis were obtained. The grade of asymmetry was lower than 0,3 cm. One case presented in the inmediate postoperatory opening of the suture in his medial side and had to be re-taken after 10 days. The palpebral postoperative edema was solved between 2 – 8th day allowing evaluation in that moment. Patient’s satisfaction was good or very good and the visual field was complete in all patients Classic surgical techniques and its modifications for correction of ptosis keep on being valid. With this modification that respects conjuctive we avoid to add morbidity to the surgical process. We think that

  14. Overlapping of Sturge-Weber Syndrome and Klippel-Trenaunay Weber Syndrome With Upper Limb Involvement

    Directory of Open Access Journals (Sweden)

    Hossein Ali Ebrahimi

    2016-05-01

    Full Text Available Introduction The phakomatoses are a group of clinical disorders that are linked. Overlap between Sturge-Weber syndrome (SWS and Klippel-Trenaunay Weber syndrome (KTWS is very rarely. We presented a case of SWS with KTWS that involved upper limb. Case Presentation A 24- year-old male with extensive port-wine staining over left side of his face, extending to lower eyelids, cheeks, neck and left upper extremity. The size of mid arm circle in left side was 34 cm and in right side was 27 cm. Conclusions This is a case of overlap SWS and KTWS that involved upper limb.

  15. Posicionamento palpebral superior e inferior em diferentes graus de rotação ocular ao longo do meridiano vertical Upper and lower eyelid position in different degrees of downgaze and upgaze

    Directory of Open Access Journals (Sweden)

    Dante Augusto Mastropietro

    2009-12-01

    Full Text Available OBJETIVO: Quantificar a relação entre o posicionamento do olho e das pálpebras, em diferentes posições do olhar, ao longo do meridiano vertical, em indivíduos normais. MÉTODOS: Foi quantificada a posição das pálpebras superior e inferior e do olho, de dez indivíduos normais, por meio do processamento da imagem da fenda palpebral usando o programa NIH Image. Foram medidas as distâncias margem-centro pupilar superior e inferior em sete posições do olhar ao longo do meridiano vertical, ou seja -30, -20, -10, 0, +10, +20 e +30 graus (sinais: negativos infraducção e positivos supraducção. RESULTADOS: Em relação à distância margem superior-centro da pupila, nota-se que o maior valor é obtido na posição primária do olhar, ou seja, tanto quando se olha para cima, como para baixo, essa distância diminui. A redução na distância margem superior-centro da pupila é um pouco maior no olhar para cima. Em relação à distância margem inferior-centro da pupila, nota-se que o valor é maior no olhar para cima e menor no olhar para baixo, em relação à posição primária do olhar. No que tange à fenda palpebral, pode-se notar que no olhar para cima a fenda aumenta até 20 graus de rotação ocular. No olhar para baixo, ela diminui. CONCLUSÃO: Os dados do presente trabalho mostram que a altura da fenda palpebral varia de acordo com a amplitude da mirada vertical e que considerações sobre o valor da magnitude da distância entre a margem palpebral e o centro da pupila devem levar em conta o grau de rotação ocular vertical.PURPOSE: To quantify the relation between eye and eyelids placement in different positions during downgaze and upgaze in healthy subjects. METHODS: The position of the eye and eyelids of 10 healthy individuals was quantified by palpebral fissure image processing with NIH Image software. Upper and lower mid-pupil margin distance was measured in 7 positions: -30, -20, -10, 0, +10, +20 and +30 degrees

  16. [Cosmetic eyelid surgery].

    Science.gov (United States)

    Ruban, J-M; Barbier, J; Malet, T; Baggio, E

    2014-01-01

    Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Early-stage mucinous sweat gland adenocarcinoma of eyelid

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    Nizawa T

    2011-05-01

    Full Text Available Tomohiro Nizawa1, Toshiyuki Oshitari1, Ryuta Kimoto1, Fusae Kajita1, Jiro Yotsukura1, Kaoru Asanagi1, Takayuki Baba1, Yoko Takahashi2, Takashi Oide2, Takako Kiyokawa2, Takashi Kishimoto2, Shuichi Yamamoto11Department of Ophthalmology and Visual Science, 2Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, JapanAbstract: We present the findings of an early-stage primary mucinous sweat gland adenocarcinoma in the lower eyelid of a Japanese patient. The patient was a 73-year-old man who had had a nodule on the left lower eyelid for two years. He was referred to our hospital with a diagnosis of a swollen chalazion. The clinical and histopathological records were reviewed and the mass was excised. Histopathological examination revealed a mucinous sweat gland adenocarcinoma. Postoperative magnetic resonance imaging and positron emission tomography excluded systemic metastases. After the histopathological findings, a complete surgical excision of the margins of the adenocarcinoma was performed, with histopathological confirmation of negative margins. After the final histopathological examination, the patient was diagnosed with a primary mucinous sweat gland adenocarcinoma of the left eyelid. Six months after the surgery, no recurrence has been observed. Because the appearance of mucinous sweat gland adenocarcinoma of the eyelid is quite variable, the final diagnosis can only be made by histopathological examination. A complete surgical excision is recommended.Keywords: complete surgical excision, eyelid, initial stage, mucinous sweat gland adenocarcinoma

  18. Efeito da facectomia no posicionamento palpebral superior: comparação entre as técnicas de facoemulsificação e a extracapsular Changes in the position of the upper eyelid after cataract surgery: a comparison between phacoemulsification and extracapsular techniques

    Directory of Open Access Journals (Sweden)

    Roberto Pinto Coelho

    2003-10-01

    Full Text Available OBJETIVO: Comparar o efeito de duas técnicas de facectomia (facoemulsificação e extracapsular no posicionamento da pálpebra superior. MÉTODOS: Foi analisado o posicionamento palpebral de dois grupos de pacientes submetidos à cirurgia de catarata: facoemulsificação e extracapsular. As imagens foram digitalizadas (antes e 30 dias após a cirurgia e processadas com o programa NIH 1.62. O posicionamento palpebral foi medido em relação a uma linha horizontal que unia os cantos medial e lateral da fenda palpebral, passando pelo centro da pupila. RESULTADOS: O posicionamento palpebral foi afetado de maneira diferente segundo a técnica utilizada. Na facoemulsificação a diferença média entre a posição palpebral superior pós e pré-operatória foi de -0,54 mm. Na extracapsular esta diferença aumentou para -1,41 mm. O teste t de Student (amostras pareadas mostrou que as médias das diferenças entre os dois grupos são significativamente diferentes (p=0,0068. CONCLUSÃO: A técnica de cirurgia de facoemulsificação induziu menor variação do posicionamento palpebral em relação à cirurgia extracapsular no pós-operatório recente.PURPOSE: To compare changes in the upper eyelid position after cataract surgery with phacoemulsification and extracapsular techniques. METHODS: The upper eyelid position was measured in two groups of patients before and 30 days after cataract surgery performed with phacoemulsification and extracapsular techniques. Palpebral fissure images (before and after the cataract surgery were digitized and then processed using the NIH 1.62 software. Eyelid position was measured relative to a horizontal line passing through the pupil center and connecting both canthi of the palpebral fissure. RESULTS: The palpebral position was differently affected according to the techniques. In phacoemulsification the mean difference between eyelids position before and after surgery was -0.54 mm. In the extracapsular technique this

  19. Management of Cosmetic Eyelid Surgery Complications

    OpenAIRE

    Klapper, Stephen R.; Patrinely, James R.

    2007-01-01

    There is a broad spectrum of complications that can occur following cosmetic eyelid surgery. The experienced eyelid surgeon should be able to avoid most serious complications through proper patient selection, a comprehensive preoperative assessment and surgical plan, meticulous surgical technique, and appropriate postoperative care. The aesthetic eyelid surgeon must counsel a patient contemplating blepharoplasty surgery regarding typical expectations including edema, eyelid numbness, dry eyes...

  20. Trichilemmal cyst of the eyelid: masquerading as recurrent chalazion.

    Science.gov (United States)

    Meena, Manju; Mittal, Ruchi; Saha, Debarati

    2012-01-01

    A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion.

  1. Escherichia coli Eyelid Abscess in a Patient with Alcoholic Cirrhosis

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    Matthew Stratton

    2015-01-01

    Full Text Available Escherichia coli (E. coli is a rare cause of ocular infections and has not yet been reported as a cause of an ocular abscess. We describe the case of a 47-year-old woman with a history of alcoholic cirrhosis who presented with painful left lower eyelid swelling that did not improve with oral antibiotics. The abscess was drained and cultures were positive for E. coli. Patients with cirrhosis are at increased risk for developing E. coli bacterial infections, but to our knowledge this is the first case of an E. coli eyelid abscess reported in the literature.

  2. Trichilemmal Cyst of the Eyelid: Masquerading as Recurrent Chalazion

    Directory of Open Access Journals (Sweden)

    Manju Meena

    2012-01-01

    Full Text Available A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion.

  3. Peripheral T-cell lymphoma of the eyelid

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    Makoto Ishikawa

    2009-09-01

    Full Text Available Makoto Ishikawa, Hiroshi Watabe, Masahiro Hayakawa, Takeshi YoshitomiDepartment of Ophthalmology, Akita University Faculty of Medicine, Akita, JapanPurpose: To report a case of a 25-year-old woman with previously treated peripheral T-cell lymphoma (PTCL presenting with a recurrent lower eyelid lesion.Patients and method: Case report.Results: A 25-year-old young woman with previously treated PTCL noted an induration in the skin of her left lower eyelid. Upon diagnosis of a chalazion, antibiotic eye drops and ointments as well as steroid eye drops were administered. However, the condition worsened rapidly and swelling of the lower eyelid became remarkable. An excisional biopsy revealed that the palpebral lesion was diagnosed as recurrence of PTCL. Electron irradiation was applied as a radical treatment, and the prognosis was satisfactory without recurrence at 10 months after the last irradiation.Conclusions: Although lymphoma isolated to the ocular adnexa is rare, it should always be included in the differential diagnosis of any patient presenting with progressive swelling of the eyelid or ocular region.Keywords: peripheral T-cell lymphoma, chalazion, eyelid

  4. Nevus of the Eyelid Margin Mimicking a Malignant Melanoma

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    A. Echchaoui

    2016-06-01

    Full Text Available Nevi are a benign skin lesions commonly found on the eyelid margin, these tumors are usually pigmented and have thickness. Nevi are not typically visible at birth; they appear during childhood and often exhibit a more rapid increase in pigmentation about the time of puberty. Most eyelid nevi can be diagnosed by clinical examination; suspicious lesions should be biopsied when rapid growth, loss of eyelashes or discoloration of the nevus is noted. Eyelid nevi require treatment if malignant transformation and/or cosmetically bothersome to the patient. We report a case of a 37-year-old female patient exhibited a single cutaneous tumor at the free margin of the lower left eyelid, she noticed a dark spot on their eyelid since childhood. It was a brown, fleshy, thickened, and nodular well-circumscribed exophytic mass, measuring 6 mm in diameter; its clinical appearance argued for a possible nodular melanoma. Excisional-biopsy was performed using a full-thickness pentagonal wedge excision technique. Histopathology showed that the lesion was a benign melanocytic nevocellular nevus. The post-operative courses were uneventful with excellent cosmetic and functional result. Preventive measures (cap, sunglasses... and regular monitoring of the lesion by assessing ABCDE criteria (asymmetry, irregular borders, multiple colors, diameter ≥ 6 mm, and enlargement remain necessary to detect and rule out a possible risk of malignant melanoma.

  5. Tratamento do coloboma de pálpebra superior pela técnica de Cutler-Beard e sua associação com ambliopia: relato de caso Upper eyelid coloboma treatment with the Cutler-Beard technique and its association with amblyopia: case report

    Directory of Open Access Journals (Sweden)

    André Bezerra de Menezes Reiff

    2002-09-01

    Full Text Available Neste relato é apresentado um caso de coloboma congênito de pálpebra superior reconstruído por meio de retalho de transposição de pálpebra inferior (retalho de Cutler-Beard, com bom resultado estético e funcional. A paciente apresentou como complicação o desenvolvimento de ambliopia por privação de imagem (em função do período de oclusão visual, entre a primeira e a segunda intervenção cirúrgica, que respondeu adequadamente à terapêutica instituída. Realizou-se revisão bibliográfica, comentando-se os princípios que regem a reconstrução de defeitos da pálpebra superior, mostrando vantagens e desvantagens de cada técnica e levantou-se discussão quanto ao melhor método de reconstrução nos recém-nascidos, em função dos riscos da ocorrência de ambliopia.The authors present a case of a large congenital coloboma of the upper eyelid which was reconstructed through a transposition flap from the lower eyelid (Cutler-Beard technique, with good esthetic and functional result. The patient presented as a complication, development of deprivation amblyopia, (as a result of the time of visual axis occlusion between the first and second operation, which was solved utilizing appropriate therapy. A bibliographic review was made and the principles that rule the treatment of upper eyelid defects were commented, showing the advantages and disadvantages of each technique. Discussion was raised about the best method of reconstruction in newborns, facing the risks of occurrence of amblyopia.

  6. Eyelid reanimation with gold weight implant and tendon sling suspension: evaluation of excursion and velocity using the FACIAL CLIMA system.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego

    2013-04-01

    This study aims to analyse the efficacy of static techniques, namely gold weight implant and tendon sling, in the reanimation of the paralytic eyelid. Upper eyelid rehabilitation in terms of excursion and blinking velocity is performed using the automatic motion capture system, FACIAL CLIMA. Seventy-four patients underwent a total of 101 procedures including 58 upper eyelid gold weight implants and 43 lower eyelid tendon suspension with 27 patients undergoing both procedures. The presence of lagophtalmos, eye dryness, corneal ulcer, epiphora and lower lid ptosis/ectropion was assessed preoperatively. The Wilcoxon signed-rank test was used to compare preoperative versus postoperative measurements of upper eyelid excursion and blinking velocity determined with FACIAL CLIMA. Significance was set at p CLIMA revealed significant improvement of eyelid excursion and velocity of blinking (p CLIMA system is a reliable method to quantify upper eyelid excursion and blinking velocity and to detect the exact position of the lower eyelid. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. One-stage reconstruction technique for large congenital eyelid coloboma.

    Science.gov (United States)

    Hashish, Aiman; Awara, Amr Mahmoud

    2011-08-01

    To determine the functional and cosmetic outcome of using skin graft from prepuce (after circumcision) to reconstruct eyelids in congenital lid coloboma. Four male infants with large eyelid coloboma and marked exposure keratopathy were included. All the patients were selected from the outpatient clinic of Tanta University Eye Hospital, Egypt from March 2006 till August 2009. One-stage reconstruction was used to repair the defect. For upper eyelid coloboma, sliding tarsoconjunctival flap with a free skin graft from of skin of prepuce (after circumcision) was done.For lower lid coloboma, conjunctival dissection with reflection over the cornea with use of a free skin graft from prepuce. All infants had large unilateral defect, 3 upper lids and 1 lower lid. The cosmetic and functional outcome of using skin of the prepuce was satisfactory with good color match in all cases. Also functional and cosmetic results of tarsoconjunctival sliding flap was excellent. All the cases were followed up for a period ranged from 7 to 36 months. Tarsoconjunctival rotational flap and the use of skin of prepuce are very helpful and seems to be an adequate method of reconstruction of large eyelid defect in male patients when the usual donor sites for skin grafts are not available as in infants.

  8. The ISOLDE experimental hall, wth the isotope separator in the upper left corner.

    CERN Multimedia

    CERN PhotoLab

    1969-01-01

    Beam tubes branch out from a switchyard, which by electrostatic deflectors direct beams of short-lived isotopes to various spectroscopic equipment. From left to right, Rudi Stoeckli at the separator control panel, Gilbert Droz and Henri Bersinger.

  9. Nonsustained Repetitive Upper Septal Idiopathic Fascicular Left Ventricular Tachycardia: Rare Type of VT

    Directory of Open Access Journals (Sweden)

    Gokhan Aksan

    2016-05-01

    Full Text Available Upper septal fascicular ventricular tachycardia is a very rare form of idiopathic fascicular ventricular tachycardia. Upper septal fascicular tachycardia uses the posterior fascicle as the anterograde limb and the septal fascicle as the retrograde limb. When evaluating the electrocardiography for this form of tachycardia, the presence of narrow QRS morphology and normal axis may be misinterpreted as supraventricular tachycardia. Here, we report a very rare subtype of fascicular tachycardia that originates more proximally in the His-Purkinje system at the base of the heart.

  10. A rare site of epidermoid cyst of the eyelid

    Directory of Open Access Journals (Sweden)

    Shivanand C Bubanale

    2013-01-01

    Full Text Available Epidermoid cysts are slow- growing, benign tumors that result from proliferation of epidermal cells within a confined space. Epidermoid cysts of the eyelid typically present during adolescence through adulthood as a solitary, elevated, round, freely mobile subcutaneous mass with smooth overlying skin. The most common site for the sebaceous or epidermoid cysts is the meibomian glands of the upper tarsus due to retention of meibomian gland material. We report a case of a 32- year- old male who presented with chief complains of painless swelling on the right upper lid since 1 year. It was an extrameibomian site, i.e., at the lateral superior aspect of the eyelid. It is a rare site for the epidermoid cyst to grow to such an extent. The lesion was excised completely, and histopathology confirmed the diagnosis of epidermoid cyst.

  11. Eyelid lymphoma in a patient with a gold weight implant.

    Science.gov (United States)

    Di Nisio, L A; Croxatto, J O; Mansur, M C; Aldecoa, J P; Weil, D

    2017-04-01

    A male patient with an exposure keratopathy caused by lagophthalmos. A gold weight was implanted in the right upper eyelid. Eight months later, he presented with erythema and swelling of right upper eyelid. An incisional biopsy was performed, reporting extranodal marginal zone B cell lymphoma. when a tumour at the site of a gold weight implant is refractory to treatment, it is essential to perform an incisional biopsy to establish the histopathological diagnosis. Ocular adnexal lymphomas are relatively common. The presence of foreign material can cause chronic inflammation that could be the stimulus for the development of a lymphoproliferative disorder. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Hypertrophic scar of the conjunctiva presenting as an eyelid mass: an unusual complication after surgical treatment of a chalazion.

    Science.gov (United States)

    Son, Jun Hyuk; Choi, Joon Hyuk; Lim, Su-Ho

    2016-01-01

    To present a rare case of a conjunctival hypertrophic scar presenting as eyelid mass after surgical treatment of a chalazion. A 74-year-old man visited our clinic with severe ocular discomfort and excessive lacrimation since several months in his left eye accompanied by itching of the upper eyelid. Examination of the anterior segment revealed a 6 mm (horizontal) × 8 mm (vertical) round, immobile, hard, mushroom-shaped protruding mass on the tarsal conjunctiva of his left eye. There was no associated pigmentation, ulceration, or tenderness. Excisional biopsy of the benign conjunctival tumor was performed using radiofrequency electrosurgical systems. The region of the excised conjunctiva was well-healed on postoperative day 14, and there was no recurrence until 1 year post-surgery. Histopathological examination demonstrated thick interlacing collagenous fibrous bundles oriented in random directions and fibroblastic proliferation. Immunohistochemical staining revealed that spindle-shaped fibroblasts were positive for CD34 and negative for smooth muscle actin. The excessive collagenous tissue was stained blue by Masson trichrome stain. These findings were consistent with a hypertrophic scar of the conjunctiva. This short report demonstrates that a hypertrophic scar of the conjunctiva can develop after surgery of a chalazion and cause severe ocular discomfort and excessive lacrimation. These lesions can be easily removed using simple excision.

  13. Monopolar radiofrequency treatment of human eyelids: a prospective, multicenter, efficacy trial.

    Science.gov (United States)

    Biesman, Brian S; Baker, Sterling S; Carruthers, Jean; Silva, Hector Leal; Holloman, Erin L

    2006-12-01

    To evaluate the efficacy of a novel 0.25 cm(2) monopolar radiofrequency (RF) treatment tip for aesthetic rejuvenation of the eyelids. This was a prospective, multicenter trial in which the eyelids of 72 patients were treated. Patients underwent a single treatment session and were then followed on a serial basis for 6 months. Cutaneous anesthesia was not required to perform the treatments. Assessments were made by the treating physician, the subjects, and by masked physician observers evaluating photographs taken at each data point. Upper eyelid tightening and reduction of hooding was noted in 88 and 86% of subjects, respectively. Lower eyelid tightening was noted in 71-74% of subjects. The majority of patients treated achieved at least up to 25% improvement while a smaller percentage achieved more dramatic results. There was no correlation between the amount of energy applied to the eyelids and the clinical outcome. There were no serious adverse sequelae. Human eyelids can be safely treated with monopolar RF energy delivered via a novel 0.25 cm(2) treatment tip. Using this technology non-invasive eyelid rejuvenation was achieved in the majority of subjects treated. The factors differentiating those patients who achieve the most impressive changes from others remain unclear. Further development and testing of this technology is warranted. (c) 2006 Wiley-Liss, Inc.

  14. Frequency of Eyelid Malpositions and their Treatment Results in Patients Referred to Ophthalmology Clinics in Educational Yazd Hospitals

    Directory of Open Access Journals (Sweden)

    M Rafieian

    2012-10-01

    Full Text Available Introduction: Entropion and ectropion with involutional changes are the most common eyelid malpositions. Entropion is a condition in which the eyelid margin turns inwards against the globe and ectropion is a malposition in which the lid turns outwards or is pulled away its normal position from the globe. Knowledge of eyelid problems and their abnormalities is a key to plan a successful surgical procedure. Methods: This descriptive study lasted from Sep. 2008 to March 2009. We evaluated 78 patients with eyelid malpositions who referred to educational hospitals of Yazd. The patients were examined by an eye specialist. Each patient’s demographic data, type of eyelid malposition, specific treatment results and 6-month follow up of each patient were recorded by the questioners and then were analyzed statistically by SPSS13 software, chi-square and fisher exact test. Results: Among 78 cases, entropion was observed in 41 cases(52.6%, trichiasis in 31 cases(39.7%, ectropion in 27 cases(34.6% and distichiasis in 3 cases (3.8%. The Wies procedure proved to be influential in entropion treatment and lateral tarsal strip canthoplasty surgery also reported acceptable results in ectropion. Conclusion: The involutional changes were the most common causing factors for eyelid malpositions. Entropion appears most prevalently specially in right upper eyelid. The Wies and lateral tarsal strip canthoplasty procedures were thoroughly successful in treatment of entropion and ectropion of either upper or lower eyelids

  15. Upper face and orbit "degloving" dog bite injury.

    Science.gov (United States)

    Bergmann, Joseph; Lee, Ken; Klein, Richard; Slonim, Charles B

    2009-01-01

    A 70-year-old woman who attempted suicide lay unconscious on her floor for an unknown time period while her 2 pet dachshunds chewed her upper face and bilateral periorbital areas including all 4 eyelids, both lacrimal glands, all of the conjunctiva from both eyes, the extraocular muscles on the left side only, and anterior orbital fat from both sides. A subtotal exenteration was performed on her left orbit and a temporoparietal fasciocutaneous flap was used to reconstruct her right orbit with buccal mucosa replacing both the bulbar and palpebral conjunctiva. To the authors' knowledge, this is the first report of such extensive orbital injuries from dog bites.

  16. Strength and endurance training of an individual with left upper and lower limb amputations.

    Science.gov (United States)

    Donachy, J E; Brannon, K D; Hughes, L S; Seahorn, J; Crutcher, T T; Christian, E L

    2004-04-22

    The purpose of this article is to describe the development of a strength and endurance training programme designed to prepare an individual with a left glenohumeral disarticulation and transtibial amputation for a bike trip across the USA. The subject was scheduled for training three times per week over a two-month period followed by two times per week for an additional two months. Training consisted of a resistance training circuit using variable resistance machines, cycling using a recumbent stationary bike, and core stability training using stability ball exercises. Changes in strength were assessed using 10 RM tests on the resistance machines and changes in peak VO(2) were monitored utilizing the Cosmed K4b pulmonary function tester. The subject demonstrated a 30.3% gain in peak VO(2). The subject's 10 RM for left single limb leg press increased 36.8% and gains of at least 7.7% were seen for all other muscle groups tested. The strength and endurance training programme adapted to compensate for this subject's limb losses was effective in increasing both strength and peak VO(2). Adapting exercise programmes to compensate for limb loss may allow individuals with amputations to participate in physically challenging activities that otherwise may not be available to them.

  17. [Nylon fixation at the internal and external canthus combined with skin graft for recurrent lower eyelids ectropion].

    Science.gov (United States)

    Yu, Li; Wang, Jiaqi

    2015-01-01

    To investigate the long-time effects of nylon fixation at the internal and external canthus combined with skin graft for recurrent lower eyelids ectropion. Under local anesthesia, the cicatricial contraction was released to repostion the lower eyelid. Then nylon thread was implanted in the fascial tissue at the upper margin of tarsus and was fixed on the periosteum at the internal and external canthus. The skin graft was applied on the wound of lower eyelids. 12 patients with lower eyelids ectropion at 19 sides were treated with primary healing. The patients were followed up for 6-24 months. All cases were satisfied with functional and cosmetic results. No complication and no recurrence happened. The technique of nylon fixation at the internal and external canthus combined with skin graft is an effective method for recurrent lower eyelids ectropion.

  18. [Descriptive study on basal cell eyelid carcinoma].

    Science.gov (United States)

    Pfeiffer, M J; Pfeiffer, N; Valor, C

    2015-09-01

    To describe a series of cases of basal cell carcinomas of the eyelid. A descriptive and retrospective study was conducted by reviewing the medical outcome, histopathological history, and photographic images of 200 patients with basal cell eyelid carcinomas. All were treated in the Herzog Carl Theodor Eye Hospital in Munich, Germany, between 2000 and 2013. In the present study, it was found that females are more affected than males. The mean age of presentation of the tumor occurred at the age of 70 years. In 50% of the cases the tumor was found on the lower lid, especially medially from the center of the lid. The lid margin was involved in 47% of all tumors. The mean diameter was 9.2mm. The recurrence rate after surgery with histologically clear resection margins was 5%. There was a significant relationship between tumor diameter and age. As tumors where located farther away from medial and closer to the lid margin, they became larger. There is a predominance of women affected by this tumor. This may be related to the fact that the sample was taken from those attending an oculoplastic surgery clinic, where there are generally more women than men attending. The formation of basal cell carcinomas increases with age. The infrequent involvement of the upper lid could be explained by the protection of the the eyebrow. The frequent involvement of the lower lid may be due to the light reflection (total reflection) by the cornea on the lower lid margin. Also chemical and physical effects of the tears may be more harmful on the lower lid. Patients tend to ask for medical help when they are females, younger, when the tumor is closer to the medial canthus or when the tumor is away from the lid margin. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Hemangioendothelioma of the eyelid can mimic chalazion.

    Science.gov (United States)

    Al-Faky, Yasser H; Al Malki, Salem; Raddaoui, Emad

    2011-09-01

    Hemangioendothelioma is an uncommon vascular lesion that usually occurs in the liver, bone, lung, skin, and other organs with unknown etiology. A rare form of this lesion has been reported in the eyelid. We report the case of a 27-year-old female with right lower eyelid mass simulating chalazion of 3 weeks duration. The histopathologic examination of the excised nodule confirmed the diagnosis. To our knowledge, this is the fourth case of eyelid epithelioid hemangioendothelioma reported in the English literature.

  20. Altered Aortic Upper Wall TDI Velocity Is Inversely Related with Left Ventricular Diastolic Function in Operated Tetralogy of Fallot.

    Science.gov (United States)

    Bassareo, Pier Paolo; Saba, Luca; Marras, Andrea R; Mercuro, Giuseppe

    2016-12-01

    Postoperative tetralogy of Fallot (TOF) patients often develop progressive aortic root dilatation due to an impairment in aortic elastic properties. (1) to assess aortic elasticity at the level of the aortic upper wall by tissue Doppler imaging (TDI); (2) to evaluate the influence of aortic elasticity on left ventricular (LV) diastolic function in TOF patients. Twenty-eight postoperative TOF patients (14 males, 14 females. Mean age: 25.7 ± 1.6 years) and 28 age- and sex-matched normal subjects were examined. Aortic distensibility and stiffness index were calculated. Aortic wall systolic and diastolic velocities, LV systolic and diastolic parameters were assessed by TDI. Aortic distensibility was significantly lower (P = .024), and aortic stiffness index significantly higher (P = .036) in TOF patients compared to controls. E/E' was significantly higher in TOF than in control group (P < .001). Aortic upper wall early diastolic velocity (AWEDV) was significantly correlated with aortic stiffness index (r: -0.42; P < .03), aortic distensibility (r = 0.54; P < .004), left atrial volume (r = -0.62; P = .0004), and E/E' ratio (r = -0.87; P < .0001). The latter relationship remained significant even when excluding the influence of age at surgery (r = -0.60; P < .0007) and of previous palliative surgery (r = -0.53; P < .02). Aortic elastic properties can be directly assessed using TDI to measure AWEDV. Aortic elasticity is significantly lower in postoperative TOF patients, exerting a negative effect also on LV diastolic function, with a potential long-term influence on clinical status. © 2016 Wiley Periodicals, Inc.

  1. Clinical observation on the effect of resection of eyelid tumor and stage Ⅰ recovery

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    Guo-Hai Wu

    2014-08-01

    Full Text Available AIM: To investigate clinical effects of local resection of eyelid tumors and pathological examination or frozen section examination as well as the stage I recovery.METHODS: For all 92 cases 92 eyes of eyelid tumor patients who underwent local resection, reconstruction in stage Ⅰ and routine pathological examination(37 cases of suspected malignant tumors using frozen section examination. If it was malignant, excision by Moths surgery. Using free palate mucosa autograft in stage I or reconstruction by Hughes surgery combined with eye flaps repaired eyelid defects.RESULTS: The postoperative pathological diagnosis: 52 cases were benign tumors, and 40 cases malignant tumors. All cases of eye flaps and hard palate mucosa grafts were survived. Followed up for more than 6mo, no tumor were recurred. The appearance and function of eyelid were satisfactory.CONCLUSION: In this group of cases, nearly half of eyelid tumors are malignant tumors. It should be treated and operated as early as possible. For suspected malignant tumors, we use frozen section examination to confirm its properties in order to excision cleanly in stage Ⅰ, reducing the recurrence and metastasis. According to the eyelid defect after resection, we could do repair operation in stage Ⅰ. The inner larger defect is repaired by using hard palate mucosa transplantation or Hughes surgery. The outer layer of the eyelid defect is repaired by using eye flap glide, the free flap, the kite flap, the simple suture, etc. It should be careful when using the hard palate mucosa transplantation in the upper eyelid defect.

  2. Eyelid liquoric fistula secondary to orbital meningocele

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    Renato Antunes Schiave Germano

    2015-02-01

    Full Text Available Liquoric fistula (LF is defined as the communication of the subarachnoid space with the external environment, which main complication is the development of infection in the central nervous system. We reported the case of a patient with non-traumatic eyelid liquoric fistula secondary to orbital meningocele (congenital lesion, which main clinical manifestation was unilateral eyelid edema. Her symptoms and clinical signs appeared in adulthood, which is uncommon. The patient received surgical treatment, with complete resolution of the eyelid swelling. In conclusion, eyelid cerebrospinal fluid (CSF fistula is a rare condition but with great potential deleterious to the patient. It should be considered in the differential diagnosis of unilateral eyelid edema, and surgical treatment is almost always mandatory.

  3. Management of cosmetic eyelid surgery complications.

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    Klapper, Stephen R; Patrinely, James R

    2007-02-01

    There is a broad spectrum of complications that can occur following cosmetic eyelid surgery. The experienced eyelid surgeon should be able to avoid most serious complications through proper patient selection, a comprehensive preoperative assessment and surgical plan, meticulous surgical technique, and appropriate postoperative care. The aesthetic eyelid surgeon must counsel a patient contemplating blepharoplasty surgery regarding typical expectations including edema, eyelid numbness, dry eyes, and mild blurred vision. Patients must also be aware of the risks and the signs of serious complications such as infection, hematoma, or severe vision loss. Oculofacial surgeons must be capable of managing these adverse outcomes. The management of these urgent complications as well as other significant postoperative problems including diplopia, lagophthalmos, eyelid malposition, severe chemosis and edema, crease abnormalities, and wound dehiscence is outlined in this review.

  4. Amblyopia in childhood eyelid ptosis.

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    Griepentrog, Gregory J; Diehl, Nancy; Mohney, Brian G

    2013-06-01

    To report the prevalence and causes of amblyopia among children with ptosis diagnosed in a well-defined population over a 40-year period. Retrospective, population-based cohort study. We retrospectively reviewed the charts of 107 patients younger than 19 years for the prevalence and causes of amblyopia who were diagnosed with childhood ptosis and were residents of Olmsted County, Minnesota, from January 1, 1965, through December 31, 2004. Amblyopia was diagnosed in 16 (14.9%) of the 107 patients with childhood ptosis. Fourteen (14.6%) of 96 patients diagnosed with a congenital form of ptosis demonstrated amblyopia. Twelve (14.8%) of the 81 patients diagnosed with simple congenital ptosis had amblyopia, 7 (8.6%) cases of which solely were the result of eyelid occlusion of the visual axis. The causes of amblyopia in the remaining 5 patients were significant refractive error in 3 patients and strabismus in 2 patients. Amblyopia occurred in 1 in 7 children diagnosed with ptosis in this population-based cohort. In approximately half of those with amblyopia, or less than 10% of all patients, the disease solely was the result of eyelid occlusion of the visual axis. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. [The eyelid-cheek junction].

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    Volpei, Ch; Fernandez, J; Chignon-Sicard, B

    2017-10-01

    The eyelid-cheek junction is a key area which generates many comments: from looking tired to looking good or rested, without forgetting charm, beauty, and a youthful appearance. In spite of many interesting medical and surgical procedures, treating this area is sometimes difficult and results are not always up to our expectations. Standardized blepharoplasty, which has often been improperly used, has shown its limits. Since the latest refinements, lipostructure has revolutionised blepharoplasty and serving as a reference, it has become an established technique. Subperiostal mediofacial lift allows outstanding results at the cost of a certain technical aggressiveness. Aesthetic medicine proposes worthy alternative and/or appropriate complementary solutions. Different procedures we dispose of have been reviewed together with their assets and their limits. A codification of therapeutic indications is proposed. The positioning of the eyelid-cheek clinical junction in relation with the low orbital bone rim influences our strategy in choosing the appropriate technique. Copyright © 2017. Published by Elsevier Masson SAS.

  6. Eyelid skin cancer: еpidemiology, prognosis

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    A. F. Brovkina

    2017-01-01

    Full Text Available Data on 3597 patients with primary malignant tumors of the visual organ were submitted to the Moscow City Cancer Register of the Moscow Healthcare Department in 2006–2015. Rate of eyelid skin cancer is 75.62 %. Calculated incidence is 3.4 per 100,000 population. The peak of the disease is at 70–80 years of age. The disease was diagnosed in people of age 46–85 years, it was 66.65 % more frequent in women than in men. Basal cell carcinoma comprised 91.14 % of all cases. In 65.7 % of cases the tumor was diagnosed at stage Т1 and Т2, and at stage Т1, when patient can be cured, only in 34 % of cases. Objective. Study of incidence of malignant eyelid tumors of epithelial genesis, their prognostic characteristics using data from Moscow City Ophthalmic Oncology Center and Ophthalmic Oncology Department of the Branch # 1 “Ophthalmology Clinic” of the S.P. Botkin City Clinical Hospital of the Moscow Healthcare Department.

  7. Metastatic eyelid disease associated with primary breast carcinoma: case report Doença metastática palpebral associada a carcinoma primário de mama: relato de caso

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    Nilson Lopes da Fonseca Júnior

    2009-06-01

    Full Text Available Metastasis confined to eyelids are rare, representing less than 1% of malignant eyelid lesions. More than 50% of all eyelid metastasis are reported to have the breast as the most common primary origin. Two cases of metastatic eyelid disease associated with primary breast carcinoma are described. These lesions were the first sign of metastatic systemic disease. Case 1: An 80-year old woman with no significant ophthalmological history complaining of a discrete painless lesion in the left upper eyelid. She had been diagnosed 10 years before as infiltrated ductal carcinoma of right mammary gland with no reference of metastatic disease. Case 2: A 77-year old woman who attends our ophthalmology service came complaining of a four-month history of a painless swelling and erythema of right lower eyelid. The past medical history was significant for infiltrated ductal carcinoma on right mammary gland 2 years before the ocular manifestation. Breast carcinoma is notorious for its presentation diversity. Metastatic disease should be considered as differential diagnosis of eyelid lesions. Although rare, these lesions can be an initial sign of systemic malignancy.Metástase confinada às pálpebras é rara, representando menos de 1% das lesões malignas palpebrais. Mais de 50% das metástases palpebrais são relatadas como tendo a mama como sítio primário. Relatamos dois casos de doença metastática palpebral associada a carcinoma primário de mama. Estas lesões foram o primeiro sinal de doença metastática sistêmica. Caso 1: Paciente do sexo feminino, 80 anos de idade sem antecedentes oftalmológicos apresentando discreta lesão nodular indolor na pálpebra superior do olho esquerdo. O carcinoma ductal de mama foi diagnosticado há 10 anos sem doença metastática. Caso 2: Paciente do sexo feminino, 77 anos de idade, com queixa de edema indolor e hiperemia na pálpebra inferior do olho direito há quatro meses. Apresentava antecedente pessoal de

  8. Topographic analysis of eyelid position using digital image processing software.

    Science.gov (United States)

    Chun, Yeoun Sook; Park, Hong Hyun; Park, In Ki; Moon, Nam Ju; Park, Sang Joon; Lee, Jeong Kyu

    2017-11-01

    To propose a novel analysis technique for objective quantification of topographic eyelid position with an algorithmatically calculated scheme and to determine its feasibility. One hundred normal eyelids from 100 patients were segmented using a graph cut algorithm, and 11 shape features of eyelids were semi-automatically quantified using in-house software. To evaluate the intra- and inter-examiner reliability of this software, intra-class correlation coefficients (ICCs) were used. To evaluate the diagnostic value of this scheme, the correlations between semi-automatic and manual measurements of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) were analysed using a Bland-Altman analysis. To determine the degree of agreement according to manual MRD length, the relationship between the variance of semi-automatic measurements and the manual measurements was evaluated using linear regression. Intra- and inter-examiner reliability were excellent, with ICCs ranging from 0.913 to 0.980 in 11 shape features including MRD1, MRD2, palpebral fissure, lid perimeter, upper and lower lid lengths, roundness, total area, and medial, central, and lateral areas. The correlations between semi-automatic and manual MRDs were also excellent, with better correlation in MRD1 than in MRD2 (R = 0.893 and 0.823, respectively). In addition, significant positive relationships were observed between the variance and the length of MRD1 and 2; the longer the MRD length, the more the variance. The proposed novel optimized integrative scheme, which is shown to have high repeatability and reproducibility, is useful for topographic analysis of eyelid position. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. Intratarsal fixation at the same level as the skin incision to reduce asymmetric double eyelids: evaluation of symmetry using photogrammetry.

    Science.gov (United States)

    Han, Kihwan; Yeo, Hyeonjung; Choi, Tae Hyun; Son, Daegu; Kim, Jun Hyung

    2010-03-01

    One of the most common complications of double eyelid operations is asymmetry. To reduce asymmetry, we fixed the dermis to the tarsal plate at the same level as the skin incision, and objectively evaluated the symmetry of the height using photogrammetry.Of 30 patients who had double eyelid operations by the intratarsal fixation technique, 15 patients completed a minimum follow-up of 6 months. After the skin incision and removal of the orbicularis oculi muscle and the orbital fat, the pretarsal fat pad was excised to expose the superior portion of the tarsal plate. The 3 fixation points were marked on the tarsal plate at the same level with the skin incision using a spreading caliper. The dermis was fixed to the marked points of the tarsal plate and the skin was closed.The height of the double eyelid was measured by clinical photography at 4 points when the eyes were opened and at 3 points when the eyes were closed. The height proportional index at each point was obtained by dividing the height of the left double eyelid by that of the right double eyelid. We compared each height proportional index with "1" to evaluate the symmetry of both double eyelids using a paired t test.The follow-up period was an average of 9.0 months. The mean height proportional indices were 0.97 (a), 0.96 (b), 0.98 (c), 1.08 (d), 0.97 (e), 1.02 (f), and 1.13 (g). According to a paired t test, the height of the left double eyelid was not different from that of the right double eyelid.Intratarsal fixation, along with other previously known methods, decreases asymmetric double eyelids.

  10. How to promote and preserve eyelid health

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    Benitez-del-Castillo JM

    2012-10-01

    Full Text Available Jose M Benitez-del-CastilloOcular Surface and Inflammation, Department Ophthalmology, Hospital Clinico San Carlos, Madrid, SpainAbstract: Disorders of the lacrimal functional unit are common in ophthalmological practice, with meibomian gland dysfunction, blepharitis, and dry eye forming a significant part of the general ophthalmologist's practice. The eyelid and its associated structures form a complex organ designed to protect the fragile corneal surface and improve visual acuity. This organ is subject to a number of disorders, including meibomian gland dysfunction, dry eye syndrome, anterior blepharitis, allergic and dermatological conditions, and disorders associated with contact lens use. Although commonly described separately, disorders of the lacrimal function unit are better considered as a group of interacting pathologies that have inflammatory mediators as a central feature. Eyelid hygiene, in the sense of routine cleansing and massage of the eyelids, is well accepted in the management of many disorders of the eyelid. However, a broader concept of eyelid health may be appropriate, in which eyelid cleansing is but a part of a more complete program of care that includes screening and risk assessment, patient education, and coaching. The ophthalmologist has an important role to play in helping patients persist with routine eyelid care that may be long-term or lifelong. A number of preparations exist to make routine eyelid care both more effective and more pleasant, and might also improve compliance. Several such preparations have been devised, and are being assessed in clinical studies, and appear to be effective and preferred by patients over traditional soap and water or baby shampoo.Keywords: eyelid, disorders, health, lacrimal functional unit

  11. Primary Nocardia brasiliensis of the eyelid.

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    Brannan, Paul A; Kersten, Robert C; Hudak, Donald T; Anderson, Heidi K; Kulwin, Dwight R

    2004-09-01

    To report a rare case of lymphocutaneous Nocardia brasiliensis originating in the eyelid. Observational case report. The clinical presentation, workup, and treatment of a case of lymphocutaneous Nocardia brasiliensis originating in the eyelid are presented. The patient presented with a preseptal cellulitis from an abrasion of the eyelid that progressed to submandibular lymph node suppuration. Culture was performed, and a diagnosis of lymphocutaneous Nocardia brasiliensis was made. Nocardia brasiliensis may cause a lymphocutaneous infection of the face and must be considered in the differential diagnosis of preseptal cellulitis.

  12. Hemangioendothelioma of the eyelid can mimic chalazion

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    Yasser H Al-Faky

    2011-01-01

    Full Text Available Hemangioendothelioma is an uncommon vascular lesion that usually occurs in the liver, bone, lung, skin, and other organs with unknown etiology. A rare form of this lesion has been reported in the eyelid. We report the case of a 27-year-old female with right lower eyelid mass simulating chalazion of 3 weeks duration. The histopathologic examination of the excised nodule confirmed the diagnosis. To our knowledge, this is the fourth case of eyelid epithelioid hemangioendothelioma reported in the English literature.

  13. Eyelid Localization for Iris Identification

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    T. Ea

    2008-12-01

    Full Text Available This article presents a new eyelid localization algorithm based on a parabolic curve fitting. To deal with eyelashes, low contrast or false detection due to iris texture, we propose a two steps algorithm. First, possible edge candidates are selected by applying edge detection on a restricted area inside the iris. Then, a gradient maximization is applied along every parabola, on a larger area, to refine parameters and select the best one. Experiments have been conducted on a database of 151 iris that have been manually segmented. The performance evaluation is carried out by comparing the segmented images obtained by the proposed method with the manual segmentation. The results are satisfactory in more than 90% of the cases.

  14. Determinants of crease width in inherent double eyelid of Asian young women.

    Science.gov (United States)

    Li, Yang; Hu, Zhen-Zhen; Du, Yong-Xing; Chen, Bing; Wang, Jin-Huang; Quan, Xian-Yue; Liu, Da-Lie

    2017-01-01

    The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results. Standard images were used to study the anatomic parameters, including crease width, crease height, and upper eyelid movement distance (ULMD) at the midpupillary axis, of the inherent double eyelid crease in 32 Chinese women aged 19-26 years. The thickness of the eyelid tissue at 5, 7.5, 10, and 15 mm from the lid margin was measured in the oblique sagittal direction by magnetic resonance imaging (MRI) at the central axis of the optic nerve. Multiple linear regression was used to analyze the relationship between crease width and crease height, ULMD, and eyelid thickness. Multiple linear regression revealed that crease height, crease thickness, and ULMD were significantly associated with crease width (partial regression coefficients: 0.67, -0.33, and -0.29 respectively). The determination coefficient R 2 was 0.667 in the regression model, and the result of analysis of variance (ANOVA) showed that the regression model was significant (F = 16.04, p = 0.000). In performing upper blepharoplasty, it is important to consider eyelid thickness and movement distance of the upper eyelid margin rather than relying on crease height alone. Attention to these factors will help to achieve the desired size and shape of the crease. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Involutional ectropion and entropion: clinicopathologic correlation between horizontal eyelid laxity and eyelid extracellular matrix.

