Pseudo-ciliary margin after neglected long-standing orbital implant extrusion

ABSTRACT

A 73-year-old woman, a resident of a nursing home, developed slow extrusion of the orbital implant from her left socket. The left eye had been enucleated many years before, or perhaps in childhood, presumably due to trauma. Because of her deteriorating mental faculties, the patient had become extremely non-cooperative and totally oblivious to her ocular or systemic problems. Because the patient never complained about it, for years the nursing home doctors kept treating the redness of the left eye, caused by the extruding implant, as chronic conjunctivitis. Gradually, the low grade infection and discharge accumulated under the upper eyelid as a white cheesy platform which kept catching the loose eyelashes in it. The blinking motions of the eyelid brushed the caught eyelashes into a smooth row which took the shape of a pseudo-ciliary margin behind and blow the upper eyelid margin. The cleaning of the pussy discharge from the most recent flare up of conjunctival inflammation uncovered this unusual clinical situation. A closer inspection of this additional row of eyelashes and the structure to which it was attached revealed the true nature of this unique pseudo-ciliary margin. [Pakistan Journal of Ophthalmology 961, 72, July, 1993.]