Corneal Abrasion and Visual Evoked Potentials Monitoring: Causes and Prevention.

Aims: The objective of this review is to explore the methods of eye protection from corneal abrasions during general anesthesia as they relate to procedures utilizing visual evoked potentials (VEP) monitoring. Because these protective measures may lower the accuracy of the VEP equipment, we wish to establish through existing literature current effective eye protection (with a focus on Tegaderm™) and why they could potentially interfere with VEP recording.

Nonsurgical Treatment of Abnormal Eyelid Position Using Hyaluronic Acid Gel

PURPOSE: The present study investigated the outcomes of nonsurgical treatment of abnormal eyelid position using hyaluronic acid gel. METHODS: Abnormal eyelid position including 18 eyes with lid retraction, 10 eyes with lagophthalmos, and 18 eyes with ectropion were treated with hyaluronic acid gel. The mean age was 50 +/- 17.8 years and the mean observation period was 11 +/- 2.4 months. The photographs of patients were taken before injection, 1 month, 4 months, and at the last follow-up after injection. The marginal reflex distance 1 (MRD1) and marginal reflex distance 2 (MRD2) of patients were measured and analyzed by the Image J Program. The severity of ectropion was graded by a scoring system. RESULTS: Ten eyes with lagopthalmos improved 1.9 +/- 1.2 mm after injection. The 16 eyes with lid retraction improved 1.3 +/- 0.9 mm. Twenty-three eyes with ectropion improved and 17 eyes (81%) were completely corrected. The average frequency of injection was 1.1 and the average dose of injection was 0.4 +/- 0.12 cc. No significant complications were observed in any patient. CONCLUSIONS: Hyaluronic acid gel injections can be used safely and effectively as a nonsurgical treatment for patients with abnormal eyelid position without any significant complications.

A case report of lagopthalmos related with facial nerve paralysis

Patient with facial paralysis may develop opthalmic complications. Poor eyelid closure, ectopion and lagophthalmos place the patinet at increased risk for development of corneal problems such as epitheilail defects, stromal thinning, bacterial infection, and even perforation. Inilital treatment should be conservative and include the use of ocular lubricants and taping of the lower eyelid into the proper position. Surgical intervention may be required in patients who have failed medical therapy or in whom the facial paralysis is not expected to improve. Gold weight implantation in upper eyelid and lower lid tightening in lower eyelid has become a popular procedure to correct upper eyelid retraction and lower eyelid laxity and to improve corneal coverage. We describe technique for placement of a gold weight in the upper lid, with attention of the maintenance of symmetric eyelid crease and susture canthopexy to correct malpositioned lower eyelid.