    Science.gov (United States)

    Damasceno, Renato Wendell; Osaki, Midori Hentona; Dantas, Paulo Elias Correa; Belfort, Rubens

    2011-01-01

    To investigate the clinicopathologic correlation between horizontal eyelid laxity and extracellular matrix components, such as collagen and elastic fibers, in involutional ectropion and entropion. Another goal was to compare the differences between involutional ectropion and entropion in regard to extracellular matrix content using computer-assisted morphometry. This clinicopathologic study included 20 consecutive patients with involutional ectropion (group 1) and 20 consecutive patients with involutional entropion (group 2). The pinch test was performed to measure horizontal eyelid laxity in both groups. Full-thickness eyelid biopsy specimens were examined by light microscopy and computer-assisted morphometry. The Mann-Whitney U test, the Pearson chi-square test, the Pearson correlation coefficient calculation, and a linear regression analysis were performed. All sections of specimens from patients in groups 1 and 2 revealed abnormal collagen and elastic fibers. The Pearson correlation coefficient revealed a significant negative correlation between horizontal eyelid laxity and extracellular matrix content in the eyelid skin, the pretarsal orbicularis oculi muscle, the perimeibomian tarsal stroma, and the intermeibomian tarsal stroma. Linear regression demonstrated that horizontal eyelid laxity is dependent upon extracellular matrix components in all eyelid regions. Collagen fiber content was significantly increased in specimens from patients in group 1 compared with specimens from patients in group 2. The present findings suggest that a reduction of collagen and elastic fibers may contribute to the development of excessive horizontal eyelid laxity in patients with involutional ectropion and entropion of the lower eyelid.

  16. Role of fine needle aspiration cytology in diagnosis of eyelid sebaceous carcinoma

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    Maheshwari Rajat

    2007-01-01

    Full Text Available Sebaceous carcinoma of the ocular adnexa is a malignant neoplasm which can exhibit aggressive local behavior and can metastasize to regional lymph nodes and distant organs. The neoplasm is known to masquerade as other benign and less malignant lesions, resulting in delay in diagnosis and relative high morbidity and mortality. Fine needle aspiration cytology (FNAC of recurrent upper eyelid nodules treated elsewhere as chalazion was done. Cytological smears were suggestive of malignancy. Subsequently histopathology confirmed the diagnosis of sebaceous gland carcinoma. Eyelid reconstruction was done after histopathologically confirmed tumor-free margins. The article highlights the role of FNAC in early diagnosis and subsequent appropriate surgical management of eyelid sebaceous gland carcinoma to prevent recurrence and metastasis.

  17. Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

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    El Essawy R

    2013-05-01

    Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

  18. The clinical characteristics and new classification of sticky eyelid syndrome in East Asian patients.

    Science.gov (United States)

    Chang, Minwook; Lee, Hwa; Park, Min Soo; Baek, Sehyun

    2014-12-01

    The aim of this study was to demonstrate the characteristics of sticky eyelid syndrome (SES) and to suggest a modified definition and new classification of the disease in relation to the severity of the syndrome in East Asian patients. Forty-four eyes of 31 patients with sticky eyelid syndrome were included in this study. The medical records of patients who were diagnosed with sticky eyelid syndrome were retrospectively reviewed. Sticky eyelid syndrome was defined as an abnormal adhesion between the upper and lower eyelids during blinking. We divided the subjects into four grades according to the severity of the disease. Among 31 patients, there were 10 men and 21 women. The mean age of patients was 62.5 years. A total of 13 patients had SES bilaterally. All patients had meibomian gland dysfunction (MGD). Thirty-three eyes had dermatochalasis, and 30 eyes had involutional ptosis. Horizontal lower lid laxity was observed in 23 eyes, and reverse ptosis found in 15 eyes. Patients were classified into four groups as follows: G1: 11 (25%), G2: 24 (54.5%), G3: 6 (13.6%) and G4: 3 eyes (6.8%). Patients in Grade 1 tended to improve only with medical treatment for MGD. However, surgical management was necessary for patients in Grades 3 and 4. Meibomian gland dysfunction is a fundamental risk factor for developing sticky eyelid syndrome. Further, combined upper lid ptosis or lower lid laxity may be aggravating factors. According to the grading, medical or surgical management can be chosen. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Association of Eyelid Position and Facial Nerve Palsy With Unresolved Weakness.

    Science.gov (United States)

    Sinha, Kunal R; Rootman, Daniel B; Azizzadeh, Babak; Goldberg, Robert A

    2016-09-01

    Understanding the prevalence and clinical features of eyelid malpositions in facial nerve palsy (FNP) may inform proper management of patients with FNP and supplement our knowledge of eyelid physiology. To describe eyelid malposition in FNP. In this retrospective cohort study, patients with FNP seen at the Center for Advanced Facial Plastic Surgery and Jules Stein Eye Institute between January 1, 1999, and June 1, 2014, were reviewed for study inclusion. Data collection was performed between June 1, 2014, to August 1, 2014, and data analysis was performed between June 15, 2014, to September 1, 2015. The distances from the center of the pupil to the upper eyelid margin (marginal reflex distance 1 [MRD1]) and to the lower eyelid margin (marginal reflex distance 2 [MRD2]) were measured on photographs of patients in the primary position and with full smile. Eyelid asymmetry, retraction, ptosis, synkinesis, and severity and duration of FNP were assessed. Eligible participants were adults with FNP at a private tertiary care clinic with primary position photographs. Exclusion criteria included prior history of procedures or medical conditions that could alter eyelid position. The 52 included patients were predominantly female (38 [73%]), with a mean (SD) age of 44.1 (13.8) years. Of this group, 34 patients (65%) were white, 8 (15%) were Asian, 8 (15%) were Hispanic, and 2 (4%) were African American. Retraction (MRD1, >5.0 mm) was present in 8 patients (15%), 3 of whom had eyelid asymmetry (MRD1, >1.0 mm). Overall, total asymmetry of greater than 1.0 mm was present in 14 patients (27%), with the FNP side higher in 12 (23%). Compared with those without asymmetry, patients with eyelid asymmetry were significantly more likely to have contralateral ptosis (42% vs 2.5%, P FNP (12.3 months vs 13.8 months, P = .82). Ptosis was noted in 4 patients and was also unrelated to duration of FNP (9.6 months in patients with ptosis vs 13.6 months in those without, P = .60

  20. Fragrance series testing in eyelid dermatitis.

    Science.gov (United States)

    Wenk, Kurt S; Ehrlich, Alison

    2012-01-01

    Allergic contact dermatitis is considered one of the most common causes of eyelid dermatitis. In addition to metals and topical antibiotics, fragrances have emerged as a leading source of contact allergy for individuals with this condition. The objective of this study was to determine the added benefit of including a fragrance tray when patch testing patients presenting with eyelid dermatitis. During a 4.5-year period, all patients with suspected allergic contact dermatitis involving the eyelids were patch tested with both standard and fragrance trays. One hundred consecutive patients with eyelid dermatitis were patch tested. Of these patients, 42 (42%) tested positive for 1 or more allergens within the fragrance series. Of these patients, 15 (36%) had no fragrance markers detected on the standard series, and these allergens would therefore have been missed had fragrance series testing not been performed. Overall, fragrance markers within the standard series detected 73.2% (41/56) of cases of fragrance allergy. Our results suggest that there may be a significant benefit to fragrance series testing in patients with eyelid dermatitis. Fragrance tray inclusion in this population may identify additional cases of fragrance allergy that are missed by the standard series.

  1. Accuracy of Marginal Reflex Distance Measurements in Eyelid Surgery.

    Science.gov (United States)

    Nemet, Arie Y

    2015-10-01

    The marginal reflex distance (MRD), the position of the eyelids with the eyes in the primary position, is fundamental to patient assessment and surgery choice in facial and ophthalmic plastic surgery. This study compares the accuracy of handheld ruler and slit lamp biomicroscope measurements of the MRD1 in patients with blepharoptosis. This is a prospective study of 85 consecutive patients who were referred to our oculoplastic clinic between 2011 and 2013 for unilateral or bilateral ptosis repair. The MRD1 was measured by 2 techniques: 1. With the use of a penlight to illuminate the cornea, the corneal light reflex is observed, and the distance between the cornea and the upper lid margin is recorded. 2. Slit lamp biomicroscope assessment. A comparison between those 2 methods was performed. The mean (SD) MRD1 was 1.18 (1.11) mm and 1.06 (1.18) mm with a penlight and a slit lamp, respectively. There was a significant difference between the 2 measurements, but they were highly correlated in the paired t-test and the Wilcoxon test. The intraclass correlation coefficient was 0.984, representing excellent reliability. The MRD1 measured by a skilled clinician yields reliable results using a penlight and a ruler. In some cases, measurement of eyelid heights (palpebral fissure, MRD1, brow position) is challenging. The use of a slit lamp biomicroscope and a close front photograph may help determine accurate measurements.

  2. Solitary neurofibroma of eyelid masquerading as chalazion.

    Science.gov (United States)

    Chen, Nancy; Hsu, Yung-Hsiang; Lee, Yuan-Chieh

    2017-01-01

    Neurofibroma, a benign peripheral nerve sheath tumor, usually appears together with café-au-lait spots, iris nodules, and other tumors within the scope of neurofibromatosis von Recklinghausen type 1 tumors. A solitary neurofibroma of the eyelid is relatively rare. In this case report, we present a 39-year-old woman who had a lesion on the eyelid crease, previously treated as a chalazion. Due to persistent wound crusting, the lesion was excised above the tarsus. Pathological examination revealed a solitary neurofibroma. The patient did not have other clinical symptoms of neurofibromatosis, and there was no recurrence of the nodule during the 1-year follow-up.

  3. Pedicled fat flap to increase lateral fullness in upper blepharoplasty.

    Science.gov (United States)

    Sozer, Sadri O; Agullo, Francisco J; Palladino, Humberto; Payne, Phileemon E; Banerji, Soumo

    2010-03-01

    The eyelid of a young person can be distinguished by the lateral fullness of the upper eyelid. With aging, lateral fullness decreases. Volume restoration in the periorbital area has been previously addressed by fat draping and grafting. More recently, techniques for regaining lateral fullness of the upper eyelid have focused on fat grafting, although effective graft take, reabsorption, and irregularities have been a concern. To address these issues, the concept of pedicled fat draping in the upper eyelid was explored. In a retrospective study from June 2006 to August 2008, 31 patients underwent upper blepharoplasty with augmentation of the lateral fullness with a pedicled fat flap from the central fat pad. The fat from the central compartment was elevated, dissected, and then transposed to the lateral upper eyelid below the orbicularis muscle. All patients were women ranging in age from 43 to 68 years. Pre- and postoperative picture comparison demonstrated a more youthful appearance with increased lateral fullness of the upper eyelids. There were no cases of fat necrosis encountered. Increased volume remained stable over an average of one-year follow-up. No complications were recorded. Transposing a pedicled fat pad from the central compartment laterally has proven to be an effective technique for achieving predictable upper lateral eyelid fullness and thus achieving a long-lasting, more youthful appearance.

  4. Case Report: Congenital upper lid eversion and severe chemosis in ...

    African Journals Online (AJOL)

    The pediatrician was also invited to co‑manage the patient. After 9‑days of treatment, the conjunctival chemosis fully resolved and lids reverted back to normal position. At 4‑week follow‑up, the lids continued to maintain their normal position and child could now open eyelids spontaneously. Congenital upper eyelid eversion ...

  5. Sleep-Induced Apraxia of Eyelid Opening.

    Science.gov (United States)

    Reggie, Sara N; Chen, John J; Lee, Michael S; Chung, Sophia M

    2017-12-01

    Apraxia of eyelid opening (AEO) primarily has been described as bilateral loss of volitional ability to open the eyes at certain times and often associated with neurodegenerative disease. Rarely, it can occur in isolation and as an idiopathic phenomenon. There are a few reports of unilateral AEO only on awakening from sleep. We report an additional 11 patients with this unusual variation of AEO. Retrospective, observational case series of patients collected from 3 separate neuro-ophthalmology practices. All 11 patients were Caucasian women with a mean age of 59 years (range 35-80 years). All experienced AEO on awakening from sleep. Eight patients had unilateral AEO, and 3 had bilateral symptoms. The duration of episodes ranged from 3 weeks to several years. Ten of the patients reported manually elevating the eyelid to open it, while 1 patient waited for the eyelid to open spontaneously. After initial manual elevation, all patients reported normal function and position of the eyelids for the remainder of the day. Seven patients had a history of autoimmune disease. Slit-lamp and fundus examinations were negative for ocular pathology to explain the patients' symptoms, and 9 patients had unremarkable brain imaging. AEO occurring only on awakening from sleep is a rare entity. Neuroimaging and extensive laboratory testing are not indicated without associated neurologic or ocular findings. There may be a Caucasian female preponderance and autoimmune link in patients with AEO, but further studies are required.

  6. Celebrity arcade suture blepharoplasty for double eyelid.

    Science.gov (United States)

    Liao, Wen-Chieh; Tung, Tung-Chain; Tsai, Tzong-Ru; Wang, Chia-Yi; Lin, Chiu-Hwa

    2005-01-01

    In Taiwan, double-eyelid surgery is the most popular cosmetic surgical procedure. The technique preferred by plastic surgeons is the incision method because it is believed that this method can provide stable double-eyelid results. It is the authors' observation that patients prefer an invagination fold rather than a significantly high fold. Suture blepharoplasty may create a relatively even and symmetric invagination fold. In the past, the major disadvantage of the suture technique has been the opinion that the double fold fades away. The celebrity arcade suture (CAS) technique was applied in double-eyelid operations. The CAS technique includes three major techniques: stabbing incision, transtarsal suture, and bridge connection. The whole procedure can be completed in 15 min. From June 2001 to November 2004, 312 patients underwent the CAS technique. Of the 312 patients who underwent the CAS technique, 5 required a revisit, with 3 of these returning patients reporting fold disappearance. These three patients received repeat suture procedures. The findings show that the CAS technique is a reliable method for establishing a smooth, constant, and symmetric double eyelid, and that CAS requires only a short recovery time.

  7. A Hyalinized Trichilemmoma of the Eyelid in a Teenager.

    Science.gov (United States)

    Jakobiec, Frederick A; Stagner, Anna M; Sassoon, Jodi; Goldstein, Scott; Mihm, Martin C

    2016-01-01

    A 16-year-old African American male, the youngest patient to date, presented with a well-circumscribed upper eyelid lesion. On excision, the dermal nodule was contiguous with the epidermis, displayed trichohyalin-like bodies in an expanded outer root sheath, and was composed chiefly of small cellular clusters separated by a prominent network of periodic acid Schiff -positive hyaline bands of basement membrane material. The tumor cells were positive for high molecular weight cytokeratins (CK) 5/6, CK14, and CK34βE12 and were negative for CK7, carcinoembryonic antigen and epithelial membrane antigen. Negative S100, glial fibrillary acidic protein, and smooth muscle actin immunoreactions ruled out a myoepithelial lesion. The Ki-67 proliferation index was <10%. The diagnosis was a hyalinized trichilemmoma, contrasting with the more common lobular type. As an isolated lesion, trichilemmoma does not portend Cowden syndrome.

  8. Brow/Upper lid anatomy, aging and aesthetic analysis.

    Science.gov (United States)

    Branham, Gregory; Holds, John B

    2015-05-01

    The upper eyelid serves the important anatomic function of protecting the eye and rewetting the cornea to maintain vision. The complex dynamic action of the upper eyelid explains its relatively complex anatomy. The brow has an important supportive role. Studies have revealed facial characteristics perceived as youthful and aged, and the anatomic basis of these changes is defined at many levels. Characteristic aging changes in the upper eyelid and brow create an appearance of aging and opportunities for functional and aesthetic improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Metastatic neuroblastoma presenting as refusal to use the left upper extremity in a six-year-old girl

    OpenAIRE

    Casey Grover; Elizabeth Crawford

    2014-01-01

    Neuroblastoma is the most common extracranial neoplasm in children, commonly presenting at an advanced stage. Despite the high prevalence of metastatic disease with neuroblastoma, metastases to the central nervous system are rare and predominantly involve the spinal cord. We present a case of neuroblastoma with metastases to the brain presenting as refusal to move the left arm. The lesion initially appeared to be both a subdural and epidural hematoma on computed tomography of the head, but up...

  10. Effectiveness of the Lower Eyelid Suspension Using Fascia Lata Graft for the Treatment of Lagophthalmos due to Facial Paralysis

    Directory of Open Access Journals (Sweden)

    Selam Yekta Sendul

    2015-01-01

    Full Text Available Purpose. To evaluate of functional and cosmetic effectiveness of lower eyelid sling technique with fascia lata graft in patients with lagophthalmos due to facial paralysis. Material and Method. Ten patients with a mean age of 55.1±19.77 years who underwent lower eyelid sling surgery with a fascia lata graft between September 2011 and January 2014 were included in this prospective study. Preoperatively and postoperatively patients were evaluated in terms of corneal epithelial defects, Schirmer’s test, and tear break-up time (TBUT. Cosmetically, vertical eyelid aperture, margin reflex distances 1 and 2 (MRD1 and MRD2 and scleral show were evaluated preoperatively and postoperatively. Results. One patient had facial paralysis on the right side whereas the other 9 patients had facial paralysis on the left side. Preoperatively, 3 patients were detected with corneal ulcer, whereas 7 patients were detected with persistent corneal epithelial defects localized in the lower half of the cornea. In the 3 patients with preoperative corneal ulcer, the ulcer recovered with corneal opacity, whereas in the 7 patients with punctate epitheliopathy, postoperative corneal transparency was obtained. Discussion. Lower eyelid sling technique with fascia lata graft is an effective technique for the repositioning of the lower eyelid and preventing the corneal complications.

  11. Effectiveness of the lower eyelid suspension using fascia lata graft for the treatment of lagophthalmos due to facial paralysis.

    Science.gov (United States)

    Sendul, Selam Yekta; Cagatay, Halil Huseyin; Dirim, Burcu; Demir, Mehmet; Acar, Zeynep; Olgun, Ali; Can, Efe; Guven, Dilek

    2015-01-01

    To evaluate of functional and cosmetic effectiveness of lower eyelid sling technique with fascia lata graft in patients with lagophthalmos due to facial paralysis. Ten patients with a mean age of 55.1 ± 19.77 years who underwent lower eyelid sling surgery with a fascia lata graft between September 2011 and January 2014 were included in this prospective study. Preoperatively and postoperatively patients were evaluated in terms of corneal epithelial defects, Schirmer's test, and tear break-up time (TBUT). Cosmetically, vertical eyelid aperture, margin reflex distances 1 and 2 (MRD1 and MRD2) and scleral show were evaluated preoperatively and postoperatively. One patient had facial paralysis on the right side whereas the other 9 patients had facial paralysis on the left side. Preoperatively, 3 patients were detected with corneal ulcer, whereas 7 patients were detected with persistent corneal epithelial defects localized in the lower half of the cornea. In the 3 patients with preoperative corneal ulcer, the ulcer recovered with corneal opacity, whereas in the 7 patients with punctate epitheliopathy, postoperative corneal transparency was obtained. Lower eyelid sling technique with fascia lata graft is an effective technique for the repositioning of the lower eyelid and preventing the corneal complications.

  12. [Upper eyelid surgery for treatment of congenital blepharoptosis].

    Science.gov (United States)

    Mesa Gutiérrez, J C; Mascaró Zamora, F; Muñoz Quiñones, S; Prat Bertomeu, J; Arruga Ginebreda, J

    2007-04-01

    [corrected] To revise techniques and indications for surgical treatment of childhood blepharoptosis. Review of the medical literature and case reports. The treatment of blepharoptosis is not easy. There are different techniques for its correction, depending on invasivity and aetiological approach. Most used techniques are resection of the levator muscle through a skin incision in moderate ptosis and frontal suspension for severe cases. The indication of each technique depends on the type of ptosis, severity, features of levator muscle and age. Simple congenital ptosis is the most frequent type of ptosis in children although is necessary to consider types associated to rectus superior palsy, blepharofimosis syndrome and Marcus-Gunn phenomenon. It is important to evaluate ptosis severity and its repercussions on visual acuity and compensating torticolli. The timing for surgical treatment varies depending on age, severity and laterality.

  13. Extensive full-thickness eyelid reconstruction with rotation flaps through “subcutaneous tunnel” and palatal mucosal grafts

    Directory of Open Access Journals (Sweden)

    Jian-Xia Cheng

    2015-08-01

    Full Text Available AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions. This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a “subcutaneous tunnel” in conjunction with a palatal mucosal graft employed for lining.METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between 2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized, leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a “subcutaneous tunnel” to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.RESULTS:All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible. The defects were repaired completely, and the evaluations showed satisfactory function and appearance.CONCLUSION: This technique is an improved single-stage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.

  14. Metastatic neuroblastoma presenting as refusal to use the left upper extremity in a six-year-old girl

    Directory of Open Access Journals (Sweden)

    Casey Grover

    2014-12-01

    Full Text Available Neuroblastoma is the most common extracranial neoplasm in children, commonly presenting at an advanced stage. Despite the high prevalence of metastatic disease with neuroblastoma, metastases to the central nervous system are rare and predominantly involve the spinal cord. We present a case of neuroblastoma with metastases to the brain presenting as refusal to move the left arm. The lesion initially appeared to be both a subdural and epidural hematoma on computed tomography of the head, but upon magnetic resonance imaging, was found to represent metastatic neuroblastoma. In pediatric patients with systemic symptoms and neurologic deficits, metastatic disease, such as neuroblastoma, should be included in the differential diagnosis and appropriate imaging should be obtained.

  15. Solitary neurofibroma of eyelid masquerading as chalazion

    Directory of Open Access Journals (Sweden)

    Chen N

    2017-05-01

    Full Text Available Nancy Chen,1 Yung-Hsiang Hsu,2 Yuan-Chieh Lee1,3 1Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; 2Department of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; 3Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan Abstract: Neurofibroma, a benign peripheral nerve sheath tumor, usually appears together with café-au-lait spots, iris nodules, and other tumors within the scope of neurofibromatosis von Recklinghausen type 1 tumors. A solitary neurofibroma of the eyelid is relatively rare. In this case report, we present a 39-year-old woman who had a lesion on the eyelid crease, previously treated as a chalazion. Due to persistent wound crusting, the lesion was excised above the tarsus. Pathological examination revealed a solitary neurofibroma. The patient did not have other clinical symptoms of neurofibromatosis, and there was no recurrence of the nodule during the 1-year follow-up. Keywords: neurofibroma, eyelid tumor, chalazion

  16. Differential effects of continuous theta burst stimulation over left premotor cortex and right prefrontal cortex on modulating upper limb somatosensory input.

    Science.gov (United States)

    Brown, Matt J N; Staines, W Richard

    2016-02-15

    Somatosensory evoked potentials (SEPs) represent somatosensory processing in non-primary motor areas (i.e. frontal N30 and N60) and somatosensory cortices (i.e. parietal P50). It is well-known that the premotor cortex (PMC) and prefrontal cortex (PFC) are involved in the preparation and planning of upper limb movements but it is currently unclear how they modulate somatosensory processing for upper limb motor control. In the current study, two experiments examined SEP modulations after continuous theta burst stimulation (cTBS) was used to transiently disrupt the left PMC (Experiment 1) and right PFC (Experiment 2). Both Experiment 1 (n=15) and Experiment 2 (n=16) used pre-post experimental designs. In both experiments participants performed a task requiring detection of varying amplitudes of attended vibrotactile (VibT) stimuli to the left index finger (D2) and execution of a pre-matched finger sequence with the right (contralateral) hand to specific VibT targets. During the task, SEPs were measured to median nerve (MN) stimulations time-locked during pre-stimulus (250 ms before VibT), early response selection (250 ms after VibT), late preparatory (750 ms after VibT) and execution (1250 ms VibT) phases. The key findings of Experiment 1 revealed significant decreases in N30 and N60 peak amplitudes after cTBS to PMC. In contrast, the results of Experiment 2, also found significant decreased N60 peak amplitudes as well as trends for increased N30 and P50 peak amplitudes. A direct comparison of Experiment 1 and Experiment 2 confirmed differential modulation of N30 peak amplitudes after PMC (gated) compared to PFC (enhanced) cTBS. Collectively, these results support that both the left PMC and right PFC have modulatory roles on early somatosensory input into non-primary motor areas, such as PMC and supplementary motor area (SMA), represented by frontal N30 and N60 SEPs. These results confirm that PMC and PFC are both part of a network that regulates somatosensory input

  17. Endocrine Mucin-Producing Sweat Gland Carcinoma of the Eyelid Associated With Mucinous Adenocarcinoma.

    Science.gov (United States)

    Charles, Norman C; Proia, Alan D; Lo, Christopher

    Endocrine mucin-producing sweat gland carcinoma, a rare, low-grade neoplasm with predilection for the eyelids, has been posited as a precursor to invasive mucinous adenocarcinoma. Endocrine mucin-producing sweat gland carcinoma and its concurrence with mucinous adenocarcinoma have received little attention in the ophthalmic literature. The combination of the 2 histologic patterns parallels endocrine ductal carcinoma in situ of the breast and its transition to Type B invasive mucinous carcinoma. The authors describe a 59-year-old man who developed a tumor of the right upper eyelid showing endocrine mucin-producing sweat gland carcinoma in the outer dermis and extensive mucinous carcinoma in the deeper tissue. Immunohistochemical analysis showed positivity for endocrine markers chromogranin, synaptophysin, CD56, estrogen, and progesterone in each histologic component of the tumor. This research was conducted in conformity with the Helsinki Declaration and HIPPA regulations.

  18. Effect of Manuka Honey on Eyelid Wound Healing: A Randomized Controlled Trial.

    Science.gov (United States)

    Malhotra, Raman; Ziahosseini, Kimia; Poitelea, Cornelia; Litwin, Andre; Sagili, Suresh

    To report outcomes of a randomized trial on the role of "active" Manuka honey on eyelid surgical wound healing. Prospective, randomized, single-blinded study was performed for patients undergoing bilateral upper blepharoplasty. Vaseline was applied 4 times a day to both sides for 6 weeks and in addition, one eyelid was randomized to receive Manuka honey twice daily. Postoperative wounds were graded by a masked observer at 1 week, 1 month, and 4 months using Manchester scar scale and a modified eyelid scar grading scale. Patients scored symptoms, expressed preferred side, and of any problems they experienced using honey. Standard photographs were graded by 2 independent assessors. Fifty-five patients were randomized. One week after surgery, 46 (29 women, 17 men, mean age 68 years, median 69, range 49-85) were available for analysis. There was a trend toward distortion of the surrounding skin being less (1.6 vs. 1.8, p = 0.07) and the scar being less palpable (1.8 vs. 2.0, p = 0.08) on the Manuka-treated side. Patients reported the scar on the Manuka side to have less stiffness (1.3 vs. 1.6, p = 0.058). At 1 month, all 3 grading scales showed no difference between the 2 sides. At 4 months, scar grading scales showed no differences; however, patients reported scar pain to be significantly less on the Manuka-treated side than control (0.48 vs. 1.9, p = 0.005). Thirty-one of 46 patients believed the scars were similar on both sides, 11 preferred the honey-treated side, and 4 preferred the control. Upper eyelid scars treated with or without Manuka honey heal well, without significant difference when assessed by validated scar grading scales; however, honey may provide subjective benefits early, postoperatively.

  19. Change in eyelid parameters after orbital decompression in thyroid-associated orbitopathy.

    Science.gov (United States)

    Park, Hong Hyun; Chun, Yeoun Sook; Moon, Nam Ju; Kim, Jee Taek; Park, Sang Joon; Lee, Jeong Kyu

    2018-02-02

    To investigate quantitative changes in eyelid parameters after orbital decompression surgery in thyroid-associated orbitopathy using the PC-based program, Eyelid Analysis Software (EAS). This study included 202 eyes of 109 thyroid-associated orbitopathy patients. Digital photographs of the patients in primary gaze were taken just before and after orbital decompression surgery, and exophthalmos degree was measured by Hertel exophthalmometry (Hertel Exophthalmometer SKU:52400; Oculus, Arlington, VA, USA). The custom-made PC-based software EAS (Biomedical Research Institute, Seoul, Korea) was used to analyze eyelid parameters. The 11 parameters included pupil to inferior eyebrow distance (PBD), margin reflex distance 1 (MRD1), margin reflex distance 2 (MRD2), palpebral fissure (PF), total lid length, upper and lower lid length, area, medial area, center area, and lateral area. Univariate linear regression analysis showed a significant positive association between amount of exophthalmos reduction and the following parameters: area (p = 0.007); MRD2 (p = 0.043); upper lid length (p = 0.045); lower lid length (p = 0.006); medial area (p = 0.045); and lateral area (p = 0.005). Multivariate linear regression analysis showed only two parameters, lower lid length (p = 0.022) and lateral area (p = 0.019) were associated with exophthalmos reduction. A reduction in the inferior lateral part of the eyelid (lateral area + lower lid length) occurred after orbital decompression surgery in patients with thyroid-associated orbitopathy.

  20. Excision of nodular basal cell carcinoma involving the lower eyelid tarsal skin using a grey line-splitting, posterior lamella-sparing technique.

    Science.gov (United States)

    Qin, Vincent; Paridaens, Dion

    2018-02-20

    To describe a posterior lamella-sparing technique to resect nodular basal cell carcinoma involving the inferior part of the tarsal skin of the lower eyelid. Excision of nodular basal cell carcinoma of the tarsal skin using a grey-line-splitting technique with preservation of the posterior lamella. Specimen was sent for frozen section control. Additional excision was performed in caseof irradicality. The defect was closed with a free skin graft from the ipsi- or contralateral upper eyelid. We show a case series of three patients with lower eyelid basal cell carcinoma and investigated radicality on histology, aesthetic outcome and clinical recurrence during a follow-up of 18 months. Pre, intra, and postoperative photographs were obtained. In all cases radicality was reached. In all patients, the skin graft was viable, with no recurrence after 18 months. Excellent aesthetic results were obtained. Anterior lamellar resection of nodular basal cell carcinomas involving the tarsal lower eyelid skin using a grey line lid-splitting technique is a simple and one-step technique with good clinical outcome. It may avoid the morbidity associated with full thickness eyelid resection and might be useful for other, nonmalignant eyelid lesions.

  1. Sebaceous Gland Carcinoma of Eyelid- A Tarnished Masquerade

    Science.gov (United States)

    Parija, Sucheta; Pujahari, Susanta; Mallick, Jyotiranjan

    2016-01-01

    Malignant tumours of the face are usually seen in the periocular region, mainly on eyelids most commonly in the inferior eyelid, medial canthus and superior eyelid, respectively. The prime treatment for eyelid malignant tumours is the total excision of the lesion with frozen section control or by Mohs Micrographic surgery. The postoperative defects should be reconstructed judicially taking care that the near normal anatomical and functional recovery is achieved. The Cutler-Beard flap procedure, a good alternative in the reconstruction of superior near-total eyelid defects resulted in good restoration of anatomy and function in our patient. We report a case of an eyelid growth persisting for 2 year duration mimicking a chalazion. Clinically the eyelid mass had malignant features and hence was planned for wide excision with frozen section of margins. After confirming the tumour free margins, we performed reconstruction of the eyelid defect with Cutler Beard flap procedure. She was followed up for one year which showed no local recurrence or regional/distant metastases. PMID:27190853

  2. Pigmented basal cell carcinoma of the eyelid in Hispanics

    Directory of Open Access Journals (Sweden)

    Lily Koo Lin

    2008-10-01

    Full Text Available Lily Koo Lin1, Han Lee2, Eli Chang11Department of Oculoplastics, Doheny Eye Institute, Los Angeles, CA, USA; 2Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USABackground: Pigmented basal cell carcinoma (PBCC of the eyelid has not been well cited in the literature, and is often overlooked in the differential diagnosis of pigmented eyelid lesions. We aim to describe PBCC of the eyelid in Hispanic patients.Methods: Retrospective review of patients with eyelid skin cancer who presented to the Department of Dermatology at the Keck School of Medicine of the University of Southern California and the Doheny Eye Institute from January 2002 to November 2005.Results: Sixty-nine of the 79 patients with eyelid skin cancer had basal cell carcinoma. Eight of these patients were Hispanic. Four of the eight Hispanic patients had PBCC.Conclusions: Although eyelid PBCC is regarded as a rare condition, it may occur more commonly in the Hispanic population and should be remembered in the differential diagnosis of pigmented eyelid lesions.Keywords: pigmented basal cell carcinoma, eyelid, skin cancer, lesions

  3. Mueller's Muscle Conjunctival Resection With Skin-Only Blepharoplasty: Effects on Eyelid and Eyebrow Position.

    Science.gov (United States)

    Moore, Grant H; Rootman, Daniel B; Karlin, Justin; Goldberg, Robert A

    2015-01-01

    To determine the effect of concurrent blepharoplasty and Mueller's muscle conjunctival resection (MMCR) surgery on eyelid position and eyebrow height. Clinical data from 274 eyes that met inclusion criteria for this study were reviewed. Mueller's muscle conjunctival resection surgery was performed alone in 198 eyes and was performed with concurrent blepharoplasty in 76 cases. In this study blepharoplasty consisted of only skin removal, leaving the muscle, fat, and tarsus intact. Preoperative and postoperative pupil to eyebrow, and eyelid margin to eyebrow distances were calculated and compared. Preoperative margin reflex distance 1 (MRD1) was similar for both groups of patients (p > 0.05) as was the postoperative MRD1 (p > 0.05). The change in MRD1 was similar between patients undergoing MMCR alone versus those undergoing MMCR with blepharoplasty (1.5 mm vs. 1.3 mm, respectively, p = 0.36). For similar amounts of tissue resection, the postoperative change in MRD1 was similar for patients undergoing MMCR-only surgery and MMCR with blepharoplasty (p > 0.05). Eyebrow height significantly decreased following both MMCR with blepharoplasty (0.73 mm, p < 0.05) and MMCR-only surgery (0.87 mm, p < 0.05), and this change in eyebrow height was not significantly different between the 2 groups. Combining MMCR surgery with skin-only blepharoplasty does not significantly alter eyelid height when compared with MMCR surgery alone for the correction of upper eyelid ptosis. This may assist in preoperative planning for combined MMCR with skin-only blepharoplasty.

  4. Tumores benignos de los párpados Bening eyelid tumors

    Directory of Open Access Journals (Sweden)

    Clara G. Gómez Cabrera

    2001-12-01

    Full Text Available Se realizó un estudio descriptivo, de tipo retrospectivo de 266 expedientes clínicos correspondientes a pacientes con diagnóstico histológico de neoplasias benignas de los párpados operados en el departamento de Cirugía Oculoplástica del Hospital Oftalmológico "Ramón Pando Ferrer" en el período comprendido entre enero de 1989 y diciembre de 1999. El 36 % de los pacientes se encontraban en el grupo comprendido entre los 31 y los 50 años de edad, y solo el 6 % eran menores de 15 años. El 64 % de los casos operados correspondieron al sexo femenino. El 41 % de las neoplasias se localizaron en párpado superior y el 40 % en el inferior. Encontramos 16 tipos histológicos de tumores. Los tumores benignos de los párpados son más frecuentes a partir de la tercera década de la vida. Afectan preferentemente al sexo femenino. Se localizan preferentemente en el párpado superior e inferior. Los quistes, seguidos por los nevus y las queratosis fueron los diagnósticos histológicos más frecuentes.A descriptive and retrospective study of 266 medical histories corresponding to patients with histological diagnosis of benign eyelid neoplasias was made. They were operated on at the Oculoplastic Surgery Department of "Pando Ferrer" Ophthalmologic Hospital from January, 1989, to December, 1999. 36 % of the patients were in the group aged 31-50 and only 6 % were under 15. 64 % of the cases that underwent surgery were females. 41 % of the neoplasias were localized in the upper eyelid and 40 % in the lower eyelid. 16 histological types of tumors were found. The benign eyelid tumors are more frequent from the third decade of life on, and females are the most affected. These tumors are localized mainly in the upper and lower eyelid. Cysts, followed by nevus and keratosis were the commonest histologic diagnoses.

  5. Indications, output and types of eyelid surgeries in a tertiary eye care ...

    African Journals Online (AJOL)

    Eyelid surgeries were performed on 237 eyes of 221 persons, 121(54.8%) were males. Mean age was 30.3 ± 17.8 years. Eyelid lacerations, chalazia, and eyelid tumours accounted for 30%, 25.8%, 21% of all morbidities respectively. 249 eyelid surgeries were performed, 246 (98.8%) as minor procedures and 3(1.2%) as ...

  6. Right upper limb bud triplication and polythelia, left sided hemihypertrophy and congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis: disorganisation-like spectrum or patterning gene defect?

    Science.gov (United States)

    Sabry, M A; al-Saleh, Q; al-Saw'an, R; al-Awadi, S A; Farag, T I

    1995-07-01

    A Somali female baby with right upper limb triplication, polythelia, left sided hemihypertrophy, congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis is described. It seems that the above described pattern of anomalies has not been reported before. The possible developmental genetic mechanism responsible for this phenotype is briefly discussed.

  7. Right putamen hemorrhage manifesting as apraxia of eyelid opening

    Directory of Open Access Journals (Sweden)

    Lin YH

    2013-09-01

    Full Text Available Yi-Hui Lin,1 Li-Min Liou,2,3 Chiou-Lian Lai,1,2 Yang-Pei Chang1,2 1Department of Neurology, Kaohsiung Medical University Hospital, 2Department of Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 3Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Purpose: The purpose of this report is to demonstrate a rare clinical manifestation of apraxia eyelid opening related to a basal ganglia lesion. Case report: In this study, we report a 91-year-old woman suffering from difficulty in eyelid opening after being treated for myocardial ischemia with dual antiplatelet medications. She could open her eyelid with fingers touching her forehead. Brain computed tomography revealed a right putamen hemorrhage. Surface electromyography revealed persistent frontalis muscle contraction during relaxation of orbicularis oculi muscles. Apraxia of eyelid opening was diagnosed. Her eyelid symptom resolved 2 months later. Conclusion: Apraxia of eyelid opening may be caused by subcortical hemorrhage of the basal ganglia. In addition to the primary motor cortex and supplemental motor area, the basal ganglia may also play a role in eyelid opening. Keywords: intracranial hemorrhage, basal ganglia, orbicularis oculi muscle, frontalis muscle

  8. Comparison between eyelid indices of ptotic eye and normal fellow eye in patients with unilateral congenital ptosis.

    Science.gov (United States)

    Bagheri, Abbas; Tavakoli, Mehdi; Najmi, Hadi; Erfanian Salim, Reza; Yazdani, Shahin

    2016-01-01

    To evaluate the relationship between levator muscle function (LMF) and other eyelid parameters in the normal and affected eyes of patients with unilateral congenital ptosis. This study includes subjects with unilateral congenital upper lid ptosis who were referred for operation over a 2-year period. Patients with other eyelid abnormalities and previous eyelid surgery were excluded. Eyelid parameters including LMF, lid fissure height (LFH) and margin reflex distance (MRD) were measured in both eyes and analyzed. A total of 77 patients with mean age of 26.4 ± 16.4 years were enrolled in the study. Mean LMF was 8.3 ± 4.6 mm in the ptotic and 13.1 ± 3.6 mm in the normal fellow eyes. Each millimeter of difference in LMF was associated with 0.30 mm of difference in LFH (95% CI: 0.25-0.35, P muscle dysfunction in the development of congenital ptosis and its severity. Furthermore, a direct correlation was also present between LMF of ptotic and non-ptotic eyes suggesting possible bilateral involvement in apparently unilateral congenital ptosis. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Digital Analysis of Eyelid Features and Eyebrow Position Following CO2 Laser-assisted Blepharoptosis Surgery

    OpenAIRE

    Zheng, Xiaodong; Kakizaki, Hirohiko; Goto, Tomoko; Shiraishi, Atsushi

    2016-01-01

    Background: To compare the margin reflex distance of the upper (MRD-1) and lower (MRD-2) eyelids and the eyebrow height (EBH) in patients with involutional and hard contact lens wear--induced blepharoptosis before and after ptosis surgery. Methods: Sixty patients with acquired blepharoptosis were studied. Group 1 consisted of 30 patients with involutional ptosis (age, 75.8???6.4 years), and group 2 consisted of 30 patients with hard contact lens wear?induced ptosis (age, 50.2???7.1 years). Al...

  10. Clinical observation on the reconstruction of large areas lower eyelid defect with Medpor spacer graft

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    Hai-Yan Li

    2014-08-01

    Full Text Available AIM: To observe the effects of porous polyethylene(Medporas a spacer graft in the reconstruction of large areas eyelid defect after the operation of malignant tumors of lower eyelids.METHODS: Nineteen cases(19 eyesof malignant tumors of lower eyelid underwent the eyelid reconstruction were selected. Medpor lower eyelid inserts implantation were used to replace tarsal joint sliding conjunctival flap and pedicle flap, and repaired full-thickness lower eyelid defects then underwent eyelid reconstruction. RESULTS: Appearance of eyelids and functional improvements were satisfactory with no stimulation on the eyeball and no effect on the visual function. Implants is with no absorption, shift, exclusion or infection and no tumor recurrence in all cases during the follow up for 6-36mo.CONCLUSION: Medpor lower eyelid inserts implantation can instead tarsal plate for the reconstruction of medium to large areas lower eyelid defect, which is easy performing with rare complications. It is an ideal alternatives of tarsal plate.

  11. [Edematous swelling of the eyelids caused by contact allergy].

    Science.gov (United States)

    Blum, A; Brummer, C; Lischka, G

    1998-08-01

    Cosmetics and ophthalmological topical preparations are the main causes of allergic contact eczema about the eye. In most cases, clinical signs are conjunctival injection, blepharitis, periorbital dermatitis and edema of lids, often combined with itching. Pure edematous swelling of the eyelids should not immediately be blamed on a contact allergy, but sufficiently evaluated to exclude a benign or malignant process of the eyelids, orbita, lacrimal duct and paranasal sinus. We present a patient with pure edematous swelling of the eyelids due to a contact allergy by the sympathicomimetic phenylephrine hydrochloride, an uncommon allergen.

  12. Radiation therapy for carcinoma of the eyelid

    International Nuclear Information System (INIS)

    Tsuchiya, Miwako; Takahashi, Mitsuhiro; Shinozaki, Jun; Kaneda, Koichi; Oda, Norio; Tabuchi, Yoshiko

    1987-01-01

    Between 1969 and 1985, 30 patients with carcinomas of the eyelid were treated by radiation, including 19 primary cases and 11 secondary cases. The latter were less controlable than the former. According to histology, there were 21 squamous cell carcinomas, 6 basal cell carcinomas and 3 adenocarcinomas. Among the 21 patients with squamous cell carcinomas, 5 had local recurrences, 10 had lymph node metastasis and 3 had distant metastasis. Patients with other histological classifications had no local recurrences, except for one who received incomplete therapy due to diabetes. Almost all of the controlled patients with squamous cell carcinomas were treated with a TDF value greater than 90. Although the visual function was damaged by irradiation in seven patients, the lesions of 6 of them were too advanced to avoid radiation injuries. (author)

  13. CONGENITAL EYELID EVERSION - A CASE REPORT WITH REVIEW OF LITERATURE

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    Chinmayee

    2015-03-01

    Full Text Available INTRODUCTION: Congenital eversion of the eyelids, a condition usually seen shortly after birth is a rare condition affecting one or both eyelids of the eye. Many etiologies have been described but no specific cause has been identified. We report a case of congenital eve rsion of eyelids which was managed conservatively with spontaneous correction seen in 6 days. KEYMESSAGE: Congenital eversion of the eyelids is a rare easily identifiable and potentially treatable condition. Decision of surgical intervention has to be take n with care and must be individualized for each case. Congenital eversion must be differentiated from congenital ectropion due to causes like ichthyosis as the treatment widely differs. All ophthalmologists need to be aware of this condition as it can be e asily managed on an outpatient basis

  14. Eversion of third eyelid and its correction using microsurgery

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    Hadži-Milić Milan

    2006-01-01

    Full Text Available Eversion of the third eyelid - EPT, is a condition when the third eyelid rolls back, actually of its margin anteriorally. It occurs almost exclusively in big dog breeds such as the German shepherd, doga, St. Bernard, Newfoundalnder, retrievers, and English bulldogs. Congenital or acquired weakness of the PT cartilage is considered as the main reason for the incidence of EPT. The clinical picture is diverse and it most often depends on the intensity, duration and possible complications. The most prominent sign is a certain degree of EPT. Therapy is based on careful submucous excision of the deformed cartilage, with optional stitching of the conjunctive. The most frequent complication is a repeated eversion of the eyelid, as well as protrusion of the PT gland. The prognosis is good if the preoperative and operative procedure are carried out as required, and the eyelid is not too long. .

