11/236. loiasis. Report of a case and review of the literature.An adult worm was isolated from the left upper eyelid of a man, eight years after he had left an area in which L loa is endemic. We described his case in order to draw attention to some differences between reported features of the disease in areas in which the worm is endemic and in areas in which it is not.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/236. Missed orbital wall blow-out fracture as a cause of post-enucleation socket syndrome.BACKGROUND: Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility. PURPOSE: To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma. methods: medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma. RESULTS: Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients. CONCLUSIONS: We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
13/236. Pericranial flap correction of superior sulcus depression in the anophthalmic orbit.Distortion of the supratarsal sulcus of the upper eyelid after orbital trauma is a well-recognized and troublesome problem. This is particularly true of the anophthalmic orbit. The authors present two patients in whom this deformity has been addressed using a pedicled pericranial flap. They found this technique provides abundant, well-vascularized tissue that is manipulated easily to conform to the demands of the defect. In addition, the vascularity of the tissue provides predictability of the result when compared with other described techniques such as fat and dermis-fat grafts.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
14/236. Palpebral myiasis.myiasis is most prevalent in mexico, central and south america, tropical africa, and the southwestern united states. Although dermal myiasis is rare in most of the United States, it is a disorder that may be seen in international travelers. In the United States, external myiasis is usually caused by the cattle botfly. We report here a case of ophthalmomyiasis involving the left upper eyelid of a child. We examined a six-year-old boy who presented to the massachusetts Eye and ear Infirmary (MEEI) in September 1998. He complained of persistent swelling of his left upper eyelid for the previous ten days. The edema and erythema were unresponsive to warm compresses and oral antibiotics. Ocular examination revealed a mild preseptal cellulitis of the left upper eyelid with a small draining fistula. On slit-lamp examination, we found one larva protruding intermittently from the fistula site. The larva was extracted with forceps, wrapped in a moist towel and sent in a jar to the parasitology laboratory. The specimen was identified as a Cuterebra larva by a parasitologist at the Harvard School of public health. One week later, the patient's eyelid edema and erythema had completely resolved.- - - - - - - - - - ranking = 3keywords = upper (Clic here for more details about this article) |
15/236. Pyogenic granuloma: a rare complication of silicone punctal plugs.To describe pyogenic granuloma formation associated with silicone punctal plugs. A 65-year-old woman with severe dry eye was treated with silicone punctal plugs in both upper and lower puncta. After 14 months of success with the plugs, the patient presented with a fleshy ampullary lesion overlying the plugged superior punctum of her right eye. It was clinically diagnosed as a pyogenic granuloma, and the silicone plug was removed. Since the lesion persisted for 1 month, it was surgically removed. Histopathologic examination confirmed the diagnosis of pyogenic granuloma. A new plug was inserted and tolerated well. The routine use of silicone plugs are recommended as long as patients are informed of possible rare complications.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
16/236. Cutaneous pseudolymphoma, lymphomatoid contact dermatitis type, as an unusual cause of symmetrical upper eyelid nodules.We describe a 74-year-old woman who rapidly developed bilateral voluminous nodules on the upper eyelids, following 4 months' treatment for chalazion. Histological and immunohistochemical findings were suggestive of cutaneous pseudolymphoma (CPL), and extensive screening for malignant lymphoma (ML) remained negative. Cutaneous pseudolymphomas are inflammatory diseases that can simulate ML either clinically, histopathologically, or both. They are a rare cause of nodules of the upper eyelids, usually characterized by a benign evolution, that can be secondary to ultraviolet sensitivity, adverse reactions to systemic medications and contact sensitization, among others. In our case, epicutaneous patch tests were strongly positive for a series of allergens contained in the ophthalmological preparations used; therefore, they were suggestive that the patient had CPL, lymphomatoid contact dermatitis type. In addition, the patient had been treated previously with several drugs, known to cause CPL and immune dysregulation. Complete regression of the lesions required treatment with systemic steroids and chlorambucil. No relapse occurred within a 5-year follow-up period.- - - - - - - - - - ranking = 6keywords = upper (Clic here for more details about this article) |
17/236. Palpebral myiasis in a Danish traveler caused by the human bot-fly (Dermatobia hominis).PURPOSE: To demonstrate a case of palpebral myiasis caused by Dermatobia hominis in a Dane traveling in the Brazilian rain forest. methods: Surgical removal and histological examination. RESULTS: Within three weeks after returning from the Brazilian rain forest, the patient developed a localized swelling of the left upper eyelid and follicular conjunctivitis. A funnel containing a larva was found between the cilia. The larva was excised together with surrounding inflammatory tissue. The clinical findings as well as zoological and pathological examinations indicated a case of palpebral myiasis caused by Dermatobia hominis. The larva was removed in its third stage four weeks from symptom debut. CONCLUSIONS: Infestation with Dermatobia hominis should be suspected when itching and red swelling of the lid are present in patients who have been to Central and south america.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
18/236. Juvenile xanthogranuloma of the orbit in an adult.We present a case of juvenile xanthogranuloma (JXG) with unilateral involvement of the orbit and eyelid and proptosis, histologically confirmed in a 32-year-old man with a 1-year history of a pansinusitis and dacryoadenitis with rhinitis. Nine months later an infiltration of the anterior upper part of the right orbit and right eyelid appeared. Computed tomography scan and magnetic resonance imaging studies confirmed the presence of pansinusitis and infiltration. The patient underwent a blepharoplasty and excision of the infiltrated tissues of the orbit, eyelid, and levator muscle. hematoxylin-eosin and immunohistochemical studies revealed features consistent with a diagnosis of JXG (Touton giant cells). JXG, a non-Langerhans'-type benign proliferation, is a rare condition in adulthood.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
19/236. Floppy eyelid syndrome and mental retardation.OBJECTIVE: To report four subjects with a combination of floppy eyelid syndrome, mental retardation, and increased mechanical stimulus to the affected side. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: The authors retrospectively reviewed the charts of four mentally retarded subjects with floppy eyelid syndrome. INTERVENTION: Surgical tightening of three upper lids and one lower lid was performed in three subjects. MAIN OUTCOME MEASURE: Relief of symptoms. RESULTS: The affected eyelids were treated surgically; in case 1 by anterior lamellar repositioning and lateral and medial canthal tightening, in case 2 by horizontal upper lid shortening, and in case 3 by horizontal lid shortening of both upper and lower lids. There was marked relief from symptoms in all three cases. In case 4, surgery was deferred at parental request. CONCLUSIONS: These cases support the role of mechanical factors in the pathogenesis of floppy eyelid syndrome. Subjects with mental retardation may cooperate poorly with examination, and we believe that there should be a careful search for floppy eyelid syndrome in the presence of chronic conjunctivitis or unexplained epitheliopathy.- - - - - - - - - - ranking = 3keywords = upper (Clic here for more details about this article) |
20/236. Punctum to punctum adhesion after dacryocystorhinostomy using silicone tubes.Adhesion between the upper and lower punctum is described after dacryocystorhinostomy with silicone stent intubation. The cause is attributed to trauma at the punctal openings and a tight silicone stent loop. Advice is given on how to avoid the complication.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
| <- Previous || Next -> |