ABSTRACT
PURPOSE: Floppy eyelid syndrome is a condition that is difficult to identify and diagnose and with no clear guidelines on its management. We propose a method of reliably grading this syndrome and have proposed a management algorithm based on the grading. MATERIALS AND METHODS: Retrospective data collection of patients diagnosed with Floppy eyelid syndrome and treated under the care of a single oculoplastic surgeon over a 9 year period. RESULTS: First, 102 patients were included and were classified into 3 groups. Grade 1 (F1) 7.5%, Grade 2 (F2) 36.5% and Grade 3 (F3) 56%. Only 12% of our cohort required surgery, and 92% of these patients demonstrated improvement in their symptoms. DISCUSSION: Clinical grading of Floppy eyelid syndrome patients will help determine patient's management plan. In our experience, operating on both upper and lower eyelids at the same time where indicated helps to maintain the normal anatomical relationship and improve epiphora.
Subject(s)
Eyelid Diseases/classification , Eyelid Diseases/surgery , Ophthalmologic Surgical Procedures , Adult , Aged , Algorithms , Blepharitis/diagnosis , Blepharoptosis/diagnosis , Conjunctivitis/diagnosis , Female , Humans , Lacrimal Apparatus Diseases/diagnosis , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
This technique describes a new painless method of injecting local anaesthetic in a highly pain-sensitive area of the body-around the eyes. We describe how a new technique using a bolus of intravenous alfentanil can help alleviate patient discomfort during the injection of the local anaesthetic and also reduce the amount of local anaesthetic injected. This also helps oculoplastic surgeons to work in a relaxed environment, whilst still utilizing the efficiencies that are provided by an ambulatory day surgery unit.
Subject(s)
Alfentanil/administration & dosage , Anesthetics, Intravenous/administration & dosage , Conscious Sedation/methods , Ophthalmologic Surgical Procedures , Surgery, Plastic , Anesthetics, Local/administration & dosage , HumansABSTRACT
We report a one stage management of a Giant Divided Naevus of the eyelids with excellent cosmetic results.
Subject(s)
Eyelid Neoplasms/surgery , Nevus, Pigmented/surgery , Plastic Surgery Procedures/methods , Skin Neoplasms/surgery , Adult , Biopsy, Needle , Blepharoplasty/methods , Esthetics , Eyelid Neoplasms/congenital , Eyelid Neoplasms/pathology , Female , Humans , Immunohistochemistry , Neoplasm Staging , Nevus, Pigmented/congenital , Nevus, Pigmented/pathology , Postoperative Care/methods , Skin Neoplasms/congenital , Skin Neoplasms/pathology , Suture Techniques , Treatment OutcomeABSTRACT
An 85-year-old lady presented with a severe cicatricial ectropion several months after a fall. The abnormality was corrected with a procedure that involved the use of a retroauricular skin graft. This provided resolution of her ocular symptoms. Several months later, she had noted significant hair growth on the graft, but elected for this to be managed conservatively. Careful harvesting of the graft from the non-hairy area between the ear and the hairline is essential to prevent unwanted transplantation of terminal hairs. Surgical success is also dependent on the final aesthetic outcome.
ABSTRACT
This report describes an unusual case of a 9-year-old boy with a 6-month history of right lower eyelid lesion and excoriation of the adjoining skin that had not responded to topical treatment. The umbilicated lesion was electively excised and the base of the lesion was cauterized under general anesthesia, which resulted in complete resolution of the periocular dermatitis without additional treatment. It is important to consider molluscum contagiosum in the differential diagnosis in patients with periocular dermatitis, especially in the presence of an umbilicated vesicle, although it is classically taught that these lesions present with toxic conjunctivitis.
ABSTRACT
Xanthelasma is a common disfiguring condition, which can be difficult to treat. Various treatments have been reported previously with varying degree of success. We report a simple yet effective technique of excision of the lesions with excellent cosmetic outcome.
Subject(s)
Eyelid Diseases/surgery , Surgery, Plastic/methods , Xanthomatosis/surgery , Cholesterol , Humans , Suture TechniquesSubject(s)
Anesthesia, Local/adverse effects , Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Lidocaine/administration & dosage , Retrobulbar Hemorrhage/prevention & control , Connective Tissue , Diabetes Mellitus, Type 1/complications , Humans , Nausea/etiology , Pain/etiology , Retrobulbar Hemorrhage/etiology , Vitrectomy , Vitreous Hemorrhage/surgeryABSTRACT
PURPOSE: To describe a case of an occipital arteriovenous malformation (AVM) presenting with unilateral signs mimicking a carotid-cavernous sinus fistula (CCF). DESIGN: Interventional case report. METHODS: A 67-year-old normotensive male presented with loss of vision, pain, and proptosis of the right eye. Best-corrected visual acuity was right eye 6/36 and left eye 6/5. Examination of the right eye revealed orbital congestion with arteriolization of the episcleral vessels and an intra-ocular pressure of 44 mm Hg which was refractory to medical treatment. RESULTS: Computed tomography (CT) angiogram and cerebral angiography found an occipital AVM draining into the right sphenoparietal sinus and thereafter the right ophthalmic vein, bypassing the cavernous sinus. Embolization followed by excision of the AVM resulted in recovery of vision, reversal of proptosis, and normalization of intraocular pressure. CONCLUSIONS: Rapid diagnosis and immediate intervention resulted in a rewarding visual recovery despite a persisting left homonymous hemianopia.