  15. Frontalis suspension surgery to treat patients with blepharospasm and eyelid opening apraxia: long-term results.

    Science.gov (United States)

    Dressler, Dirk; Karapantzou, Chrisanthi; Rohrbach, Saskia; Schneider, Simon; Laskawi, Rainer

    2017-02-01

    Blepharospasm may be accompanied by eyelid opening apraxia (EOA) reducing the efficacy of botulinum toxin (BT) therapy. The frontalis suspension operation (FSO) is then the only effective treatment option available. We want to report the first long-term results with FSO. We studied 15 patients with blepharospasm and EAO unresponsive to BT therapy (9 females, 6 males, age 61.9 ± 11.5 years). FSO was performed by applying 2 polytetrafluoroethylene threads (PTFE, Gore-Tex ® ) per eye connecting the frontalis muscle to the upper eye lid. Tension of the two carrés was set to produce a palpebral fissure width of 2-3 mm. Therapy outcome was monitored by a quality-of-life questionnaire (QoL-Q) and a self-assessment calendar reviewing postoperative days 0-9 (T1), 10-89 (T2), 90-179 (T3), 180-365 (T4), and >365 days (T5). Altogether, 40 FSO were performed. Postoperatively, all patients reported improved eyelid opening, 4 (27%) complete remission of symptoms. At T1, this improvement was 74.6 ± 26.4% on the self-assessment scale, after 1 year 68.2 ± 27.5%. Throughout the observation period (T1-T5), the improvement was 71.9 ± 25.6%. All 19 items on the QoL-Q (except for presence of involuntary eye lid closure) showed postoperative improvement. Adverse effects included circumscript upper eyelid haematomas, suture extrusion, suture granuloma, lacrimation, and infections. In all patients, BT therapy had to be continued to treat orbicularis oculi contractions. Our first long-term results demonstrate that FSO is a benign procedure producing robust and stable therapeutic effects on EOA in blepharospasm.

  16. Merkel Cell Carcinoma of the Eyelid and Periocular Region

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    Merritt, Helen [Orbital Oncology and Ophthalmic Plastic Surgery Program, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, Unit 1488, Houston, TX 77030 (United States); Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, TX 77030 (United States); Sniegowski, Matthew C.; Esmaeli, Bita, E-mail: besmaeli@mdanderson.org [Orbital Oncology and Ophthalmic Plastic Surgery Program, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, Unit 1488, Houston, TX 77030 (United States)

    2014-05-09

    Merkel cell carcinoma (MCC) in the eyelid and periocular region can be treated surgically, in most cases, with preservation of the eye and reasonable visual function. Adjuvant radiation therapy, sentinel lymph node biopsy, and chemotherapy should be considered for MCC of the eyelid and periocular region, especially for larger tumors that are T2b or more advanced and lesions that present with regional nodal or distant metastasis.

  17. Merkel Cell Carcinoma of the Eyelid and Periocular Region

    International Nuclear Information System (INIS)

    Merritt, Helen; Sniegowski, Matthew C.; Esmaeli, Bita

    2014-01-01

    Merkel cell carcinoma (MCC) in the eyelid and periocular region can be treated surgically, in most cases, with preservation of the eye and reasonable visual function. Adjuvant radiation therapy, sentinel lymph node biopsy, and chemotherapy should be considered for MCC of the eyelid and periocular region, especially for larger tumors that are T2b or more advanced and lesions that present with regional nodal or distant metastasis

  18. The prefabricated temporal island flap for eyelid and eye socket reconstruction in total orbital exenteration patients: A new method.

    Science.gov (United States)

    Altindas, Muzaffer; Yucel, Akin; Ozturk, Guncel; Sarac, Mesud; Kilic, Ali

    2010-08-01

    Anophtalmic socket reconstruction is a challenging problem in plastic surgery. We had described a prefabricated superficial temporal fascia island flap and used this technique in >50 enucleation patients with severe socket contraction ending in excellent or good results for 28 years (Altindas- 1 procedure). However, the flap was not suitable for the exenteration patients with complete eyelid loss. The technique was modified and used in exenteration patients (Altindas-2 procedure). In this 2-staged procedure, the temporoparietal fascia is prefabricated with a full-thickness skin graft from the retroauricular area, and a strip of scalp is preserved at the middle of the flap. The flap is transferred to the orbit through a subcutaneous tunnel at the second stage. The prefabricated flap is used for the reconstruction of eyelids and periorbital skin; scalp island is used for the reconstruction of lid margins and eyelashes; and the neighboring bare temporoparietal fascia is used for the augmentation of the periorbital soft tissues. The orbital lining is elevated as a centrally based skin flap and used for the reconstruction of the eye socket, fornicles, and posterior lining of the eyelids. The technique was used successfully in 5 total exenteration patients with complete eyelid loss. In 1 patient, the ipsilateral temporal island flap was used previously, and the flap was prepared from the contralateral site and transferred to the anophtalmic orbit as a free flap 5 weeks later. By this procedure, it is possible to reconstruct a stable eye socket that is suitable for ocular prosthesis, upper and lower fornicles, periorbital skin with good color matching, naturally looking eyelids with eyelashes and lid margins, and medial and lateral canthal areas. It is also possible to improve periorbital soft tissue atrophy, which is an important problem in patients who had radiotherapy previously. Free transfer of the flap provides a new solution for the reconstruction of cases that

  19. A clinicopathological study of eyelid malignancies from central India

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    Jahagirdar Sameer

    2007-01-01

    Full Text Available Background: Eyelid malignancies are completely treatable if detected early. The treatment depends on the invasiveness of the cancer which in turn depends on the type of malignancy. Aim: The aim of the study was to characterize the distribution of the types of eyelid malignancies in central India. Settings and Design: The study was conducted in the Department of Plastic and Maxillofacial Surgery at a tertiary care hospital. Materials and Methods: We report a series of 27 cases of eyelid malignancies. In the same case series, we also include a case of malignant hemangiopericytoma which is an extremely rare form of eyelid malignancy worldwide. Statistical Analysis: Depending on the underlying statistical distribution, either analysis of variance (ANOVA or the Kruskal-Wallis (K-W test was used to assess the differential distribution of these variables across the types of eyelid malignancies observed in this study. Results: We observed that sebaceous cell carcinoma (~37% was almost as prevalent as basal cell carcinoma (~44% in the study subjects and had an earlier age of occurrence and a more rapid clinical course. Conclusions: Sebaceous cell carcinoma of the eyelid is almost as common as basal cell carcinoma in a large tertiary care centre in central India.

  20. Botulinum toxin for treating unilateral apraxia of eyelid opening in a patient with congenital myotonia

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    Estrella Fernández

    Full Text Available ABSTRACT A 37-year-old female presented with severe apraxia of lid opening (ALO affecting the right upper lid associated with Becker congenital myotonia (MC. The patient had a history of right upper lid ptosis for 25 years that was exacerbated over the previous month with severe incapacity to open her right eye. No other associated neurological or ophthalmic symptoms were observed. The patient was treated with botulinum toxin (BoNT-A injection into the pretarsal and lateral canthus region of the orbicularis oculi of the affected eyelid. Treatment with BoNT-A is an effective method of managing ALO in Becker MC. This is the first case of unilateral ALO in the course of Becker MC that was successfully treated with injections of botulinum toxin.

  1. Botulinum toxin for treating unilateral apraxia of eyelid opening in a patient with congenital myotonia.

    Science.gov (United States)

    Fernández, Estrella; Latasiewicz, Marta; Pelegrin, Laura; Romera, Manuel; Schellini, Silvana; Galindo-Ferreiro, Alicia

    2017-01-01

    A 37-year-old female presented with severe apraxia of lid opening (ALO) affecting the right upper lid associated with Becker congenital myotonia (MC). The patient had a history of right upper lid ptosis for 25 years that was exacerbated over the previous month with severe incapacity to open her right eye. No other associated neurological or ophthalmic symptoms were observed. The patient was treated with botulinum toxin (BoNT-A) injection into the pretarsal and lateral canthus region of the orbicularis oculi of the affected eyelid. Treatment with BoNT-A is an effective method of managing ALO in Becker MC. This is the first case of unilateral ALO in the course of Becker MC that was successfully treated with injections of botulinum toxin.

  2. Primary basosquamous carcinoma of the lower eyelid with ocular invasion A case report.

    Science.gov (United States)

    Papadopoulos, Georgios Ouilson; Charitonidi, Eleni; Filippou, Nikolaos; Fanidou, Domna; Filippou, Dimitrios; Scandalakis, Panagiotis

    2018-03-26

    Ocular invasion is extremely rare for a primary eyelid Basosquamous Carcinoma (BSC). It can however occur in neglected cases if the clinical signs are overseen and the BSC is misdiagnosed for a less aggressive skin carcinoma. A 58-year-old man suffering from an inferior eyelid BSC that had been neglected for 7 years was referred to our clinic. A local infiltration of the maxillary sinus and the contents of the orbit by the tumor was discovered, and he was managed with a left orbital exenteration and resection of the involved orbital bone. A follow up was established. BSC is a rare type of skin malignancy which as an entity rests between Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), and its aggressive nature is often greater than that of the BCC and the SCC. Having no specific clinical features differentiating it from other BCC types, it can only be diagnosed by an adequate biopsy. Its early diagnosis is crucial in diminishing it's recurrence rate and it's metastatic potential. The standard therapeutical approach is the complete excision of the tumor, best performed by Mohs micrographic surgery. In cases of ocular infiltration, orbital exenteration is also usually necessary. Suspect, rapidly growing skin lesions should alert clinicians and an adequate biopsy should be performed. Regarding BSC, prompt and complete excision along with systemic exclusion of metastases and a close follow up are necessary. Adjuvant radiotherapy and chemotherapy could be beneficial to the patients. Basosquamous carcinoma (BSC), Basal cell carcinoma (BCC), Eyelid tumor, Ocular tissue invasion, Imiquimod, Maxillectomy, Metatypical basal cell carcinoma, Mohs micrographic surgery, Orbital exenteration, Orbit invasion, Squamous cell carcinoma (SCC), Vismodegib.

  3. Mucinous sweat gland adenocarcinoma of the eyelid - current knowledge of a rare tumor.

    Science.gov (United States)

    Segal, Avichai; Segal, Nili; Gal, Andrew; Tumuluri, Krishna

    2010-12-01

    To review the medical literature on mucinous sweat gland adenocarcinoma of the eyelid (MSA) and present two new cases. Details of published case reports and small series (between 1971-2010) were evaluated and summarized including two patients diagnosed and treated at our institution. Data regarding age, gender, ethnicity, precise location, clinical presentation, treatment and follow up of each patient were collected. 25 reports describing 55 patients were found in the medical literature. The mean age was 61.3 years (30-87), 22(59%) were male and 28(80%) were Caucasian. In 23(44.2%) patients the lesion was in the lower lid, in 20(38.5%) in the upper lid, in 3(5.7%) involving both lids and in 6(11.6%) in a canthus. In 12(21.8%) patients a lesion with a benign diagnosis was previously excised from the same location. In 2 of them histological re-examination resulted in a diagnosis of MSA. Intraorbital involvement was found in 2(3.6%) patients. Regional lymph node metastasis was found in 2(4.4%) patients. Surgical excision was the treatment of choice using Mohs' micrographic-controlled excision technique in recent years. Radiotherapy was applied to 2 patients with clinical resolution in 1. Recurrence of the tumor was reported in 14(30%) patients. MSA is a rare tumor of the eyelid with no clinically distinguishing features. It should be suspected particularly with recurrent eyelid lesions and must be differentiated from metastatic disease. The tumor may extend into the orbit and metastasize regionally. Surgical removal with continued regular follow-up examination is the treatment of choice.

  4. Eyelid Edema: A Rare Cause of a Common Sign

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    Andreia Soares

    2017-01-01

    Full Text Available We report a 48-year-old female patient who presented to the emergency room with right eyelid edema, with 3 days of evolution. She had suffered minor trauma to this eye one week before. She reported episodes of right eyelid swelling of spontaneous resolution since the occurrence of a traumatic brain injury 5 years ago. Ophthalmological examination showed a soft and painless eyelid edema of the right eye. Brain computed tomography showed an area of bone discontinuity of the orbital roof with brain herniation and a CSF leak into the eyelid (blepharocele. Magnetic resonance confirmed the result of TC and revealed an area of frontal encephalomalacia. Ibuprofen (800 mg/day was prescribed, with complete resolution within 20 days. She was evaluated by Neurosurgery with no indication of surgery due to the resolution of the edema and absence of symptoms. Blepharocele is a rare entity that should be considered in the differential diagnosis of unilateral eyelid edema. It can be secondary to an orbital fracture or congenital lesion.

  5. Comparison of two surgical treatments for pediatric lower eyelid trichiasis

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    Yan-Xia Xiao

    2014-06-01

    Full Text Available AIM: To compare the clinical results of suture method and partial eyelash resection treating for pediatric eyelid trichiasis, and screen an effective method for the treatment of pediatric lower eyelid trichiasis. METHODS: Fifty-six cases of pediatric patients with lower eyelid trichiasis were randomly divided into a control group and an observation group in accordance with the method of drawing lots, and each group was 28 cases. The control group was treated with suture method, and the observation group was treated with partial eyelash resection. The clinical efficacy, patient satisfaction before and after treatment, and the incidence of complications were compared. RESULTS:(1The clinically total effective rate was 74% of the control group, which was 89% of the observation group, and there were statistical differences of the clinical efficacy between the two groups(PPPPCONCLUSION: The treatment of children with lower eyelid trichiasis, suture method is simple and can be performed under local anesthesia in collaboration with children, but with a higher relapse rate, some patients required reoperation; partial resection of eyelashes can be more thoroughly solve the problem of pediatric eyelid trichiasis with low recurrence rate, but children need to be under general anesthesia with some of big risk. So partial resection of eyelashes is unsuitable for using in clinical practice widely and can be used in special cases.

  6. A case of primary signet-ring cell/histiocytoid carcinoma of the eyelid: immunohistochemical comparison with the normal sweat gland and review of the literature.

    Science.gov (United States)

    Iwaya, Mai; Uehara, Takeshi; Yoshizawa, Akihiko; Kobayashi, Yukihiro; Momose, Masanobu; Honda, Takayuki; Ota, Hiroyoshi

    2012-12-01

    Primary signet-ring cell/histiocytoid carcinomas of the eyelid are extremely rare tumors considered to originate from sweat glands. Here, we report the case of a 72-year-old man diagnosed with primary signet-ring cell/histiocytoid carcinoma of the eyelid and present immunohistochemical analyses of the eyelid apocrine gland (Moll gland) and apocrine and eccrine sweat glands of perineum and axilla. Widespread infiltration of tumor cells with signet-ring cell or histiocytoid appearance was observed in his left eyelid, orbit, and periocular lesion. Tumor cells expressed mucins and showed immunoreactivity that was similar to that of the Moll gland: MUC6(+), GlcNAcα1→4Gal→R(-), MUC2(-), MUC5AC(-), GCDFP15(+), CD15(+), S100(-), CK7(+), CK20(-), ER(+), PgR (+), HER2(-), E-cadherin(+), p63(-), PSA(-), and TTF-1(-). The tumor cells differed from those of perineal and axillary apocrine and eccrine sweat glands, which were MUC6(-). The Moll gland was ER(-) and PgR(-), whereas perineal and axillar apocrine sweat glands were ER(+) and PgR(+), and perineal and axillary eccrine sweat glands were ER(+) and PgR(-). The tumor showed characteristics similar to that of the eyelid Moll gland, which is demonstrated to be an apocrine gland with a protein expression distinct from that of other apocrine glands. MUC6 and GCDFP15 expression are useful in identifying the Moll gland immunophenotype and GCDFP15, ER and PgR expression are useful in distinguishing primary eyelid signet-ring/histocytoid carcinoma from gastrointestinal malignancies.

  7. Imaging meibomian glands on a patient with chalazia in the upper and lower lids: a case report.

    Science.gov (United States)

    Srinivasan, Sruthi; Menzies, Kara L; Sorbara, Luigina; Jones, Lyndon W

    2013-08-01

    To describe the meibomian gland (MG) appearance in a case of eyelid chalazia, using a novel meibography method. A 29-year-old female of South Asian origin presented with mild swelling in the lower lid of the left eye. The patient also presented with a history of a recurrent chalazion in the upper lid of the same eye, which later progressed to an active chalazion. A chalazion also developed in the upper lid of the right eye. Meibography was performed using a novel Keratograph (Keratograph 4, OCULUS, Wetzlar, Germany) to evaluate the structure of the MG in the area affected by the chalazia. The area of the recurrent chalazion in the upper left lid showed partial and/or complete MG loss. The active chalazia in the lower left lid and the upper right lid showed inflammation and MG drop out at the affected site. The inflammation was found to be reduced during the follow-up visits, however disappearance of MG very specific to the region of the chalazion was observed. The Keratograph 4 was able to image the MG structures clearly, allowing the clinician to monitor the progression of chalazia and the MG loss in the affected areas. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  8. Analysis of lower eyelid aging in an Asian population for customized lower eyelid blepharoplasty.

    Science.gov (United States)

    Lee, Hwa; Ahn, So Min; Chang, Minwook; Park, Minsoo; Baek, Sehyun

    2014-03-01

    The objectives of this study were to evaluate the factors that contribute to aging in the lower eyelids and periorbital changes in Asians and to analyze the contribution of different anatomic factors before surgery. We analyzed photographs and examination findings of 108 patients older than 80 years who had consultations for lower eyelid blepharoplasty. Structural changes were categorized to 7 anatomical categories, and each category was scored from 0 to 3 based on severity. The total point for each category for all patients was divided by the 456 total possible points and was considered a cumulative contribution score for that category. "A uniqueness score" for each patient was calculated as the maximum score in 1 category divided by the patient's total score to reflect the percentage contribution of the patient's most severe anatomic problem. A total of 108 cases (51 male and 57 female patients) were evaluated. The mean age was 57 ± 11 years (age range, 30-75 years). The cumulative contribution score for each category was as follows: orbital fat prolapse 33.8 (medial 15.3, central 11.7, lateral 6.8), skin laxity 22.3%, periorbital hollow 20.8 (tear trough 15.5, lateral orbital rim 5.3), septal confluence 9.5, orbicularis oculi muscle hypertrophy 3.6, triangular malar mound 3.4, and eyelid fluid 0.5. The average uniqueness score was 40.1%, and skin laxity and orbital fat prolapse had the highest average uniqueness score, but no single category played a dominant role in most patients. Medial orbital fat prolapse and skin laxity had the highest proportion of grade 3 scores of 9.5% and 6.7%, respectively. When the patients were grouped according to age, either younger than 50 years or older than 50 years, there was a prominent difference in orbital fat prolapse and skin laxity between the 2 groups. Various anatomic factors were related to periorbital changes in Asian patients. Understanding of the complex factors that contribute to periorbital changes during the

  9. Kaposi Sarcoma of the eyelid as an initial manifestation of AIDS.

    Science.gov (United States)

    Teixeira, Ana Isabel; Neno, Miguel; Badura, Robert; Borges-Costa, João; Filipe, Paulo Leal

    2016-07-15

    Kaposi sarcoma (KS) is a multifocal systemic disease that originates in the vascular endothelium related to Human Herpes Virus 8 (HHV-8). In the early 1980s the first series of cases of disseminated Kaposi Sarcoma in HIV infected patients were reported. However, with the advent of highly active antiretroviral therapy (HAART) since 1997, these cases are less frequently observed by clinicians. We report the case of a 40-year-old woman, presenting with two asymptomatic purpuric nodules localized in the superior and inferior left eyelids, occluding the palpebral fissure, which were present for 4 months prior to presentation. The eyelid nodules were determined to represent KS, but there were no additional cutaneous lesions. Pulmonary and gastric KS involvement was documented. Antiretroviral therapy was initiated along with pegylated liposomal doxorubicin. The nodules gradually disappeared and her immune status eventually improved. Ocular and periorbital involvement of KS associated with HIV-1 infection as the initial clinical manifestations is a rare advent. This case is important as it illustrates that disseminated KS was not to be predicted by the number or the extension of cutaneous lesions.

  10. Sebaceous adenomas of the eyelid and Muir-Torre Syndrome.

    Science.gov (United States)

    Jagan, Lisa; Zoroquiain, Pablo; Bravo-Filho, Vasco; Logan, Patrick; Qutub, Mohammed; Burnier, Miguel N

    2015-07-01

    Sebaceous adenomas (SAs) are rare, benign sebaceous gland tumours of the eyelid. SAs may be associated with primary internal malignancies. This association is known as Muir-Torre Syndrome (MTS). The purpose of this study was to approximate the prevalence of SAs, to determine the reliability of the clinical diagnosis of SAs and to demonstrate immunohistochemical staining of DNA mismatch repair proteins mutL homologue 1 (MLH1) and mutS homologue 2 (MSH2) for a case of MTS. We reviewed the histopathology reports from all eyelid specimens collected between 1993 and 2013 at the Henry C Witelson Ocular Pathology Laboratory to determine the proportion of SAs. For the SAs identified on histopathology, we looked at patient charts to see what diagnosis was originally suspected on clinical examination. Immunohistochemical staining for MLH1 and MSH2 was performed on all SAs to screen for MTS. Of the 5884 eyelid specimens collected, 9 were SAs (6 women, 3 men; 42-72 years old). The diagnosis of SA was suspected clinically in only one of the nine cases based on the gross appearance of the eyelid lesion. Immunohistochemistry revealed one SA case with positive MLH1 expression and negative MSH2 expression. These findings prompted systemic work-up and this patient was diagnosed with MTS after discovery of a colon adenocarcinoma T2M0N0. The diagnosis of eyelid SA is rare. The importance of this benign eyelid tumour stems from its association with internal malignancies in MTS. Immunohistochemical staining of mismatch repair proteins MLH1 and MSH2 is a valid and accessible strategy for investigating MTS in patients with SAs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Irradiation of malignant eyelid melanoma with iodine 125 plaque

    International Nuclear Information System (INIS)

    Stanowsky, A.; Krey, H.F.; Kopp, J.; Kanitz, W.; Wagner, T.

    1990-01-01

    We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months

  12. Irradiation of malignant eyelid melanoma with iodine 125 plaque

    Energy Technology Data Exchange (ETDEWEB)

    Stanowsky, A.; Krey, H.F.; Kopp, J.; Kanitz, W.; Wagner, T. (Eye Clinic, Central Clinic, Augsburg (West Germany))

    1990-07-15

    We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months.

  13. Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results.

    Science.gov (United States)

    Karapantzou, Chrisanthi; Dressler, Dirk; Rohrbach, Saskia; Laskawi, Rainer

    2014-10-22

    We describe the results of 15 patients suffering from essential blepharospasm with apraxia of eyelid opening who underwent frontalis suspension surgery. Patients with apraxia of eyelid opening and unresponsive to botulinum toxin injections were studied. Bilateral frontalis suspension surgery was performed (sling operation) using polytetrafluoroethylene (Gore-Tex®) sutures. The patients reported the degree of improvement using a subjective rating scale to evaluate the benefit of the operation at two times after surgery (0-10 days and 180-360 days). The patients reported a high degree of subjective improvement. In the early postoperative period (0-10 days) the mean degree of subjective improvement was 74.6% (standard deviation (SD) 26.4%). At 180-360 days after surgery the mean improvement was 70.0% (SD 26.7%). Small hematomas of the upper lid occurred postoperatively in all patients. Other complications were suture extrusions (9.1%), suture granulomas (6.1%), lacrimation (5.0%) and local infections (7.5%). Postoperatively, all patients needed additional botulinum toxin injections for optimal outcome. Frontalis suspension surgery is a minimally invasive and effective treatment option for apraxia of eyelid opening in patients with essential blepharospasm unresponsive to botulinum toxin injections alone.

  14. A gene prenature ovarian failure associated with eyelid malformation maps to chromosomes 3q22-q23

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    Premature ovarian failure and XX gonadal dysgenesis leading to female infertility have been reported in association with an autosomal dominantly inherited malformation of the eyelids: blepharophimosis-ptosis-epicanthus inversus syndrome (BPES; MIM 110100). This association distinguishes BPES type I from BPES type II, in which affected females are fertile and the transmission occurs through both sexes. Recently, a gene responsible for BPES type II has been mapped to chromosome 3q22-q23, and the critical region for the gene location has been reduced to the interval between loci D3S1615 and D3S1316. Hitherto, however, no information regarding the localization of the gene for BPES type I, in which female ovarian failure is associated with eyelid malformation, has been available. We have studied two independent families affected with BPES type I, including a total of 12 affected individuals (6 infertile women) and 6 healthy relatives. The diagnostic criteria for the ophthalmological anomaly included (1) reduced horizontal diameter of palpebral fissures, (2) drooping of the upper eyelids, and (3) an abnormal skinfold running from the lower lids. Telecanthus and a flat nasal bridge were present in most cases. In both families the disease was transmitted only by the male, and no affected woman of childbearing age was fertile. 12 refs., 2 figs., 1 tab.

  15. Perforating eyelid injury extending to the brain stem in a 17-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Yoshikawa-Kobayashi Izumi

    2010-01-01

    Full Text Available Abstract Introduction This case report describes a patient who had a perforating eyelid injury that extended to the brain stem. Case presentation A 17-year-old Japanese woman complained of decreased vision in her right eye, with severe ocular pain and headaches, after the metal tip of an umbrella struck her upper right eyelid accidentally. Her vision in the right eye decreased to light perception with commotio retinae, intraretinal hemorrhage, and severe lid swelling. Magnetic resonance imaging (MRI demonstrated edema of the head of the caudate nucleus and putamen, and the edema extended to the hypothalamus. The MRI findings indicated that the umbrella tip had penetrated through the eyelid and the posterior orbital wall. Vision improved to 20/50 in the right eye, with subretinal fibrosis caused by the choroidal rupture. Conclusions We recommend that MRI be performed on the orbit and brain in patients who appear to have symptoms that are inconsistent with the observed injury and when a severe orbitocranial injury is suspected.

  16. Cortical disconnection of the ipsilesional primary motor cortex is associated with gait speed and upper extremity motor impairment in chronic left hemispheric stroke.

    Science.gov (United States)

    Peters, Denise M; Fridriksson, Julius; Stewart, Jill C; Richardson, Jessica D; Rorden, Chris; Bonilha, Leonardo; Middleton, Addie; Gleichgerrcht, Ezequiel; Fritz, Stacy L

    2018-01-01

    Advances in neuroimaging have enabled the mapping of white matter connections across the entire brain, allowing for a more thorough examination of the extent of white matter disconnection after stroke. To assess how cortical disconnection contributes to motor impairments, we examined the relationship between structural brain connectivity and upper and lower extremity motor function in individuals with chronic stroke. Forty-three participants [mean age: 59.7 (±11.2) years; time poststroke: 64.4 (±58.8) months] underwent clinical motor assessments and MRI scanning. Nonparametric correlation analyses were performed to examine the relationship between structural connectivity amid a subsection of the motor network and upper/lower extremity motor function. Standard multiple linear regression analyses were performed to examine the relationship between cortical necrosis and disconnection of three main cortical areas of motor control [primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA)] and motor function. Anatomical connectivity between ipsilesional M1/SMA and the (1) cerebral peduncle, (2) thalamus, and (3) red nucleus were significantly correlated with upper and lower extremity motor performance (P ≤ 0.003). M1-M1 interhemispheric connectivity was also significantly correlated with gross manual dexterity of the affected upper extremity (P = 0.001). Regression models with M1 lesion load and M1 disconnection (adjusted for time poststroke) explained a significant amount of variance in upper extremity motor performance (R 2  = 0.36-0.46) and gait speed (R 2  = 0.46), with M1 disconnection an independent predictor of motor performance. Cortical disconnection, especially of ipsilesional M1, could significantly contribute to variability seen in locomotor and upper extremity motor function and recovery in chronic stroke. Hum Brain Mapp 39:120-132, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. The Correction of Involutional Entropion of Eyelid by Lateral Strip ...

    African Journals Online (AJOL)

    Involutional entropion is the most common type of entropion and usually involves the lower lids bilaterally, though not necessarily symmetrically.[1] The pathophysiologic mechanisms for the development of involutional entropion includes, horizontal eyelid laxity, detachment of retractors, overriding of the preseptal orbicularis ...

  18. C syndrome with skeletal anomalies, mental retardation, eyelid ...

    African Journals Online (AJOL)

    C syndrome with skeletal anomalies, mental retardation, eyelid chalazion, Bitot's spots and agenesis of the corpus callosum in an Egyptian child. ... broad nose, high arched palate, microretrognathia, low set ears, short neck, scoliosis, hypertrichosis over the back, talipes equinovarus as well as interatrial septal defect.

  19. Contemporary thoughts on lower eyelid/midface aging.

    Science.gov (United States)

    Buchanan, Dallas R; Wulc, Allan E

    2015-01-01

    Midfacial aging is a multifactorial, 3-D process that involves volume loss, volume descent, and skin alterations. Every anatomic component of the midface is affected. This article discusses the morphologic consequences of midfacial aging and reviews the salient literature relating to the numerous factors that contribute to an aged appearance of the lower eyelid and midface. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Eyelid and ocular surface carcinoma: diagnosis and management.

    Science.gov (United States)

    Yin, Vivian T; Merritt, Helen A; Sniegowski, Matt; Esmaeli, Bita

    2015-01-01

    Eyelid cancers account for 5% to 10% of all cutaneous malignancies. The incidence of eyelid cancer is approximately 15 cases per 100,000 individuals per year. Basal cell carcinoma is by far the most common cutaneous malignancy in the periocular area; other cutaneous malignancies that occur in this area include, in decreasing order of frequency, squamous cell carcinoma, sebaceous carcinoma, melanoma, and Merkel cell carcinoma. The most common treatment for eyelid carcinomas is surgical resection with frozen section examination for margin control, but exenteration may be needed when there is orbital invasion. Adjuvant radiotherapy may be needed in patients at high risk for local recurrence; sentinel lymph node biopsy may be considered in patients at high risk for lymph node metastasis. Primary or residual in situ disease of the conjunctiva can be treated with topical chemotherapy, such as mitomycin C, 5-fluorouracil, or interferon alpha-2 b. For patients with metastatic or locally advanced basal cell or squamous cell carcinoma not amenable to surgical excision or radiotherapy, targeted therapy against the hedgehog pathway (for basal cell carcinoma) or epidermal growth factor receptor (for squamous cell carcinoma) has been shown to be effective in preventing disease progression. Patients with eyelid and ocular surface malignancies need to be monitored with careful clinical examination for at least 5years after surgical treatment, and additional investigations may be warranted in some cases. Copyright © 2015. Published by Elsevier Inc.

  1. Effect of sleep deprivation on saccades and eyelid blinking

    NARCIS (Netherlands)

    Crevits, Luc; Simons, Brian; Wildenbeest, Joanne

    2003-01-01

    In this study the effect of sleep deprivation on specific components of eye and eyelid movement was investigated in a group of young and healthy subjects. The duration of sleep deprivation was 20 h. Each subject had to execute different saccade tasks: reflexive saccades, voluntary prosaccades and

  2. Fish Hook Injury of Eyelid: An Unusual Case

    African Journals Online (AJOL)

    [Figure 6]. Barb can be single or multiple with different types of baits like colored feathers (to imitate insect wings) and live baits like earthworm or grasshopper. Kamath[1] described a case of fishhook injury to the eyelid in which the fish hook was loaded with live maggots. Multiple barb fishhooks are much difficult to remove.

  3. Bilateral linear nevus comedonicus on eyelids – A rare presentation

    Directory of Open Access Journals (Sweden)

    Vijay Zawar

    2016-01-01

    Full Text Available We describe a female child with linear comedone-like lesions over both the eyelids which histologically confirmed Naevus Comedonicus. She only partially responded to topical tretinoin cream. There was no clinically evident overt systemic association in our case.

  4. Fibrosarcoma of the eyelid in two sibling Czech wolfdogs | Nordio ...

    African Journals Online (AJOL)

    To the best of authors' knowledge, this is the first report of canine eyelid fibrosarcoma. Since this rare tumor has been observed in two full siblings, we could speculate the existence of some genetic predisposition to sarcoma, however the present data did not allow any definite conclusion on the etiopathogenesis or genetic ...

  5. Outcomes of lower eyelid retractor recession and lateral horn lysis in lower eyelid elevation for facial nerve palsy.

    Science.gov (United States)

    Tan, P; Wong, J; Siah, W F; Malhotra, R

    2018-02-01

    PurposeTo report outcomes and complications of lower eyelid retractor recession and lateral horn lysis (RR) for lower eyelid elevation in patients with facial nerve palsy (FNP).Patients and methodsRetrospective review. Patients with FNP undergoing RR alone (group 1) or with adjunctive procedures (canthal suspension-group 2, tarsorrhaphy-group 3, and full-thickness skin graft-group 4) during a 5-year period were included. Patient demographics, lagophthalmos, occurrence of eyelid malpositions, recurrent retraction, and repeat procedures were noted from medical records. Measures of lower eyelid height (LEH) and lid lag on downgaze were obtained from standard photographs.ResultsForty-two patients (23 females, mean age was 59 years) were included. Mean follow-up was 24 months (range 6-77). Median improvement in LEH following surgery was significant in Group 1 (0.90 mm, IQR: 0.37-0.91, P=0.20) and in Group 2 (0.51 mm, IQR: 0.30-1.37, PFNP either alone or when combined as an adjunctive procedure. It does not aggravate paralytic ectropion although repeated retractor recessions may be required to improve retraction.

  6. Necrotizing Scleritis, Conjunctivitis, and Other Pathologic Findings in the Left Eye and Brain of an Ebola Virus-Infected Rhesus Macaque (Macaca mulatta) With Apparent Recovery and a Delayed Time of Death.

    Science.gov (United States)

    Alves, Derron A; Honko, Anna N; Kortepeter, Mark G; Sun, Mei; Johnson, Joshua C; Lugo-Roman, Luis A; Hensley, Lisa E

    2016-01-01

    A 3.5-year-old adult female rhesus macaque (Macaca mulatta) manifested swelling of the left upper eyelid and conjunctiva and a decline in clinical condition 18 days following intramuscular challenge with Ebola virus (EBOV; Kikwit-1995), after apparent clinical recovery. Histologic lesions with strong EBOV antigen staining were noted in the left eye (scleritis, conjunctivitis, and peri-optic neuritis), brain (choriomeningoencephalitis), stomach, proximal duodenum, and pancreas. Spleen, liver, and adrenal glands, common targets for acute infection, appeared histologically normal with no evidence of EBOV immunoreactivity. These findings may provide important insight for understanding sequelae seen in West African survivors of Ebola virus disease. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. Borderline to Moderate Blepharoptosis Correction Using Retrotarsal Tucking of Müller Muscle: Levator Aponeurosis in Asian Eyelids.

    Science.gov (United States)

    Chung, Seungil; Ahn, Byungjoon; Yang, Wonyong; Burm, Jansik; Bum, Jinsik; Kim, Kiyup; Kang, Sangyoon

    2015-02-01

    The purpose of this paper is to report the outcome of retrotarsal tucking of Müller muscle-levator aponeurosis for the correction of borderline to moderate ptosis in conjunction with esthetic blepharoplasty in Asian eyelids and to explore the relationship between the extent of advancement and change in the eyelid position (MRD1). The medical records of 290 consecutive patients who underwent retrotarsal tucking of Müller muscle-levator aponeurosis from February 2005 to November 2011 were reviewed. Of those, 26 patients (51 eyelids) were statistically analyzed. The correction was performed through an external upper blepharoplasty approach. Once the orbital septum was opened, the Müller muscle-levator aponeurosis was advanced and tucked under the posterior surface of the tarsus by a single lifting suture. The average follow-up period was 20.6 months, with a range of 3-68 months. In 26 patients (51 eyelids), satisfactory results were recorded for 49 of 51 eyelids (96.1 %). The margin reflex distance-1 (MRD1) increased from 1.56 ± 0.70 mm preoperatively to 3.86 ± 0.94 mm postoperatively (p MRD1 of 1 mm was achieved. For 7.2 and 8.3 mm of advancement, the average MRD1 achieved was 2 and 3 mm each. A noteworthy complication, although not included in statistical analysis, was one patient who had developed corneal irritation caused by the conjunctival exposure to the non-absorbable suture 3 years after the surgery, which led the subject to have the suture removed. The author concludes that this procedure is one of the most effective surgical options in correcting borderline to moderate blepharoptosis in conjunction with esthetic blepharoplasty. The main advantage of such a method is that once the orbital septum is opened, Müller muscle-levator aponeurosis is easily advanced and tucked under the posterior surface of the tarsal plate without extensive dissection or resection, which is less traumatic and gives a more vertical lifting vector, thus producing excellent

  8. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: case report and review.

    Science.gov (United States)

    Villalon-Lopez, J S; Valle-Mejia, C A; Patino-Lara, A; Moreno-Perez, B A; Munoz-Lopez, J A; Alcantar-Andrade, A

    2006-01-01

    Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor for development of illness such as severe solar burns during childhood or adolescence. BCC is mainly located on sun-exposed sites, head and neck being the areas of more incidences; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options such as surgical and nonsurgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs' micrographic surgery is the standard treatment for all nonmelanoma skin cancers. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77-year-old patient is presented with BCC of inferior eyelid of 14 years' duration, formerly managed with radiotherapy; however, due to recurrent illness and invasion to the maxillary antrum, he needed supraestructure maxillectomy with left orbital exenteration.

  9. [Unilateral apraxia of eyelid closure in ischemic stroke: role of the right hemisphere in the emotional gesture communication].

    Science.gov (United States)

    Pérez-Martínez, D A; Puente-Muñoz, A I; Doménech, J; Baztán, J J; Berbel-Garcia, A; Porta-Etessam, J

    Apraxia of eyelid closure (AEC) is an infrequent disorder that is characterised by the inability to close the eyelids on command, although spontaneous blinking and reflex shutting of the eyes is preserved. Very few cases of unilateral AEC have been reported and no long-term follow-ups have been carried out. We report the case of a patient with unilateral AEC that was followed up over a 3-year period and also discuss the role played by the right hemisphere in this disorder. CASE REPORT" We examined the case of a 67-year-old right-handed male who was admitted because of a parietotemporal infarction with extension into the subcortex. A few days after the stroke the patient reported the inability to close his left eye on command, although he was still able to blink spontaneously and the blink and visual threat reflexes were preserved. This deficiency was associated to a dense hemiparesis on the left side and notable aprosodia affecting language. At 3 years' follow-up the AEC had not improved significantly. There are data to suggest that the right hemisphere is related to emotional perception and expressiveness, as well as the regulation of language prosody. Likewise, symbolic anthropology stresses the importance of winking as a gesture involved in non-verbal communication. These data suggest that AEC may be a consequence of a dysfunction of the role played by the right hemisphere in emotional expressiveness through gestures. The association with language aprosodia could support this hypothesis.

  10. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review

    Directory of Open Access Journals (Sweden)

    Villalon-Lopez J

    2006-01-01

    Full Text Available Basal cell carcinoma (BCC is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor for development of illness such as severe solar burns during childhood or adolescence. BCC is mainly located on sun-exposed sites, head and neck being the areas of more incidences; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options such as surgical and nonsurgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs′ micrographic surgery is the standard treatment for all nonmelanoma skin cancers. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77-year-old patient is presented with BCC of inferior eyelid of 14 years′ duration, formerly managed with radiotherapy; however, due to recurrent illness and invasion to the maxillary antrum, he needed supraestructure maxillectomy with left orbital exenteration.

  11. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review.

    Directory of Open Access Journals (Sweden)

    Sebastian Villalon-Lopez

    2005-01-01

    Full Text Available Basal cell carcinoma (BCC is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation (UVR as important risk factor for development of the illness as such as severe solar burns during childhood or adolescence. BCC is mainly located on sun exposed sites, being head and neck the areas of more incidence; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as: nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options as surgical and non-surgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs′ micrographic surgery is the standard treatment for all non-melanoma skin cancer. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77 year-old patient is presented with BCC of inferior eyelid of 14 years duration, formerly managed with radiotherapy and, due to recurrent illness and invasion to the maxillary antrum; he needed supraestructure maxillectomy with left orbital exenteration.

  12. Tumores malignos de pálpebra Malignant eyelid tumors

    Directory of Open Access Journals (Sweden)

    Luis Henrique Schneider Soares

    2001-08-01

    Full Text Available Objetivos: Estudar a incidência de tumores malignos de pálpebra no Hospital Banco de Olhos de Porto Alegre. Métodos: Estudo retrospectivo dos casos de tumores malignos de pálpebra no período de 1985 a 1997, que tiveram diagnóstico confirmado por exame anátomopatológico. Resultados: Foram encontradas 54 neoplasias malignas, sendo 75,92% carcinoma basocelular, 12,96% carcinoma espinocelular, 7,40% melanoma e 1,85% lentigo maligna. A maioria dos pacientes apresentava mais de 40 anos e não houve prevalência de sexo. Conclusões: O tumor de pálpebra mais freqüente em nosso meio foi o carcinoma basocelular, seguido do carcinoma espinocelular. O melanoma foi o terceiro em freqüência mais encontrado em nossa pesquisa.Purposes: To study the incidence of eyelid malignant tumors in the Banco de Olhos Hospital of Porto Alegre from 1985 to 1997. Methods: We retrospectivelly analyzed clinical archives and in this study all cases of malignant eyelid tumors with histopathologic examination were included. Results: We found 54 eyelid tumors: 75.92% basal cell, 12.96% squamous cell, 7.40% melanoma, 1.85% undifferentiated carcinoma and 1.85% lentigo maligna. The majority of the patients was over 40 years old, 50% were male and 50% female. The diagnosis was confirmed in all cases through histopathologic examination. Conclusions: Basal cell carcinoma was the most frequent eyelid malignancy followed by squamous cell carcinoma. Melanoma was the third most frequently found tumor in our study.

  13. Lymphoma of the Eyelid - An International Multicenter Retrospective Study.

    Science.gov (United States)

    Svendsen, Frederik Holm; Rasmussen, Peter Kristian; Coupland, Sarah E; Esmaeli, Bita; Finger, Paul T; Graue, Gerardo F; Grossniklaus, Hans E; Honavar, Santosh G; Khong, Jwu Jin; McKelvie, Penelope A; Mulay, Kaustubh; Ralfkiaer, Elisabeth; Sjö, Lene Dissing; Vemuganti, Geeta K; Thuro, Bradley A; Curtin, Jeremy; Heegaard, Steffen

    2017-05-01

    To document subtype-specific clinical features of lymphoma of the eyelid, and their effect on patient outcome. Retrospective observational case series. Patient data were collected from 7 international eye cancer centers from January 1, 1980 through December 31, 2015. The cases included primary and secondary lymphomas affecting the eyelid. Overall survival, disease-specific survival (DSS), and progression-free survival were the primary endpoints. Eighty-six patients were included. Mean age was 63 years and 47 (55%) were male. Non-Hodgkin B-cell lymphomas constituted 83% (n = 71) and T-cell lymphomas constituted 17% (n = 15). The most common subtypes were extranodal marginal-zone lymphoma (EMZL) (37% [n = 32]), follicular lymphoma (FL) (23% [n = 20]), diffuse large B-cell lymphoma (DLBCL) (10% [n = 9]), mantle cell lymphoma (MCL) (8% [n = 7]), and mycosis fungoides (MF) (9% [n = 8]). EMZL had a female predilection (69% [22 of 32]), whereas MCL (71% [5 of 7]) and MF (88% [7 of 8]) had a male predominance. MCL (57% [4 of 7]), DLBCL (56% [5 of 9]), and MF (88% [7 of 8]) were frequently secondary lymphomas. Localized EMZL and FL were mostly treated with external beam radiation therapy, whereas DLBCL, MCL, and high Ann Arbor stage EMZL and FL were frequently treated with chemotherapy. DLBCL and MCL had a poor prognosis (5-year DSS, 21% and 50%, respectively), whereas EMZL, FL, and MF had a good prognosis (5-year DSS, 88%, 88% and 86%, respectively). Lymphoma of the eyelid consists mainly of the lymphoma subtypes EMZL, FL, DLBCL, MCL, and MF. High-grade DLBCL and MCL, as well as MF, are frequently secondary eyelid lymphomas. The main predictor of outcome was the histologic subtype: EMZL, FL, and MF had a significantly better prognosis than MCL and DLBCL. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Ultrasound biomicroscopy as a tool for conjunctiva and eyelids evaluation

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2015-01-01

    Full Text Available Currently, ultrasound biomicroscopy (UBM is the only diagnostic method that uses a 50‑100 MHz transducer with a depth of penetration of 4 mm. This provides greater sensitivity and resolution.Aim. To visualize meibomian glands and to evaluate their morphological and functional status using UBM.Methods. UBM was performed in 14 patients aged 29‑81 with obvious meibomian gland dysfunction (MGD and healthy meibomian glands. 6 patients had no biomicroscopic signs of blepharitis while 8 patients had biomicroscopic signs of blepharitis, blepharoconjunctivitis, and MGD.Results. UBM provides detailed information on meibomian glands and eyelid margins and their pathological conditions, i.e., eyelid margin thickening due to inflammation, meibomian gland orifice obstruction, increase in distance between meibomian glands due to their atrophy, and cartilaginous tissue destruction. UBM findings may depend on patient age as well as on disease stage and severity. When re-positioning UBM transducer, bullous conjunctiva and subconjunctival cysts can be visualized. This provides differential diagnosis between opaque cysts and tumors.Conclusion. UBM combined with standard exams increases information value, reliability, and accuracy of the diagnostics of anterior segment disorders and facilitates the development of targeted therapeutic approaches. Further studies on diagnostic value of conjunctiva and eyelids UBM are required.

