Seven Common Allergen Groups Causing Eyelid Dermatitis: Education and Avoidance Strategies.

OBJECTIVE: Eyelid dermatitis is most commonly attributed to allergic response. This retrospective clinical study identifies common allergens with eyelid involvement and addresses a literary gap by providing a clear approach for effective management of periorbital allergic contact dermatitis (ACD) recurrence. METHODS: Charts of 215 patients diagnosed with periorbital dermatitis who were patch tested with Mayo Clinic Standard Series, Extended Standard Series, and personal products from 2013 to 2017 were examined. Positive reaction rates for patients with eyelid involvement were compared to those without. Findings were also compared to North American Contact Dermatitis Group (NACDG) 2013-2014 and Mayo Clinic Contact Dermatitis Group (MCCDG) 2011-2015 general patch test populations. RESULTS: The 215 patients showed more common allergy to shellac, benzalkonium chloride, acrylates, and surfactants than the NACDG and MCCDG study populations. Periorbital ACD allergen groups eliciting the highest positive reaction rates were, in descending order: metals, shellac, preservatives, topical antibiotics, fragrances, acrylates, and surfactants. Of the corticosteroids, only tixocortol pivalate (the screening agent for prednisolone and fluorometholone) and budesonide elicited positive reactions. CONCLUSION: The top seven eyelid ACD allergen groups were identified. Avoidance of these allergens can be straightforward, with initial empiric counseling and free, online allergen avoidance programs. Patients who are unresponsive to avoidance should undergo patch testing.

Case report: extreme patient positioning for retinal surgery in advanced kyphosis.

PURPOSE: To describe the atypical intraoperative positioning of a kyphosis patient resulting in successful retinal detachment repair. METHODS: Case report. RESULTS: A 66-year-old man presented with bilateral vision loss, and pars plana lensectomy and retinal detachment repair were planned for the left eye. Innovative surgical positioning was required for the patient's severe ankylosing spondylitis-related kyphosis, a fixed 90° curvature of his cervical spine. With straps, orthopedic padding and surgical tape, he was securely placed head-down on the operating table. No intraoperative complications occurred, and the retina remained attached at follow-up. CONCLUSION: To our knowledge, this is the first report of special positioning for a 90° kyphosis patient requiring retinal surgery. Extreme spinal curvature can hinder suitable horizontal positioning of the eye, but resourceful solutions can make surgical repair possible.