ABSTRACT
Our understanding of tear-flow mechanics is based upon work performed on eyes in the normal, nucleated state. On this basis, decisions are made regarding the reconstruction of lacerated canaliculi. When called upon to repair such a laceration in a patient who is coincidentally undergoing a traumatic enucleation, the surgeon has traditionally done so when it was practical. This assumes that the tear-flow requirements in these patients are similar to those of patients in the nucleated condition. We have investigated twelve patients after traumatic enucleation and believe, based on this preliminary work, that eyes in the enucleated state may not have the same tear-flow requirements and therefore may not require canalicular reconstruction.
Subject(s)
Eye Enucleation , Lacrimal Apparatus/physiology , Adult , Aged , Aged, 80 and over , Humans , Lacrimal Apparatus/pathology , Longitudinal Studies , Middle Aged , Prostheses and Implants , Tears/metabolismABSTRACT
Congenital ptosis and congenital heart disease are known to occur simultaneously in the presence of several well-recognized clinical syndromes. We report seven cases of documented, structural congenital heart defects found among 156 consecutive congenital ptosis patients operated at the Wills Eye Hospital. The possibility that the concurrence found in the patients was a manifestation of a dysmorphic syndrome was carefully excluded by observers skilled in the recognition of such anomalies. The observed rate of congenital heart disease, in otherwise normal congenital ptosis patients, was five times the expected rate in the pediatric population at large. This should alert ophthalmologists examining pediatric ptosis patients to the possibility of a coexisting structural heart defect.