  15. Persistence of Upper Blepharoptosis After Cosmetic Botulinum Toxin Type A.

    Science.gov (United States)

    Steinsapir, Kenneth D; Groth, Michael J; Boxrud, Cynthia A

    2015-07-01

    Upper eyelid ptosis after cosmetic botulinum toxin is generally considered short-lived and responsive to apraclonidine ophthalmic drops. The authors present a series with persistent ptosis. To report a series of patients with persistent upper eyelid ptosis after cosmetic botulinum toxin. A retrospective case review series of 7 patients referred for management after developing visually significant upper eyelid ptosis after cosmetic botulinum toxin type A treatment. Patients in this series experienced persistent visually significant ptosis after cosmetic botulinum toxin lasting from 6 weeks to 13 months. Six of the 7 patients were treated with apraclonidine ophthalmic solution. Apraclonidine drops appeared to be clinically effective within 4 to 6 weeks of the resolution of ptosis. Upper eyelid ptosis after cosmetic botulinum toxin can persist for many months after treatment. Based on this series, the authors propose that apraclonidine drops can be used at the time of initial assessment to predict the relative longevity of ptosis after cosmetic botulinum toxin treatment (Level 4 evidence recommendation). After a 1-week trial, responders can be advised that ptosis is likely to resolve in 4 to 6 weeks. Nonresponders should be counseled that resolution may take longer than 6 weeks.

  16. The prevalence of glaucoma in patients undergoing surgery for eyelid entropion or ectropion

    Directory of Open Access Journals (Sweden)

    Golan S

    2016-10-01

    Full Text Available Shani Golan, Gilad Rabina, Shimon Kurtz, Igal Leibovitch Division of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Purpose and design: The aim of this study was to establish the prevalence of known glaucoma in patients undergoing ectropion or entropion surgical repair. In this study, retrospective review of case series was performed.Participants: All patients who underwent ectropion or entropion surgery in a tertiary medical center between 2007 and 2014 were included. The etiology of eyelid malpositioning was involutional or cicatricial.Methods: The medical files of the study participants were reviewed for the presence and type of glaucoma, medical treatment, duration of treatment, and the amount of drops per day. These data were compared to a matched control group of 101 patients who underwent blepharoplasty for dermatochalasis in the same department during the same period.Main outcome measure: In this study, the prevalence of glaucoma in individuals with ectropion or entropion was the main outcome measure.Results: A total of 227 patients (57% men, mean age: 79.2 years who underwent ectropion or entropion surgery comprised the study group and 101 patients who underwent upper blepharoplasty for dermatochalasis comprised the control group. Compared to four patients in the control group (4%, P=0.01, 30 of the study patients (13.2% had coexisting glaucoma. Of 30 glaucomatous patients, 25 had primary open-angle glaucoma for a mean duration of 10.3 years. The glaucomatous patients were treated with an average of 2.7 antiglaucoma medications.Conclusion: An increased prevalence of known glaucoma in patients undergoing ectropion or entropion repair surgery was found. This observation may indicate that the chronic usage of topical anti-glaucoma eyedrops may lead to an increased risk of developing eyelid malpositions, especially in

  17. Validation of the facial assessment by computer evaluation (FACE) program for software-aided eyelid measurements.

    Science.gov (United States)

    Choi, Catherine J; Lefebvre, Daniel R; Yoon, Michael K

    2016-06-01

    The aim of this article is to validate the accuracy of Facial Assessment by Computer Evaluation (FACE) program in eyelid measurements. Sixteen subjects between the ages of 27 and 65 were included with IRB approval. Clinical measurements of upper eyelid margin reflex distance (MRD1) and inter-palpebral fissure (IPF) were obtained. Photographs were then taken with a digital single lens reflex camera with built-in pop-up flash (dSLR-pop) and a dSLR with lens-mounted ring flash (dSLR-ring) with the cameras upright, rotated 90, 180, and 270 degrees. The images were analyzed using both the FACE and ImageJ software to measure MRD1 and IPF.Thirty-two eyes of sixteen subjects were included. Comparison of clinical measurement of MRD1 and IPF with FACE measurements of photos in upright position showed no statistically significant differences for dSLR-pop (MRD1: p = 0.0912, IPF: p = 0.334) and for dSLR-ring (MRD1: p = 0.105, IPF: p = 0.538). One-to-one comparison of MRD1 and IPF measurements in four positions obtained with FACE versus ImageJ for dSLR-pop showed moderate to substantial agreement for MRD1 (intraclass correlation coefficient = 0.534 upright, 0.731 in 90 degree rotation, 0.627 in 180 degree rotation, 0.477 in 270 degree rotation) and substantial to excellent agreement in IPF (ICC = 0.740, 0.859, 0.849, 0.805). In photos taken with dSLR-ring, there was excellent agreement of all MRD1 (ICC = 0.916, 0.932, 0.845, 0.812) and IPF (ICC = 0.937, 0.938, 0.917, 0.888) values. The FACE program is a valid method for measuring margin reflex distance and inter-palpebral fissure.

  18. Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs

    OpenAIRE

    ZHENG, YA-JUAN; DONG, YU-CHEN; ZHU, CHAO; ZHAO, MEI-SHENG

    2016-01-01

    Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (...

  19. Linfedema Primário em Membro Superior Esquerdo em Paciente Idosa / Primary Lymphedema in Upper Left Member in Elderly Patient

    Directory of Open Access Journals (Sweden)

    Melissa Andreia de Moraes Silva

    2016-09-01

    Full Text Available Introdução: O Linfedema Primário (LP é caracterizado por disfunção do sistema linfático de etiologia idiopática. Este pode ser dividido em congênito, precoce e tardio, sendo o tipo congênito o mais raro. O diagnóstico desta patologia é predominantemente clínico, podendo ser solicitado linfocintilografia quando há dúvida diagnóstica. O diagnóstico precoce está diretamente relacionado com o melhor prognóstico do paciente, postergando limitações físicas e psico­sociais. O tratamento do LP é clínico e multiprofissional. Relato do Caso: Relatou­se caso raro de uma paciente de 78 anos de idade, sexo feminino, portadora de Linfedema Primário em membro superior esquerdo desde o nascimento, o qual foi investigado durante a infância, porém com resultados inconclusivos. Conclusão: Embora seja pequena a quantidade de trabalhos sobre o tema, este relato confirma que o diagnóstico precoce é fundamental e que o tratamento igualmente precoce e multiprofissional melhora a qualidade de vida dos pacientes. Introduction: Primary lymphedema (PL is characterized by dysfunction of the lymphatic system of idiopathic etiology. It can be divided into congenital, early and late, with the congenital type being the rarest. The diagnosis of this pathology is predominantly clinical, and a lymphoscintilography may be requested when the diagnostic is uncertain. Early diagnosis is directly related to better patient prognosis, delaying physical and psychosocial limitations. Treatment of PL is clinical and multiprofessional. Case Report: The aim of this paper is to describe a rare case of a 78­ year­old female with primary lymphedema in the left arm since her birth, which was investigated during childhood, but with inconclusive results. Conclusion: Although there is small amount of work on the topic, this report confirms that early diagnosis is crucial and also that early and multidisciplinary treatment improves the quality of life of patients.

  20. Electrostatic artificial eyelid actuator as an analog micromirror device

    Science.gov (United States)

    Goodwin, Scott H.; Dausch, David E.; Solomon, Steven L.; Lamvik, Michael K.

    2005-05-01

    An electrostatic MEMS actuator is described for use as an analog micromirror device (AMD) for high performance, broadband, hardware-in-the-loop (HWIL) scene generation. Current state-of-the-art technology is based on resistively heated pixel arrays. As these arrays drive to the higher scene temperatures required by missile defense scenarios, the power required to drive the large format resistive arrays will ultimately become prohibitive. Existing digital micromirrors (DMD) are, in principle, capable of generating the required scene irradiances, but suffer from limited dynamic range, resolution and flicker effects. An AMD would be free of these limitations, and so represents a viable alternative for high performance UV/VIS/IR scene generation. An electrostatic flexible film actuator technology, developed for use as "artificial eyelid" shutters for focal plane sensors to protect against damaging radiation, is suitable as an AMD for analog control of projection irradiance. In shutter applications, the artificial eyelid actuator contained radius of curvature as low as 25um and operated at high voltage (>200V). Recent testing suggests that these devices are capable of analog operation as reflective microcantilever mirrors appropriate for scene projector systems. In this case, the device would possess larger radius and operate at lower voltages (20-50V). Additionally, frame rates have been measured at greater than 5kHz for continuous operation. The paper will describe the artificial eyelid technology, preliminary measurements of analog test pixels, and design aspects related to application for scene projection systems. We believe this technology will enable AMD projectors with at least 5122 spatial resolution, non-temporally-modulated output, and pixel response times of <1.25ms.

  1. Combined excision and intralesional bevacizumab for sebaceous carcinoma of the eyelid in an Amur tiger (Panthera tigris altaica).

    Science.gov (United States)

    Edelmann, Michele L; Utter, Mary L; Klein, Lin V; Wotman, Kathryn L

    2013-05-01

    An 18-year-old zoo-kept female Amur tiger presented with an approximately 5 mm diameter lateral canthal eyelid mass in the left eye which grossly appeared red and irregular. The mass was completely excised via lateral canthoplasty. Histopathologic evaluation was consistent with a diagnosis of sebaceous cell carcinoma, which is a potentially aggressive cutaneous neoplasm. The sebaceous carcinoma recurred within 3 months and slowly increased in size until a second surgical excision was performed 9 months following the first surgery. The second surgical excision was combined with intralesional injection of 10 mg of the antiangiogenic drug bevacizumab. Histology confirmed the diagnosis. The tiger was euthanized 16 months postoperatively for reasons unrelated to, and without recurrence of, the eyelid neoplasm. At postmortem, no gross periocular or metastatic lesions were noted, and histopathology of the lateral canthus provided no evidence of recurrence. Surgical excision combined with intralesional bevacizumab treatment induced life-long resolution of the sebaceous carcinoma. Bevacizumab treatment may be associated with the regression of periocular angiogenic proliferative conditions, including neoplasia, by inhibiting angiogenesis. © 2012 American College of Veterinary Ophthalmologists.

  2. Schwannoma of the Lower Eyelid Resembling a Recurrent Chalazion : A Case Report

    OpenAIRE

    Fukuyama, Junichiro; Hayasaka, Seiji; Setogawa, Tomoichi

    1990-01-01

    A 55-year-old man complained of foreign body sensation and a solid mass in the lower eyelid of the right eye. Clinically, the lesion resembled a chalazion, and it was excised. Histopathologic examination of the excised specimen revealed a schwannoma (neurilemmoma). We believe that this is a rare case of a schwannoma of the lower eyelid simulating a chalazion.

  3. Spectrum of eyelid disorders at a Nigerian tertiary eye care center ...

    African Journals Online (AJOL)

    Background: The eyelids are an essential part of the human face and is a multilayered structure that covers and protects the human eye. Disorders of the eyelids may lead to visual compromise, facial disfigurement, aesthetically unacceptable appearance andits attendant psychosocial impact. Objective: To describe the ...

  4. Malignant eyelid lesions: histopathological types and degree of tissue invasion at the time of presentation

    Directory of Open Access Journals (Sweden)

    Mohamed F Khalil

    2015-01-01

    In our locality, BCC represented two-thirds of the malignant eyelid lesions, whereas SCC was responsible for one-fourth of the lesions. Most of the malignant lesions were confined to the eyelid only. Although SGC was less frequent, it was aggressive and invasive; moreover, it had a higher rate of local recurrence.

  5. Double-Eyelid Surgery Using Septoaponeurosis Junctional Thickening Results in Dynamic Fold in Asians

    Directory of Open Access Journals (Sweden)

    Hong Seok Kim, MD, PhD

    2013-05-01

    Conclusions: The authors introduce a double-eyelid surgery technique using the SAJT. This SAJT fixation technique creates a dynamic double-eyelid fold. Our study showed a high patient satisfaction rate and that the resulting fold mimics the movement of the congenital supratarsal fold in Asians.

  6. Factors prompting sneezing in intravenously sedated patients receiving local anesthetic injections to the eyelids.

    Science.gov (United States)

    Morley, Ana M S; Jazayeri, Fiona; Ali, Syed; Malhotra, Raman

    2010-05-01

    To investigate the frequency of sneezing among patients receiving intravenous sedation and periocular local anesthetic for oculoplastic procedures in a single center. To identify potential risk factors involved. Prospective, consecutive, interventional case series in a single tertiary-referral oculoplastic unit. A total of 294 patients undergoing 314 isolated oculoplastic procedures, performed under intravenous sedation with periocular local anesthetic from November 2007 to November 2008. Prospective data collection on patient demographics, history of photic sneezing, intravenous sedative, depth of sedation, nasal oxygen, and periocular infiltration site. Standard local anesthetic was used in all cases, but the intravenous sedation was at the discretion of the attending anesthesiologist (7 in total). Sneezing or attempted sneezing within 5 minutes of injection of the local anesthetic, as determined by agreed observation between attending staff. Sneezing was observed in 16% of cases. No association was found between sneezing and patient age or presence of nasal oxygen. A weakly positive association was observed with male gender (55% sneezers vs. 37% non-sneezers, P = 0.03, relative risk [RR] = 1.5, confidence interval [CI], 1.1-2.0), bilateral infiltration (65% vs. 40%, P = 0.005, RR = 1.6, CI, 1.2-2.1), and upper eyelid infiltration (73% vs. 54%, P = 0.01, RR = 1.4, CI, 1.1-1.7). Photic sneezing was described in 47% of sneezers and 19% of non-sneezers (P = 0.0004, RR = 2.6, CI, 1.6-4.0). Because propofol was given to 95% of patients, no association with sneezing could be ascertained. However, opioid derivatives were found to be protective (12% vs. 43%, Plocal anesthetic injections, induces sneezing in approximately one sixth of general oculoplastic cases. Male gender, a history of photic sneezing, bilateral or upper eyelid infiltration, deep sedation, and the concurrent administration of midazolam all increased the risk, whereas adjunctive opioid use reduced the

  7. Muir-Torre Syndrome in a Middle-Aged Chinese Patient with Sebaceous Carcinoma of the Eyelid.

    Science.gov (United States)

    Wong, Ching-Yuen; Tang, Raymond Kai-Tat; Lam, Robert Fung; Io, Ida Yu-Fong; Yuen, Can Yin-Fun; Ho, Judy Wai-Chu; Tse, Raymond Kwok-Kay

    2015-01-01

    Muir-Torre syndrome is a rare, autosomal dominant condition characterized by the presence of a skin tumor of sebaceous differentiation and visceral malignancies. We reviewed the case of a 46-year-old Chinese man who had a bleeding mass over the right upper eyelid. He had a history of colon cancer and a family history satisfying the Amsterdam criteria for hereditary non-polyposis colorectal cancer syndrome with germline mutation in the MutS homolog-2 gene. The eyelid lesion was excised completely and submitted for histopathologic examination which showed sebaceous carcinoma. Frozen section and conjunctival map biopsy showed no residual malignancy or local metastasis. Post-operative positron-emission tomography with combined computed tomography did not reveal any residual or visceral malignancy. He had no recurrence in the 32-month follow-up period. We should consider Muir-Torre syndrome in patients with sebaceous carcinoma, especially in the presence of personal and/or family history of visceral malignancies.

  8. Schwannoma de párpado Eyelid schwannoma

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    E. Moretti

    2012-09-01

    Full Text Available El schwannoma es un tumor benigno de las células de Schwann de los nervios periféricos. Cuando se origina en ramas del V par craneal puede representar el 0,7 % de los tumores palpebrales. Aunque rara vez maligniza, la cirugía es el tratamiento de elección. Hasta donde conocemos, existen 11 casos de schwannoma palpebral publicados en la literatura. Nuestro objetivo es presentar un caso clínico de esta estirpe tumoral en una paciente de 51 años de edad, con antecedentes de extirpación transconjuntival previa de chalazión.Schwannoma is a benign tumour of Schwann cells of the peripheral nerves. When originated from branches of the V cranial nerve can represent 0.7 % of eyelid tumours. Although rarely malignant, surgery is the treatment of choice. Until we can know, there are 11 cases reported in the literature. Our goal is to present a case of eyelid schwannoma in a 51 years old patient with a history of previous transconjunctival excision of chalazion.

  9. A Case of Orbital Myiasis in Recurrent Eyelid Basal Cell Carcinoma Invasive into the Orbit

    Directory of Open Access Journals (Sweden)

    Triptesh Raj Pandey

    2016-01-01

    Full Text Available Introduction. Orbital myiasis is the infestation of the orbital tissues by fly larvae or maggots. Compromise of periorbital tissues by malignant disease, surgery, ischemia, or infection may predispose the patient to orbital myiasis. Case Report. A 73-year-old male patient with neglected recurrent basal cell carcinoma of the eyelid invasive into the orbit presented with complaints of intense itching and crawling sensation with maggots wriggling and falling from the wound of left orbit. The patient improved following manual removal of the maggots along with oral Ivermectin treatment. Recurrence of the basal cell carcinoma was confirmed by punch biopsy from the wound and extended exenteration of the orbit followed by reconstructive surgery was done. Conclusion. Orbital myiasis is a rare and preventable ocular morbidity that can complicate the malignancies resulting in widespread tissue destruction. The broad spectrum antiparasitic agent, Ivermectin, can be used as noninvasive means to treat orbital myiasis. In massive orbital myiasis and those associated with malignancies, exenteration of the orbit must be seriously considered.

  10. A Case of Orbital Myiasis in Recurrent Eyelid Basal Cell Carcinoma Invasive into the Orbit.

    Science.gov (United States)

    Pandey, Triptesh Raj; Shrestha, Gulshan Bahadur; Sitaula, Ranju Kharel; Shah, Dev Narayan

    2016-01-01

    Introduction. Orbital myiasis is the infestation of the orbital tissues by fly larvae or maggots. Compromise of periorbital tissues by malignant disease, surgery, ischemia, or infection may predispose the patient to orbital myiasis. Case Report. A 73-year-old male patient with neglected recurrent basal cell carcinoma of the eyelid invasive into the orbit presented with complaints of intense itching and crawling sensation with maggots wriggling and falling from the wound of left orbit. The patient improved following manual removal of the maggots along with oral Ivermectin treatment. Recurrence of the basal cell carcinoma was confirmed by punch biopsy from the wound and extended exenteration of the orbit followed by reconstructive surgery was done. Conclusion. Orbital myiasis is a rare and preventable ocular morbidity that can complicate the malignancies resulting in widespread tissue destruction. The broad spectrum antiparasitic agent, Ivermectin, can be used as noninvasive means to treat orbital myiasis. In massive orbital myiasis and those associated with malignancies, exenteration of the orbit must be seriously considered.

  11. C syndrome with skeletal anomalies, mental retardation, eyelid chalazion, Bitot’s spots and agenesis of the corpus callosum in an Egyptian child

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2017-01-01

    Full Text Available We report a 2.5 year old female child, third in order of birth of healthy non consanguineous Egyptian parents with C syndrome. The patient had moderate mental retardation, trigonocephaly, protruding forehead, low anterior hair line, wide upslanted palpebral fissures, depressed nasal bridge, broad nose, high arched palate, microretrognathia, low set ears, short neck, scoliosis, hypertrichosis over the back, talipes equinovarus as well as interatrial septal defect. The patient had in addition chalazion in left lower eyelid as well as bilateral Bitot’s spots most probably due to vitamin A deficiency. MRI brain revealed agenesis of the corpus callosum.

  12. Xantelasma: relato de um caso Eyelid xanthelasma: a case report

    Directory of Open Access Journals (Sweden)

    André Henrique Miranda

    2001-04-01

    Full Text Available Os autores relatam um caso raro em paciente do sexo masculino, de 71 anos de idade, com história de surgimento de "carocinho" na pálpebra superior direita há nove anos, que teve aumento importante há um ano. A tomografia computadorizada evidenciou espessamento da musculatura do reto lateral e de partes moles adjacentes. O diagnóstico pela biópsia foi de xantelasma.The authors report a rare case of a 71-year-old male patient with a 9-year history of appearance of a "little node" in the right superior eyelid, which increased significantly in size in the last year. Computed tomography showed thickening of the lateral rectus muscle and adjacent soft tissues. The diagnosis after biopsy was xanthelasma.

  13. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

    2014-03-15

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

  14. SQUAMOUS CELL CARCINOMA OF EYELID MASQUERADING AS BASAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Nagaraju

    2015-04-01

    Full Text Available The main malignant tumors affecting the eyelid are Basal cell carcinoma (BCC, Sebaceous gland carcinoma (SGC, Squamous cell carcinoma (SCC, and Malignant melanoma (MM in that order of frequency in Asia. SGC and BCC forms majority of tumors in India. SC C is rare in Indian population and generally occurs in predisposed individuals like in patients with Xeroderma pigmentosa. BCC may present as pigmented or non - pigmented, nodular or noduloulcerative lesion. Usually SGC and BCC are not confused because of va ried clinical appearance and morphology. However non pigmented noduloulcerative BCC can be confused with SCC. We report a case of histopathologically proven squamous cell carcinoma presenting as basal cell carcinoma in a 90 year old patient and its managem ent.

  15. Timing and causality in the generation of learned eyelid responses

    Directory of Open Access Journals (Sweden)

    Raudel eSánchez-Campusano

    2011-08-01

    Full Text Available The cerebellum-red nucleus-facial motoneuron (Mn pathway has been reported as being involved in the proper timing of classically conditioned eyelid responses. This special type of associative learning serves as a model of event timing for studying the role of the cerebellum in dynamic motor control. Here, we have re-analyzed the firing activities of cerebellar posterior interpositus (IP neurons and orbicularis oculi (OO Mns in alert behaving cats during classical eyeblink conditioning, using a delay paradigm. The aim was to revisit the hypothesis that the IP neurons can be considered a neuronal phase-modulating device supporting OO Mns firing with an emergent timing mechanism and an explicit correlation code during learned eyelid movements. Optimized experimental and computational tools allowed us to determine the different causal relationships (temporal order and correlation code during and between trials. These intra- and inter-trial timing strategies expanding from sub-second range (millisecond timing to longer-lasting ranges (interval timing expanded the functional domain of cerebellar timing beyond motor control. Interestingly, the results supported the above-mentioned hypothesis. The causal inferences were influenced by the precise motor and premotor spike-timing in the cause-effect interval, and, in addition, the timing of the learned responses depended on cerebellar-Mn network causality. Furthermore, the timing of CRs depended upon the probability of simulated causal conditions in the cause-effect interval and not the mere duration of the inter-stimulus interval. In this work, the close relation between timing and causality was verified. It could thus be concluded that the firing activities of IP neurons may be related more to the proper performance of ongoing CRs (i.e., the proper timing as a consequence of the pertinent causality than to their generation and/or initiation.

  16. Temperature profiles of patient-applied eyelid warming therapies.

    Science.gov (United States)

    Wang, Michael T M; Gokul, Akilesh; Craig, Jennifer P

    2015-12-01

    To compare temperature profile characteristics (on and off eye) of two patient-applied heat therapies for meibomian gland dysfunction (MGD): an eye mask containing disposable warming units (EyeGiene(®)) and a microwave-heated flaxseed eye bag(®) (MGDRx EyeBag(®)). In vitro evaluation: surface temperature profiles of activated eye masks and heated eye bags(®) (both n=10), were tracked every 10s until return to ambient temperature. Heat-transfer assessment: outer and inner eyelid temperature profiles throughout the eye mask and eye bag(®) treatment application period (10min) were investigated in triplicate. The devices were applied for 12 different time intervals in a randomised order, with a cool-down period in between to ensure ocular temperatures returned to baseline. Temperature measurements were taken before and immediately after each application. In vitro evaluation: on profile, the eye bag(®) surface temperature peaked earlier (0±0 s vs. 100±20 s, ptemperatures (38.1±0.4°C vs. 37.4±0.2°C, p=0.04), as well as larger inner eyelid temperature increases over the first 2 min, and between 9 and 10 min (all ptemperature profile displayed greater uniformity and slower cooling than the eye mask, and was demonstrated to be significantly more effective in raising ocular temperatures than the eye mask, both statistically and clinically. This has implications for MGD treatment, where the melting points of meibomian secretions are likely to be higher with increasing disease severity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. [Lacrimal duct treatment with ring intubation in injuries of the upper and lower eyelids].

    Science.gov (United States)

    Kohlhaas, M; Wiegmann, L; Gaszczyk, M; Walter, A; Schaudig, U; Richard, G

    2001-08-01

    Treating injuries of the lacrimal system with a silicon intubation is an approved method to prevent post-traumatic epiphora. Between 1990 and 1999, operations were carried out on 44 patients with injuries of the canaliculi with silicon ring intubations. Interesting for us were the age distribution, causes of injuries, localisation and mid- to long-term postoperative complications. The age of the patients was between 1.75 and 74 years, 48% of the injuries were caused by household accidents, 23% by violence, 20% by traffic accidents and 9% by job-related accidents. The canaliculus inferior was injured in 68% of all patients. We found 10 postoperative complications, e.g. ectropia, a too long silicon ring or granuloma. We found a positive anatomical readapted lacrimal system in 88% and 12% of our patients complained of distinct to severe epiphora. The treatment of lacrimal laceration with a silicon intubation is an excellent method but special care should be taken with correct positioning of the lid margin.

  18. Detailed anatomy of the transverse superior fascial expansion of the upper eyelid.

    Science.gov (United States)

    Nam, Yong Seok; Kim, In-Beom; Shin, Sun Young

    2015-04-01

    This study was designed to elucidate the detailed anatomy of the transverse superior fascial expansion (TSFE) and its relationship to the superior rectus muscle (SRM) and the levator palpebrae superioris (LPS). In this cohort study, 46 eyes of 23 cadavers were observed macroscopically. Dissection from the SRM origin to its insertion was performed, and the width, length, and tensile strength of the TSFE were determined. The TSFE was located between the LPS and SRM. It originated at the surface of the SRM, 32.75 ± 4.40 mm from the origin of the SRM, and extended anteriorly. The TSFE firmly adhered to the SRM surface, 1.53 ± 0.47 mm medially and 1.19 ± 0.19 mm laterally, extended upwards and anteriorly, and inserted to the under surface of the LPS. The TSFE width was 6.70 ± 1.17 mm at the origin site on the SRM surface and 11.42 ± 6.70 mm at the insertion site on the LPS under the surface. Its total length was 11.67 ± 0.87 mm medially and 11.55 ± 0.94 mm laterally The TSFE was first encountered 11.49 ± 1.17 mm laterally and 11.57 ± 1.27 mm medially from the SRM insertion on the SRM's anterior surface. The tensile strength of the TSFE was significantly greater than that of the intermuscular fascia between the SRM and LPS (9.74 ± 4.53 N vs 3.02 ± 1.85 N, P =0.001). This study provides a good understanding of the TSFE structures conducive to performing SRM surgery.

  19. Comparative Clinical Outcomes of Pediatric Patients Presenting With Eyelid Nodules of Idiopathic Facial Aseptic Granuloma, Hordeola, and Chalazia.

    Science.gov (United States)

    Ozer, Pinar Altiaylik; Gurkan, Asuman; Kurtul, Bengi Ece; Kabatas, Emrah Utku; Beken, Serdar

    2016-07-01

    To present the clinical features of the eyelid nodules observed in a newly determined dermatologic disorder, idiopathic facial aseptic granuloma (IFAG), and to compare them with children having acute hordeolum and chalazion. Duration of the lesion, localization, presence of coexisting facial nodules, management strategies, and response time to topical/oral antibiotics were retrospectively reviewed in 50 children with IFAG, acute hordeolum, or chalazion. Fourteen children with one or more IFAG nodules on their eyelids, 28 children with one or more acute hordeolum, and 8 children with one or more chalazion were examined. Children with IFAG on their eyelids and face presented earlier than children with acute hordeolum (P = .006). The duration of this lesion was similar among patients with IFAG on their eyelids and acute hordeolum (P = .53). Duration of the lesion and treatment response time were shorter in children with IFAG on their eyelids and face (P = .004) than in those with IFAG on their eyelids (P = .013). The lesions of patients with chalazion had a longer duration compared to those with IFAG on their eyelids (P = .005), IFAG on their eyelids and face (P < .001), and acute hordeolum (P = .04). Twenty patients with acute hordeolum recovered after topical antibiotics and had a similar treatment response time to those with IFAG on their eyelids and face (P = .06) and those with IFAG on their eyelids (P = .16). IFAG should be considered in the differential diagnosis of painless eyelid nodules in children. Because IFAG on the eyelids has many overlapping features with hordeola/chalazia, its differentiation may be difficult in the absence of accompanying facial granulomas. Chronic subepidermal eyelid nodules resembling skin abscess should alert clinicians for IFAG. Because IFAG responds well to oral clarithromycin, unnecessary surgical interventions should be avoided in these cases. [J Pediatr Ophthalmol Strabismus. 2016;53(4):206-211.]. Copyright 2016, SLACK

  20. A Rare Case of Lateral Canthal Gouty Tophus Presenting as an Eyelid Mass

    Directory of Open Access Journals (Sweden)

    Austin S. Nakatsuka

    2016-01-01

    Full Text Available A 41-year-old man with a history of gout presented with an enlarging eyelid growth. Clinical examination revealed a mildly indurated nodule at the lateral canthus. Following resection, histopathological examination revealed needle-shaped, crystalline material surrounded by multinucleated giant cells, findings consistent with gouty tophus. This represents just the sixth case of gouty tophus of the eyelid reported in the literature.

  1. A case of localized amyloidosis of the eyelid misdiagnosed as recurrent chalazion

    Directory of Open Access Journals (Sweden)

    Hind Manaa Alkatan

    2017-07-01

    Full Text Available Localized amyloidosis of the eyelid is uncommon and is classically associated with systemic manifestations. We present an interesting case of a localized eyelid mass misdiagnosed as a recurrent chalazion presenting in an 85-year-old Saudi gentleman with no definite associate findings suggestive of an underlying systemic amyloid disease. Debulking surgery was subsequently performed. Proper diagnosis was reached based on the histopathologic examination of the excised tissue, which demonstrated the typical Congo red staining of the amyloid deposits.

  2. A case of localized amyloidosis of the eyelid misdiagnosed as recurrent chalazion.

    Science.gov (United States)

    Manaa Alkatan, Hind; Al-Mohizea, Asma; Alsuhaibani, Adel

    2017-01-01

    Localized amyloidosis of the eyelid is uncommon and is classically associated with systemic manifestations. We present an interesting case of a localized eyelid mass misdiagnosed as a recurrent chalazion presenting in an 85-year-old Saudi gentleman with no definite associate findings suggestive of an underlying systemic amyloid disease. Debulking surgery was subsequently performed. Proper diagnosis was reached based on the histopathologic examination of the excised tissue, which demonstrated the typical Congo red staining of the amyloid deposits.

  3. Malignant nodular hidradenoma of the eyelid: a rare sweat gland tumor.

    Science.gov (United States)

    Al Baghli, Abdulla; Reddy, Suresh S; Reddy, Maragaret A

    2010-10-01

    We report a case of malignant nodular hidradenoma in a middle-aged man, who presented with a nodular swelling in the eyelid. The tumor was similar to its benign counterpart but had additional features such as surface ulceration, numerous mitiotic figures, and an infiltrative growth pattern. Malignant forms of hidradenomas are unusual and the possibility this variant should be considered in the differential diagnosis of eyelid tumors.

  4. Treatment efficacy of lower eyelid twitch shift joint outer canthal ligament shortening surgery in degenerative analysis

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    Jun Shao

    2015-08-01

    Full Text Available AIM: To observe and compare efficacy of the lower eyelid twitch shift joint outer canthal ligament shortening surgery and orbicularis muscle resection surgery to treat degenerative entropion. METHODS: Patients with degenerative entropion in our hospital were selected. The test group was 40 cases(70 eyes, of which double eyes with attack(30 cases, and lower eyelid twitch shift joint outer canthal ligament shortening surgery was applied to the test group. Control group was 20 cases(26 eyes, of which double eyes with attack(6 cases, and the control group was used by orbicularis muscle resection surgery. The correction rate, double eyelid symmetry and overcorrection rate were observed in two groups at postoperative 1wk. The long- term recurrence rate, double eyelid symmetry and overcorrection rate with follow-up 6mo were observed. RESULTS: After 1wk, the correction rate of experimental group 98.6%,undercorrection rate of that was 1.4%, all the eyelid was symmetry, only one eye with a slight overcorrection. Correction rate of control group was 92.3%; all the eyelid was symmetry, and the poor rate of this group was 7.7%. After 6mo, correction rate of experimental group was 95.2%; undercorrection rate of experimental group was 3.2%, and overcorrection rate was 1.6%. Correction rate of control group was 87%, and 2 eyes of recurrence, 1 eye with a poor overcorrection. Double eyelid was symmetry, overcorrection rate difference was not statistically significant(P>0.05, and the correction rate were significantly different(PCONCLUSION: Compared toorbicularis muscle resection surgery, postoperative recurrence rate of lower eyelid twitch shift joint outer canthal ligament shortening surgery is significantly lowered.

  5. 3D printing for low cost, rapid prototyping of eyelid crutches.

    Science.gov (United States)

    Sun, Michael G; Rojdamrongratana, Duangmontree; Rosenblatt, Mark I; Aakalu, Vinay K; Yu, Charles Q

    2018-03-02

    Blepharoptosis or ptosis is a common and potentially debilitating clinical problem. Long-term surgical treatment for ptosis caused by progressive myopathies can be challenging due to potential recurrence and complications associated with facial muscle weakness. When surgical treatment is no longer effective, an eyelid crutch can be used as an alternative intervention. This report demonstrates how 3D printing was used to rapidly design, prototype, and manufacture new custom-fit eyelid crutches at a low cost.

  6. Hyaluronidase injection for the treatment of eyelid edema: a retrospective analysis of 20 patients

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    Hilton, Said; Schrumpf, Holger; Buhren, Bettina Alexandra; Bölke, Edwin; Gerber, Peter Arne

    2014-01-01

    Background Hyaluronidase (Hylase Dessau®) is a hyaluronic acid-metabolizing enzyme, which has been shown to loosen the extracellular matrix, thereby improving the diffusion of local anesthetics. Lower eyelid edema is a common post-interventional complication of cosmetic procedures performed in the lid region, such as the injection of hyaluronic acid fillers for tear-trough augmentation. The purpose of this study was to validate the efficacy of hyaluronidase in the management of lower eyelid e...

  7. Radiation therapy for primary carcinoma of the eyelid. Tumor control and visual function

    International Nuclear Information System (INIS)

    Hata, M.; Koike, I.; Odagiri, K.; Kasuya, T.; Minagawa, Y.; Kaizu, H.; Mukai, Y.; Inoue, T.; Maegawa, J.; Kaneko, A.

    2012-01-01

    Background and purpose: Surgical excision remains the standard and most reliable curative treatment for eyelid carcinoma, but frequently causes functional and cosmetic impairment of the eyelid. We therefore investigated the efficacy and safety of radiation therapy in eyelid carcinoma. Patients and methods: Twenty-three patients with primary carcinoma of the eyelid underwent radiation therapy. Sebaceous carcinoma was histologically confirmed in 16 patients, squamous cell carcinoma in 6, and basal cell carcinoma in 1. A total dose of 50-66.6 Gy (median, 60 Gy) was delivered to tumor sites in 18-37 fractions (median, 30 fractions). Results: All but 3 of the 23 patients had survived at a median follow-up period of 49 months. The overall survival and local progression-free rates were 87% and 93% at 2 years, and 80% and 93% at 5 years, respectively. Although radiation-induced cataracts developed in 3 patients, visual acuity in the other patients was relatively well preserved. There were no other therapy-related toxicities of grade 3 or greater. Conclusion: Radiation therapy is safe and effective for patients with primary carcinoma of the eyelid. It appears to contribute to prolonged survival as a result of good tumor control, and it also facilitates functional and cosmetic preservation of the eyelid. (orig.)

  8. Epidemiology of benign eyelid lesions in patients presenting to a teaching hospital

    Science.gov (United States)

    Al-Faky, Yasser H.

    2011-01-01

    Purpose This study evaluates the relative frequency of benign eyelid lesions presented to a teaching hospital in Saudi population. Patients and methods Charts of patients with benign eyelid lesions were retrospectively reviewed from January 2003 to December 2008. Clinical details included demographic data, symptoms and signs, surgical findings, primary diagnosis, and indication for biopsy were analyzed in a histopathologically confirmed benign eyelid lesions. Eyelid lesions were arranged according to their order of frequencies. Results A total of 222 biopsies were evaluated from 181 patients (male 39.2% and female 60.8%). The age of the patient at the time of biopsy ranged from 2 to 87 years old. The most common benign eyelid lesion encountered in our practice was sweat gland hidrocystoma followed by chalazion, skin tag, epidermal cyst, nevus, seborrheic keratosis, xanthelasma, and molluscum contagiosum respectively. Histopathological studies confirmed the clinical diagnosis in 95.9% (213/222) of specimens and was different from the clinical diagnosis in 4.1% (9/222) of the lesions which included seborrheic keratosis (n = 3), pilomatrixoma, steatocystoma, hemangioendothelioma, juvenile xanthogranuloma, calcinosis cutis, and syringocystadenoma papilliferum. No malignant lesion was labeled as benign. Conclusion Epidemiology of benign eyelid lesions in Saudi population is different from Far East or Western populations. Sweat gland hidrocystoma with classical clinical features and straightforward diagnosis is the most frequent lesion in our series which could be due to characteristic dry climate. PMID:23960994

  9. Radiation therapy for primary carcinoma of the eyelid. Tumor control and visual function

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    Hata, M.; Koike, I.; Odagiri, K.; Kasuya, T.; Minagawa, Y.; Kaizu, H.; Mukai, Y.; Inoue, T. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Radiology; Maegawa, J. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Plastic and Reconstructive Surgery; Kaneko, A. [Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Ophthalmology

    2012-12-15

    Background and purpose: Surgical excision remains the standard and most reliable curative treatment for eyelid carcinoma, but frequently causes functional and cosmetic impairment of the eyelid. We therefore investigated the efficacy and safety of radiation therapy in eyelid carcinoma. Patients and methods: Twenty-three patients with primary carcinoma of the eyelid underwent radiation therapy. Sebaceous carcinoma was histologically confirmed in 16 patients, squamous cell carcinoma in 6, and basal cell carcinoma in 1. A total dose of 50-66.6 Gy (median, 60 Gy) was delivered to tumor sites in 18-37 fractions (median, 30 fractions). Results: All but 3 of the 23 patients had survived at a median follow-up period of 49 months. The overall survival and local progression-free rates were 87% and 93% at 2 years, and 80% and 93% at 5 years, respectively. Although radiation-induced cataracts developed in 3 patients, visual acuity in the other patients was relatively well preserved. There were no other therapy-related toxicities of grade 3 or greater. Conclusion: Radiation therapy is safe and effective for patients with primary carcinoma of the eyelid. It appears to contribute to prolonged survival as a result of good tumor control, and it also facilitates functional and cosmetic preservation of the eyelid. (orig.)

  10. Investigating the Short-term Effect of Eyelid Massage on Corneal Topography.

    Science.gov (United States)

    Riede-Pult, Britta H; Evans, Katharine; Pult, Heiko

    2017-06-01

    The aim of this study was to evaluate the short-term effect of eyelid massage, after the use of warm compresses, on corneal topography. Corneal topography was evaluated on 20 subjects (mean age, 47.0 [SD ±17.3] years) using the Oculus Keratograph (Oculus, Wetzlar, Germany). Corneal eccentricity (Epsilon) was compared between topography measurements before eyelid warming (using warm compresses) (T1), after eyelid warming (T2), directly after eyelid massage (T3), and 30 minutes after eyelid massage (T4). Differences in corneal eccentricity between the enrolment measurement (T1) and consecutive measurements (T1-4) were analyzed. The contralateral eye-treated by warm compresses, but not by eyelid massage-was the control. Visual acuity (decimal), bulbar conjunctival hyperemia, and corneal staining (Cornea and Contact Lens Research Unit grading scale) were evaluated at T1 and T4 to assess clinical safety. No significant differences were found between consecutive eccentricity measurements overall and with the central radii (repeated-measures analysis of variance, P > .238 (massaged eyelid: Epsilon T1: 0.48 [95% confidence interval, ±0.07], T2: 0.49 [±0.05], T3: 0.49 [±0.06], T4: 0.48 [±0.06]; horizontal radii T1: 7.76 [±0.13] mm, T2: 7.74 [±0.13] mm, T3: 7.75 [±0.13] mm, T4: 7.76 [±0.13] mm; vertical radii T1: 7.56 [±0.12] mm, T2: 7.55 [±0.10] mm, T3: 7.54 [±0.10] mm, T4: 7.58 [±0.11] mm). Decimal visual acuity significantly improved at the end of the study (massaged eyelid: T1: 1.1 [±0.1]; T4: 1.3 [±0.1]; P .285). Redness was not significantly different between time points (repeated-measures analysis of variance; P = .187) in the colateral eyes. Hyperemia was significantly reduced in the massaged eyes (T1: 2.0 grade units [±0.3]; T4: 1.9 [±0.3]; P = .021). Eyelid warming followed by eyelid massage appears to be a safe procedure, without any clinically relevant short-term effects on the cornea.

  11. Bereitschaftspotential preceding eyelid blinks in Parkinson’s disease

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    Isabella Araújo Mota

    Full Text Available ABSTRACT The Bereitschaftspotential (BP is a negative wave observed in EEG retrograde averaging, preceding a motor act. The objective was to study the BP preceding voluntary eyelid blinks in Parkinson’s disease (PD patients during off and on phases of levodopa. Methods Ten PD patients in stages 1 and 2 of the Hoehn & Yahr classification were compared to 18 healthy controls. Artifact-free EEG segments of two seconds preceding the onset of the blink potential were averaged and analyzed, and the statistical significance of the measured amplitudes were evaluated by analysis of variance models. Results The presence of a BP in the PD patients was demonstrated. The mean amplitudes at 0 ms were respectively 0.6 µV and 3.3 µV for the BP patients and the normal controls, respectively. Conclusions The BP amplitudes were significantly smaller in PD patients than normal participants. The amplitudes of the BP were not modified by levodopa.

  12. Volume rejuvenation of the facial upper third.

    Science.gov (United States)

    Buckingham, Edward D; Glasgold, Robert; Kontis, Theda; Smith, Stephen P; Dolev, Yalon; Fitzgerald, Rebecca; Lam, Samuel M; Williams, Edwin F; Pollei, Taylor R

    2015-02-01

    The next three articles in this issue take a unique approach to discussing volumetric restoration. Robert Glasgold has provided an assessment for each facial region and five different renowned authors (TK, SPS, RF, SML, and EFW) have been asked to speak on a particular volumetric product, of which they are considered an expert, as it applies to the different regions of the face. The articles are broken into the following: (1) upper third which corresponds to the upper eyelid, brow, temple, and forehead; (2) middle third which will cover lower eyelid, cheek, and perioral area; and (3) lower third which discusses the marionette, prejowl, and jawline. Our hope is that by placing differing opinions of experienced authors, organized by facial region together, the reader will have the opportunity to more readily compare the options. The contributing authors and their product area are as follows: Theda Kontis, MD-hyaluronic acid; Steve Smith, MD-calcium hydroxyl appetite; Rebecca Fitzgerald, MD-poly-L lactic acid; Sam Lam, MD-polymethyl methacrylate; and Edwin Williams, MD-Autologous Fat Transfer. If the author included general comments on the product, they are included in the article on the upper face only and are not repeated. Please note that other individuals may also have significantly assisted in the production of these articles, but those listed above are the senior authors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. The expression of Pax6 variants is subject to posttranscriptional regulation in the developing mouse eyelid.

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    Fangyu Shi

    Full Text Available Pax6 is a pivotal transcription factor that plays a role during early eye morphogenesis, but its expression and function in eyelid development remain unknown. In this study, the expression patterns of Pax6 mRNA and protein were examined in the developing mouse eyelid at embryonic days 14.5, 15.5, and 16.5. The function of Pax6 in eyelid development was determined by comparing it to that in the eyes-open-at-birth mutant mouse. In the normally developing eyelid, Pax6 and Pax6(5a mRNA levels were low at E14.5, increased at E15.5, and then declined at E16.5, accompanied by a change in the Pax6/Pax6(5a ratio. Pax6 protein was mainly located in the mesenchyme and conjunctiva. It was expressed at low levels in the epidermis at E14.5, severely reduced at E15.5, but re-expressed in the keratinocyte cells of the periderm at E16.5. In contrast, Pax6 and the Pax6/Pax6(5a ratio were considerably higher with strong nuclear expression in the mutant at E15.5. Next, we examined the relationship of Pax6 to epidermal cell proliferation, migration, and the associated signalling pathways. The Pax6 protein in the developing eyelid was negatively correlated with epidermal cell proliferation but not migration, and it is in contrast to the activation of the EGFR-ERK pathway. Our in vivo data suggest that Pax6 expression and the Pax6/Pax6(5a ratio are at relatively low levels in the eyelid, and acting as a transcription factor, Pax6 is required for the initiation of eyelid formation and for differential development of the keratinised cells in the closed eyelid. The Pax6 protein is likely to be controlled by the EGFR-ERK pathways. An abnormal increase in Pax6 expression and the Pax6/Pax6(5a ratio due to alteration of the pathway activity could suppress epidermal cell proliferation leading to the eyes-open-at-birth defect. This study offers insight into the function of the Pax6 protein in eyelid development.

