1/11. Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.PURPOSE: To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis. methods: A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations. RESULTS: The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions. CONCLUSION: This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Chronic eyelid lymphedema and acne rosacea. Report of two cases.OBJECTIVE: The authors describe the clinical findings and surgical treatment of two patients affected by chronic eyelid lymphedema associated with facial acne rosacea. DESIGN: Two interventional case reports. methods AND INTERVENTION: The clinical diagnosis of acne rosacea was based on the physical examination and confirmed by the histopathologic findings obtained from biopsy of the involved tissue. Surgical treatment was required to address the disfiguring chronic eyelid lymphedema and to correct the resultant mechanical lower eyelid ectropion in both patients. RESULTS: Surgical debulking of the affected soft tissue resulted in very satisfactory cosmetic and functional improvement in both patients. CONCLUSIONS: To our knowledge, this is the first series of cases of chronic eyelid lymphedema secondary to acne rosacea reported in the ophthalmic literature. Six similar cases have been described previously in the dermatologic literature; all of which had been treated medically without satisfactory results. Surgical debulking of the involved eyelids should be considered in patients affected by persistent symptomatic rosacea lymphedema.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
3/11. Colloid milium of the upper eyelid margins: a rare presentation.AIM: To report a rare presentation of colloid milium occurring only on the upper eyelid margins. DESIGN: Interventional case report. methods: (1) Slit-lamp examination of eyelids and eyes and clinical examination including the face and a general physical examination; (2) photography of the lesions on the lids; and (3) excision biopsy and histopathologic examination. MAIN OUTCOME MEASURES: Histologic examination confirmed the clinical diagnosis. RESULTS: Clinical examination and histopathologic findings revealed the cysts to be colloid milium. CONCLUSIONS: Colloid milium can involve upper eyelids in isolation, sparing the lower eyelids and facial skin. Such rare presentations should be kept in mind while examining similar lesions.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
4/11. Upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C.PURPOSE: To describe 3 cases of upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C and to highlight possible causes. methods: A report of 3 patients, identified over an 8-year interval period, who had development of upper eyelid retraction a few months after undergoing trabeculectomy with mitomycin C in the ipsilateral eye. RESULTS: Testing for graves disease, including second-generation thyrotropin receptor antibodies (TRAb), was negative in all cases. A complete physical examination was performed by an internist: Orbital and intracranial neuroimaging studies were ordered when necessary, and all were negative. One patient underwent surgical repair of the eyelid retraction and had a satisfactory result. CONCLUSIONS: Upper eyelid retraction after filtering surgery is a rarely reported entity. Muller muscle overaction, independent of graves disease, is a likely cause and has been pointed out as a possible factor in one previous report. Muller muscle fibrosis, euthyroid graves disease, and mechanical hindrance to an elevated bleb are other possible factors.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
5/11. Eyelid swelling as the only manifestation of ocular sarcoidosis.PURPOSE: To describe a case of eyelid sarcoidosis without systemic manifestations with a three-year follow-up. methods: A 73-year-old woman presented complaining of a one-year history of swelling and hyperemia in the right upper eyelid. To confirm the diagnosis, we performed an incisional biopsy of the eyelid. RESULTS: Histopathological examination showed a non-caseating granulomatous process suggestive of sarcoidosis. After three years, the patient was asymptomatic and physical and laboratory examination showed no signs of systemic sarcoidosis. CONCLUSION: The histopathological exam was fundamental for the diagnosis.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/11. A case of discoid lupus erythematosus of the eyelid.A 39-year-old man was first evaluated 12 years ago for erosive erythema of the left lower eyelid. The response to topical therapy was poor. The eyelid lesion was excised on the patient's demand 6 years ago and blepharoplasty was performed. However, recurrence of erythematous plaques at the same site prompted referral to our department. Examination clinically revealed atrophic erythematous plaques and several white papules on the left lower eyelid, in addition to an atrophic erythema of the upper back. The histopathological findings of both plaques and papules were typical of discoid lupus erythematosus. Immunoserological findings suggestive of systemic lupus erythematosus were absent. The lesions improved with administration of low-dose corticosteroids. Discoid lupus erythematosus involving the eyelid is rare, and definitive diagnosis often takes considerable period of time. In patients with lesions of the eyelid such as erythema or papules that are refractory to treatment, skin biopsy and careful physical examination of the entire body for similar lesions are important.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
7/11. Blepharochalasis.The condition of blepharochalasis and its treatment are discussed. Four cases are presented which show a physical sign that may help in its diagnosis.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
8/11. Lid splitting and posterior lamella cryosurgery for congenital and acquired distichiasis.Congenital distichiasis is a rare condition with an accessory row of lashes at the Meibomian gland orifices. We suggest "acquired distichiasis" as an appropriate term for the accessory row of lashes in or near the Meibomian gland orifices, occurring as a result of such conditions as stevens-johnson syndrome, ocular pemphigoid, or chemical and physical injuries. We report a new treatment technique in which the eyelid is divided along the gray line then followed by cryotherapy to the posterior lid lamella. This removes the distichiatic lashes without damaging the normal lashes in the anterior lid lamella and avoids depigmentation. Histologic examination demonstrates the aberrant lashes result from a metaplasia of tissues in or around the meibomian glands. Thirteen eyelids with acquired distichiasis and four eyelids with congenital distichiasis have been followed up for eight to 48 months. All have been greatly improved.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
9/11. amyloid plaque of the lower eyelid: a patient report and review of the literature.Localized conjunctival amyloid plaque is a rare disorder. It usually remains localized and is only rarely associated with systemic disease, unlike cutaneous amyloid deposits of the eyelid. The pathogenesis is unknown, but appears to be related to long-standing chronic inflammation. There may be a localized immunological disorder or an underlying systemic disease in rare instances. Because of this possible association, all patients should undergo through physical examination with close follow-up to rule out systemic disease. Plastic surgeons need to be aware of this lesion because the diagnosis is easily missed, clinically. The primary clinical working diagnosis before biopsy is a neoplasm, and recognition of this entity can prevent unnecessarily radical surgery.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
10/11. Self-induced cicatricial conjunctivitis with symblephara.PURPOSE: Cicatricial conjunctivitis is an uncommon ocular finding with several possible origins. We report a patient whose obsessive-compulsive disorder involved constant self-induced mechanical trauma to the eyes, leading to bilateral cicatricial conjunctivitis. METHOD: Case report. RESULTS: Based on the history, physical examination, ocular surface scraping, and conjuctival biopsy, other causes of cicatrical conjunctivitis were ruled out, and a self-induced cause was confirmed. CONCLUSIONS: Inquiries pertaining to psychiatric history may be important in patients with cicatricial conjunctivitis.- - - - - - - - - - ranking = 4.9072531322331keywords = physical examination, physical (Clic here for more details about this article) |
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