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1/75. Jones tube insertion in children with canalicular agenesis.

    The purpose of this report is to describe a simplified method of Jones tube insertion in the management of pediatric patients with symptomatic upper and lower punctal and canalicular agenesis. A 5-year-old female with bilateral upper and lower canalicular agenesis, and a 4-year-old male with agenesis of the right upper and lower canaliculi, underwent placement of Jones tubes without performing standard external conjunctivodacryocystorhinostomy. The first child requiring bilateral Jones tube insertion has remained asymptomatic for 24 months. The Jones tube dislodged in the second patient 6 weeks postoperatively. The tube was replaced, and the child has been asymptomatic for 16 months. The technique of Jones tube insertion without a previous or concomitant external dacryocystorhinostomy may be a useful modification in the management of pediatric patients with symptomatic upper and lower canalicular agenesis.
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ranking = 1
keywords = upper
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2/75. Benign pleomorphic adenoma arising from the palpebral lobe of the lacrimal gland associated with elevated intraocular pressure.

    A 46-year-old man complained of a painless mass in the left upper eyelid. At age 51 years, the patient complained of dull pain in the left eye and diplopia. His left intraocular pressure had increased to 33 mm Hg. No proptosis was noted. The nontender mass in the eyelid was palpable. Computed tomography showed a mass anterior to the orbital rim compressing the globe. The lesion was removed en bloc by a transconjunctival approach. Histopathologic examination of the excised mass showed myxomatous stroma and highly cellular epithelial areas. Postoperatively, the left intraocular pressure normalized. To our knowledge, benign pleomorphic adenomas arising from the palpebral lobe of the lacrimal gland associated with elevated intraocular pressure, as demonstrated in our patient, may be rare.
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ranking = 0.46645886369758
keywords = upper, pain
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3/75. Mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion.

    PURPOSE: To report a case of mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion. methods: The clinical history and pathologic findings of a patient with a left upper eyelid lesion were reviewed. RESULTS: The patient was evaluated and found to have an epithelial tumor arising in an accessory lacrimal gland. Special stains showed mucin production by individual tumor cells. The tumor was classified as mucoepidermoid carcinoma. CONCLUSIONS: Mucoepidermoid carcinoma may arise in accessory lacrimal glands and invade the orbit.
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ranking = 0.25
keywords = upper
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4/75. sunct syndrome responsive to gabapentin (Neurontin).

    A 48-year-old male suffering with SUNCT (severe unilateral neuralgiform headache with conjunctival injection and tearing, rhinorrhea and sub-clinical sweating) presented in 1996 after a 10-year history of multiple failed therapies. The symptoms included strictly left-sided ocular, as well as facial and temple pain. The pain attacks were burning, sharp, shooting and occurred 25 times daily, lasting 2 to 3 minutes with tearing and conjunctival injection. There was no associated nausea or vomiting, but there was photophobia. No other autonomic changes were reported and the pain was not triggerable. Initially Indocin (indomethacin) was tried without significant benefit. Gabapentin (Neurontin) was then started with improvement at 1800 mg per day. The patient was then lost to follow-up for 3 years, as he moved from the los angeles area. He returned in 1999 having stopped the gabapentin after his prescription ran out in 1996, reporting the pain returned immediately. Again gabapentin was prescribed and at 900 mg three times daily he has been pain free for 12 months.
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ranking = 0.78348174307554
keywords = headache, pain
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5/75. 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.
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ranking = 0.25
keywords = upper
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6/75. Two new SUNCT cases responsive to lamotrigine.

    Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare and debilitating headache form generally unresponsive to treatment. Following a recent report of a SUNCT patient who responded to lamotrigine, we tried this drug in two new SUNCT patients, reported here. In both cases prophylaxis was successful, suggesting lamotrigine might be the first effective treatment for this rare and debilitating headache syndrome.
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ranking = 0.72700375149477
keywords = headache
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7/75. Lacrimal gland ductal cyst abscess.

    PURPOSE: To describe a case of lacrimal gland ductal cyst complicated by secondary infection. methods: Case report. RESULTS: A 51-year-old woman presented acutely with an enlarging, painful mass in the superotemporal fornix. Clinical examination, echography, and surgical evaluation revealed a lacrimal gland ductal cyst with abscess formation. The lacrimal gland cyst was treated with oral antibiotics in combination with incision, drainage, and marsupialization. CONCLUSIONS: Lacrimal gland ductal cysts are rare but must be considered in the differential diagnosis of lacrimal gland and upper eyelid mass lesions. Typically, lacrimal gland ductal cysts develop after chronic inflammation, infection, or trauma. We describe a patient who presented acutely with a lacrimal gland ductal cyst associated with a rare complication of abscess formation.
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ranking = 0.35822943184879
keywords = upper, pain
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8/75. Posttraumatic benign pleomorphic adenoma of the lacrimal gland.

    A 55-year-old man presented with a painless and slowly developing mass in the right superior lateral eyelid region. He had sustained periorbital blunt injury about 4 years previously. The mass was observed several months later in the persisting traumatic tumefaction region. Computed tomography showed a cystic soft-tissue mass with central low density and peripheral enhancement over the upper anterior quadrant of the right orbit. Lateral orbitotomy was performed to remove the lesion. Histopathologic examination showed proliferation of epithelial and myoepithelial cells arranged in ductules and nests in the myxoid stroma. Benign pleomorphic adenoma of the lacrimal gland associated with traumatic tumefaction, as demonstrated in our patient, may be rare.
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ranking = 0.35822943184879
keywords = upper, pain
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9/75. Orbital epithelial cyst derived from the lacrimal sac.

    We describe a 32-year-old female who presented with a painless, moderately hard mass in the left inferior medial canthal region which had been present for about 6 years. She suffered from epiphora in the left eye in that time. The nasolacrimal system was completely patent on irrigation. Computed tomography showed a nodular mass with a diameter measuring about 25 mm located over the upper portion of the left lacrimal sac. The lesion was found to be a cyst located separately with close proximity to the lacrimal sac via anterior orbitotomy. Histopathologic examination revealed a cystic cavity lined by columnar to cuboidal epithelium consistent with a cyst derived from lacrimal sac epithelium. The patient has remained free of symptoms with a patent lacrimal system during the follow-up period of 1 year, without recurrence of the lesion. Orbital cysts of lacrimal sac derivation should be considered in the diagnosis of medial orbital tumors. Careful evaluation clinically with imaging studies and planning surgery constituted adequate therapy in this case.
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ranking = 0.35822943184879
keywords = upper, pain
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10/75. gold implant treatment for discomfort induced by a filtering bleb.

    We present a post-trabeculectomy patient suffering from blurred vision and foreign body sensation that was not alleviated by conventional treatments. Our treatment involved placing a gold weight implant onto the anterior surface of the tarsal plate to gravity-assist closure and increase coverage of the filtering bleb.
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ranking = 40.573574229045
keywords = discomfort
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