  14. Surgical Outcome of Autogenic Hard Palate Grafts in Lower Eyelid Reconstruction

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    İlke Bahçeci Şimşek

    2013-12-01

    Full Text Available Purpose: To evaluate the surgical outcome of autogenic hard palate mucosal grafts (HPMGs in full-thickness lower eyelid reconstruction following tumor excision. Material and Method: The medical records of patients who had full-thickness lower eyelid tumor excision between 2005 and 2009 were retrospectively reviewed. Seven patients who had HPMG for posterior lamellar reconstruction were included in the study. Graft complications like necrosis, contraction, excessive mucous discharge, and potential problems in the graft harvesting site and technique were evaluated. Results: Seven eyelid reconstructions with HPMG were performed on 4 female and 3 male patients with an age range of 48 to 71 years at surgery. The patients were followed for 6 to 56 months. Two patients had inferior eyelid retraction - one of them was severe and the other one was mild. None of the patients had HPMG necrosis. Donor site haemorrhage occurred in two patients which was controlled with direct pressure and cauterization in the early postoperative period. Discussion: HPMGs have been the golden standard for the reconstruction of posterior lamellar eyelid defects. The main problem about these grafts is that the oral cavity is an unusual region for ophthalmologists with potential complications arising from the hard palate. Comprehension of the anatomy, proper surgical technique, and postoperative care can decrease the rate of these complications. (Turk J Ophthalmol 2013; 43: 442-5

  15. Timing of eyelid surgery in the setting of refractive surgery: preoperative and postoperative considerations.

    Science.gov (United States)

    Victoria, Ana C; Chuck, Roy S; Rosenberg, Jamie; Schwarcz, Robert M

    2011-07-01

    With any operation, the surgeon should be aware of predisposing factors that may lead to postoperative complications. Here we review the major factors due for consideration in both eyelid and refractive eye surgery, preoperatively and postoperatively, and consider the importance of timing to lessen the inherent risks of each procedure. Refractive surgery can affect corneal sensation by ablating the corneal nerves and can cause serious corneal complications if followed by eyelid surgery. Studies find that patients undergoing eyelid surgery have a change in astigmatic error of as much as 1.0 D during the first 3 postoperative months. The longest reported follow-up period of astigmatic changes in adult patients following eyelid ptosis surgery is 1 year and a considerable number of patients had a change in cylinder of up to 0.3 D postoperatively. Blepharoplastic surgery is also reported to cause astigmatic changes postoperatively, significantly more if entire fat pads are removed. To prevent corneal exposure, postrefractive eyelid surgery should be performed at least 6 months after lamellar ablative procedures and at least 3 months after surface ablative procedures. Refractive surgery revision may be necessary when astigmatic error occurs and should be carried out no earlier than 6 months postoperatively to allow for stabilization. Cosmetic blepharoplasty with fat pad debulking should be performed at least 6 months prior to refractive surgery to allow for any potential corneal astigmatic change to stabilize, for regained strength in the orbicularis, and for improved tear film distribution.

  16. The Efficacy of Intense Pulsed Light Therapy in Postoperative Recovery from Eyelid Surgery.

    Science.gov (United States)

    Linkov, Gary; Lam, Vincent B; Wulc, Allan E

    2016-05-01

    The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery. Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board-approved study. Intense pulsed light therapy was administered three times to the same randomly assigned side on postoperative days 1 to 2, 5 to 7, and 10 to 12. Sham light therapy was administered to the contralateral side. Patient surveys and physician ratings were obtained based on photographic evaluation of ecchymosis, edema, and erythema. Three physicians, including the senior author (A.E.W.), submitted ratings, and these ratings were assessed for interobserver reliability. Twenty-eight patients who underwent bilateral eyelid surgery followed by intense pulsed light therapy were enrolled. The mean age of the patients was 66 years (range, 44 to 81 years). Eighty-six percent of patients were female. The change in ratings between postoperative days 1 to 2 and 10 to 12, in the treatment and control groups, was statistically significant for severity of bruising by both patient and physician assessment and for color of bruising only by patient assessment. The interobserver reliability reached the greatest agreement in the ecchymosis category at each time point for the treatment group. In a series of patients who underwent eyelid surgery, intense pulsed light therapy decreased the degree of ecchymosis compared with sham treatment in postoperative eyelid surgery patients. Therapeutic, II.

  17. Eyelid fissure dimensions in Japanese and in Brazilians of European descent over 50 years of age.

    Science.gov (United States)

    Viveiros, Magda Massae Hata; Matai, Olívia; Takahagi, Rodrigo Ueno; Padovani, Carlos Roberto; Schellini, Silvana Artioli

    2017-01-01

    To investigate differences in the palpebral fissure eyelid position in Japanese subjects and in Brazilian subjects of European descent over 50 years of age. A cross-sectional study evaluating 50 Japanese subjects and 50 Bra---zilian subjects of European descent over 50 years of age was performed to evaluate the effect of aging on eyelid position. Digital photographs were taken with the eyes in the primary position and transferred to a computer to be processed by Scion imaging software for evaluation of palpebral fissure width, height, and margin reflex distance (MRD). The data were statistically analyzed according to sex, age, and race. The width of the eyelid fissure in Japanese subjects was higher than that in Brazilian subjects, whereas the height of the eyelid fissure and the MRD1 was higher in Brazilians than in Japanese (pMRD1 were linearly associated with age only in the Japanese group (p0.05). There are racial differences in age-related changes in the eyelids, which are more marked in Japanese subjects.

  18. Eyelid fissure dimensions in Japanese and in Brazilians of European descent over 50 years of age

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    Magda Massae Hata Viveiros

    Full Text Available ABSTRACT Purpose: To investigate differences in the palpebral fissure eyelid position in Japanese subjects and in Brazilian subjects of European descent over 50 years of age. Methods: A cross-sectional study evaluating 50 Japanese subjects and 50 Brazilian subjects of European descent over 50 years of age was performed to evaluate the effect of aging on eyelid position. Digital photographs were taken with the eyes in the primary position and transferred to a computer to be processed by Scion imaging software for evaluation of palpebral fissure width, height, and margin reflex distance (MRD. The data were statistically analyzed according to sex, age, and race. Results: The width of the eyelid fissure in Japanese subjects was higher than that in Brazilian subjects, whereas the height of the eyelid fissure and the MRD1 was higher in Brazilians than in Japanese (p0.05. Conclusion: There are racial differences in age-related changes in the eyelids, which are more marked in Japanese subjects.

  19. VARIATION IN THE OPENINGS (OSTIA OF LEFT PULMONARY VEINS INTO THE LEFT ATRIUM: A CASE REPORT

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    Sesi

    2015-03-01

    Full Text Available During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmon ary veins which open into the left atrium, may vary. Here we report a variation in the opening of the Left upper (superior pulmonary vein into the Left atrium. A total of six openings observed

  20. Scar sarcoidosis developing 16 years after complete excision of an eyelid Basal carcinoma.

    Science.gov (United States)

    Tawfik, Hatem A; Assem, Maher; Elkafrawy, Mamdouh H; Talib, Norlaila M

    2008-01-01

    A 56-year-old patient developed sarcoidosis on top of an old eyelid scar from previous removal of an eyelid basal cell carcinoma 16 years prior to presentation. An irregular, firm, ill-defined subcutaneous mass was palpable beneath an old minimally visible scar from the previous surgery. The patient had a strong family history of sarcoidosis and persistent dyspnea and cough for the past two years, which were only elicited after the histopathology results came out with multiple non-caseating granulomas with multi-nucleated giant cells. Sarcoidosis should be considered in the differential diagnosis of recurrent eyelid skin cancers especially if the external appearance or the duration after the initial surgery does not fit the criteria for recurrence.

  1. Noninvasive and Curative Radiation Therapy for Sebaceous Carcinoma of the Eyelid

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    Hata, Masaharu, E-mail: mhata@syd.odn.ne.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Koike, Izumi; Omura, Motoko [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Maegawa, Jiro [Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Ogino, Ichiro [Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Kanagawa (Japan); Inoue, Tomio [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan)

    2012-02-01

    Purpose: Sebaceous carcinoma of the eyelid is a rare malignancy. Surgical excision remains the standard and most reliable curative treatment. However, surgery is sometimes not possible because many patients are elderly, and it frequently causes functional and cosmetic impairment of the eyelid. We therefore carried out a study to determine the role of radiation therapy in relation to sebaceous carcinoma of the eyelid. Methods and Materials: Thirteen patients with sebaceous carcinoma of the eyelid underwent radiation therapy with curative intent. There were 6 men and 7 women, and their ages at irradiation ranged from 60 to 85 years (median, 78 years). Only 1 patient had cervical lymph node metastasis, and none of the patients had distant metastasis. A total dose of 50 to 66.6 Gy (median, 60 Gy) was delivered to tumor sites in 22 to 37 fractions. Results: All irradiated tumors were controlled at a median follow-up period of 55 months. Only 1 patient had recurrence of cervical lymph node metastasis outside the radiation field, at 22 months after irradiation. The 5-year local progression-free and disease-free rates were 100% and 89%, respectively. The overall and disease-free survival rates at 5 years were 100% and 89%, respectively. Although acute and transient therapy-related reactions of Grade 2 or less were observed, there were no severe toxicities of Grade 3 or greater. Conclusions: Radiation therapy is a safe and effective treatment for patients with sebaceous carcinoma of the eyelid. It appears to contribute to prolonged survival as a result of good tumor control, and it also facilitates functional and cosmetic preservation of the eyelid.

  2. Hyaluronidase injection for the treatment of eyelid edema: a retrospective analysis of 20 patients.

    Science.gov (United States)

    Hilton, Said; Schrumpf, Holger; Buhren, Bettina Alexandra; Bölke, Edwin; Gerber, Peter Arne

    2014-05-28

    Hyaluronidase (Hylase Dessau(®)) is a hyaluronic acid-metabolizing enzyme, which has been shown to loosen the extracellular matrix, thereby improving the diffusion of local anesthetics. Lower eyelid edema is a common post-interventional complication of cosmetic procedures performed in the lid region, such as the injection of hyaluronic acid fillers for tear-trough augmentation. The purpose of this study was to validate the efficacy of hyaluronidase in the management of lower eyelid edema. We performed a retrospective analysis with 20 patients with lower eyelid edema. Most patients (n = 14) presented with edema following hyaluronic acid injection (tear-trough augmentation), whereas the minority (n = 6) were treated due to idiopathic edema (malar edema or malar mounds). Patients were treated by local infiltration of approximately 0.2 ml to 0.5 ml of hyaluronidase (Hylase Dessau(®) 20 IU to 75 IU) per eyelid. Photographs were taken prior to and seven days after infiltration. Hyaluronidase was found to reduce effectively and rapidly or resolve eyelid edema after a single injection. No relevant adverse effects were observed. However, it must be noted that a hyaluronidase injection may also dissolve injected hyaluronic acid fillers and may therefore negatively affect tear-trough augmentations. While the effects of a treatment for edema due to tear-trough augmentation were permanent, malar edema and malar mounds reoccurred within two to three weeks. The infiltration of hyaluronidase is rapid, safe and currently the only effective option for the management of eyelid edema. No relevant adverse effects were observed.

  3. Eyelid Fat Atrophy and Depigmentation After an Intralesional Injection of Triamcinolone Acetonide to Treat Chalazion.

    Science.gov (United States)

    Park, Jihyun; Chang, Minwook

    2017-05-01

    Two patients with depigmentation and fat atrophy after an intralesional injection of triamcinolone acetonide (TA) to treat chalazion are reported. A 2-year-old girl with chalazion in her right lower eyelid received a subconjunctival injection of TA and developed fat atrophy and depigmentation around the injected area. These changes subsided after 7 months. The second patient was a 5-year-old boy who received a triamcinolone injection into a chalazion through the eyelid skin and also developed fat atrophy and depigmentation but these changes improved after 1 year.

  4. A brief review of different types of sweat-gland carcinomas in the eyelid and orbit.

    Science.gov (United States)

    Zhang, Leilei; Ge, Shengfang; Fan, Xianqun

    2013-01-01

    Sweat-gland carcinoma is a rare cutaneous appendage malignant tumor. Primary sweat-gland cancer can arise in the eyelid and orbit and is extremely rare. It has been classified into different types, and is usually locally recurrent after surgery. The tumors also appear in the orbit, which is characterized by metastasis. Therefore, great attention should be paid to the development of sweat-gland carcinomas. Specifically, our report briefly reviews the types of sweat-gland carcinomas that occur in the eyelid and orbit according to pathological classifications.

  5. Eyelid contracture may indicate recurrent basal cell carcinoma, even after Mohs' micrographic surgery.

    Science.gov (United States)

    Ong, Lorraine Y; Lane, Carol M

    2009-01-01

    Mohs' micrographic surgery (MMS) is an effective means of margin control in the management of periocular basal cell carcinomas (BCC). We describe three cases of recurrent BCC that presented with progressive eyelid contracture after MMS. They illustrate high-risk factors for recurrence, namely large tumor size, medial canthal location, previous treatment, and aggressive histological features. Careful long-term surveillance with serial photography may identify early eyelid contracture and thus assist in the detection of recurrent BCC after MMS and improve patient outcome.

  6. Fractionated stereotactic irradiation by Cyberknife of choroid melanomas: repositioning validation, closed eyelids

    International Nuclear Information System (INIS)

    Horn, S.; Rezvoy, N.; Lacornerie, T.; Mirabel, X.; Labalette, P.; Lartigau, E.

    2009-01-01

    The fractionated stereotactic radiotherapy by Cyberknife is an option in the treatment of eyes tumors. The advantages of the Cyberknife in the choroid melanomas are in its infra-millimetric precision, to the automated repositioning on the skull bones and to the conformity brought by the stereotaxy. The objective of this study was to validate the quality of repositioning and the immobility of the eyes with closed eyelids. Conclusion: the reproducibility of the eye positioning with closed eyelids seems enough to consider the conservative treatment of choroid melanomas by fractionated stereotactic radiotherapy by Cyberknife without implementation of fiducials nor retrobulbar anaesthesia. (N.C.)

  7. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  8. Giant eyelid eccrine hidrocystoma-induced progressive ptosis in childhood

    Directory of Open Access Journals (Sweden)

    Dhivya Ashok Kumar

    2017-01-01

    Full Text Available An upper lid eccrine hidrocystoma presenting as early childhood progressive ptosis is very rare. We present a 9-year-old female child with droopy right upper lid since birth and progressive increase in symptoms. She had right upper lid ptosis (marginal reflex distance 1 of −1 mm with fair levator function (8 mm and abnormal cystic change on the conjunctival side. Computerized tomography imaging delineated the well-defined cystic lesion with homogeneous cavity with no contrast enhancement. Following the cyst excision, a giant eccrine hidrocystoma measuring 25 mm × 15 mm was removed, the largest reported in pediatric eyes. The case demonstrates the possibility of giant lid eccrine hidrocystomas presenting as progressive ptosis at a pediatric age and the need for early surgical intervention to prevent amblyopia.

  9. 78 FR 9349 - Medical Devices; Ophthalmic Devices; Classification of the Eyelid Weight

    Science.gov (United States)

    2013-02-08

    .... 22. U.S. Department of Commerce, Bureau of Economic Analysis, National Income and Product Accounts...?ReqID=9&step=1 , accessed January 17, 2013; National Income and Product Accounts Table 1.1.4 Price... migration Biocompatibility testing and labeling. Extrusion through the eyelid Biocompatibility testing and...

  10. Hierarchical online appearance-based tracking for 3D head pose, eyebrows, lips, eyelids, and irises

    NARCIS (Netherlands)

    Orozco, Javier; Rudovic, Ognjen; Gonzalez Garcia, Jordi; Pantic, Maja

    In this paper, we propose an On-line Appearance-Based Tracker (OABT) for simultaneous tracking of 3D head pose, lips, eyebrows, eyelids and irises in monocular video sequences. In contrast to previously proposed tracking approaches, which deal with face and gaze tracking separately, our OABT can

  11. Colophony in mascara as a cause of eyelid dermatitis. Chemical analyses and patch testing.

    Science.gov (United States)

    Karlberg, A T; Lidén, C; Ehrin, E

    1991-01-01

    Contact allergy to various components in cosmetics may cause eyelid dermatitis. Of 8 mascaras analysed with High Performance Liquid Chromatography (HPLC), 3 contained colophony. Patients with contact allergy to colophony showed positive patch test reactions when tested with the two mascaras with the highest content of colophony. One mascara without colophony but containing nickel, gave positive reactions in persons with contact allergy to nickel.

  12. The pathology of the eyelid at the University Hospital of Brazzaville ...

    African Journals Online (AJOL)

    Domestic violence topped trauma (31 patients I 45). Infections were dominated by ophthalmic Zona (18 patients I 25) and two rare diseases, one case of North American blastomycosis and one case of post surgical eyelid gangrene. Basal cell carcinoma was the first cancer (11 patients I 20). Conclusion: The pathologies of ...

  13. Cancers of eyelid: Report of two cases | Atipo-Tsiba | East African ...

    African Journals Online (AJOL)

    There are four main types of eyelid cancer. Basal Cell Carcinoma that by far the most common (85% of cases). This is a tumour of older person, after 50 years. Its occurrence in a child must search for Basal Cell Hamartoma. Squamous Cell Carcinoma represents about 5% of cases. It can occur de novo or more frequently on ...

  14. 76 FR 51876 - Medical Devices; Ophthalmic Devices; Classification of the Eyelid Thermal Pulsation System

    Science.gov (United States)

    2011-08-19

    ... validate electromagnetic compatibility (EMC) and safety of exposure to non-ionizing radiation; (2) Design... HUMAN SERVICES Food and Drug Administration 21 CFR Part 886 Medical Devices; Ophthalmic Devices; Classification of the Eyelid Thermal Pulsation System AGENCY: Food and Drug Administration, HHS. ACTION: Final...

  15. Classical Conditioning and Retention of the Infant's Eyelid Response: Effects of Age and Interstimulus Interval.

    Science.gov (United States)

    Little, Arlene H.; And Others

    1984-01-01

    Reports that lengthy interstimulus interval facilitates classical conditioning in very young infants. Infants trained in a single session at 20 days of age exhibited reliable retention of the conditioned eyelid reflex 10 days later, but infants 10 days of age did not. (Author)

  16. Classical Conditioning of Eyelid and Mystacial Vibrissae Responses in Conscious Mice

    Science.gov (United States)

    Delgado-Garcia, Jose Maria; Troncoso, Julieta; Munera, Alejandro

    2004-01-01

    The murine vibrissae sensorimotor system has been scrutinized as a target of motor learning through trace classical conditioning. Conditioned eyelid responses were acquired by using weak electrical whisker-pad stimulation as conditioned stimulus (CS) and strong electrical periorbital stimulation as unconditioned stimulus (US). In addition,…

  17. Comparison of two- and three-point sutures for advancing the levator aponeurosis in Asian eyelids.

    Science.gov (United States)

    Kim, Y S; Yoon, J S; Jang, S Y

    2015-09-01

    To compare the functional and cosmetic outcomes of two- and three-point sutures for advancing the levator aponeurosis in blepharoptosis surgery on Asians. This retrospective study examined 60 Asian patients with blepharoptosis who had undergone advancement of the levator aponeurosis: 34 patients (46 eyelids) had ptosis correction using the two-point suture technique and 26 patients (41 eyelids) had ptosis correction using the three-point suture technique. The postoperative marginal reflex distance (MRD1), lid height difference, and eyelid contour were evaluated. Twenty-seven (79.4%) of the 34 patients in the two-point group and 19 (73.1%) of 26 patients in the three-point group had a postoperative MRD1 of 2-4 mm, lids within 0.5 mm of each other, and a satisfactory eyelid contour; this difference was not significant. The rate of reoperation did not differ significantly between the two groups. Two- and three-point sutures for advancing the levator aponeurosis were equally effective for correcting blepharoptosis in Asians.

  18. Total Reconstruction of Lower Eyelid in a Post-traumatic Patient ...

    African Journals Online (AJOL)

    But apart from their cosmetic value, they have very important function to serve. They protect the eyes from trauma, excessive light, and also contribute in maintaining the biomechanics of the lacrimal apparatus, keeping the eyes moist. The architecture of the eyelids is very complex posing a real challenge to reconstruction.

  19. Pre-operative therapeutic eyelid hygiene in the prevention of complications following excimer laser vision correction

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2012-01-01

    Full Text Available Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.Methods: In enrolled 144 patients (288 eyes, ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK. In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time. In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes, therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX. In both groups, Natural tears and Systane Ultra (Alcon were used as tear replacement therapy.Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

  20. Pre-operative therapeutic eyelid hygiene in the prevention of complications following excimer laser vision correction

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2014-07-01

    Full Text Available Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.Methods: In enrolled 144 patients (288 eyes, ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK. In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time. In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes, therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX. In both groups, Natural tears and Systane Ultra (Alcon were used as tear replacement therapy.Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

  1. Therapeutic eyelids hygiene in the algorithms of prevention and treatment of ocular surface diseases

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2016-01-01

    Full Text Available When acute inflammation in anterior eye segment of a forward piece of an eye was stopped, ophthalmologists face a problem of absence of acute inflammation signs and at the same time complaints to the remain discomfort feelings. It causes dissatisfaction from the treatment. The complaints are typically caused by disturbance of tears productions. No accidental that the new group of diseases was allocated — the diseases of the ocular surface. Ocular surface is a difficult biologic system, including epithelium of the conjunctiva, cornea and limb, as well as the area costal margin eyelid and meibomian gland ducts. Pathological processes in conjunctiva, cornea and eyelids are linked with tears production. Ophthalmologists prescribes tears substitutions, providing short-term relief to patients. However, in respect that the lipid component of the tear film plays the key role in the preservation of its stability, eyelids hygiene is the basis for the treatment of dry eye associated with ocular surface diseases. Eyelids hygiene provides normal functioning of glands, restores the metabolic processes in skin and ensures the formation of a complete tear film. Protection of eyelids, especially the marginal edge from aggressive environmental agents, infections and parasites and is the basis for the prevention and treatment of blepharitis and dry eye syndrome. The most common clinical situations and algorithms of their treatment and prevention of dysfunction of the meibomian glands; demodectic blepharitis; seborrheic blepharitis; staphylococcal blepharitis; allergic blepharitis; barley and chalazion are discussed in the article. The prevention keratoconjunctival xerosis (before and postoperative period, caused by contact lenses, computer vision syndrome, remission after acute conjunctiva and cornea inflammation is also presented. The first part of the article presents the treatment and prevention algorithms for dysfunction of the meibomian glands, as well as

  2. Hearing eyeball and/or eyelid movements on the side of a unilateral superior semicircular canal dehiscence.

    Science.gov (United States)

    Bertholon, Pierre; Reynard, Pierre; Lelonge, Yann; Peyron, Roland; Vassal, François; Karkas, Alexandre

    2018-02-01

    Hearing of eyeball movements has been reported in superior semicircular canal dehiscence (SSCD), but not hearing of eyelid movements. Our main objective was to report the hearing of eyeball and/or eyelid movements in unilateral SSCD. Our secondary objective was to access its specificity to SSCD and discuss the underlying mechanism. Six patients with SSCD who could hear their eyeball and/or eyelid movements were retrospectively reviewed. With the aim of comparisons, eight patients with an enlarged vestibular aqueduct (EVA), who share the same mechanism of an abnormal third window, were questioned on their ability to hear their eyeball and/or eyelid movements. Three patients with SSCD could hear both their eyeball and eyelid movements as a soft low-pitch friction sound. Two patients with SSCD could hear only their eyelid movements, one of whom after the surgery of a traumatic chronic subdural hematoma. The latter remarked that every gently tapping on the skin covering the burr-hole was heard in his dehiscent ear as the sound produced when banging on a drum, in keeping with a direct transmission of the sound to the inner ear via the cerebrospinal fluid. One patient with SSCD, who could hear only his eyeball movements, had other disabling symptoms deserving operation through a middle fossa approach with an immediate relief of his symptoms. None of the eight patients with EVA could hear his/her eyeball or eyelid movements. Hearing of eyeball and/or eyelid movements is highly suggestive of a SSCD and do not seem to occur in EVA. In case of radiological SSCD, clinicians should search for hearing of eyeball and/or eyelid movements providing arguments for a symptomatic dehiscence. The underlying mechanism is discussed particularly the role of a cerebrospinal fluid transmission.

  3. Simultaneous Double Eyelid Blepharoplasty and Ptosis Correction with a Single-Knot, Continuous, Nonincisional Technique: A Five-Year Review.

    Science.gov (United States)

    Hu, Jung-Woo; Byeon, Jun Hee; Shim, Hyung-Sup

    2016-01-01

    Double eyelid blepharoplasty is one of the most popular facial cosmetic surgeries performed in patients with Asian eyelids. Although most patients choose to undergo blepharoplasty for cosmetic purposes, rather than functional reasons, these patients frequently present with concomitant mild-to-moderate blepharoptosis. Performing nonincisional double eyelid surgery without correcting the ptosis tends to lead to unsatisfactory results. The authors introduce our new method for simultaneous correction of blepharoptosis during double eyelid blepharoplasty. For 5 years, the authors have performed a single-knot continuous nonincisional technique for simultaneous correction of blepharoptosis during double eyelid blepharoplasty. The medical charts of 127 patients (254 eyelids) were retrospectively reviewed. Müller muscle tagging suture was utilized to achieve the accurate amount of Müller tucking during the surgery. There was a statistically significant difference between pretreatment MRD1 (1.62 ± 0.57 mm), and postoperative MRD1 (3.97 ± 0.81 mm; P < .001, Wilcoxon signed rank test, nonparametric paired comparison). The mean duration of surgery for both eyelids was 14.8 minutes (range, 14.1-19.7 minutes), and the mean extent of Müller muscle tucking was 7.8 mm (range, 6.0-10.0 mm). The majority of patients showed favorable results during long-term follow-up, with minimal complications. There are no previously published articles documenting simultaneous double eyelid blepharoplasty and ptosis correction, using a single-knot continuous nonincisional technique. The authors suggest our simple and effective method is a good option for double eyelid blepharoplasty in cases with mild-to-moderate blepharoptosis.' LEVEL OF EVIDENCE 4: Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  4. Monitoring kinetic and frequency-domain properties of eyelid responses in mice with magnetic distance measurement technique

    NARCIS (Netherlands)

    W.L. den Ouden; G. Perry; S.M. Highstein; C.I. de Zeeuw (Chris); S.K.E. Koekkoek (Bas)

    2002-01-01

    textabstractClassical eye-blink conditioning in mutant mice can be used to study the molecular mechanisms underlying associative learning. To measure the kinetic and frequency domain properties of conditioned (tone - periorbital shock procedure) and unconditioned eyelid responses

  5. Customized Orbital Decompression Surgery Combined with Eyelid Surgery or Strabismus Surgery in Mild to Moderate Thyroid-associated Ophthalmopathy

    OpenAIRE

    Choi, Seung Woo; Lee, Jae Yeun; Lew, Helen

    2016-01-01

    Purpose To evaluate the efficacy and safety of customized orbital decompression surgery combined with eyelid surgery or strabismus surgery for mild to moderate thyroid-associated ophthalmopathy (TAO). Methods Twenty-seven consecutive subjects who were treated surgically for proptosis with disfigurement or diplopia after medical therapy from September 2009 to July 2012 were included in the analysis. Customized orbital decompression surgery with correction of eyelid retraction and extraocular m...

  6. A STUDY ON EYELID AND CONJUNCTIVAL NEOPLASM IN A TERTIARY CARE CENTRE IN EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Soumya Swarup Chattopadhyay

    2017-09-01

    Full Text Available BACKGROUND Eyelid and conjunctival tumours (benign and malignant are very common in a tropical country like India causing not only cosmetic deformity, but also endangering patients’ life. The aim of our study is to determine the sociodemographic factors and clinicopathological assessment in order to early diagnosis and treatment. MATERIALS AND METHODS The present study is an observational study involving the cases with primary eyelid and/or conjunctival tumours. After thorough clinical history including detailed demographic details and clinical examination, the cases are admitted in the hospital. After undergoing thorough preoperative evaluation, FNAB or partial excision biopsy or total excision biopsy of the tumour mass is done by single competent ophthalmic surgeon and sent for histopathological analysis. The cases were classified into two major groups, eyelid neoplasm group and conjunctival neoplasm group. Each major group was subdivided into benign neoplasm and malignant neoplasm groups. The demographic details, clinical history, examination findings and results of the histopathological analysis is documented, appropriately tabulated and reported and statistical calculations done. RESULTS In this prospective observational study, 133 eyes of 133 patients (M:F=70:63 with primary eyelid and conjunctival tumour attending OPD and oculoplasty clinic at Regional Institute of Ophthalmology, Kolkata, were recruited into the study. There were a total of 103 (77.44% eyelid neoplasms and 30 (22.55% patients were having conjunctival neoplasms. Out of the 103 eyelids, neoplasms diagnosed 42.72% (n=44 of them were histopathologically diagnosed as benign and 57.28% (n=59 as malignant. Of the 59 cases diagnosed as malignant, four most common eyelid malignant neoplasms were sebaceous cell carcinoma (n=22, 37%, basal cell carcinoma (n=15, 25%, squamous cell carcinoma (n=10, 17% and malignant melanoma (n=7, 12%. Among the 30 conjunctival neoplasms

  7. Sebaceous carcinoma of the eyelid diagnosed on fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Meenu Gill

    2012-01-01

    Full Text Available Sebaceous carcinoma of the ocular adnexa is a malignant neoplasm which has aggressive local behavior and can metastasize to regional lymph nodes and distant organs. It is a malignant neoplasm known to masquerade as other benign and less malignant lesions, resulting in delay in diagnosis and relatively high morbidity and mortality. Aspiration cytological features of this neoplasm have not been well characterized in the literature. We report a case of this tumor diagnosed on fine needle aspiration. Clinically, a diagnosis of chalazion was made and fine needle aspiration cytology (FNAC was performed. Cytological diagnosis of a malignant tumor with closest resemblance to sebaceous carcinoma was suggested which was confirmed on histopathology. Eyelid reconstruction was done after histopathological confirmation of tumor-free margins. The article highlights the role of FNAC in early diagnosis and subsequent appropriate surgical management of eyelid sebaceous gland carcinoma to prevent recurrence and metastasis.

  8. Giant Merkel cell carcinoma of the eyelid: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sun Baocun

    2011-05-01

    Full Text Available Abstract Merkel cell carcinoma (MCC is a rare cutaneous tumor and cases located in the eyelid have been described, but still its rarity may lead to difficulty in diagnosis and delay in treatment. A 51-year-old female patient that presented with large lesions in the eyelid underwent surgery after the diagnosis of acute chalazion. Following respiratory distress secondary to pulmonary metastasis, the patient's condition deteriorated and was not fit for complete excision treatment. Histopathological investigation of the biopsies, taken from the tumor, revealed that it was undifferentiated small cell carcinoma. Our aim with this paper is to point out that more cases should be reported for more effective diagnosis, histopathological study, clinical investigation, treatment and prognosis of this specific neoplasm.

  9. Delayed resolution of eyelid swelling in preseptal cellulitis in a child: beware of causing occlusion amblyopia

    Science.gov (United States)

    Upendran, Muralidharan R; McLoone, Eibhlin

    2013-01-01

    A 7-month-old child presented with a 6-day history of right eyelid swelling and redness. She was being treated with chloramphenicol ointment and oral flucloxacillin by the general practitioner. Clinical examination revealed features of preseptal cellulitis. There was no evidence of orbital involvement and the child was generally well otherwise. Her oral antibiotics were changed and she was adviced to attend for a review in 2 days time. However, the child did not return for a review. Three weeks later following resolution of the eyelid swelling, the child represented with a divergent squint in the right eye. Clinical and orthoptic investigations suggested occlusion amblyopia. The child is currently receiving patching treatment for the amblyopia and is awaiting surgery for squint eye. PMID:23476010

  10. A brief review of different types of sweat-gland carcinomas in the eyelid and orbit

    Directory of Open Access Journals (Sweden)

    Zhang L

    2013-04-01

    Full Text Available Leilei Zhang, Shengfang Ge, Xianqun Fan Department of Ophthalmology, Ninth People’s Hospital, Shanghai, People’s Republic of China Abstract: Sweat-gland carcinoma is a rare cutaneous appendage malignant tumor. Primary sweat-gland cancer can arise in the eyelid and orbit and is extremely rare. It has been classified into different types, and is usually locally recurrent after surgery. The tumors also appear in the orbit, which is characterized by metastasis. Therefore, great attention should be paid to the development of sweat-gland carcinomas. Specifically, our report briefly reviews the types of sweat-gland carcinomas that occur in the eyelid and orbit according to pathological classifications. Keywords: spiroma, syringomatous carcinoma, mucinous eccrine carcinoma, clear-cell eccrine gland carcinoma, eccrine porocarcinoma, orbit

  11. MUSTARDE’S FLAP FOR POST BASAL CELL CARCINOMA EXCISION LOWER EYELID RECONSTRUCTION: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Amit

    2015-06-01

    Full Text Available PURPOSE: To review the role of Mustarde’s flap for post basal cell carcinoma excision lower eyelid reconstruction , its clinical outcomes and complications. METHODS: The Mustarde’s rotational cheek flap has been used to reconstruct the lower eyelids of 16 patients from 2008 to 2015 in proven cases of bcc. RESULT S: Mustarde’s flaps have very high functionally as well as cosmetic acceptability with minimum patient morbidity. The most frequent complications were downward contraction and sagging of the flap and ectropion of the lid margin. To prevent them, the zygomatico - cheek flap must be carefully designed, rotated, and sutured as high as possible so that immediately postoperatively, t he palpebral fissure is only a narrow slit.

  12. Sclerosing lipogranuloma of the eyelid: unusual complication following nasal packing in endoscopic sinus surgery.

    Science.gov (United States)

    Ramaswamy, Balakrishnan; Singh, Rohit; Manusrut, Manusrut; Hazarika, Manali

    2015-03-06

    An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petroleum jelly or an antibiotic-based cream. It usually presents a few weeks or months after the initial procedure. We present a report of three such cases of sclerosing lipogranuloma involving the eyelid, which occurred following a sinonasal surgery where nasal packing using petroleum jelly was performed. The typical clinical course and the classical histopathological features are highlighted. All cases were diagnosed by histopathological examination as sclerosing lipogranuloma. Complete surgical removal resulted in complete resolution on 1 month follow-up. The diagnosis is based on a high degree of suspicion following a detailed history of prior use of lipid-based products for nasal packing following endonasal surgery. Histopathology is diagnostic. Surgical excision is the treatment of choice, however, due to its infiltrative nature, it may be difficult to obtain a complete cure. 2015 BMJ Publishing Group Ltd.

  13. An asystolic event after eyelid skin bupivicaine injection during chalazion surgery.

    Science.gov (United States)

    Katowitz, William R; O'Brien, Meghan; Kiskis, Eris; Elliott, Elizabeth M

    2016-02-01

    We report an asystolic event in an 8-year-old girl under general anesthesia that occurred after bupivicaine was injected into the eyelid during routine chalazion incision and drainage surgery. Because the bupivacaine was injected directly into the subcuticular space and not intravascularly, we concluded that the patient's asystolic event was induced by an oculocardiac reflex. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  14. A brief review of different types of sweat-gland carcinomas in the eyelid and orbit

    OpenAIRE

    Zhang, Leilei; Ge, Shengfang; Fan, Xianqun

    2013-01-01

    Leilei Zhang, Shengfang Ge, Xianqun Fan Department of Ophthalmology, Ninth People’s Hospital, Shanghai, People’s Republic of China Abstract: Sweat-gland carcinoma is a rare cutaneous appendage malignant tumor. Primary sweat-gland cancer can arise in the eyelid and orbit and is extremely rare. It has been classified into different types, and is usually locally recurrent after surgery. The tumors also appear in the orbit, which is characterized by metastasis. Therefore, gre...

  15. Clear cell hidradenocarcinoma of the eyelid: a case report with a review of the literature.

    Science.gov (United States)

    Singh, Gurcharan; Narasimha, Aparna; Kumar, Harendra; Datti, Narendra

    2013-04-01

    Clear cell hidradenocarcinomas are extremely rare neoplasms, with very few well-documented cases reported in the literature. The most common sites are the head and neck regions. These tumors are histologically malignant but are not always aggressive. They are known for recurrence and may metastasize widely. Treatment is wide local resection. We report on a case of clear cell hidradenocarcinoma occurring over the eyelid together with a review of the literature.

  16. Acquired capillary hemangioma of the eyelid in a 49-year-old woman from Turkey

    Directory of Open Access Journals (Sweden)

    Sertac Argun Kivanc

    2014-01-01

    Full Text Available A 49-year-old woman developed a dark brown nodular mass in the lower eyelid. The lesion had grown fast for 2 months and then had remained stable in size. Excisional biopsy was performed. Histopathological examination of an excisional biopsy specimen pointed to proliferative vessels lined by increased endothelial cells without nuclear atypism. The nodular mass evaluated as a capillary hemangioma.

  17. [Management of eyelid carcinomas: Retrospective bicentric study of 64 cases and review of the literature].

    Science.gov (United States)

    Echchaoui, A; Benyachou, M; Houssa, A; Kajout, M; Oufkir, A A; Hajji, C; Daoudi, R; Hafidi, J; El Mazouz, S; Gharib, N; Abbassi, A

    2016-02-01

    To study the epidemiologic, clinical and histological aspects of eyelid carcinomas in our context, and to evaluate our surgical management on an oncological, functional and aesthetic level. This work is a retrospective bicentric study extended over a 5-year period between January 2009 and December 2013, including 64 patients with eyelid carcinoma undergoing surgery in the Plastic and Reconstructive Surgery Department at the Avicenne University Hospital of Rabat and in the ENT/Head and Neck Surgery Department at the Hassan II University Hospital of Fez. The study included 25 men and 39 women with a mean age of 60.6 ± 15.33 years. Advanced age and chronic sun exposure were the most important risk factors. The most commonly involved site was the lower eyelid (53%). Histological examination emphasized the very high prevalence of basal cell carcinoma (90.62%). Surgical treatment was performed in all our patients followed by an extemporaneous and/or standard histological examination of the surgical specimen. Exenteration was performed in one patient with adjuvant radiation therapy. Reconstruction incorporated a variety of techniques, of which total skin graft and Mustardé flap were the most common in our series. Aside from a few complications, the postoperative results were satisfactory for the majority of our patients. Malignant tumors of the eyelids, of which basal cell carcinoma is the most common, pose a therapeutic problem where surgery remains the most utilized treatment option. The best treatment is prevention and diagnosis of early lesions to improve prognosis and to avoid worse outcomes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Effect of combination laser hyperthermia and radiation therapy for malignant tumor of the eyelid

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Tomoko [Chukyo Hospital, Nagoya, Aichi (Japan); Ando, Fumitaka; Watanabe, Michiko

    1997-10-01

    Malignant tumors of the eyelid have been treated successfully by excision of a margin of normal tissue, but cosmesis may be a problem postoperatively. To avoid the problems of surgery, we used a combination therapy of laser hyperthermia followed by radiation in 4 eyes of 4 patients (2 eyes with sebaceous gland carcinoma, 1 with squamous cell carcinoma, and 1 with basal cell carcinoma). An interstitial contact laser probe of artificial sapphire connected to a continuous wave neodymium yttrium-aluminum-garnet (Nd:YAG) laser was used to effect hyperthermia in the tumor for 15 to 20 minutes at each treatment. The laser energy was applied directly to the surface of the conjunctiva, which was anesthetized before each treatment by topical application of anesthetic drops and injection of lidocaine. The temperature around the tumor was maintained between 42 and 43 degrees C by intermittent low-power irradiation of 2 watts. Radiotherapy was administered 3 to 5 times a week using a linear accelerator set at 4 to 6 MeV to deliver 2.5 to 3.5 Gy at each session for a total of 50 to 65 Gy. None of the 4 patients experienced recurrence of eyelid tumor, and the only complications observed were madarosis (2 eyes) and cataract (1 eye). This protocol seems to be a promising method to treat malignant tumor of the eyelid. (author)

  19. Derivation of epithelial-like cells from eyelid fat-derived stem cells in thermosensitive hydrogel.

    Science.gov (United States)

    Heidari Keshel, Saeed; Rostampour, Maryam; Khosropour, Golbahar; Bandbon B, Atefehsadat; Baradaran-Rafii, Alireza; Biazar, Esmaeil

    2016-01-01

    Injectable hydrogel is one of the great interests for tissue engineering and cell encapsulation. In the study, the thermosensitive chitosan/gelatin/β-glycerol phosphate (C/G/GP) disodium salt hydrogels were designed and investigated by different analyses. The eye fat-derived stem cells were used to evaluate the biocompatibility of hydrogels based on their phenotypic profile, viability, proliferation, and attachment ability. The results show that the sol/gel transition temperature of the C/G/GP hydrogel was in the range of 31.1-33.8 °C at neutral pH value, the gelation time was shortened, and the gel strength also improved at body temperature when compared with the C/GP hydrogel. In vitro cell culture experiments with eyelid fat-derived stem cells in hydrogel showed beneficial effects on the cell phenotypic morphology, proliferation, and differentiation. Microscopic figures showed that the eyelid fat stem cell were firmly anchored to the substrates and were able to retain a normal stem cell phenotype. Immunocytochemistry (ICC) and real-time-PCR results revealed change in the expression profile of eyelid fat stem cells grown with hydrogels when compared to those grown on control in epithelial induction condition. This study indicates that using chitosan/gelatin/β-glycerol phosphate hydrogel for cell culture is feasible and may apply in minimal invasive surgery in the future.

  20. RARE BENIGN EYELID TUMOR IN CHILDREN (EPITHELIOMA OF MALHERBE, PILOMATRIXOMA, OR TRICHELEMMOMA

    Directory of Open Access Journals (Sweden)

    A. A. Ryabtseva

    2015-01-01

    Full Text Available Aim. To describe clinical manifestations of rare eyelid tumor (epithelioma Malherbe and to improve differential diagnosis of benign eyelid tumors in children. Patients and methods. We observed 8 children aged 3,5‑8 years (sex ratio was 1:1. In all cases, examination, palpation, surgical excision of the tumor with histological examination were performed. Results. Trichilemmoma, or pilomatricoma, was suggested from clinical manifestations. Epithelioma Malherbe was diagnosed by histology only. Microscopically, the tumor is surrounded by a capsule which includes two cell types. Peripheral basophilic cells are small cells with poor cytoplasm, indistinct borders, and deeply basophilic nucleus. Central shadow cells have a distinct border and a central unstained area. Islands of small basaloid epithelial cells with squamous cell focuses and cornification are embedded in the stroma. Epithelial lesions are often necrotized. Epithelial mass is surrounded by granulations with giant cells. Osseous trabeculae are often adjacent to necrotic lesions. Further follow-up revealed no complications or recurrences. Conclusions. Our observations and literature data suggest that epithelioma Malherbe is occured in 1.3 % of benign eyelid tumors in childern. Tumor growth is slow and non-invasive. 

  1. Oral doxycycline, niacinamide and prednisolone used to treat bilateral nodular granulomatous conjunctivitis of the third eyelid in an Australian Kelpie dog.

    Science.gov (United States)

    Hurn, Simon; Mc Cowan, Christina; Turner, Andrew

    2005-01-01

    A 5-year-old, female neutered, Australian Kelpie presented with a 2-month history of dramatic bilateral erythematous thickening of the third eyelids. Ophthalmic examination demonstrated raised, pink to red, irregular thickening of the entire palpebral surface of both third eyelids. There were no other ocular abnormalities. A surgical biopsy was taken from each third eyelid. Histopathologic examination revealed sheets of macrophages, plasma cells, lymphocytes, and occasional fibroblasts and neutrophils infiltrating the third eyelid stroma. A diagnosis of chronic granulomatous conjunctivitis was made. Grossly and histopathologically this case closely resembles previously described cases of nodular granulomatous conjunctivitis involving the third eyelids of Collie dogs. This report describes an unusual case of nodular granulomatous conjunctivitis isolated to the third eyelids in an Australian Kelpie. Resolution of the condition was achieved with a combination of oral doxycycline, niacinamide and prednisolone.

  2. A Case of Primary Signet-Ring Cell/Histiocytoid Carcinoma of the Eyelid: Immunohistochemical Comparison With the Normal Sweat Gland and Review of the Literature

    OpenAIRE

    Iwaya, Mai; Uehara, Takeshi; Yoshizawa, Akihiko; Kobayashi, Yukihiro; Momose, Masanobu; Honda, Takayuki; Ota, Hiroyoshi

    2012-01-01

    Primary signet-ring cell/histiocytoid carcinomas of the eyelid are extremely rare tumors considered to originate from sweat glands. Here, we report the case of a 72-year-old man diagnosed with primary signet-ring cell/histiocytoid carcinoma of the eyelid and present immunohistochemical analyses of the eyelid apocrine gland (Moll gland) and apocrine and eccrine sweat glands of perineum and axilla. Widespread infiltration of tumor cells with signet-ring cell or histiocytoid appearance was obser...

  3. Mersilene Mesh Vs Autogenous Fascia Lata for Upper Lid Sling Procedure

    Directory of Open Access Journals (Sweden)

    Hossein Salour

    2008-12-01

    Full Text Available

    PURPOSE: To compare mersilene mesh and autogenous fascia lata for upper lid sling procedure in the management of ptosis with poor levator function. METHODS: This randomized clinical trial included 9 patients with unilateral and 11 patients with bilateral congenital ptosis and poor levator function. All subjects underwent upper lid sling procedure with a random choice of two different materials: mersilene mesh in 16 eyelids and autogenous fascia lata in 15 eyelids. RESULTS: Overall, 31 eyelids underwent the upper lid sling procedure. There was no difference between the two groups in terms of final functional (lid fissure height stability and cosmetic (lid margin contour results. Dermatochalasis was more common in the fascia lata group (10 eyes compared to the mersilene mesh group (2 eyes. Mersilene mesh extrusion occurred in two eyelids. CONCLUSION: Mersilene mesh has favorable long-term functional results and a low rate of complications. This material may be considered as an alternative to autogenous fascia lata for frontalis suspension surgery.

  4. Left-sided portal hypertension revisited

    Directory of Open Access Journals (Sweden)

    Antonio Manenti

    2016-12-01

    Conclusions: In every case of left-sided portal hypertension, upper digestive endoscopy and close follow-up are recommended. Besides, computed tomography can demonstrate particular conditions directly favoring gastroesophageal varices, and aid in selection of the appropriate therapeutic decisions. [Arch Clin Exp Surg 2016; 5(4.000: 211-215

  5. Diagnosis and treatment of upper limb apraxia

    OpenAIRE

    Dovern, A.; Fink, G. R.; Weiss, P. H.

    2012-01-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

  6. Validity of Forced Eyelid Closure Test: A Novel Clinical Screening Test for Ocular Myasthenia Gravis.

    Science.gov (United States)

    Apinyawasisuk, Supanut; Zhou, Xinkai; Tian, Jack J; Garcia, Giancarlo A; Karanjia, Rustum; Sadun, Alfredo A

    2017-09-01

    Forced eyelid closure test (FECT) is a clinical screening test developed from the original Cogan lid twitch (CLT) sign to assist in the diagnosis of ocular myasthenia gravis (OMG), We evaluated the sensitivity and specificity of FECT compared with CLT and benchmarked to standard diagnostic tests. This study was a retrospective chart review of 48 patients using electronic medical records of those that presented with ptosis and/or diplopia at Doheny Eye Institute, University of California, Los Angeles between February 2015 and April 2016. Patients without FECT testing were excluded. FECT and CLT results, and final diagnosis were recorded. To perform FECT, the patient was asked to squeeze his or her eyelids shut for 5-10 seconds then open quickly and fixate in primary position. The excessive upward overshoot of eyelids movement indicated a positive FECT. The test was performed by a neuro-ophthalmologist before establishing the diagnosis. Patients who had equivocal test results and/or inconclusive final diagnosis were excluded. Of the 48 patients studied, 18 patients (37.5%) had positive FECT; 15 of whom had a final diagnosis of OMG (83.3%). Of the 30 patients with negative FECT, 1 had OMG (3.3%). Of the 48 patients, 35 patients also had a documented CLT result (72.9%). CLT was positive in 11 of these 35 patients (31.4%), and 9 of these 11 had OMG (81.8%). Of the 24 patients with negative CLT, 2 of them had OMG (8.3%). Sensitivity and specificity of FECT were 94% and 91% (joint 95% confidence region: sensitivity × specificity = [0.70, 1] × [0.75, 1]). The relative true-positive fraction (rTPF) between FECT and CLT was 1.15; the relative false-positive fraction was 1.31. FECT is a simple clinical screening test with good sensitivity and specificity for OMG.

  7. Eyelid Opening with Trigeminal Proprioceptive Activation Regulates a Brainstem Arousal Mechanism.

    Directory of Open Access Journals (Sweden)

    Kiyoshi Matsuo

    Full Text Available Eyelid opening stretches mechanoreceptors in the supratarsal Müller muscle to activate the proprioceptive fiber supplied by the trigeminal mesencephalic nucleus. This proprioception induces reflex contractions of the slow-twitch fibers in the levator palpebrae superioris and frontalis muscles to sustain eyelid and eyebrow positions against gravity. The cell bodies of the trigeminal proprioceptive neurons in the mesencephalon potentially make gap-junctional connections with the locus coeruleus neurons. The locus coeruleus is implicated in arousal and autonomic function. Due to the relationship between arousal, ventromedial prefrontal cortex, and skin conductance, we assessed whether upgaze with trigeminal proprioceptive evocation activates sympathetically innervated sweat glands and the ventromedial prefrontal cortex. Specifically, we examined whether 60° upgaze induces palmar sweating and hemodynamic changes in the prefrontal cortex in 16 subjects. Sweating was monitored using a thumb-mounted perspiration meter, and prefrontal cortex activity was measured with 45-channel, functional near-infrared spectroscopy (fNIRS and 2-channel NIRS at Fp1 and Fp2. In 16 subjects, palmar sweating was induced by upgaze and decreased in response to downgaze. Upgaze activated the ventromedial prefrontal cortex with an accumulation of integrated concentration changes in deoxyhemoglobin, oxyhemoglobin, and total hemoglobin levels in 12 subjects. Upgaze phasically and degree-dependently increased deoxyhemoglobin level at Fp1 and Fp2, whereas downgaze phasically decreased it in 16 subjects. Unilateral anesthetization of mechanoreceptors in the supratarsal Müller muscle used to significantly reduce trigeminal proprioceptive evocation ipsilaterally impaired the increased deoxyhemoglobin level by 60° upgaze at Fp1 or Fp2 in 6 subjects. We concluded that upgaze with strong trigeminal proprioceptive evocation was sufficient to phasically activate sympathetically

  8. Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective.

    Science.gov (United States)

    Di Somma, Alberto; Andaluz, Norberto; Cavallo, Luigi Maria; de Notaris, Matteo; Dallan, Iacopo; Solari, Domenico; Zimmer, Lee A; Keller, Jeffrey T; Zuccarello, Mario; Prats-Galino, Alberto; Cappabianca, Paolo

    2017-12-15

    OBJECTIVE Recent studies have proposed the superior eyelid endoscopic transorbital approach as a new minimally invasive route to access orbital lesions, mostly in otolaryngology and maxillofacial surgeries. The authors undertook this anatomical study in order to contribute a neurosurgical perspective, exploring the anterior and middle cranial fossa areas through this purely endoscopic transorbital trajectory. METHODS Anatomical dissections were performed in 10 human cadaveric heads (20 sides) using 0° and 30° endoscopes. A step-by-step description of the superior eyelid transorbital endoscopic route and surgically oriented classification are provided. RESULTS The authors' cadaveric prosection of this approach defined 3 modular routes that could be combined. Two corridors using bone removal lateral to the superior and inferior orbital fissures exposed the middle and anterior cranial fossa (lateral orbital corridors to the anterior and middle cranial base) to unveil the temporal pole region, lateral wall of the cavernous sinus, middle cranial fossa floor, and frontobasal area (i.e., orbital and recti gyri of the frontal lobe). Combined, these 2 corridors exposed the lateral aspect of the lesser sphenoid wing with the Sylvian region (combined lateral orbital corridor to the anterior and middle cranial fossa, with lesser sphenoid wing removal). The medial corridor, with extension of bone removal medially to the superior and inferior orbital fissure, afforded exposure of the opticocarotid area (medial orbital corridor to the opticocarotid area). CONCLUSIONS Along with its minimally invasive nature, the superior eyelid transorbital approach allows good visualization and manipulation of anatomical structures mainly located in the anterior and middle cranial fossae (i.e., lateral to the superior and inferior orbital fissures). The visualization and management of the opticocarotid region medial to the superior orbital fissure are more complex. Further studies are needed

  9. ECONOMIC ASPECTS OF THERAPEUTIC EYELID HYGIENE IN MEIBOMIAN GLAND DYSFUNCTION TREATMENT

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    V. N. Trubilin

    2015-01-01

    Full Text Available The value of dry eye for general public health increases due to its high occurence in elderly persons and aging population. Non-specific questionnaires are adopted for dry eye. Additionally, 36‑item Medical Outcomes Study-Short Form (MOS-SF-36 and benefit evaluation method were developed. Methods. Information analysis and mathematical methods and public health technology evaluation methods (i.e., modelling, analysis of disease burden, and budget impact analysis were applied to economic aspect study. Decision tree model based on these finding was developed and applied to cost estimating of blepharoconjunctival and exogenous dry eye treatment in computer vision syndrome. Two scenarios of patient management were considered, i.e., typical management and management using therapeutic eyelid hygiene. Similar model was developed for early postoperative period after LASIK. Short-run analysis (1 year was performed, direct medical costs were considered. This analysis implies the calculation of overall cost (economic burden of the disease. Official data on adult population size in 2014 and the occurrence of the disease were used to assess prevalence. Budget impact analysis evaluates the difference in total economic effects due to comparison technology use in money terms. Sensitivity analysis assesses the stability of simulation results. Medical treatment cost was considered the most valuable parameter. Results and conclusions. Direct medical costs of typical management and management using therapeutic eyelid hygiene in demodicosis, computer vision syndrome, and after LASIK were 14,623 RUB and 9,200 RUB (savings of 37 %, 17,630 RUB and 9,200 RUB (savings of 47 %, 4,425.5 RUB and 3,004 RUB (savings of 32 %, respectively. Analysis of economic burden with respect to disease occurrence and typical management costs demonstrated that in 2015 this parameter was estimated as 576,198,416,556 RUB. In terms of direct medical costs, therapeutic eyelid hygiene saves 44

  10. Infectious bovine keratoconjunctivitis and lymphofollicular hyperplasia of the third eyelid in heifers.

    Science.gov (United States)

    Yeruham, I; Perl, S; Elad, D

    2001-03-01

    On a dairy cattle farm, infectious bovine keratoconjunctivitis was diagnosed in 29 (24%) calves and heifers aged from 2 weeks to 1 year old. The highest infection rate (18%) occurred in animals aged 3-6 months. The bacteriological examination of swabs from the affected animals yielded several species of bacteria: Moraxella bovis, Neisseria ovis, N. cuniculi, plasma coagulase-negative Staphylococcus spp., alpha-haemolytic Streptococcus spp., Arcanobacterium pyogenes and Escherichia coli. Moraxella bovis and N. ovis were the most common isolates. Hyperplasia of the lymphatic tissue of the third eyelid in the form of nodules 7-8 mm in diameter was diagnosed in two heifers aged 8 and 10 months.

  11. Minimally invasive eyelid care in dermatology: medical, laser, and cosmetic therapies.

    Science.gov (United States)

    Fathi, Ramin; Pfeiffer, Margaret L; Tsoukas, Maria

    2015-01-01

    There is a high demand for facial aesthetic enhancement, and the periorbital region is one of the first areas to show signs of aging. Many nonsurgical therapies exist to tackle these problems. These therapies are becoming more efficacious while reducing postprocedural recovery time. The goal is to restore the natural youthful appearance rather than to create an effect that differs from the patient's appearance earlier in life. Eyelid care, and cosmetic dermatology in general, intends to restore balance and symmetry. We discuss the initial consultation, relevant anatomy for the dermatologist, and medical, laser and cosmetic therapies. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Bilateral eyelid ecchymosis and subconjunctival haemorrhage manifesting as presenting feature in a case of dengue haemorrhagic fever.

    Science.gov (United States)

    Jain, Sparshi; Goswami, Anup; Singh, Nidhi; Kaur, Savleen

    2015-10-01

    We report a case of bilateral eyelid ecchymosis and subconjunctival haemorrhage, a rare presenting feature of dengue haemorrhagic fever. A 17-year-old boy presented to the emergency department with complaints of redness in both eyes and vomiting. He had bilateral eyelid ecchymosis with subconjunctival haemorrhage. Complete blood count revealed a significantly reduced platelet count of 11000/µL suggestive of dengue haemorrhagic fever (DHF). Ocular manifestations were followed by other systemic haemorrhagic manifestations of dengue later on which violates the usual sequence of events of dengue fever. Bilateral eyelid ecchymosis is a rare clinical manifestation and a rare presenting feature of dengue fever and one has to keep high index of suspicion for presence of dengue whenever a case of fever presents with lid ecchymosis/haemorrhage. © The Author(s) 2014.

  13. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    International Nuclear Information System (INIS)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja

    2010-01-01

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman

  14. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  15. Left bronchial artery arising from a replaced left hepatic artery in a patient with massive hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Khil, Eun Kyung; Lee, Jae Myung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-09-15

    A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

  16. Tricoepitelioma palpebral: relato de 2 casos Eyelid trichoepithelioma: report of 2 cases

    Directory of Open Access Journals (Sweden)

    Débora Mayumi Sugano

    2005-02-01

    Full Text Available O tricoepitelioma é tumor cutâneo benigno derivado dos folículos pilosos. É comum na face, porém há poucos relatos sobre a ocorrência na pálpebra. não é freqüentemente reconhecido devido à sua raridade, controvérsias na sua classificação, origem e potencial biológico. O objetivo deste artigo é apresentar 2 casos de tricoepitelioma solitário na pálpebra, o exame histopatológico e seu tratamento. Esta lesão deve ser considerada quando for encontrado um nódulo solitário na região facial e diferenciada do carcinoma basocelular. A confirmação por meio do exame histopatológico é essencial.Trichoepithelioma is a benign skin tumor and is most commonly found on the face, however, there are few reports about its occurrence on the eyelids. It is not usually recognized because of its rarity, origin, biological potential, and controversial classification. The purpose of this paper is to report two cases of solitary trichoepithelioma on the eyelid, their histopathology and treatment. This lesion should be considered when a single solid nodule on the face appears, and can be differentiated from basal-cell carcinoma. Histopathologic confirmation is essential.

  17. Acquisition, consolidation, reconsolidation, and extinction of eyelid conditioning responses require de novo protein synthesis.

    Science.gov (United States)

    Inda, Mari Carmen; Delgado-García, José María; Carrión, Angel Manuel

    2005-02-23

    Memory, as measured by changes in an animal's behavior some time after learning, is a reflection of many processes. Here, using a trace paradigm, in mice we show that de novo protein synthesis is required for acquisition, consolidation, reconsolidation, and extinction of classically conditioned eyelid responses. Two critical periods of protein synthesis have been found: the first, during training, the blocking of which impaired acquisition; and the second, lasting the first 4 h after training, the blocking of which impaired consolidation. The process of reconsolidation was sensitive to protein synthesis inhibition if anisomycin was injected before or just after the reactivation session. Furthermore, extinction was also dependent on protein synthesis, following the same temporal course as that followed during acquisition and consolidation. This last fact reinforces the idea that extinction is an active learning process rather than a passive event of forgetting. Together, these findings demonstrate that all of the different stages of memory formation involved in the classical conditioning of eyelid responses are dependent on protein synthesis.

  18. Cutaneous squamous cell carcinoma of the eyelid masquerading as a chalazion.

    Science.gov (United States)

    Vrcek, Ivan; Hogan, R N; Mancini, Ronald

    2015-02-01

    Chalazia are among the most common eyelid lesions presenting to eye care providers. Often successfully managed conservatively, some require more invasive intervention such as incision and drainage or steroid injection. Lesions that recur, do not respond to treatment, or are atypical in appearance or natural history should prompt more thorough analysis, often with biopsy and subsequent microscopic analysis. Not uncommonly, such atypical chalazia may be masking a more serious diagnosis. Eyelid cutaneous squamous cell carcinoma masquerading as a chalazion is exceedingly rare. We present a case report of an atypical chalazion that was refractory to incision and drainage as well as intralesional steroid injection. Incisional biopsy revealed the lesion to be a cutaneous squamous cell carcinoma requiring full-thickness excision and subsequent reconstruction. The patient provided written informed consent, and the contents herein are acceptable under the provisions of the institutional review board. Following Mohs excision and oculoplastic reconstruction with a Hughes flap, the patient has had a good outcome and is currently free of recurrence. Recurrent chalazia that are defiant to surgical and medical interventions should prompt biopsy and evaluation by pathology. Cutaneous squamous cell carcinoma should be considered in the differential diagnosis as early intervention can save a patient's eye and, not infrequently, their life.

  19. Lymphatic vessels in human eyelids: an immunohistological study in dermatochalasis and chalazion.

    Science.gov (United States)

    Aglianó, M; Lorenzoni, P; Volpi, N; Massai, L; Carbotti, P; Fruschelli, M; Muscettola, M; Alessandrini, C; Grasso, G

    2008-03-01

    We investigated lymphatic morphology and expression of endothelin (ET-1) axis molecules in human eyelids affected by an inflammatory state (chalazion) and an age-related degenerative condition (dermatochalasis). Lymphatics were immunohistologically detected by D2-40/LYVE-1 staining. Absorbing lymphatic vessels were localized in papillary dermis and around skin appendages with distinctive morphology. In chalazion, D2-40 reactive flattened lymphatic profiles were compressed by inflammatory infiltrate; in dermatochalasis, large fully opened lymphatics were observed, with a significantly wider total area (lymphatic lumina/200x field; p < 0.05). The lymphatic density (number/200x field) in the two groups was within the same range. Lymphatic dilation is possibly dependent on reduction and fragmentation of the dermal elastic network as well as of oxytalanic fibers in the papillary dermis of dermatochalasis, as shown by Weigert's reaction. Multifunctional peptide ET-1, involved in vasomotion, inflammation and connective proliferation, was faintly and discontinuously localized on lymphatics, as was its type A receptor. In contrast, the consistent expression of type B receptor indicates that lymphatic endothelium is a physiological target for ET-1, whose effects are modulated by multiple pathophysiological conditions. Thus, vasoactive factors play a role in the physiology of richly vascularized eyelids, and therefore, morphofunctional characterization of lymphatic vessels may be useful in suggesting treatment options.

  20. Ontogeny of metabolic rate and red blood cell size in eyelid geckos: species follow different paths.

    Directory of Open Access Journals (Sweden)

    Zuzana Starostová

    Full Text Available While metabolism is a fundamental feature of all organisms, the causes of its scaling with body mass are not yet fully explained. Nevertheless, observations of negative correlations between red blood cell (RBC size and the rate of metabolism suggest that size variation of these cells responsible for oxygen supply may play a crucial role in determining metabolic rate scaling in vertebrates. Based on a prediction derived from the Cell Metabolism Hypothesis, metabolic rate should increase linearly with body mass in species with RBC size invariance, and slower than linearly when RBC size increases with body mass. We found support for that prediction in five species of eyelid geckos (family Eublepharidae with different patterns of RBC size variation during ontogenetic growth. During ontogeny, metabolic rate increases nearly linearly with body mass in those species of eyelid geckos where there is no correlation between RBC size and body mass, whereas non-linearity of metabolic rate scaling is evident in those species with ontogenetic increase of RBC size. Our findings provide evidence that ontogenetic variability in RBC size, possibly correlating with sizes of other cell types, could have important physiological consequences and can contribute to qualitatively different shape of the intraspecific relationship between metabolic rate and body mass.

  1. Cytohistological study of eyelid lesions and pitfalls in fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Mondal Santosh

    2008-01-01

    Full Text Available Aims : The purpose of the study was to evaluate different eyelid lesions appearing as a swelling or mass, using fine needle aspiration cytology (FNAC, to conduct a cytological diagnosis of these lesions with subsequent histopathological correlation, and to identify the problems faced during microscopical examination of the smears. Materials and Methods : Fine needle aspirates from 80 eyelid swellings and histopathological correlation in 62 cases were studied. Results: Forty eight cases of benign and 32 cases of malignant lesions were diagnosed by FNAC. The five leading benign lesions were chalazions (12 cases, 15%, epithelial cysts (eight cases, 10%, chronic nonspecific inflammation (six cases, 7.5%, seborrheic keratosis (five cases, 6.25% and benign adnexal adenoma (four cases, 5%. The most common malignant lesion was basal cell carcinoma (12 cases, 15% followed by sebaceous gland carcinoma (nine cases, 11.25% and squamous cell carcinoma (eight cases, 10%. Conclusions: Histopathological correlation showed that the accuracy of fine needle aspiration cytology in making diagnosis was 83.87%. Incidence of basal cell carcinoma in the study was lower, compared to most western studies. Therefore, there may be a racial and geographical variation.

  2. Ontogeny of metabolic rate and red blood cell size in eyelid geckos: species follow different paths.

    Science.gov (United States)

    Starostová, Zuzana; Konarzewski, Marek; Kozłowski, Jan; Kratochvíl, Lukáš

    2013-01-01

    While metabolism is a fundamental feature of all organisms, the causes of its scaling with body mass are not yet fully explained. Nevertheless, observations of negative correlations between red blood cell (RBC) size and the rate of metabolism suggest that size variation of these cells responsible for oxygen supply may play a crucial role in determining metabolic rate scaling in vertebrates. Based on a prediction derived from the Cell Metabolism Hypothesis, metabolic rate should increase linearly with body mass in species with RBC size invariance, and slower than linearly when RBC size increases with body mass. We found support for that prediction in five species of eyelid geckos (family Eublepharidae) with different patterns of RBC size variation during ontogenetic growth. During ontogeny, metabolic rate increases nearly linearly with body mass in those species of eyelid geckos where there is no correlation between RBC size and body mass, whereas non-linearity of metabolic rate scaling is evident in those species with ontogenetic increase of RBC size. Our findings provide evidence that ontogenetic variability in RBC size, possibly correlating with sizes of other cell types, could have important physiological consequences and can contribute to qualitatively different shape of the intraspecific relationship between metabolic rate and body mass.

  3. Assessing the Accuracy of Eyelid Measurements Utilizing the Volk Eye Check System and Clinical Measurements.

    Science.gov (United States)

    Sinha, Kunal R; Yeganeh, Amir; Goldberg, Robert A; Rootman, Daniel B

    2017-08-23

    The purpose of this study was to validate the accuracy of marginal reflex distance 1 (MRD1) measurements obtained by the Volk Eye Check system, a modified smartphone that measures MRD1 automatically, relative to clinical and digital measurements. In this prospective observational study of adults with normal eyelids and ptosis, MRD1 was measured clinically, digitally, and automatically with the Volk device. Eyes were divided into successful versus unsuccessful Volk trial groups; successful eyes were then subdivided into control and ptosis subgroups. The primary outcome measures were mean MRD1 obtained by the 3 modalities. Secondary outcome measures included the success rate of the device and the prevalence of ptosis within the successful and unsuccessful groups. In the overall sample of 88 eyes, clinical and digital MRD1 were not significantly different. Among eyes with successful Volk trials, significant differences in MRD1 measured by the 3 modalities were as follows: in the successful group, Volk MRD1 (3.05 mm) was significantly (p MRD1 (2.68 mm); in the ptosis subgroup, Volk MRD1 (2.47 mm) was significantly higher than clinical (2.05 mm; p MRD1 (1.91 mm; p MRD1 (mean difference, 1.21 mm; p MRD1 well in normal patients but overestimates MRD1 in patients with ptosis. It may be most appropriate in assessing patients with normal or elevated eyelid position. Clinical and digital MRD1 measurements were not different than each other.

  4. An upper limb mathematical model of an oil palm harvester

    Science.gov (United States)

    Tumit, N. P.; Rambely, A. S.; BMT, Shamsul; Shahriman A., B.; Ng Y., G.; Deros, B. M.; Zailina, H.; Goh, Y. M.; Arumugam, Manohar; Ismail, I. A.; Abdul Hafiz A., R.

    2014-09-01

    The main purpose of this article is to develop a mathematical model of human body during harvesting via Kane's method. In this paper, a 2-D closed-kinematic biomechanical model that represents a harvesting movement is developed. The model of six segments consisted of upper right arm, right forearm, harvesting equipment, left forearm, upper left arm, and upper part of trunk. Finally, the inverse dynamic equations are represented in matrix form.

  5. Non-invasive quick diagnosis of cardiovascular problems from visible and invisible abnormal changes with increased cardiac troponin I appearing on cardiovascular representation areas of the eyebrows, left upper lip, etc. of the face & hands: beneficial manual stimulation of hands for acute anginal chest pain, and important factors in safe, effective treatment.

    Science.gov (United States)

    Omura, Yoshiaki; Jones, Marilyn K; Duvvi, Harsha; Shimotsuura, Yasuhiro; Ohki, Motomu; Rodriques, Aaron

    2014-01-01

    Our previous study indicated that there are at least 7 cardiovascular representation areas on the face, including the "Eyebrows", both sides of the "Nose", "Lelt Upper Lip" and the "Outside of the corner of both sides of the mouth," in addition to 2 areas in each hand. When there are cardiovascular problems, some of the heart representation areas of these areas often show the following changes: 1) Most distinctive visible changes such as the initial whitening with or without long white hair, then hair loss and complete disappearance of the hairs of the heart representation area of "Eyebrows" 2) Invisible biochemical changes that happen in heart representation areas at the "Left Upper Lips", 3) "Nose" below eye level as well as 4) "3rd segment of Middle Finger of Hands." Most distinctive visible & invisible changes are found in heart representation areas on the "Eyebrow", located nearest to the midline of face, where the color of the hairs becomes white compared with the rest of the Eyebrow. Then the cardiovascular problem advances, and hair starts disappearing. When there are no hairs at the heart representation areas of the Eyebrow, usually Cardiac Troponin I is increased to a very serious, abnormal high value. Most of the cardiovascular representation areas of the face show, regardless of presence or absence of visible change. When there is a cardiovascular problem, not only simple Bi-Digital O-Ring Test can detect without using any instrument in several minutes but also, corresponding biochemical changes of abnormally increased Cardiac Troponin I level can often be detected non-invasively from these Organ Representation Areas of Face & Hands, although changes in Eyebrows, L-Upper Lip & 3rd segment of middle fingers are clinically the most reliable changes & easy to identify the locations. Manual Stimulation of Hand's heart representation areas often eliminated acute anginal chest pain before medical help became available. Important factors for safe, effective

  6. Eyelid Cancer

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  7. Eyelid Growths

    Science.gov (United States)

    ... Study ALL NEWS > Resources First Aid Videos Figures 3D Models Images Infographics Audio Pronunciations The One-Page Manual of Health Quizzes ... Commentary ALL NEWS > Resources First Aid Videos Figures 3D Models Images Infographics Audio Pronunciations The One-Page Manual of Health Quizzes ...

  8. Tight Left Upper Lobe Collapse from Lung Cancer

    Science.gov (United States)

    2010-07-01

    tight pulmonary lobar collapse. Summary of Imaging Findings An 83-year-old male smoker with history of COPD on 2L home oxygen presented to...appendage.” Recent prior spirometry was noted to have “decreased FEV1 and FEV1/FVC ratio with hyperbolic expiratory limb of the flow-volume loop...when assessing lobar collapse in adults and smokers . 1 In young adults (less than age 40), endobronchial carcinoid tumor is common. In post

  9. A Novel Technique for Repositioning Lower Eyelid Fat via the Transoral Approach in Association with Midface Lift

    OpenAIRE

    Mofid, M. Mark

    2011-01-01

    Background Orbital fat repositioning in association with subperiosteal midface elevation has been variably described via both the transconjunctival and skin muscle flap approaches. Poor visualization, middle and posterior lamellar cicatricial fibrosis, technical difficulty, and incomplete release are disadvantages commonly ascribed to the transconjunctival approach. Lower eyelid malposition and retraction also are commonly seen in association with skin muscle flap approaches. A simple techniq...

  10. Largest case series of Latin American eyelid tumors over 13-Years from a single center in Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Jéssica Carolinne Damasceno

    Full Text Available ABSTRACT Purpose: Malignant lesions of the eyelid are the most common eye cancers. Although rarely lethal, late diagnosis can lead to serious visual morbidity. Definitive diagnosis of neoplastic lesions is pathological. Indications and types of eyelid lesions in a single high-volume ophthalmic reference center in Sao Paulo, Brazil, were analyzed. Methods: The surgical pathological reports of patients who underwent eye removal procedures between January 2000 and December 2012 were retrieved from the electronic database of the Ophthalmology Department and retrospectively reviewed. Data regarding the final anatomopathological diagnosis, sex, and age were analyzed via the χ2 test with Yates' correction. Results: Of the 1,113 eyelid tumors resected over the 13-year study period, 324 (29% lesions were malignant. The most prevalent lesions were basal cell, squamous cell, and sebaceous gland carcinomas. The median ages of patients (females, n=165, 51%; males, n=159, 49% with a diagnosis of basal cell, squamous cell, and sebaceous gland carcinomas were 65, 75, and 70 years, respectively. Conclusion: This is the largest retrospective cohort analysis of eyelid tumors in a Latin American population. These findings are in agreement with those from large centers in other countries and regions.

  11. Histological and clinical evaluation of the hard palate mucous membrane graft for treatment of lower eyelid retraction

    DEFF Research Database (Denmark)

    Larsen, Sofie D H; Heegaard, Steffen; Toft, Peter B

    2017-01-01

    PURPOSE: To evaluate the histological appearances of the epithelial cells and the clinical effect of the hard palate mucous membrane (HPM) graft for the treatment of lower eyelid retraction (LER). METHODS: This was a follow-up study involving 15 patients, with a total of 16 eyes operated. Five...

  12. Camera-Based Microswitch Technology to Monitor Mouth, Eyebrow, and Eyelid Responses of Children with Profound Multiple Disabilities

    Science.gov (United States)

    Lancioni, Giulio E.; Bellini, Domenico; Oliva, Doretta; Singh, Nirbhay N.; O'Reilly, Mark F.; Lang, Russell; Didden, Robert

    2011-01-01

    A camera-based microswitch technology was recently used to successfully monitor small eyelid and mouth responses of two adults with profound multiple disabilities (Lancioni et al., Res Dev Disab 31:1509-1514, 2010a). This technology, in contrast with the traditional optic microswitches used for those responses, did not require support frames on…

  13. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  14. Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs.

    Science.gov (United States)

    Zheng, Ya-Juan; Dong, Yu-Chen; Zhu, Chao; Zhao, Mei-Sheng

    2016-03-01

    Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (SR) were analyzed. The mPFC sites in the guinea pigs were examined under a light microscope following Nissl staining. In addition, the expression of Fos protein in neurons was detected using immunohistochemistry and western blot analysis. The results indicated that the acquisition rates of CR and SR were increased significantly (Pmicrocurrent electrical stimulation of the mPFC in guinea pigs was triggered by the expression of Fos protein. The observations of the present study further expand the understanding of conditioned reflexes and may aid future investigations into the formation of eyelid conditioning and the mechanisms underlying the circuit in various conditions.

  15. Intralesional tetracycline injection for treatment of lower eyelid festoons: a preliminary report.

    Science.gov (United States)

    Perry, Julian D; Mehta, Viraj J; Costin, Bryan R

    2015-01-01

    To determine the safety and effectiveness of intralesional tetracycline 2% injection for the treatment of lower eyelid festoons. The authors retrospectively reviewed the charts of all patients undergoing tetracycline 2% injection of lower eyelid festoons at the Cole Eye Institute from August 2008 to August 2013. Charts were reviewed for patient demographic data, dose and number of tetracycline injections, follow-up interval, the presence of preinjection and postinjection photographs, and complications. Charts without preinjection and postinjection photographs were excluded from review. The preinjection and postinjection photographs were randomized, masked, and graded by 4 independent examiners. Photographs were graded on a scale of 0 (no festoon) to 4 (severe festoon). Student t test was used for statistical analysis. Eleven patients met inclusion criteria. Each patient underwent bilateral injection. Average follow up was 121 days (range, 18-586 days). Patients received up to 0.75 ml (mean, 0.24 ml) of tetracycline 2% per side. Average preinjection grade was 2.1 (standard deviation, 0.89; range, 0-3), and average postinjection grade was 1.2 (standard deviation, 0.72; range, 0-2; p < 0.001). Three patients had follow up less than 60 days (mean, 34 days), with an average preinjection grade of 1.96 and postinjection grade of 1.23 (p < 0.001). Five patients had follow up between 60 and 100 days (mean, 82 days), with an average preinjection grade of 2.18 and postinjection grade of 1.38 (p < 0.001). Three patients had follow up longer than 100 days (mean, 275 days), with an average preinjection grade of 2.08 and postinjection grade of 0.78 (p < 0.001). Complications other than pain and bruising were not identified in any patient. Intralesional tetracycline 2% injection may offer a safe option to treat lower eyelid festoons. Complications such as cutaneous ischemia or necrosis were not identified in any patient. Further study may determine optimal treatment doses and

  16. [Vectorcardiographic manifestations of left intraventricular conduction disorders].

    Science.gov (United States)

    de Micheli, A; Medrano, G A

    1979-01-01

    Both, the vectorcardiographic changes produced by the various degrees of left bundle branch block and these observed with the different types of left distal block, are described. When a "wave jumping" phenomenon exists, the vectorcardiographic changes are more characteristic in the horizontal plane than in the frontal plane and can be interpreted satisfactorily in basis of the ventricular activation sequence. The normal counterclockwise rotation of the horizontal vectorcardiogram persists in the presence of left bundle branch block of slight and moderate degrees, since the electromotive forces of the free left ventricular wall are still predominant. In the majority of intermediate degree blocks, the middle portion of the RH loop develops with a clockwise rotation and general aspect with a clockwise rotation and the general aspect of the ventricular loop resembles an eight figure. This is due to the electromotive forces originated by the delayed depolarization of the left septal mass that starts to predominate. With advanced degrees of block, the largest portion of the RH loop shows a clockwise rotation, as well as marked notchings and slurrings. The initial anterior portion of the horizontal vectorcardiogram does not disappear, but is situated to the left of the anterior-posterior axis with a counterclockwise rotation (first right septal vector). Otherwise, the direct electrical sign of left distal block emphasized: evidence of delayed activation in a limited zone of the homolateral ventricle. This local delay gives rise to an asynchronism of the activation phenomenon between the upper and lower regions of the ventricle. The diagnosis of left bifascicular block is based essentially on the evidence of unequal delay of the activation sequence in the basal regions and in the inferior ones of the homolateral ventricle and also on the frequent persistence of the first left septal vector.

  17. A rare case of eyelid sarcoidosis presenting as an orbital mass

    Directory of Open Access Journals (Sweden)

    Balan Louis Gaspar

    2016-01-01

    Full Text Available Intraorbital sarcoidosis presenting externally as a solitary eyelid mass has been described in the literature as isolated case reports. We describe a rare case of asymptomatic sarcoidosis with orbital mass as the presenting feature in a young woman. The lesion was excised with the clinical possibility of a thrombosed varix. On histology, the lesion was characterized by numerous nonnecrotizing epithelioid cell granulomas with several multinucleated giant cells containing abundant asteroid bodies and oxalate crystals. No tubercular bacilli were detected. A diagnosis of sarcoidosis was rendered and on further clinical work-up, she was detected to have hilar lymphadenopathy. Sarcoidosis should be considered in the differential diagnosis of orbital mass as it could be the initial manifestation of the disease process.

  18. Primary cutaneous adenoid cystic carcinoma of the eyelid and literature review

    Directory of Open Access Journals (Sweden)

    Deniz Turgut Coban

    2015-10-01

    Full Text Available ABSTRACTPrimary cutaneous adenoid cystic carcinoma (PCACC is a rare malignant epithelial tumor most commonly observed in the scalp and skin of the chest and originating from the palpebral portion of the lacrimal gland in the orbit. Here we describe the diagnosis and treatment of a rare case of PCACC in an eye of a 52-year-old male. The patient presented with a mass lesion of the right lower eyelid. During incisional biopsy, lack of encapsulation and a secretion pattern different to that of chalazion was observed, which differentiated the lesion from chalazion. Pathological analysis revealed the diagnosis of PCACC. This case highlights the importance of careful inspection for macroscopic differentiation of PCACC from chalazion after initial surgery and pathological evaluation of all surgically removed mass lesions for accurate diagnosis and treatment.

  19. The double-eyelid operation in Japan: its evolution as related to cultural changes.

    Science.gov (United States)

    Shirakabe, Y; Kinugasa, T; Kawata, M; Kishimoto, T; Shirakabe, T

    1985-09-01

    Of the many aspects of aesthetic surgery, the double-eyelid operation generates the most interest for Japanese surgeons, as there has been an enormous demand for it by patients who are fashion-conscious. It has been possible to locate 32 operative procedures that have been published in the Japanese literature over the past ninety years. Some of these procedures have been reviewed here in relation to the cultural and social changes which are important factors determining the extent of the demand for the operation and which correlate with various changes in surgical technique. This study chronologically describes each of the principal methods related to these social changes and also considers the influence of cultural fads and fashions.

  20. Eyelid Molluscum Contagiosum Lesions in Two Patients with Unilateral Chronic Conjunctivitis

    Directory of Open Access Journals (Sweden)

    Şule Serin

    2017-08-01

    Full Text Available Molluscum contagiosum (MC is a viral infection of the skin and mucosal tissues characterized by skin-colored or transparent round nodules with a dimple or pit in the center. The infection is caused by a DNA poxvirus called the MC virus. Although MC generally occurs in children, it has also been reported in immunocompromised and atopic patients. The virus is transmitted by skin contact or sexual intercourse. The lesions disappear spontaneously within several months in most cases. However, excision, cryotherapy, cauterization, topical chemical and antiviral agents, and/or oral cimetidine are used in refractory cases or to accelerate the healing process. Herein, we discussed the clinical findings and our treatment of two patients with unilateral chronic conjunctivitis associated with eyelid MC lesions in light of the literature.

  1. Ptose palpebral associada a paquidermoperiostose: relato de caso Eyelid ptosis associated with pachydermoperiostosis: case report

    Directory of Open Access Journals (Sweden)

    Ana Paula Ximenes Alves

    2005-06-01

    Full Text Available Descreve-se caso clínico de um indivíduo acometido por paquidermoperiostose, cuja queixa principal foi ptose palpebral bilateral. Trata-se de doença hereditária, autossômica dominante, que acomete a pele, os ossos e os tecidos moles, resultando em acentuada hipertrofia tarsal. Discute-se a fisiopatologia da ptose e o tratamento executado no caso.We describe a clinical case of a patient with pachydermoperiostosis and bilateral palpebral ptosis. It is a hereditary, dominant autosomic disease, which affects skin, bones and soft tissues. In the eyelid, it causes an important tarsal hypertrophy. We discuss the physiopathology and treatment of the ptosis.

  2. Mucin-producing sweat gland carcinoma of the eyelid: diagnostic and prognostic considerations.

    Science.gov (United States)

    Hoguet, Ambika; Warrow, David; Milite, James; McCormick, Steven A; Maher, Elizabeth; Della Rocca, Robert; Della Rocca, David; Goldbaum, Andrew; Milman, Tatyana

    2013-03-01

    To describe the clinical and pathologic characteristics of mucin-producing sweat gland carcinoma of the eyelid and to determine whether neuroendocrine differentiation is of prognostic significance. Retrospective interventional case series. Search of the New York Eye and Ear Infirmary pathology database between 1990 and 2011 identified 16 patients with mucin-producing sweat gland carcinoma. Clinical, histopathologic, and immunohistochemical analyses were performed on all identified cases. The patients presented with vascularized, focally cystic, nonulcerated eyelid margin lesions. Histopathologic evaluation showed that 4 lesions (25%) had a cystic, papillary, and solid growth pattern with an in situ component, 7 (44%) were pure invasive mucinous carcinomas, and 5 (31%) demonstrated both growth patterns. Immunohistochemical analysis of 15 tumors showed that pure cystic/papillary lesions had a significantly greater percentage of synaptophysin-immunoreactive cells (P = .036). There was no significant difference in the number of neuroendocrine markers expressed or in the intensity of immunostaining among the 3 different growth patterns. Re-excision for margin clearance was performed in 8 of 13 cases (61.5%). Two of 13 lesions recurred (15%); 1 of these was an in situ tumor with cystic morphology and neuroendocrine differentiation and the other was pure invasive mucinous carcinoma. None of the lesions metastasized. Mucin-producing sweat gland carcinoma pathologically represents a continuum, from an in situ lesion to a classic, invasive mucinous carcinoma. Immunohistochemical evidence of neuroendocrine differentiation can be observed in all lesions and does not appear to have a prognostic significance, arguing against the utility of immunohistochemical subtyping of mucinous sweat gland carcinomas. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Congenital eyelid ptosis: onset and prevalence of amblyopia, associations with systemic disorders, and treatment outcomes.

    Science.gov (United States)

    Stein, August; Kelly, John P; Weiss, Avery H

    2014-10-01

    To determine the age at onset of amblyopia, the response to occlusion therapy, and the association with systemic disorders in children with congenital eyelid ptosis. Retrospective chart review of children seen at Seattle Children's Hospital with moderate or severe congenital ptosis. Assessments were longitudinal visual acuity development using objective methods, definition of ptosis severity by eyelid margin to pupillary light reflex distance (margin reflex distance [MRD]), age at amblyopia diagnosis, correlation between amblyopia and MRD, and associated systemic disorders. Eighty-four children with moderate-to-severe congenital ptosis met inclusion criteria; the mean longitudinal follow-up was 49.1 months. Fifteen (18%) of these children had amblyopia, of which 9 had deprivation amblyopia (mean age 17.3 months ± 11.2) and 6 had anisometropic or strabismic amblyopia (mean age 60 months ± 11.8). Eleven (73%) of the children with amblyopia were successfully treated with occlusion therapy. Amblyopia was not correlated with MRD. A systemic disorder was identified in 29 (35%) of the children, the most common being genetic, chromosomal, or neurologic conditions. Patients with systemic disorders and developmental delay have significantly lower visual acuity bilaterally compared with patients without systemic disorders (P ≤ .003). Using longitudinal and objective visual acuity assessments, the incidence of amblyopia was 18% in children with moderate to severe congenital ptosis. Visual deprivation was the predominant risk factor that was reliably distinguished by its earlier onset in young children. The best indicator of amblyopia in children is visual acuity rather than MRD measurements. Systemic disorders are frequent in children with moderate to severe congenital ptosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. 100-μsec pulsed CO2 laser resurfacing of lower eyelids: erythema and rhytides reduction

    Science.gov (United States)

    Bell, Thomas; Harris, David M.; Schachter, Daniel; Burkart, John

    1997-05-01

    Lower eyelid skin is very thin with a low density of adnexal structures. Attempts to remove rhytides and improve surface appearance with chemical peels and dermabrasion have been disappointing. Laser resurfacing offers a new modality that may improve the outcome. We evaluated a very short duration (100 microsecond(s) ec) pulsed carbon-dioxide laser (Tru-PulseTM) in terms of healing time (duration of erythema) and efficacy (wrinkle reduction). Female patients aged 35 - 75 received laser resurfacing in a variety of cosmetic zones but only data from lower lids are reported here. Dosimetry varied from total fluences of 5 to 20 J/cm2 (9 mm2 spot, 250 - 500 mJ pulse, 1 to 4 passes). Patients followed a strict regime of post-op wound care. Pre-treatment and follow-up photographs were taken in a studio with constant photographic parameters. Projected 35 mm slides were evaluated side-by-side for clinical improvement and presence of erythema. Within the first 4 days post-op all (100%) lower eyelids exhibited erythema and swelling, at 7 days: 71%, 12 days: 60%, 3 weeks: 25%, and one (1) month or longer 7%. In our sample the longest duration of post-op lower lid erythema lasted 5 weeks. Most patients experienced 70 -80% wrinkle reduction with a range of 0 - 100%. Regression analysis was used to evaluate the relationships between percent wrinkle reduction and the treatment, demographic, and evaluation variables. There was a significant trend for wrinkles to improve over the 3 to 9 month evaluation period. Older patients improved slightly more than younger patients. There was no relationship between total energy density and wrinkle reduction.

  5. Mucin-producing Malignant Tumor of Lower Eyelid Presenting in a 14-year-old Patient.

    Science.gov (United States)

    Latorre, Andrea; Alghothani, Lana; Lambert, David; Jatana, Kris R; Peters, Sara; Foster, Jill; Hill, Robert

    2012-04-01

    Malignancies of the ocular adnexa are rare, aggressive tumors with significant potential for local recurrence and metastases. Although basal cell carcinoma remains the most common malignancy of the eyelid, encompassing more than 90 percent of all periocular cancers, several other malignant neoplasms have been reported. Malignant ocular adnexal neoplasms are most commonly of sweat gland origin and include hidradenocarcinoma, mucinous eccrine adenocarcinoma, and apocrine adenocarcinoma of the glands of Moll. The different ocular adnexal adenocarcinomas share many of the same characteristics with regard to incidence, primary location, and rates of recurrence and metastases. As a result, these tumors are difficult to distinguish clinically and true diagnosis depends on histological findings. The highest incidence of the reported cases occurred during the sixth decade of life. The head, neck, and trunk are the most frequently reported primary locations. Ocular adnexal adenocarcinomas have a significant rate of metastasis to regional lymph nodes as well as distant sites. Standard treatment of care includes surgical excision of the tumor; however, these malignancies have a tendency to recur locally. The authors present a 14-year-old Caucasian girl with no significant past medical history who presented with a recurrent right lower eyelid tumor. She previously had multiple resections at an outside hospital; however, the margins could not be cleared. The patient was taken to the operating room for Mohs-type resection of the primary site as well as a right parotidectomy with facial nerve preservation and right modified radical neck dissection. The final pathology was consistent with a mucin-producing malignant tumor of ocular adnexa. Due to the great potential for local recurrence and metastases, the prognosis for ocular adnexal adenocarcinoma remains poor even with aggressive surgical management. The use of Mohs surgery for resection has increased as it has been linked to

  6. The lid wiper and muco-cutaneous junction anatomy of the human eyelid margins: an in vivo confocal and histological study

    Science.gov (United States)

    Knop, Erich; Knop, Nadja; Zhivov, Andrey; Kraak, Robert; Korb, Donald R; Blackie, Caroline; Greiner, Jack V; Guthoff, Rudolf

    2011-01-01

    The inner border of the eyelid margin is critically important for ocular surface integrity because it guarantees the thin spread of the tear film. Its exact morphology in the human is still insufficiently known. The histology in serial sections of upper and lower lid margins in whole-mount specimens from 10 human body donors was compared to in vivo confocal microscopy of eight eyes with a Heidelberg retina-tomograph (HRT II) and attached Rostock cornea module. Behind the posterior margin of the Meibomian orifices, the cornified epidermis stopped abruptly and was replaced by a continuous layer of para-keratinized (pk) cells followed by discontinuous pk cells. The pk cells covered the muco-cutaneous junction (MCJ), the surface of which corresponded to the line of Marx (0.2–0.3 mm wide). Then a stratified epithelium with a conjunctival structure of cuboidal cells, some pk cells, and goblet cells formed an epithelial elevation of typically about 100 μm initial thickness (lid wiper). This continued for 0.3–1.5 mm and formed a slope. The MCJ and lid wiper extended all along the lid margin from nasal to temporal positions in the upper and lower lids. Details of the epithelium and connective tissue were also detectable using the Rostock cornea module. The human inner lid border has distinct zones. Due to its location and morphology, the epithelial lip of the lid wiper appears a suitable structure to spread the tear film and is distinct from the MCJ/line of Marx. Better knowledge of the lid margin appears important for understanding dry eye disease and its morphology can be analysed clinically by in vivo confocal microscopy. PMID:21413985

  7. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  8. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  9. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review.

    OpenAIRE

    Sebastian Villalon-Lopez; Arturo Valle-Mejia; Antonio Patino-Lara; Alicia Moreno-Perez; Alejo Munoz-Lopez; Antonio Alcantar-Andrade

    2005-01-01

    Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor for development of illness such as severe solar burns during childhood or adolescence. BCC is mainly located on sun-exposed sites, head and neck being the areas of more incidences; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as nodular, superficial, mic...

  10. THERAPEUTIC EYELIDS HYGIENE IN THE ALGORITHMS OF PREVENTION AND TREATMENT OF OCULAR SURFACE DISEASES. PART II

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2016-01-01

    Full Text Available The second part of the article is focused on the issue of prevention and treatment of the most common clinical situations in which applicable therapeutic hygiene: seborrheic blepharitis; Staphylococcal blepharitis; Allergic blepharitis; barley and chalazion; prevention keratoconjunctival xerosis (during the preoperative and postoperative period, while wearing contact lenses, in computer vision syndrome, in remission after acute inflammation of the conjunctiva and cornea. There is an algorithm for the therapeutic care of eyelids and the basic mechanisms of action of this procedure. Until recently, the treatment of dry eye syndrome involves the use tearsubstitude therapy. Ten or fifteen years ago, 2–3 tearsubstitudes were presented at the domestic market. Currently, there are doses of different forms of artificial tears, while there are hundreds of them on the western pharmaceutical market. The rapid development in the search for new forms tearsubstitudes is not accident. This is due to the increasing number of patients suffering from disorders of the tear membrane stability, which achieves, according to different sources, up to 40–60% of the adult population. It should be noted that the primary cause of dry eye syndrome in 85–95% of patients is meibomian gland’s dysfunction, thus applying tearsubstitudes symptomatic therapy is treatment that does not solve the problem on the pathogenic level. For this reason, conducting therapeutic hygiene century (warm compresses + self-massage is an important component of the treatment of this group of patients. Objective evidence of relevance and effectiveness of therapeutic care age, in our opinion, is the rapid development of the pharmaceutical market in this area. There is a large number of new gels, lotions, wipes and other products for hygiene century every year. Clear algorithms that include therapeutic hygiene century (dates, the indications for the use of certain hygiene products is an actual

  11. A γA-Crystallin Mouse Mutant Secc with Small Eye, Cataract and Closed Eyelid.

    Directory of Open Access Journals (Sweden)

    Man Hei Cheng

    Full Text Available Cataract is the most common cause of visual loss in humans. A spontaneously occurred, autosomal dominant mouse mutant Secc, which displayed combined features of small eye, cataract and closed eyelid was discovered in our laboratory. In this study, we identified the mutation and characterized the cataract phenotype of this novel Secc mutant. The Secc mutant mice have eyelids that remain half-closed throughout their life. The mutant lens has a significant reduction in size and with opaque spots clustered in the centre. Histological analysis showed that in the core region of the mutant lens, the fiber cells were disorganized and clefts and vacuoles were observed. The cataract phenotype was evident from new born stage. We identified the Secc mutation by linkage analysis using whole genome microsatellite markers and SNP markers. The Secc locus was mapped at chromosome 1 flanked by SNPs rs3158129 and rs13475900. Based on the chromosomal position, the candidate cataract locus γ-crystallin gene cluster (Cryg was investigated by sequencing. A single base deletion (299delG in exon 3 of Cryga which led to a frame-shift of amino acid sequence from position 91 was identified. As a result of this mutation, the sequences of the 3rd and 4th Greek-key motifs of the γA-crystallin are replaced with an unrelated C-terminal peptide of 75 residues long. Coincidentally, the point mutation generated a HindIII restriction site, allowing the identification of the CrygaSecc mutant allele by RFLP. Western blot analysis of 3-week old lenses showed that the expression of γ-crystallins was reduced in the CrygaSecc mutant. Furthermore, in cell transfection assays using CrygaSecc mutant cDNA expression constructs in 293T, COS-7 and human lens epithelial B3 cell lines, the mutant γA-crystallins were enriched in the insoluble fractions and appeared as insoluble aggregates in the transfected cells. In conclusion, we have demonstrated that the Secc mutation leads to the

  12. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  13. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  14. Upper GI Endoscopy

    Science.gov (United States)

    ... Upper GI Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Upper GI Endoscopy What is upper gastrointestinal ( ... endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece ...

  15. Kaposi sarcoma of the conjunctiva and eyelids associated with the acquired immunodeficiency syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Shuler, J.D.; Holland, G.N.; Miles, S.A.; Miller, B.J.; Grossman, I.

    1989-06-01

    Three studies were performed to assess more accurately the prevalence, natural history, and appropriate treatment of acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma involving ocular structures. The first study was a prospective examination of 100 male homosexuals with AIDS-related Kaposi sarcoma for signs of ophthalmic involvement. Of the 20 patients who had ophthalmic lesions, 16 had eyelid lesions and seven had conjunctival lesions. In four patients, the ophthalmic lesion was the first, and initially the only, clinically identified manifestation of Kaposi sarcoma. The second study was a retrospective review of all patients with ophthalmic Kaposi sarcoma examined at one institution over a six-year period to determine its natural history and response to therapy. Most lesions were slowly progressive and responded to systemic drug therapy. Six patients were successfully treated with radiation therapy to prevent complications. The third study was a retrospective review of all patients with AIDS-related ophthalmic Kaposi sarcoma treated with local irradiation by one radiation oncologist. Each of 12 patients showed a response to treatment, and ten had a complete resolution of lesions, but recurrences were common. Side effects included skin erythema in six patients and hair loss in one patient. For local treatment of ophthalmic Kaposi sarcoma, irradiation appears to be safe and effective for palliative therapy.

  16. A Gaze Independent Brain-Computer Interface Based on Visual Stimulation through Closed Eyelids.

    Science.gov (United States)

    Hwang, Han-Jeong; Ferreria, Valeria Y; Ulrich, Daniel; Kilic, Tayfun; Chatziliadis, Xenofon; Blankertz, Benjamin; Treder, Matthias

    2015-10-29

    A classical brain-computer interface (BCI) based on visual event-related potentials (ERPs) is of limited application value for paralyzed patients with severe oculomotor impairments. In this study, we introduce a novel gaze independent BCI paradigm that can be potentially used for such end-users because visual stimuli are administered on closed eyelids. The paradigm involved verbally presented questions with 3 possible answers. Online BCI experiments were conducted with twelve healthy subjects, where they selected one option by attending to one of three different visual stimuli. It was confirmed that typical cognitive ERPs can be evidently modulated by the attention of a target stimulus in eyes-closed and gaze independent condition, and further classified with high accuracy during online operation (74.58% ± 17.85 s.d.; chance level 33.33%), demonstrating the effectiveness of the proposed novel visual ERP paradigm. Also, stimulus-specific eye movements observed during stimulation were verified as reflex responses to light stimuli, and they did not contribute to classification. To the best of our knowledge, this study is the first to show the possibility of using a gaze independent visual ERP paradigm in an eyes-closed condition, thereby providing another communication option for severely locked-in patients suffering from complex ocular dysfunctions.

  17. Kaposi sarcoma of the conjunctiva and eyelids associated with the acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Shuler, J.D.; Holland, G.N.; Miles, S.A.; Miller, B.J.; Grossman, I.

    1989-01-01

    Three studies were performed to assess more accurately the prevalence, natural history, and appropriate treatment of acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma involving ocular structures. The first study was a prospective examination of 100 male homosexuals with AIDS-related Kaposi sarcoma for signs of ophthalmic involvement. Of the 20 patients who had ophthalmic lesions, 16 had eyelid lesions and seven had conjunctival lesions. In four patients, the ophthalmic lesion was the first, and initially the only, clinically identified manifestation of Kaposi sarcoma. The second study was a retrospective review of all patients with ophthalmic Kaposi sarcoma examined at one institution over a six-year period to determine its natural history and response to therapy. Most lesions were slowly progressive and responded to systemic drug therapy. Six patients were successfully treated with radiation therapy to prevent complications. The third study was a retrospective review of all patients with AIDS-related ophthalmic Kaposi sarcoma treated with local irradiation by one radiation oncologist. Each of 12 patients showed a response to treatment, and ten had a complete resolution of lesions, but recurrences were common. Side effects included skin erythema in six patients and hair loss in one patient. For local treatment of ophthalmic Kaposi sarcoma, irradiation appears to be safe and effective for palliative therapy

  18. Basal and squamous cell carcinoma of the eyelids and their treatment by radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fitzpatrick, P.J.; Thompson, G.A.; Easterbrook, W.M.; Gallie, B.L.; Payne, D.G.

    1984-04-01

    The authors report 1,166 tumors of the eyelids that were treated by single or fractionated exposures to doses of 20-60 Gy. The five year tumor control rate was 95% for basal cell and 93.3% for squamous cell carcinoma. Irradiation was equally successful in primary cases and in those recurrent following surgery. The cosmetic and functional results were generally excellent and readily accepted by most patients. The overall complication rate was 9.6% with fewer than one-half rated as serious; these problems mainly occurred with large tumors that had destroyed normal tissues. In only 14 (1.2%) patients was death related to the tumor. Approximately one-half of the patients received a dose of 35 Gy in five daily fractions, one-quarter, 20 to 22.5 Gy in a single exposure and the others with larger tumors 42.5-60 Gy in 10 to 30 exposures in two to six weeks.

  19. A Gaze Independent Brain-Computer Interface Based on Visual Stimulation through Closed Eyelids

    Science.gov (United States)

    Hwang, Han-Jeong; Ferreria, Valeria Y.; Ulrich, Daniel; Kilic, Tayfun; Chatziliadis, Xenofon; Blankertz, Benjamin; Treder, Matthias

    2015-10-01

    A classical brain-computer interface (BCI) based on visual event-related potentials (ERPs) is of limited application value for paralyzed patients with severe oculomotor impairments. In this study, we introduce a novel gaze independent BCI paradigm that can be potentially used for such end-users because visual stimuli are administered on closed eyelids. The paradigm involved verbally presented questions with 3 possible answers. Online BCI experiments were conducted with twelve healthy subjects, where they selected one option by attending to one of three different visual stimuli. It was confirmed that typical cognitive ERPs can be evidently modulated by the attention of a target stimulus in eyes-closed and gaze independent condition, and further classified with high accuracy during online operation (74.58% ± 17.85 s.d.; chance level 33.33%), demonstrating the effectiveness of the proposed novel visual ERP paradigm. Also, stimulus-specific eye movements observed during stimulation were verified as reflex responses to light stimuli, and they did not contribute to classification. To the best of our knowledge, this study is the first to show the possibility of using a gaze independent visual ERP paradigm in an eyes-closed condition, thereby providing another communication option for severely locked-in patients suffering from complex ocular dysfunctions.

  20. Ação do colírio de fenilefrina 10% no posicionamento palpebral de indivíduos normais Phenylephrine 10% eye drop action in the eyelid position in healthy subjects

    Directory of Open Access Journals (Sweden)

    Tânia Pereira Nunes

    2008-10-01

    Full Text Available OBJETIVOS: Determinar a ação de uma gota do colírio de fenilefrina 10% sobre as pálpebras superior e inferior de indivíduos normais; verificar a ocorrência de alterações no posicionamento das pálpebras superior e inferior do olho contralateral, após instilação desta medicação. MÉTODOS: Estudo prospectivo observacional, do qual participaram 24 indivíduos normais, com idade entre 20 e 39 anos, submetidos à instilação de uma gota do colírio de fenilefrina 10% no fundo de saco conjuntival superior, aleatoriamente em um dos olhos. Todos os indivíduos foram filmados antes e após a instilação do colírio (3, 10, 15, 30, 45 e 60 minutos. As imagens foram submetidas ao processamento digital e editadas para análise das medidas palpebrais. Foi traçada uma linha horizontal do canto medial até o canto externo. Considerou-se a altura da pálpebra superior a distância entre o ponto mais alto da margem palpebral superior e a linha horizontal traçada. A altura palpebral inferior foi avaliada como a distância entre o ponto mais baixo da margem palpebral inferior e a referida linha. RESULTADOS: Em relação à pálpebra superior, a medida antes da instilação da fenilefrina 10% diferiu significativamente dos demais momentos (pPURPOSE: To determine the upper and lower eyelid position with a single drop of 10% phenylephrine in normal individuals and observe positional lid changes in upper and lower lids of the opposite eye. METHODS: Prospective observational study including 24 healthy subjects of both genders (age range: 20-39 yrs submitted to instillation of a single drop of 10% phenylephrine in the upper fornix of one randomly chosen eye. A video camera recorded the images of both eyes before and after eye drop application at 3, 10, 15, 30, 45 and 60 minutes. The images were digitally processed and edited to analyze lid measurements (upper lid height: distance between the highest upper margin lid point and a horizontal line traced

  1. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  2. Vergisson 4: a left-handed Neandertal.

    Science.gov (United States)

    Condemi, Silvana; Monge, Janet; Quertelet, Sylvain; Frayer, David W; Combier, Jean

    2017-01-01

    Handedness is an important marker for lateralization of humans in the modern and fossil record. For the most part, Neandertals and their ancestors are strongly right-handed. We describe a single tooth from a Neandertal level at Vergisson 4 (Vg 4-83). This left upper central incisor shows all the features typical of Neandertal incisors. It also exhibits a predominance of left-handed striations. Striations on the incisor's labial surface were mapped at 20x magnification using Photoshop. Angulations of the striations were determined from their deviation from the maximum mesio-distal line and were analyzed using NIH's freeware, Image J. Of the 60 labial surface striations, Vg 4-83 shows a strong predominance of left-handed striations (46; 76.7%), which are statistically significantly different (p handed striations. The identification of another left-handed Neandertal adds to our understanding about handedness variation in this fossil hominin. Given the high frequency of right-handed Neandertals, the 90: 10 modern ratio is still preserved in this group. © 2016 Wiley Periodicals, Inc.

  3. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  4. Comparison of Two Methods for Upper Lid Fascia Lata Sling in Congenital Blepharoptosis: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Abbas Bagheri

    2008-12-01

    Full Text Available

    PURPOSE: To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. METHODS: In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function (< 4mm were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling (modified Crawford method and group B, monotriangular fascia sling (modified Fox method. RESULTS:  This study included 30 upper eyelids (15 eyelids in each surgical group of 19 patients (8 unilateral and 11 bilateral cases with congenital ptosis. Mean increase in eyelid fissure height was 2.7±2.3 mm in group A and 3.4±2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant (P < 0.001, paired t-test but intergroup difference was not (P=0.4, independent sample t-test. Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. CONCLUSION:  The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia.

  5. Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.

    Science.gov (United States)

    Batistão, Mariana Vieira; Sentanin, Anna Cláudia; Moriguchi, Cristiane Shinohara; Hansson, Gert-Åke; Coury, Helenice Jane Cote Gil; de Oliveira Sato, Tatiana

    2012-01-01

    The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (β=0.410) and 90th percentile of right upper arm elevation (β=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (β=-0.282) and 90th percentile of right upper arm elevation (β=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation.

  6. Xantogranuloma órbito-palpebral: relato de caso Xantogranuloma of the eyelid and orbit: case report

    Directory of Open Access Journals (Sweden)

    Silvana Artioli Schellini

    2004-06-01

    Full Text Available Xantogranuloma é doença histiocítica, caracterizada por lesões amareladas na pele ou na derme, acompanhadas ou não de alterações hematológicas ou neoplasias. O objetivo deste é relatar o caso de uma mulher de 39 anos, com queixa de "inchaço" progressivo nas pálpebras superiores, há 6 anos, indolor, sem alterações sistêmicas. O exame histológico mostrou infiltração maciça da pele, tecido muscular e gordura orbitária por histiócitos xantomatosos e abundantes células gigantes do tipo Touton. O diagnóstico foi de xantogranuloma do adulto. Os autores comentam os diagnósticos diferenciais, assim como a necessidade de exames periódicos, devido ao risco de associação com doenças sistêmicas malignas.Xantogranuloma is a histiocytic disease, characterized by yellowish lesions affecting the epidermis or the dermis, with or without hematological abnormalities and malignancy. The purpose of this paper is to report a 39-year-old woman with bilateral, progressive, painless swelling in both eyelids and anterior orbit, onset 6 years ago, with no systemic alterations. Histology of the excised tissue showed dermis, muscles and orbital fat with xantomatous histiocytes and "Touton" giant cells. The diagnosis was xantogranuloma of the adult. The authors call attention to other differential diagnosis and the necessity of periodical examinations because of the possibility of associated malignancies and systemic diseases.

  7. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

    Full Text Available Left ventricular pseudo-aneurysm is a rare complication of aneurysmectomy. We present a case of surgically-treated left ventricular pseudo-aneurysm which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation and surgical repair are described. [Cukurova Med J 2013; 38(1.000: 123-125

  8. 'En face' ex vivo reflectance confocal microscopy to help the surgery of basal cell carcinoma of the eyelid.

    Science.gov (United States)

    Espinasse, Marine; Cinotti, Elisa; Grivet, Damien; Labeille, Bruno; Prade, Virginie; Douchet, Catherine; Cambazard, Frédéric; Thuret, Gilles; Gain, Philippe; Perrot, Jean Luc

    2017-07-01

    Ex vivo confocal microscopy is a recent imaging technique for the perioperative control of skin tumour margins. Up to date, it has been used in the fluorescence mode and with vertical sections of the specimen margins. The aim of this study was to evaluate its use in the reflectance mode and with a horizontal ('en face') scanning of the surgical specimen in a series of basal cell carcinoma of the eyelid. Prospective consecutive cohort study was performed at the University Hospital of Saint-Etienne, France. Forty-one patients with 42 basal cell carcinoma of the eyelid participated in this study. Basal cell carcinomas were excised with a 2-mm-wide clinically safe margin. The surgical specimens were analysed under ex vivo confocal microscopy in the reflectance mode and with an en face scanning in order to control at a microscopic level if the margins were free from tumour invasion. Histopathogical examination was later performed in order to compare the results. Sensitivity and specificity of ex vivo confocal microscopy for the presence of tumour-free margins. Ex vivo confocal microscopy results were consistent with histopathology in all cases (tumour-free margins in 40 out of 42 samples; sensitivity and specificity of 100%). Ex vivo confocal microscopy in the reflectance mode with an 'en face' scanning can control tumour margins of eyelid basal cell carcinomas and optimize their surgical management. This procedure has the advantage on the fluorescent mode of not needing any contrast agent to examine the samples. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  9. Pulsing blue light through closed eyelids: effects on acute melatonin suppression and phase shifting of dim light melatonin onset

    Directory of Open Access Journals (Sweden)

    Figueiro MG

    2014-12-01

    Full Text Available Mariana G Figueiro, Barbara Plitnick, Mark S Rea Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA Abstract: Circadian rhythm disturbances parallel the increased prevalence of sleep disorders in older adults. Light therapies that specifically target regulation of the circadian system in principle could be used to treat sleep disorders in this population. Current recommendations for light treatment require the patients to sit in front of a bright light box for at least 1 hour daily, perhaps limiting their willingness to comply. Light applied through closed eyelids during sleep might not only be efficacious for changing circadian phase but also lead to better compliance because patients would receive light treatment while sleeping. Reported here are the results of two studies investigating the impact of a train of 480 nm (blue light pulses presented to the retina through closed eyelids on melatonin suppression (laboratory study and on delaying circadian phase (field study. Both studies employed a sleep mask that provided narrowband blue light pulses of 2-second duration every 30 seconds from arrays of light-emitting diodes. The results of the laboratory study demonstrated that the blue light pulses significantly suppressed melatonin by an amount similar to that previously shown in the same protocol at half the frequency (ie, one 2-second pulse every minute for 1 hour. The results of the field study demonstrated that blue light pulses given early in the sleep episode significantly delayed circadian phase in older adults; these results are the first to demonstrate the efficacy and practicality of light treatment by a sleep mask aimed at adjusting circadian phase in a home setting. Keywords: circadian phase, dim light melatonin onset, light through closed eyelids, blue light, sleep

  10. A train of blue light pulses delivered through closed eyelids suppresses melatonin and phase shifts the human circadian system

    Directory of Open Access Journals (Sweden)

    Figueiro MG

    2013-10-01

    Full Text Available Mariana G Figueiro, Andrew Bierman, Mark S ReaLighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USAAbstract: A model of circadian phototransduction was published in 2005 to predict the spectral sensitivity of the human circadian system to narrow-band and polychromatic light sources by combining responses to light from the spectral-opponent “blue” versus “yellow” cone bipolar pathway with direct responses to light by the intrinsically photosensitive retinal ganglion cells. In the model, depolarizing “blue” responses, but not hyperpolarizing “yellow” responses, from the “blue” versus “yellow” pathway are combined with the intrinsically photosensitive retinal ganglion cell responses. Intrinsically photosensitive retinal ganglion cell neurons are known to be much slower to respond to light than the cone pathway, so an implication of the model is that periodic flashes of “blue” light, but not “yellow” light, would be effective for stimulating the circadian system. A within-subjects study was designed to test the implications of the model regarding retinal exposures to brief flashes of light. The study was also aimed at broadening the foundation for clinical treatment of circadian sleep disorders by delivering flashing light through closed eyelids while people were asleep. In addition to a dark control night, the eyelids of 16 subjects were exposed to three light-stimulus conditions in the phase delay portion of the phase response curve while they were asleep: (1 2-second flashes of 111 W/m2 of blue (λmax ≈ 480 nm light once every minute for 1 hour, (2 131 W/m2 of green (λmax ≈ 527 nm light, continuously on for 1 hour, and (3 2-second flashes of the same green light once every minute for 1 hour. Inferential statistics showed that the blue flash light-stimulus condition significantly delayed circadian phase and significantly suppressed nocturnal melatonin. The results of this study further our

  11. Management of difficult pediatric facial burns: reconstruction of burn-related lower eyelid ectropion and perioral contractures.

    Science.gov (United States)

    Egeland, Brent; More, Sunita; Buchman, Steven R; Cederna, Paul S

    2008-07-01

    Despite significant burn treatment advances, modern multidisciplinary care, and improved survival after burns, facial burn scars remain clinically challenging. Achieving a successful reconstruction requires a comprehensive approach, entailing many advanced techniques with an emphasis on preserving function and balancing intricate aesthetic requirements. Pediatric facial burns present the same reconstructive challenges seen in adults, with additional developmental and psychologic concerns. In this paper, we describe the basic principals of facial burn care in the pediatric burn population, with a specific focus on lower-eyelid burn ectropion and oral commissure burn scar contracture leading to microstomia. Several cases are demonstrated.

  12. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... critics, and not least by feminists. The aim of this paper is to point out the position Freud took toward his patient. Dora stands out as the one case among Freud’s 5 great case stories that has a female protagonist, and reading the case it becomes clear that Freud stumbled because of an unresolved...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  13. Upper Extremity Length Equalization

    OpenAIRE

    DeCoster, Thomas A.; Ritterbusch, John; Crawford, Mark

    1992-01-01

    Significant upper extremity length inequality is uncommon but can cause major functional problems. The ability to position and use the hand may be impaired by shortness of any of the long bones of the upper extremity. In many respects upper and lower extremity length problems are similar. They most commonly occur after injury to a growing bone and the treatment modalities utilized in the lower extremity may be applied to the upper extremity. These treatment options include epiphysiodesis, sho...

  14. Upper Gastrointestinal (GI) Series

    Science.gov (United States)

    ... standard barium upper GI series, which uses only barium a double-contrast upper GI series, which uses both air and ... evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that ...

  15. [As opposed to normal subjects, eyelid position doesn't interfere with postural behavior in blind subjects].

    Science.gov (United States)

    Olin, C; Rougier, P

    2009-12-01

    A previous study has shown some behavioral differences in normal subjects depending on the position of the eyelids: the postural behavior was varying if the subject had the eyes open in darkness or the eyes closed. In this study, we explore the possible role of vision on this behavior. The postural behavior of 12 blind and nine visually impaired participants was studied during undisturbed upright stance. In this sample, no difference was found in the conditions eyes open in the dark and eyes closed: the observed behavior in blind and visually impaired subjects is different compared to normal sighted subjects who show a visual preference even in total darkness when the eyes are open. Our two groups (blind and visually impaired) actually show a difference on the median frequency of the centre of gravity displacements. Our results suggest an adaptive mechanism of the central nervous system in healthy individuals to predominantly weigh visual cues when the eyelids remain open. Good visual acuity and time seem to be necessary for this process.

  16. Evaluation of the efficacy, safety, and acceptability of an eyelid warming device for the treatment of meibomian gland dysfunction.

    Science.gov (United States)

    Benitez Del Castillo, José Manuel; Kaercher, Thomas; Mansour, Khaled; Wylegala, Edward; Dua, Harminder

    2014-01-01

    Meibomian gland dysfunction (MGD) is widespread and has significant impact on patients' quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist. Blephasteam(®) is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam(®) sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation) on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam(®) as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer) during the Blephasteam(®) session. No safety or tolerability issues were identified.

  17. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  18. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  19. Widening of mediastinum with persistent left superior Vena cava - CT diagnosis

    International Nuclear Information System (INIS)

    Neuwirth, J.; Kolar, J.

    1992-01-01

    Described in this paper are radiographic findings recorded from a case of persistent left superior vena cava which grew manifest by widening of the left contour of the upper mediastinal region. Contrast-enhanced computed tomography (CT) was undertaken to clear up suspicion of mediastinal tumour and revealed double superior vena cava. The diagnosis was then confirmed by digital subtraction venography. (orig.) [de

  20. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  1. Stereotactic radiosurgery with an upper partial denture

    International Nuclear Information System (INIS)

    Tayama, Shusaku; Kunieda, Etsuo; Takeda, Atsushi; Takeda, Toshiaki; Oku, Yohei

    2009-01-01

    A 54-year-old male with partial denture underwent stereotactic radiosurgery with an infrared camera-guided system for a metastatic brain tumor arising from lung cancer. Although this method utilizes a biteplate mounted on the upper jaw to detect head movement, the patient only had four teeth in his upper jaw. In order to stabilize the biteplate, the maxillary denture was fixed to the biteplate with an autopolymerizing resin. In addition, the rest-occlusal position of the lower jaw was impressed on the inferior surface of the biteplate with an autopolymerizing resin. To assess reproducibility and stability, the distance between the left and right incus and left and right markers was measured during pre-planning, as well as before and after stereotactic irradiation. Wearing the biteplate ensures the accuracy of radiotherapy planning for the implementation of radiosurgery in patients who have many maxillary teeth missing. However, a large degree of error was observed when the biteplate was removed. (author)

  2. Paroxysmal atrial fibrillation due to left atrial appendage herniation and review of the literature.

    Science.gov (United States)

    Misthos, Panagiotis; Neofotistos, Kostas; Drosos, Polivios; Kokotsakis, John; Lioulias, Achilleas

    2009-04-17

    The incidence of the isolated form of partial absence of the pericardium is a rare finding. The authors present a case of an isolated left sided pericardial defect with intrathoracic protrusion of the left atrial appendage found during a left upper lobectomy for lung cancer, unrecognized after serial echocardiographs and computed tomography scan of the thorax. The patient suffered from episodes of atrial fibrillation which disappeared after pericardial defect repair without antiarrhythmic medication.

  3. Successful Treatment Of Basal Cell Carcinoma Encroaching The Eyelid With Cryofreeze And Plastic Repair

    Directory of Open Access Journals (Sweden)

    Kochhar Atul M

    2001-01-01

    Full Text Available Basal cell carcinoma is one of the most common skin cancers encountered in dermatological practice. The case details of a basal cell epithelioma occurring near the left eye in a 42 years old male and its successful treatment with cryofeeze is reported for its clincial interest and therapeutic considerations.

  4. Triple-layer midface lifting : long-term follow-up of an effective approach to aesthetic surgery of the lower eyelid and the midface

    NARCIS (Netherlands)

    Stevens, Hieronymus P. Jerome D.; Willemsen, Joep C. N.; Durani, Piyush; Rasteiro, David; Omoruyi, Ogbe J.

    BACKGROUND: It is becoming more and more accepted that better aesthetic results can be obtained when the lower eyelid is considered as part of the midface when contemplating surgical rejuvenation. Descent of the orbicularis muscle and midface tissue causes malar bags, loss of volume over the

  5. Differentiation of sex chromosomes and karyotypic evolution in the eye-lid geckos (Squamata: Gekkota: Eublepharidae), a group with different modes of sex determination

    Czech Academy of Sciences Publication Activity Database

    Pokorná, M.; Rábová, Marie; Ráb, Petr; Kratochvíl, L.

    2010-01-01

    Roč. 18, č. 6 (2010), s. 748-748 ISSN 0967-3849. [19th International Colloquium on animal cytogenetics and gene mapping. 06.06.-09.06.2010, Krakow] Institutional research plan: CEZ:AV0Z50450515 Keywords : sex chromosomes * karyotypic evolution * eye-lid geckos Subject RIV: EB - Genetics ; Molecular Biology

  6. Significance of Early Postoperative Eyelid Position on Late Postoperative Result in Mueller's Muscle Conjunctival Resection and External Levator Advancement Surgery.

    Science.gov (United States)

    Danesh, Jennifer; Ugradar, Shoaib; Goldberg, Robert; Joshi, Naresh; Rootman, Daniel B

    2018-01-09

    The purpose of this study was to determine whether advancement of the levator aponeurosis in external levator resection surgery or Mueller's muscle and conjunctiva in Mueller's muscle conjunctival resection (MMCR) surgery has a differential effect on variation in eyelid position during the postoperative period. In this retrospective observational cohort study, 2 groups of patients were defined. The first underwent MMCR surgery without tarsectomy by surgeon 1. The second underwent external levator resection without dissection posterior to the levator aponeurosis by surgeon 2. Marginal reflex distance (MRD1) was calculated based on digital photographs at baseline, 1 week postoperatively and at 3-month follow up. The primary outcome measure was change in MRD1 over time. The secondary outcome was defined as the proportion of patients with minimal early postoperative change (change of MRD1 less than 0.5 mm at 1 week postoperatively). Repeated measures analysis of variance, t test, and chi-square analyses were performed. Of the 114 eyes in the sample, there were 68 in the MMCR group and 46 in the external levator resection group. A significant interaction between group and time was noted (p MRD1 over time was different between the groups. Bonferroni corrected multiple comparisons yielded significant differences between each time point for MMCR surgery (p MRD1 was noted for the external levator resection group from the early to late postoperative visit. Comparing each time point across groups revealed significantly lower MRD1 for the MMCR group at the early postoperative visit (p MRD1 did not significantly differ between the groups. Regarding the secondary outcome, patients undergoing MMCR surgery were 3.7× as likely to demonstrate MRD1 at week 1 (p MRD1 increase >1 mm from the early postoperative to the late postoperative time points. Both external levator resection and MMCR can effectively elevate the eyelid in cases of primary involutional ptosis, and have similar

  7. Light and electron microscopic study of the eyelids, conjunctiva-associated lymphoid tissue and lacrimal gland in Bilgorajska Goose (Anser anser).

    Science.gov (United States)

    Klećkowska-Nawrot, Joanna; Nowaczyk, Renata; Goździewska-Harłajczuk, Karolina; Barszcz, Karolina; Kowalczyk, Artur; Łukaszewicz, Ewa

    2016-01-01

    Normal structure of the accessory organs of the eye is essential for normal eye physiology. Among the most important accessory organs of the eye are the eyelids, the conjunctiva-associated lymphoid tissue (CALT) and the lacrimal gland (LG). The aim of this study was to demonstrate the histological structure of the eyelids and LG by histochemical and ultrastructural analysis. The study was performed on 13 adult female Bilgorajska geese. Eyelid samples were stained with the Alcian blue (AB pH 2.5) and periodic acid-Schiff (PAS) methods. Staining methods used for LG were AB pH 2.5, aldehyde fuchsin (AF), PAS and Hale's dialysed iron (HDI). Within the connective tissue of the eyelids, well-developed, diffuse, CALT follicles were observed, mostly under the conjunctival epithelium. Numerous lymphocytes were present within loose connective tissue. Staining of the eyelids with the PAS method demonstrated the presence of goblet cells of a mucous nature, and AB pH 2.5 staining indicated the presence of sulfated acid mucopolysaccharides. PAS staining of LG revealed the presence of secretory cells containing weakly PAS-positive granules. All epithelial cells of the corpus glandulae and the duct systems reacted positively to AB pH 2.5. HDI staining detected the presence of carboxylated acid mucopolysaccharides. Transmission electron microscopy investigations revealed two types of secretory epithelial cells in LG. Both types of LG cells contained drop-like secretory vesicles of different sizes with low or high electron density in cytoplasm, as well as small and large lipid vacuoles, and numerous small primary lysosomes.

  8. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

    This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma. PMID:25120392

  9. Left ventricular hypertrophy in athletes.

    Science.gov (United States)

    Douglas, P S; O'Toole, M L; Katz, S E; Ginsburg, G S; Hiller, W D; Laird, R H

    1997-11-15

    Left ventricular wall thickness >1.3 cm, septal-to-posterior wall ratios > 1.5, diastolic left ventricular size >6.0 cm, and eccentric or concentric remodeling are rare in athletes. Values outside of these cutoffs in an athlete of any age probably represent a pathologic state.

  10. The Left-Handed Writer.

    Science.gov (United States)

    Bloodsworth, James Gaston

    Contrary to the beliefs of many, right-handedness is not a single factor existing in almost all people, with a few exceptions termed left-handed: neither extreme exists independently of the other. During the first 4 years of life there is a period of fluctuation between right and left-handed dominance. Statistics and findings vary in determining…

  11. Two Lefts in Latin America?

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba

    In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given.......In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given....

  12. A Giant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Medhat F. Zaher

    2014-01-01

    Full Text Available Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma.

  13. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

    Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

  14. Left ventricular wall stress compendium.

    Science.gov (United States)

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  15. Eyebrow Position Following Upper Blepharoplasty.

    Science.gov (United States)

    Dar, Suhail A; Rubinstein, Tal J; Perry, Julian D

    2015-01-01

    To evaluate the effect of upper blepharoplasty on eyebrow height, accounting for ocular dominance, fat excision, change in MRD1, and degree of dermatochalasis. Retrospective review of patients undergoing upper blepharoplasty between January 2013 and July 2014. Patients with a prior history of ocular trauma, disease, and surgery were excluded. Digital photographs were analyzed using NIH ImageJ software to measure pre and postoperative eyebrow height at the medial, central, and lateral positions, MRD1, and dermatochalasis. Univariable comparisons of brow height and MRD1 were performed. A multivariate analysis was used to assess for the effect of percentage change in MRD1 and dermatochalasis and of ocular dominance and fat excision in mean percentage change of eyebrow height. Charts of 19 patients were reviewed. Mean age was 73.2 years (SD = 8.86). There were 9 male (47.4%) and 10 female (52.6%) patients. There were 11 right eye dominant (57.9%) and 8 left eye dominant (42.1%) patients. Then 13 patients (68.4%) underwent fat removal. A univariable comparison found insufficient evidence to suggest a significant change from 0 postoperatively in brow height at all positions. A multivariable comparison found insufficient evidence to suggest MRD1, ocular dominance, or dermatochalasis were significantly associated with mean percentage change in brow height at all positions with or without fat excision. Upper blepharoplasty does not change eyebrow height at the medial, central, or lateral positions, after accounting for any impact of ocular dominance, fat excision, change in MRD1, or degree of dermatochalasis.

  16. Keratoconus progression is not inhibited by reducing eyelid muscular force with botulinum toxin A treatment: a randomized trial

    Directory of Open Access Journals (Sweden)

    Adimara da Candelaria Renesto

    Full Text Available ABSTRACT Purpose: To evaluate whether reducing eyelid muscular force through the administration of botulinum toxin type A (BTX-A to the orbicularis oculi muscles of patients with keratoconus affected corneal parameters indicative of disease progression. Methods: In this prospective parallel randomized clinical trial, 40 eyes of 40 patients with keratoconus were randomized into equally sized control and BTX-A groups. Patients in the BTX-A group received subcutaneous BTX-A injections into the orbicularis muscle. The control group received no intervention. Palpebral fissure height, best spectacle-corrected visual acuity (BSCVA, and corneal topographic parameters were evaluated at baseline and at 3-, 6-, 12-, and 18-month follow-ups. Results: The mean ± standard deviation vertical palpebral fissure heights were 9.74 ± 1.87 mm and 9.45 ± 1.47 mm at baseline in the control and BTX-A groups, respectively, and 10.0 ± 1.49 mm and 9.62 ± 1.73 mm at 18 months, with no significant difference between the groups (p=0.337. BSCVA values were 0.63 ± 0.56 and 0.60 ± 0.27 at baseline in the control and BTX-A groups (p=0.643, and 0.52 ± 0.59 and 0.45 ± 0.26 at 18 months, again with no significant difference between the groups (p=0.452. In addition, there were no statistical differences between the groups at 18 months for the three keratometry topographic parameters: flattest (K1, steepest (K2, and mean (Km keratometry (p=0.562. Conclusion: BTX-A inhibition of eyelid force generation did not result in detectable changes in corneal parameters in keratoconic patients during 18 months of follow-up.

  17. Evaluation of the efficacy, safety, and acceptability of an eyelid warming device for the treatment of meibomian gland dysfunction

    Directory of Open Access Journals (Sweden)

    Benitez del Castillo JM

    2014-10-01

    Full Text Available José Manuel Benitez del Castillo,1 Thomas Kaercher,2 Khaled Mansour,3 Edward Wylegala,4 Harminder Dua5 1Universidad Complutense, Madrid, Spain; 2Augenarztpraxis, Heidelberg, Germany; 3Department of Ophthalmology, Tjongerschans Hospital, Heerenveen, the Netherlands; 4Department of Ophthalmology, Medical University of Silesia, District Railway Hospital, Katowice, Poland; 5Division of Ophthalmology and Visual Sciences, Eye ENT Centre, Queens Medical Centre, Nottingham, UKAbstract: Meibomian gland dysfunction (MGD is widespread and has significant impact on patients’ quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist. Blephasteam® is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam® sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam® as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer during the Blephasteam® session. No safety or tolerability issues were identified.Keywords: dry eye, Blephasteam®

  18. Pancreatic Aetiology for Massive Upper Gastrointestinal Haemorrhage in Pregnancy

    OpenAIRE

    Zaborowski, Alexandra; Walsh, Siun M.; Ravi, Narayanasamy; Reynolds, John V.

    2016-01-01

    We present herein what we believe is the first reported case of massive upper gastrointestinal bleeding in pregnancy due to a pancreatic neuroendocrine tumour causing left sided portal hypertension. A 37-year-old 27-week pregnant female presented with massive haematemesis and melaena requiring transfusion of 10 units of red cell concentrate. Gastric varices were evident at endoscopy. An MRI revealed a large mass infiltrating the pancreatic tail and spleen with massive upper abdominal varix fo...

  19. Fused upper central incisors: management of two clinical cases

    OpenAIRE

    Sfasciotti, Gian Luca; Marini, Roberta; Bossù, Maurizio; Ierardo, Gaetano; Annibali, Susanna

    2012-01-01

    This paper reports the management of two clinical cases, in which the upper right central incisor was fused with a supernumerary tooth and the upper left central incisor was macrodontic. A radiographic examination revealed that the fused teeth had two separate roots. Hemisectioning of the fused teeth was performed, the supernumerary portion was extracted and the remaining part was reshaped to remove any sharp margins and to achieve a normal morphology. The macrodontic central incisors were no...

  20. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  2. Dabigatran for left ventricular thrombus

    Directory of Open Access Journals (Sweden)

    Satishkumar Kolekar

    2015-09-01

    Dabigatran is a reversible direct thrombin inhibitor and currently approved for the prevention of thromboembolic episodes in non-valvar atrial fibrillation. This case demonstrates possible thrombolytic properties of dabigatran in resolution of left ventricular thrombus.

  3. Apraxia in left-handers.

    Science.gov (United States)

    Goldenberg, Georg

    2013-08-01

    In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness. Pantomime of tool use, actual tool use and imitation of meaningless hand and finger postures were examined in 50 consecutive left-handed subjects with unilateral hemisphere lesions. There were three aphasic patients with pervasive apraxia caused by left-sided lesions. As the dominant hand is controlled by the right hemisphere, they constitute dissociations of apraxia from handedness. Conversely there were also three patients with pervasive apraxia caused by right brain lesions without aphasia. They constitute dissociations of apraxia from aphasia. Across the whole group of patients dissociations from handedness and from aphasia were observed for all manifestations of apraxia, but their frequency depended on the type of apraxia. Defective pantomime and defective tool use occurred rarely without aphasia, whereas defective imitation of hand, but not finger, postures was more frequent after right than left brain damage. The higher incidence of defective imitation of hand postures in right brain damage was mainly due to patients who had also hemi-neglect. This interaction alerts to the possibility that the association of right hemisphere damage with apraxia has to do with spatial aptitudes of the right hemisphere rather than with its control of the dominant left hand. Comparison with data from right-handed patients showed no differences between the severity of apraxia for imitation of hand or finger postures, but impairment on pantomime of tool use was milder in apraxic left-handers than in apraxic right-handers. This alleviation of the severity of apraxia corresponded with a similar alleviation of the severity of aphasia as

  4. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  5. Left Main Coronary Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Hossein Doustkami

    2016-07-01

    Full Text Available Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic.

  6. Right colon cancer: Left behind.

    Science.gov (United States)

    Gervaz, P; Usel, M; Rapiti, E; Chappuis, P; Neyroud-Kaspar, I; Bouchardy, C

    2016-09-01

    Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC. We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation. Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Mechanisms of pulsus paradoxus in upper airway obstruction.

    Science.gov (United States)

    Parsons, G H; Green, J F

    1978-10-01

    Pulsus paradoxus, a greater than 10 Torr systolic pressure fluctuation during the respiratory cycle, is seen in upper airway obstruction. To test the hypotheses 1) that blood is pooled in the pulmonary circulation with reduced return to the left heart during inspiration and 2) that inspiration increases left ventricular afterload, the following was done. Esophageal pressure (Pes), pericardial pressure (Pp), left atrial transmural pressure (Platm), and left ventricular transmural pressure at end-isovolumic systole (Plvtm) were recorded during partially obstructed inspirations in spontaneously breathing dogs anesthetized with pentobarbital (25 mg/kg). Changes in Pes and Pp were nearly identical (r = 0.9883) confirming that changes in Pes adequately reflect changes in Pp. During inspiration Platm and Plvtm increased 0.5 and 0.4 Torr, respectively, per Torr decrease in Pes suggesting that increased blood return to left atrium and increased left ventricular afterload occur. Similar changes were observed during near constant thoracic volume (total airway block) and cardiac reflex blockade (atropine 0.05 mg/kg and propranolol 0.5 mg/kg). Thus mechanical factors including left ventricular afterload appear of major importance in producing pulsus paradoxus in upper airway obstruction.

  8. Traumatic superior orbital fissure syndrome: a rare case report

    OpenAIRE

    Eskitascioglu, Teoman; Yontar, Yalcin; Aydin, Ahmet; Tucer, Bulent

    2017-01-01

    Superior orbital fissure syndrome is a severe clinical entity characterized by injuries of neurovascular structures passing through the superior orbital fissure. A 38-year-old male patient admitted to outpatient clinic with left upper eyelid ptosis, ecchymosis, mydriasis, hypoesthesia in upper eyelid and frontal region, blepharoptosis, restriction of ocular movements in all directions, loss of accommodation reflex and absence of direct pupillary reflex. Three-dimensional computed tomography s...

  9. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  10. Upper respiratory tract (image)

    Science.gov (United States)

    The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

  11. ACA Federal Upper Limits

    Data.gov (United States)

    U.S. Department of Health & Human Services — Affordable Care Act Federal Upper Limits (FUL) based on the weighted average of the most recently reported monthly average manufacturer price (AMP) for...

  12. Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex.

    Science.gov (United States)

    Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

    2014-03-15

    Bimanual visuomotor movement training (BMT) enhances the excitability of human preparatory premotor and primary motor (M1) cortices compared to unimanual movement. This occurs when BMT involves mirror symmetrical movements of both upper-limbs (in-phase) but not with non-symmetrical movements (anti-phase). The neural mechanisms mediating the effect of BMT is unclear, but may involve interhemispheric connections between homologous M1 representations as well as the dorsal premotor cortices (PMd). The purpose of this study is to assess how intermittent theta burst stimulation (iTBS) of the left PMd affects left M1 excitability, and the possible combined effects of iTBS to left PMd applied before a single session of BMT. Left M1 excitability was quantified using transcranial magnetic stimulation (TMS) in terms of both the amplitudes and spatial extent of motor evoked potentials (MEPs) for the extensor carpi radialis (ECR) before and multiple time points following (1) BMT, (2) iTBS to left PMd or (3) iTBS to left PMd and BMT. Although there was not a greater increase in either specific measure of M1 excitability due to the combination of the interventions, iTBS applied before BMT showed that both the spatial extent and global MEP amplitude for the ECR became larger in parallel, whereas the spatial extent was enhanced with BMT alone and global MEP amplitude was enhanced with iTBS to left PMd alone. These results suggest that the modulation of rapid functional M1 excitability associated with BMT and iTBS of the left PMd could operate under related early markers of neuro-plastic mechanisms, which may be expressed in concurrent and distinct patterns of M1 excitability. Critically, this work may guide rehabilitation training and stimulation techniques that modulate cortical excitability after brain injury. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Thermotherapy to the facial region in and around the eyelids altered prefrontal hemodynamic responses and autonomic nervous activity during mental arithmetic.

    Science.gov (United States)

    Takamoto, Kouich; Hori, Etsuro; Urakawa, Susumu; Katayama, Miho; Nagashima, Yoshinao; Yada, Yukihiro; Ono, Taketoshi; Nishijo, Hisao

    2013-01-01

    To investigate neural mechanisms of local thermotherapy to reduce mental stress, participants were required to perform mental arithmetic after treatment by a heat- and steam-generating sheet on the facial eyelid region while hemodynamic activity and ECGs were monitored. The results indicated that thermotherapy decreased hemodynamic activity in the anterior dorsomedial prefrontal cortex (aDMPFC) involved in sympathetic activity. Consistently, thermotherapy increased parasympathetic activity while it decreased sympathetic activity. Furthermore, thermotherapy increased hemodynamic activity in the dorsolateral prefrontal cortex (DLPFC) during mental arithmetic. These hemodynamic responses in the DLPFC during mental arithmetic were negatively correlated with that in the aDMPFC during thermotherapy. The results suggest that thermotherapy in the facial eyelid region is useful to ameliorate mental fatigue through its effects on the prefrontal cortex. Copyright © 2012 Society for Psychophysiological Research.

  14. Alcohol-related massive eyelid swelling: case report Edema palpebral maciço relacionado ao uso de álcool: relato de caso

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2007-02-01

    Full Text Available Alcohol-related massive eyelid edema has been rarely reported. The differential diagnosis includes local and systemic conditions. Alcohol itself can be associated with dermatological hypersensitivity reactions, appearing soon after alcoholic drinks. Massive bilateral eyelid swelling can constitute diagnostic pitfalls and therapeutic challenges to general practitioners with a placebo.Edema palpebral maciço relacionado ao uso de álcool tem sido raramente descrito. O diagnóstico diferencial inclui condições locais e sistêmicas. O próprio álcool pode estar associado com reações dermatológicas de hipersensibilidade, surgindo logo após uso de bebidas alcoólicas. Edema palpebral bilateral maciço pode constituir embaraços diagnósticos e desafios terapêuticos para os clínicos.

  15. A Well-Known Lesion in An Unusual Location: Infantile Myofibroma of the Eyelid:A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Fahimeh Asadi Amoli

    2010-12-01

    Full Text Available Myofibroma is a neoplasia of myofibroblasts that can be solitary or multiple and it is found most commonly in the head & neck region including scalp, forehead, parotid region and oral cavity. In the eyelid it is rarely reported. It has a benign course in the solitary form and fatal in its multiple form. A 4 month male infant referred to Farabi hospital -the referral center for eye diseases- with a 2 month history of a mass in his eyelid with gradual enlargement with no other complaints. The only abnormal physical finding was a 2.5 cm mass in the eyelid. This mass was excised and sent to the hospital pathology laboratory. When confronting a spindle cell lesion with a nodular or multinodular growth pattern which appears biphasic due to alteration of light and dark staining areas, the surgical pathologist should think to the possibility of myofibroma. Its pattern of growth and architecture rules out the other differential diagnoses like nodular fasciitis, fibrous histiocytoma, infantile fibromatosis, and peripheral primitive neuroectodermal tumor, mesenchymal chondrosarcoma, malignant hemangiopericytoma, juvenile fibrosarcoma and poorly differentiated synovial sarcoma. In difficult cases immunohistochemical staining is helpful that is Vimentin & Actin positivity & Desmin, CK, EMA & S100 negativity.

  16. A well-known lesion in an unusual location: infantile myofibroma of the eyelid: a case report and review of literature.

    Science.gov (United States)

    Asadi Amoli, Fahimeh; Sina, Amir Hossein; Kasai, Aboulfazl; Ayan, Zahra

    2010-01-01

    Myofibroma is a neoplasia of myofibroblasts that can be solitary or multiple and it is found most commonly in the head & neck region including scalp, forehead, parotid region and oral cavity. In the eyelid it is rarely reported. It has a benign course in the solitary form and fatal in its multiple form. A 4 month male infant referred to Farabi hospital -the referral center for eye diseases- with a 2 month history of a mass in his eyelid with gradual enlargement with no other complaints. The only abnormal physical finding was a 2.5 cm mass in the eyelid. This mass was excised and sent to the hospital pathology laboratory. When confronting a spindle cell lesion with a nodular or multinodular growth pattern which appears biphasic due to alteration of light and dark staining areas, the surgical pathologist should think to the possibility of myofibroma. Its pattern of growth and architecture rules out the other differential diagnoses like nodular fasciitis, fibrous histiocytoma, infantile fibromatosis, and peripheral primitive neuroectodermal tumor, mesenchymal chondrosarcoma, malignant hemangiopericytoma, juvenile fibrosarcoma and poorly differentiated synovial sarcoma. In difficult cases immunohistochemical staining is helpful that is Vimentin & Actin positivity & Desmin, CK, EMA & S100 negativity.

  17. Espiroadenoma ecrino de presentación inusual en párpado: Eccrine spiradenoma of inusual presentation on the eyelid

    Directory of Open Access Journals (Sweden)

    E Dumanski

    2007-12-01

    Full Text Available Reportamos el caso de un espiroadenoma ecrino en una paciente de 90 años de edad, que empezó un año antes de la consulta con una lesión en el párpado. Se trata de un tumor benigno de la glándulas sudoríparas que es raro en el párpado. Al principio pensamos en otro tumor, como el carcinoma sebáceo, por su rápido crecimiento. La posibilidad de un tumor de glándulas sudoríparas debiera considerarse en el diagnóstico de tumores palpebrales.We report a case of an eccrine spiradenoma in a 90 years old woman, who began a year before with the lesion on the eyelid. It is a begin sweat gland tumor, that is rare on the eyelid. At the beginning we thougth in an other tumor, like sebaceous carcinoma for its quick growth. The possibility of sweat gland tumor should be kept in mind in the diagnosis of eyelid tumours.

  18. Age-Related Changes in the Regenerative Potential of Adipose-Derived Stem Cells Isolated from the Prominent Fat Pads in Human Lower Eyelids.

    Science.gov (United States)

    Ye, Xinhai; Liao, Caihe; Liu, Guangpeng; Xu, Yipin; Tan, Jian; Song, Zhenshun

    2016-01-01

    The existence of multipotent adipose-derived stem cells isolated from human orbital fat (OF) tissue has shown great therapeutic potential in tissue engineering and regenerative medicine. But the use of stem cells for therapeutic applications is influenced by their proliferative and differentiation potentials, which may be affected by the age of the donor. So far there is little knowledge about the effects of donor age on the biological properties of human orbital adipose-derived stem cells (OASCs). The intraorbital fat protrusion in the lower eyelids occurs as an aging process, and the protruded fat is routinely removed during aesthetic surgeries. Based on the ease of OF harvest and the availability of OASCs, we investigated in this study the relationship between age and the differentiation and proliferation potentials of human OASCs. Human orbital adipose samples were harvested from young (with normal lower eyelid appearance) and old donors (having protruded fat pads in the lower eyelids). The morphological properties of orbital adipocytes were assessed and the fat cell size displayed a decreasing trend with advancing age. OASCs were isolated from the fat samples, expanded in vitro and cultured under appropriate inducive conditions. Compared to the young cells, although no difference was found in the cell yield and phenotype expression, aged OASCs showed fewer progenitor cell numbers, reduced proliferative rates, increased senescent features and decreased differentiation potentials towards adipogenic, osteogenic and chondrogenic lineages. Our data suggested that using autologous OASCs from elderly patients for potential therapeutic purposes might be restricted.

  19. Differentiation of sex chromosomes and karyotypic evolution in the eye-lid geckos (Squamata: Gekkota: Eublepharidae), a group with different modes of sex determination.

    Science.gov (United States)

    Pokorná, Martina; Rábová, Marie; Ráb, Petr; Ferguson-Smith, Malcolm A; Rens, Willem; Kratochvíl, Lukáš

    2010-11-01

    The eyelid geckos (family Eublepharidae) include both species with temperature-dependent sex determination and species where genotypic sex determination (GSD) was suggested based on the observation of equal sex ratios at several incubation temperatures. In this study, we present data on karyotypes and chromosomal characteristics in 12 species (Aeluroscalabotes felinus, Coleonyx brevis, Coleonyx elegans, Coleonyx variegatus, Eublepharis angramainyu, Eublepharis macularius, Goniurosaurus araneus, Goniurosaurus lichtenfelderi, Goniurosaurus luii, Goniurosaurus splendens, Hemitheconyx caudicinctus, and Holodactylus africanus) covering all genera of the family, and search for the presence of heteromorphic sex chromosomes. Phylogenetic mapping of chromosomal changes showed a long evolutionary stasis of karyotypes with all acrocentric chromosomes followed by numerous chromosomal rearrangements in the ancestors of two lineages. We have found heteromorphic sex chromosomes in only one species, which suggests that sex chromosomes in most GSD species of the eyelid geckos are not morphologically differentiated. The sexual difference in karyotype was detected only in C. elegans which has a multiple sex chromosome system (X(1)X(2)Y). The metacentric Y chromosome evolved most likely via centric fusion of two acrocentric chromosomes involving loss of interstitial telomeric sequences. We conclude that the eyelid geckos exhibit diversity in sex determination ranging from the absence of any sexual differences to heteromorphic sex chromosomes, which makes them an interesting system for exploring the evolutionary origin of sexually dimorphic genomes.

  20. An assessment of the efficiency of PrPsc detection in rectal mucosa and third-eyelid biopsies from animals infected with scrapie.

    Science.gov (United States)

    Monleón, Eva; Garza, Ma Carmen; Sarasa, Rocío; Alvarez-Rodriguez, Javier; Bolea, Rosa; Monzón, Marta; Vargas, M Antonia; Badiola, Juan José; Acín, Cristina

    2011-01-27

    In classical scrapie, detection of PrPsc on lymphoreticular system is used for the in vivo and post mortem diagnosis of the disease. However, the sensitivity of this methodology is not well characterised because the magnitude and duration of lymphoid tissue involvement can vary considerably. The aim of the present study was to evaluate the efficiency of detecting PrPsc in rectal mucosa and third-eyelid biopsies. A total of 474 genetically susceptible sheep and 24 goats from three scrapie infected flocks were included in this study. A sample from rectal mucosa and a sample from third-eyelid lymphoid tissue were collected from each animal. Biopsy samples were fixed in formaldehyde and processed for immunohistochemical examination. Animals with negative biopsy results were studied more closely through a post mortem examination of central nervous and lymphoreticular systems and if there was a positive result, additional biopsy sections were further tested. The sensitivity of rectal mucosa and third-eyelid assays were 36% and 40% respectively on initial examination but increased to 48% and 44% respectively after retesting. The results of this field study show a high percentage of infected animals that do not have detectable levels of PrPsc in the biopsied lymphoid tissue, due mainly to the relatively high number of animals with minimal or no involvement of lymphoid tissue in the pathogenesis of the disease. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. Diagnosis and treatment of upper limb apraxia.

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

  2. Paracoccidioidomicose primária de pálpebra e conjuntiva Primary paracoccidioidomycosis of eyelid and conjunctiva

    Directory of Open Access Journals (Sweden)

    Ezon Ferraz

    2001-06-01

    Full Text Available A paracoccidioidomicose (Pbmicose é a micose profunda mais freqüente no Brasil, mas o acometimento ocular é raro e, quando presente, geralmente secundário. Os autores relatam caso de Pbmicose pálpebro-conjuntival em que não foi encontrado foco extra-ocular. É feita uma revisão da literatura e discutida a importância da suspeita diagnóstica em população de risco e do tratamento precoce desta condição para o bom prognóstico visual.Paracoccidioidomycosis is the most frequent systemic mycosis in Brazil, but ocular involvement is rare and, if present, often secondary to another site. The authors report a case of paracoccidioidomycosis of eyelid and conjunctiva where no extraocular focus was found. A brief review of the literature is made discussing the importance of diagnostic suspecion in a population at risk and early treatment for a good visual prognosis.

  3. Left Activism, Succour and Selfhood

    DEFF Research Database (Denmark)

    Hughes, Celia Penelope

    2014-01-01

    an interchange of motherhood, domesticity, far-left politics, and close female friendship. The article will show how the women's epistolary friendship offers intimate insight into female self-fashioning at a breakthrough social and political moment in 1970s Britain. As they reflected on some of the key political...

  4. Right upper quadrant pain

    International Nuclear Information System (INIS)

    Ralls, P.W.; Colletti, P.M.; Boswell, W.D. Jr.; Halls, J.M.

    1984-01-01

    Historically, assessment of acute right upper quadrant abdominal pain has been a considerable clinical challenge. While clinical findings and laboratory data frequently narrow the differential diagnosis, symptom overlap generally precludes definitive diagnosis among the various diseases causing acute right upper quadrant pain. Fortunately, the advent of newer diagnostic imaging modalities has greatly improved the rapidity and reliability of diagnosis in these patients. An additional challenge to the physician, with increased awareness of the importance of cost effectiveness in medicine, is to select appropriate diagnostic schema that rapidly establish accurate diagnoses in the most economical fashion possible. The dual goals of this discussion are to assess not only the accuracy of techniques used to evaluate patients with acute right upper quadrant pain, but also to seek out cost-effective, coordinated imaging techniques to achieve this goal

  5. Upper-extremity venography

    International Nuclear Information System (INIS)

    Yao, J.S.T.; Neiman, H.L.

    1985-01-01

    Symptomatically, patients often present with pain, swelling, and occasionally discoloration of the hand. In the presence of chronic swelling, it may be difficult to differentiate thrombosis from lymphedema, especially in patients who have undergone mastectomy. Noninvasive testing is helpful in differentiating between these two conditions, but venography offers definitive diagnosis. More importantly, venography demonstrates the site as well as the extent of the thrombotic process. Venography of the upper extremity was first introduced in 1931. Unlike the lower extremity, the use of this simple radiographic technique to evaluate venous problems of the upper extremity has received little attention

  6. Left ventricular diastolic performance of left ventricular hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Ikezono, Tohru; Ozaki, Masaharu; Yamagishi, Takashi; Shimizu, Tatsuro; Furutani, Yuji; Kusukawa, Reizo

    1987-02-01

    To study left ventricular diastolic performance in different forms of left ventricular hypertrophy, ECG gated cardiac blood pool scan was performed in 11 patients with hypertrophic nonobstructive cardiomyopathy (HCM) and in 19 patients with hypertension (HT), and left ventricular volume curve (LVVC) was analyzed and compared with those of 13 normal subjects (N). Ejection fraction (EF) and early filling volume ratio (the ratio of volume increment of 100 msec later than the zero point in the first derivative of LVVC to the end diastolic volume) (%EFV) were computed from LVVC. Peak ejection rate (PER) and peak filling rate (PFR) were obtained from the first derivative of LVVC. Peak ejection acceleration (PEA) and peak filling acceleration (PFA) were calculated from the second derivative of LVVC. EF, PER and PEA did not show any difference between these 3 groups. PFR was lower in HT (2.6 +- 0.5) compared with those in HCM (3.0 +- 0.5) (p < 0.05) and in N (3.4 +- 0.5) (p < 0.001), but the %EFV in HCM (4.9 +- 1.8) was lower than those in HT (6.9 +- 1.9) (p < 0.01) and in N (11.4 +- 1.4) (p < 0.001). Moreover, PFA in HCM (27.9 +- 7.2) was increased than those in HT (20.2 +- 5.4) (p < 0.01) with no differences between HCM and N (29.4 +- 8.1). Significant correlation was observed between PFR and PFA (Y = 0.06X + 1.4. r = 0.856. p < 0.001). These result indicate that, in HCM, reduced increase in early left ventricular volume is compensated by a greater filling acceleration. In contrast, there is no compensation by filling acceleration in HT.

  7. Change in Eyelid Position Following Muller's Muscle Conjunctival Resection With a Standard Versus Variable Resection Length.

    Science.gov (United States)

    Rootman, Daniel B; Sinha, Kunal R; Goldberg, Robert A

    2017-09-12

    This study compares the use of a standard 7 mm resection length to a variable 4:1 ratio of resection length to desired elevation nomogram when performing Muller's muscle conjunctival resection surgery. In this cross-sectional case control study, 2 groups were defined. The first underwent Muller's muscle conjunctival resection surgery with a standard 7 mm resection length and the second underwent the same surgery with a variable resection length determined by a 4:1 ratio of resection length to desired elevation nomogram. Groups were matched for age (within 5 years) and sex. Pre- and postoperative photographs were measured digitally. Change in upper marginal reflex distance 1 (MRD1) and final MRD1 were the primary outcome measures. The study was powered to detect a 1 mm difference in MRD1 to a beta error of 0.95. No significant preoperative differences between the groups were noted. No significant difference in final MRD1 (0.1 mm; p = 0.74) or change in MRD1 (0.2 mm; p = 0.52) was noted. Mean resection length to elevation ratios were 3.9:1 for standard group and 4.3:1 for the variable group (p = 0.54). The authors were not able to detect a significant difference in final MRD1 or change in MRD1 for patients undergoing Muller's muscle conjunctival resection surgery with standard or variable resection lengths. These results tend to argue against a purely mechanical mechanism for Muller's muscle conjunctival resection surgery.

  8. Upper airway evaluation

    International Nuclear Information System (INIS)

    Hoffman, E.A.; Gefter, W.B.; Schnall, M.; Nordberg, J.; Listerud, J.; Lenkinski, R.E.

    1988-01-01

    The authors are evaluating upper-airway sleep disorders with magnetic resonance (MR) imaging and x-ray cine computed tomography (CT). Fixed structural anatomy is visualized with multisection spin-echo MR imaging, the dynamic component with cine CT. Unique aspects of the study are described in this paper

  9. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    This thesis is the first comprehensive research work conducted on the Beirut based TV station, an important representative of the post-2011 generation of Arab satellite news media. The launch of al-Mayadeen in June 2012 was closely linked to the political developments across the Arab world...... members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...

  10. Repair of pectus excavatum in a toddler with Prune Belly syndrome and left bronchus compression

    Directory of Open Access Journals (Sweden)

    Shawn T. Liechty

    2017-01-01

    Full Text Available A 2-year-old boy with prune-belly syndrome and severe pectus excavatum experienced recurrent pulmonary infections. A CT scan of the chest demonstrated compression of the left mainstem bronchus and leftward shift of the heart. The bronchial compression resulted in left upper lobe collapse and left lower lobe air-trapping requiring two hospitalizations for respiratory distress and pneumonia. The child underwent minimally invasive repair of his pectus excavatum and has not experienced any further pulmonary events. The pectus bar was removed 3 years post-operatively and at seven years following surgery he has a sustained repair.

  11. Isolated left-sided partial anomalous pulmonary venous connection in a child.

    Science.gov (United States)

    Onan, İsmihan Selen; Sen, Onur; Gökalp, Selman; Onan, Burak

    2017-09-01

    Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described.

  12. Diagnosis of aggressive subtypes of eyelid basal cell carcinoma by 2-mm punch biopsy: prospective and comparative study.

    Science.gov (United States)

    Rossato, Luiz Angelo; Carneiro, Rachel Camargo; Macedo, Erick Marcet Santiago de; Lima, Patrícia Picciarelli de; Miyazaki, Ahlys Ayumi; Matayoshi, Suzana

    2016-01-01

    : to compare the accuracy of preoperative 2-mm punch biopsy at one site and at two sites in the diagnosis of aggressive subtypes of eyelid basal cell carcinoma (BCC). : we randomly assigned patients to Group 1 (biopsy at one site) and Group 2 (biopsy at two sites). We compared the biopsy results to the gold standard (pathology of the surgical specimen). We calculated the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa coefficient to determine the level of agreement in both groups. : we analyzed 105 lesions (Group 1: n = 44; Group 2: n = 61). The agreement was 54.5% in Group 1 and 73.8% in Group 2 (p = 0.041). There was no significant difference between the groups regarding the distribution of quantitative and qualitative variables (gender, age, disease duration, tumor larger diameter, area and commitment of margins). Biopsy at two sites was two times more likely to agree with the gold standard than the biopsy of a single site. : the accuracy and the performance indicators were better for 2-mm punch biopsy in two sites than in one site for the diagnosis of aggressive subtypes of eyelid BCC. comparar a acurácia da biópsia pré-operatória por trépano de 2mm em um sítio e em dois sítios no diagnóstico dos subtipos agressivos de carcinoma basocelular (CBC) palpebral. os pacientes foram distribuídos aleatoriamente em Grupo 1 (biópsia em um sítio) e Grupo 2 (biópsia em dois sítios). Os resultados das biópsias foram comparados com o padrão-ouro (exame anatomopatológico da peça cirúrgica). A sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, precisão e coeficiente Kappa foram calculados para determinar o nível de concordância nos dois grupos. foram analisadas 105 lesões (Grupo 1: n = 44; Grupo 2: n = 61). A concordância foi de 54,5% no Grupo 1 e 73,8% no Grupo 2 (p-valor = 0,041). Não houve diferença significativa entre os grupos quanto à distribuição das vari

  13. Tbx5 Buffers Inherent Left/Right Asymmetry Ensuring Symmetric Forelimb Formation.

    Directory of Open Access Journals (Sweden)

    Fatima A Sulaiman

    2016-12-01

    Full Text Available The forelimbs and hindlimbs of vertebrates are bilaterally symmetric. The mechanisms that ensure symmetric limb formation are unknown but they can be disrupted in disease. In Holt-Oram Syndrome (HOS, caused by mutations in TBX5, affected individuals have left-biased upper/forelimb defects. We demonstrate a role for the transcription factor Tbx5 in ensuring the symmetric formation of the left and right forelimb. In our mouse model, bilateral hypomorphic levels of Tbx5 produces asymmetric forelimb defects that are consistently more severe in the left limb than the right, phenocopying the left-biased limb defects seen in HOS patients. In Tbx hypomorphic mutants maintained on an INV mutant background, with situs inversus, the laterality of defects is reversed. Our data demonstrate an early, inherent asymmetry in the left and right limb-forming regions and that threshold levels of Tbx5 are required to overcome this asymmetry to ensure symmetric forelimb formation.

  14. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...

  15. A Prospective, Comparative Study of the Pain of Local Anesthesia Using 2% Lidocaine, 2% Lidocaine With Epinephrine, and 2% Lidocaine With Epinephrine-Bupivicaine Mixture for Eyelid Surgery.

    Science.gov (United States)

    Han, Jung-Woo; Nah, Seung Kwan; Lee, Sang Yeul; Kim, Chang Yeom; Yoon, Jin Sook; Jang, Sun Young

    A mixture of 2% lidocaine with epinephrine and bupivacaine was developed to achieve the fast-onset anesthetic effect of lidocaine and the long-lasting effect of bupivacaine. The authors compared pain scores between 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture during local anesthesia for eyelid surgeries. This was a double-blind, randomized, prospective, comparative study. In total, 120 consecutive patients (43 males, 77 females, mean age = 47.2 ± 21.2) who underwent bilateral eyelid surgery under subcutaneous anesthesia were asked to report pain scores for each eye during the first injection of anesthesia. Each patient was randomly assigned to receive 1 of the 3 anesthetic agents in 1 eyelid, and 1 of the remaining 2 agents in the other. The pH values of the 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture were 6.23 ± 0.21, 4.21 ± 0.37, and 3.87 ± 0.19, respectively. The pain scores of each were 4.3 ± 1.8, 5.1 ± 1.8, and 5.7 ± 1.9, respectively. The 2% lidocaine with epinephrine produced a statistically significantly higher pain score than 2% lidocaine (p = 0.044, generalized estimating equation method). The mixture also showed a significantly higher pain score than 2% lidocaine (p = 0.003, generalized estimating equation method). Epinephrine seemed to increase subjective pain scores. Compared with 2% lidocaine with epinephrine, 2% lidocaine with epinephrine-bupivicaine mixture was not significantly different in terms of subjective symptoms or pH.

  16. Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.

    Science.gov (United States)

    Luciano, Debora; Laux, Daniela; Boudjemline, Younes; Hascoët, Sébastien; Lusson, Jean-René; Sorensen, Clio; Ovaert, Caroline; Kreitmann, Bernard; Van Praagh, Richard; Fraisse, Alain

    2013-12-10

    A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. We retrospectively studied such patients in 5 institutions. Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056). In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013.

  17. Rebuilding the US Health Left

    Directory of Open Access Journals (Sweden)

    Victor W. Sidel, MD

    2010-02-01

    Full Text Available With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series. We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance, provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health, traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA, fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics, were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health, supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights, played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay

  18. Fused upper central incisors: management of two clinical cases.

    Science.gov (United States)

    Sfasciotti, Gian Luca; Marini, Roberta; Bossù, Maurizio; Ierardo, Gaetano; Annibali, Susanna

    2011-03-01

    This paper reports the management of two clinical cases, in which the upper right central incisor was fused with a supernumerary tooth and the upper left central incisor was macrodontic. A radiographic examination revealed that the fused teeth had two separate roots. Hemisectioning of the fused teeth was performed, the supernumerary portion was extracted and the remaining part was reshaped to remove any sharp margins and to achieve a normal morphology. The macrodontic central incisors were not treated. At 12-months post-surgery there were no periodontal problems and no hypersensitivity. Orthodontic treatment was performed to appropriately align the maxillary teeth and to correct the malocclusion.

  19. Biomechanics of the upper limb

    OpenAIRE

    Łukasz Jaworski; Robert Karpiński; Angelika Dobrowolska

    2016-01-01

    The article presents basics of the human upper limb’s anatomy, including skeletal system, joints and basic division of muscles in the limb. The biomechanics of the upper limb is introduced. The range of performed motions is depicted. The possible applications of anatomy and biomechanics of the upper limb are shown.

  20. Anatomical variations of the thymus in relation to the left brachiocephalic vein, findings of necropsia.

    Science.gov (United States)

    Plaza, Oscar Alonso; Moreno, Freddy

    2018-04-01

    Two cases of anatomical variations of the thymus are presented with respect to the anatomical relations with the left brachiocephalic vein and found during the necropsy process. Less than 2 days after birth with Noonan Syndrome, when the left brachiocephalic vein was scanning behind the upper thymus horns, there were other adjacent lesions consisting of three supernumerary spleens and three hepatic veins. The second case was an 8-year-old infant with child malpractice who died from urinary sepsis due to obstructive uropathy, in which case the upper lobes of the thymus were fused and formed a ring through which the left brachiocephalic vein passed. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Left-handed Children in Singapore.

    Science.gov (United States)

    Gan, Linda

    1998-01-01

    Used teacher questionnaires to examine incidence of left-handedness in nearly 2,800 Singaporean children, racial differences in this left-handed population, and educational provisions in preschool and primary school. Findings indicated that 7.5% of preschoolers and 6.3% of primary children were left-handed, with a higher proportion being Chinese…

  2. The Left-Handed: "Their Sinister" History.

    Science.gov (United States)

    Costas, Elaine Fowler

    The history of left-handedness can provide teachers and parents a better understanding of left-handed children and give those children more pride in their difference. No child should be made to feel that he or she is abnormal because of using the left hand, although some specific instruction for these students is necessary in handwriting. Many…

  3. Flavoured Dark Matter moving left

    Science.gov (United States)

    Blanke, Monika; Das, Satrajit; Kast, Simon

    2018-02-01

    We investigate the phenomenology of a simplified model of flavoured Dark Matter (DM), with a dark fermionic flavour triplet coupling to the left-handed SU(2) L quark doublets via a scalar mediator. The DM-quark coupling matrix is assumed to constitute the only new source of flavour and CP violation, following the hypothesis of Dark Minimal Flavour Violation. We analyse the constraints from LHC searches, from meson mixing data in the K, D, and B d,s meson systems, from thermal DM freeze-out, and from direct detection experiments. Our combined analysis shows that while the experimental constraints are similar to the DMFV models with DM coupling to right-handed quarks, the multitude of couplings between DM and the SM quark sector resulting from the SU(2) L structure implies a richer phenomenology and significantly alters the resulting impact on the viable parameter space.

  4. Disseminated orbital actinomycetoma: A case report

    Directory of Open Access Journals (Sweden)

    Shanbhag Nita

    2010-01-01

    Full Text Available Mycetoma is a chronic granulomatous infection. Lower extremities are commonly involved. A 20-year-old male came with complaints of multiple sinuses on scalp, left eyelid swelling with a sinus and dystopia, since one year. On examination there was relative proptosis in left eye of 2 mm. Computed tomography scan showed soft tissue swelling of the pre-septal area of the left upper eyelid with orbital involvement. Magnetic resonance imaging showed increased left orbital volume and evident dystopia. Microbiology testing of the erosive scalp and lid lesions showed genus Nocardia, suggestive of actinomycetoma. This case is presented as it shows an unusual involvement of the orbit.

  5. Left Vocal Cord Paralysis Detected by PET/CT in a Case of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ali Ozan Oner

    2015-01-01

    Full Text Available We report a patient with lung cancer. The first PET/CT imaging revealed hypermetabolic mass in the left aortopulmonary region and hypermetabolic nodule in the anterior segment of the upper lobe of the left lung. After completing chemotherapy and radiotherapy against the primary mass in the left lung, the patient underwent a second PET/CT examination for evaluation of treatment response. This test demonstrated, compared with the first PET/CT, an increase in the size and metabolic activity of the primary mass in the left lung in addition to multiple, pathologic-sized, hypermetabolic metastatic lymph nodes as well as multiple metastatic sclerotic areas in bones. These findings were interpreted as progressive disease. In addition, an asymmetrical FDG uptake was noticed at the level of right vocal cord. During follow-up, a laryngoscopy was performed, which demonstrated left vocal cord paralysis with no apparent mass. Thus, we attributed the paralytic appearance of the left vocal cord to infiltration of the left recurrent laryngeal nerve by the primary mass located in the apical region of the left lung. In conclusion, the knowledge of this pitfall is important to avoid false-positive PET results.

  6. Giant coronary artery aneurysm after Takeuchi repair for anomalous left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Dunlay, Shannon M; Bonnichsen, Crystal R; Dearani, Joseph A; Warnes, Carole A

    2014-01-01

    A 33-year-old woman with an anomalous left coronary artery arising from the pulmonary artery who had undergone Takeuchi repair at age 7 years presented for evaluation. The Takeuchi procedure creates an aortopulmonary window and an intrapulmonary tunnel that baffles the left coronary artery to the aorta. A mediastinal mass was identified as a giant aneurysm of the left coronary artery resulting in compression of the pulmonary artery and left upper pulmonary vein. The patient underwent open repair with patch closure at the aortic entrance of the left coronary Takeuchi repair and resection and evacuation of the aneurysm. A saphenous vein graft to the left anterior descending artery was performed. Postoperative echocardiography demonstrated normal left ventricular function. This is the first reported case of giant aneurysm formation after Takeuchi repair. The reported complications have included the development of pulmonary artery stenosis at the intrapulmonary baffle, baffle leak, decreased left ventricular function, and mitral regurgitation. In conclusion, late complications of the Takeuchi procedure are common, underscoring the importance of lifelong follow-up at a center with experience in treating coronary anomalies. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. [Surface ECG characteristics of right and left atrial flutter].

    Science.gov (United States)

    Rostock, Thomas; Konrad, Torsten; Sonnenschein, Sebastian; Mollnau, Hanke; Ocete, Blanca Quesada; Bock, Karsten; Spittler, Raphael; Huber, Carola; Theis, Cathrin

    2015-09-01

    Atrial tachycardia in virtually all areas of both atria has become more important in the clinical management of patients with previous complex atrial fibrillation ablation. Accurate interpretation of surface electrocardiogram (ECG) characteristics is of paramount importance to localize the origin of atrial tachycardia, particularly for planning interventional treatment. This article highlights the ECG features of different types of right and left atrial tachycardia. Typical right atrial flutter through the cavotricuspid isthmus conducts septally in a cranial direction and demonstrates sawtooth-like flutter waves which start negative in II, III and aVF and then show a steep slope upwards to the isoelectric line. The flutter rate typically ranges between 240-250 beats/min. In contrast, right atrial flutter in a clockwise rotation, flutter around the vena cava inferior or superior and around a scar (e.g. after cardiac surgery) show positive or biphasic flutter waves (lower or upper loop reentry). Left atrial flutter waves (e.g. around the mitral valve or around the pulmonary veins) are very heterogeneous and are typically positive in V1 as the left atrium is located in the posterior mediastinum. Specific knowledge of flutter wave morphology in surface ECG facilitates planning and performance of the ablation strategy.

  8. Monomelic amyotrophy with proximal upper limb involvement: a case report.

    Science.gov (United States)

    Al-Ghawi, Eman; Al-Harbi, Talal; Al-Sarawi, Adnan; Binfalah, Mohamed

    2016-03-17

    Monomelic amyotrophy is an uncommon, benign, unilateral disorder of the lower motor neurons, affecting predominantly the hand and forearm muscles. Proximal involvement of the arm and shoulder muscles is an unusual presentation that has been rarely reported in the literature. A 28-year-old white man presented with insidious-onset, slowly progressive, unilateral weakness and atrophy of his left shoulder girdle and deltoid muscles. A neurological examination revealed weakness and atrophy in his left deltoid, infraspinatus and supraspinatus muscles. Electromyography demonstrated an active and chronic neurogenic pattern affecting his left C5 and C6 myotomes; magnetic resonance imaging of his cervical spine was normal. He did well with conservative treatment. Upper limb proximal form of monomelic amyotrophy is a rare clinical entity with a wide differential diagnosis. Physicians, especially neurologists, should be familiar with this benign condition to avoid inappropriately labeling patients as having amyotrophic lateral sclerosis and other disorders with less favorable outcomes.

  9. Association between social capital and health-related quality of life among left behind and not left behind older people in rural China.

    Science.gov (United States)

    Zhong, Yaqin; Schön, Pär; Burström, Bo; Burström, Kristina

    2017-12-16

    The association between social capital and health-related quality of life (HRQoL) has not been thoroughly studied among older persons in rural China, especially among those who were left behind or not. This study investigates the association between social capital and HRQoL and examines possible differences of this association between being left behind or not in rural China. A cross-sectional survey of 825 people aged 60 years and older, residing in three rural counties in Jiangsu Province in China, was conducted in 2013. Factor analysis was performed to measure social capital. EQ-5D was used to measure HRQoL. Tobit regression analysis with upper censoring was conducted to explore the association between social capital and EQ-5D index. After controlling for individual characteristics, low social capital and being left behind were significantly associated with low HRQoL. Old people with low social capital had 0.055 lower EQ-5D index compared to those with high social capital. Old people being left behind had 0.040 lower EQ-5D index compared to those who were not left behind. For different dimensions of social capital, the main effects came from the domain of trust and reciprocity. There was a significant interaction between low social capital and being left behind on HRQoL, suggesting that low social capital was associated with low HRQoL among persons left behind. Our findings indicate that the left behind old people with low social capital were a potentially vulnerable group in rural China. Formulating and implementing initiatives and strategies which increase social capital may foster better HRQoL, especially for old people who were left behind.

  10. Upper Carboniferous herbaceous lycopsids

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, B.A. [University of Wales, Cardigan (United Kingdom). Dept. of Geography

    1997-01-01

    Herbaceous lycopsids are often overlooked in palaeobotanical studies because of problems of morphological interpretation and identification. The literature on Euramerican Upper Carboniferous herbaceous lycopsids is reviewed on those species referred to the genera Selaginellites, Lycopodites, Paurodendron, Carinostrobus, Miadesmia, Spencerites and the identification of some specimens is challenged. The stratigraphical range of these lycopsids and those of dispersed spores referable to them are also reviewed and suggestions are given for the relatively late appearance of many of these lycopsids in the Euramerican Coal Measures swamps. It is suggested that anisophyllous Selaginella-like lycopsids made their first appearance in the Bolsovian (ex Westphalian C) of the Saar-Lorraine intramontane basin. Evidence from studies of coal balls and dispersed spore assemblages confirm that herbaceous lycopsids were most abundantly present in open-moor communities. Certain species of these herbaceous lycopsids, the Selaginella-like ones, are included within the extant genus Selaginella Linnaeus. For this reason a number of new combinations are proposed.

  11. Use of the Amplatzer ASD Occluder for Closing a Persistent Left Vertical Vein

    International Nuclear Information System (INIS)

    Zanchetta, Mario; Zennaro, Marco; Zecchel, Roberto; Mancuso, Daniela; Pedon, Luigi

    2009-01-01

    We report the case of a very large anomalous connection of the veins draining the upper lobe of the left lung to both the left-sided vertical vein and the left atrium, associated with mild rheumatic mitral valve stenosis, in which the atrial septum was intact and the remaining venous system, including the coronary sinus, was otherwise normal (a variant of Lutembacher's syndrome). In order to abolish the left-to-right shunting, a transcatheter approach to close this venous structure was successfully attempted using an Amplatzer ASD Occluder device. The technical aspects and the alternative options of performing a procedure with a device for a purpose outside the scope of its approved label are discussed.

  12. Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

    Science.gov (United States)

    Page, Stephen J; Hill, Valerie; White, Susan

    2013-06-01

    To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

  13. Severe form of streptococcal necrotizing fasciitis of the upper limb - diagnostic and therapeutic challenge: A case report

    Directory of Open Access Journals (Sweden)

    Mikić Dragan

    2015-01-01

    Full Text Available Introduction. Since delay in recognition and effective treatment of necrotizing fasciitis (NF caused by invasive group A streptococcus increases the mortality and disability, the early diagnosis and management of this disease are essential for a better outcome. We presented a patient with a severe form of streptococcal NF of the left upper limb in whom amputation was performed as a life saving procedure. Case report. A 65-year-old man, previously healthy, suffered an injury to his left hand by sting on a fish bone. Two days after that the patient got fever, redness, swelling and pain in his left hand. Clinical examination of the patient after admission indicated NF that spread quickly to the entire left upper limb, left armpit, and the left side of the chest and abdomen. Despite the use of aggressive antibiotic and surgical therapy severe destruction of the skin and subcutaneous tissues developed with the development of gangrene of the left upper limb. In this situation, the team of specialists decided that the patient must be operated on submited to amputation of the left arm, at the shoulder. After amputation and aggressive debridement of soft tissue on the left side of the trunk, the patient completely recovered. β-hemolytic streptococcus group A was isolated from the skin and tissue obtained during the surgery. Conclusion. In the most severe forms of streptococcal NF of the extremities, adequate multidisciplinary treatment, including limb amputation, can save the life of a patient.

  14. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed.

  15. Multiplicativity of left centralizers forcing additivity

    Directory of Open Access Journals (Sweden)

    Mohammad Sayed Tammam El-Sayiad

    2014-01-01

    Full Text Available A multiplicative left centralizer for an associative ring R is a map satisfying T(xy = T\\(xy for all x,y in R. T is not assumed to be additive. In this paper we deal with the additivity of the multiplicative left centralizers in a ring which contains an idempotent element. Specially, we study additivity for multiplicative left centralizers in prime and semiprime rings which contain an idempotent element.

  16. Effects of Azithromycin on Gene Expression Profiles of Proinflammatory and Anti-inflammatory Mediators in the Eyelid Margin and Conjunctiva of Patients With Meibomian Gland Disease

    Science.gov (United States)

    Zhang, Lili; Su, Zhitao; Zhang, Zongduan; Lin, Jing; Li, De-Quan; Pflugfelder, Stephen C.

    2017-01-01

    IMPORTANCE Topical application of azithromycin suppresses expression of proinflammatory mediators while restoring transforming growth factor β1 (TGF-β1) levels as evaluated by eyelid margin and conjunctival impression cytology. OBJECTIVE To explore the effects of azithromycin therapy on expression of proinflammatory and anti-inflammatory mediators in meibomian gland disease (MGD). DESIGN, SETTING, AND PARTICIPANTS Case-control study performed in a clinic setting from August 17, 2010, to December 31, 2010. Sixteen patients with posterior blepharitis and conjunctival inflammation due to MGD were treated with azithromycin, 1%, drops for 4 weeks. Impression cytology of the lower eyelid margin and tarsal conjunctiva to measure cytokine expression by quantitative real-time polymerase chain reaction as well as tear collection to measure matrix metalloproteinase 9 (MMP-9) activity were performed once in 8 asymptomatic healthy control participants and 5 times in the 16 symptomatic patients (every 2 weeks for 8 weeks), before, during, and after azithromycin treatment. EXPOSURE Azithromycin, 1%, drops for 4 weeks. MAIN OUTCOMES AND MEASURES Cytokine expression in the eyelid margin and conjunctiva, and MMP-9 activity in tears. RESULTS Compared with a 1-time measurement of 8 healthy participants, among 16 symptomatic patients, the mean (SD; 95% CI) fold change of expression of proinflammatory mediators interleukin 1β (IL-1β), IL-8, and MMP-9 increased to 13.26 (4.33; 11.14–15.38; P Azithromycin, 1%, caused a change in the expression pattern of these mediators toward normal levels during 4 weeks of treatment. Levels of IL-1β, IL-8, and MMP-9 mRNA remained suppressed, although they rebounded toward pretreatment values 4 weeks after azithromycin withdrawal. Expression of TGF-β1 increased during treatment and remained at levels similar to the healthy controls after drug withdrawal. Change in tear MMP-9 activity was similar to the pattern of MMP-9 transcripts. CONCLUSIONS

  17. Anarchy, socialism and a Darwinian left.

    Science.gov (United States)

    Clarke, Ellen

    2006-03-01

    In A Darwinian left Peter Singer aims to reconcile Darwinian theory with left wing politics, using evolutionary game theory and in particular a model proposed by Robert Axelrod, which shows that cooperation can be an evolutionarily successful strategy. In this paper I will show that whilst Axelrod's model can give support to a kind of left wing politics, it is not the kind that Singer himself envisages. In fact, it is shown that there are insurmountable problems for the idea of increasing Axelrodian cooperation within a welfare state. My surprising conclusion will be that a Darwinian left worthy of the name would be anarchistic.

  18. What is Beyond Right/Left?

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    2009-01-01

    The article looks at New Labour's move beyond right/left in the mid/late 1990s, which is an occasion to spell out the nature of right/left and what it means for democracy. In contrast to both defenders and critics of this move I argue in the first part that right/left is not an empty label bound up...... right/left. I argue that the new hegemonic orientation is that of front/back, which designs political renewal as a response to the social changes cutting across the outdated lines of contestation of partisan politics. The democratic problem of this move lies in squeezing politics between technocratic...

  19. Upper-extremity Deep Vein Thrombosis Complicating Apheresis in a Healthy Donor.

    Science.gov (United States)

    Haba, Yuichiro; Oshima, Hiroko; Naito, Toshio; Takasu, Kiyoshi; Ishimaru, Fumihiko

    2017-01-01

    Venous thrombus was recognized in the upper extremity of a 53-year-old man after blood donation. The patient presented with a 15-day history of swelling in the left upper-extremity that started 6 hours after apheresis. Contrast-enhanced computed tomography revealed clots in the deep veins of the left arm and the peripheral pulmonary artery. Blood donation had proceeded smoothly, and the patient had no thrombotic predisposition, except for a smoking habit. The thrombus resolved following anticoagulant therapy, and the patient' s clinical course was uncomplicated. Despite a thorough investigation, the cause of this thrombus remains unknown.

  20. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Chinali, M.; Simone, G. de; Wachtell, K.

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... with larger left ventricular diameter and higher left ventricular mass index (both P hypertrophy was greater (84 vs. 64%; P ..., transmitral peak E velocities and peak A velocities; and lower E/A ratio (all P hypertrophy, but normal left ventricular chamber systolic function with increased...