Eyelid Position Research Articles

Long-Term Burden of Pain and Reduced Visual Acuity after Gunshot Wounds to the Orbit

ABSTRACT Purpose To characterize the clinical presentation, surgical management, long-term complications and outcomes of Gunshot Wounds(GSW) to the orbit. Methods An extended case series with retrospective chart-review was conducted on all cases (1985–2020) of traumatic ocular injuries secondary to GSWs at an academic institution with a level 1 trauma center. Predictors included demographic information, clinical and radiologic examination findings, and surgical intervention at time of presentation. Outcomes included long-term lid malposition, visual acuity, pain, and secondary surgery. Descriptive statistics and tests of association were performed, including Fishers exact tests for categorical data, Kruskal-Wallis rank sum tests, analysis of variance, and, in the case of repeated measures, generalized estimating equations. Results 88 patients with GSW involving the orbit were included with average age of 32.6 years (sd = 15.7). Patients were 85.2% male, 75% African-American, 25.0% Caucasian, and 5.7% Hispanic. Median follow up was 43.3 months (4.6, 136.4). The injuries at presentation were 53.4% intracranial, 21.6% open globe, 80.7% orbital fracture, 89.8% lid laceration. Visual acuity did not significantly improve over time. Long-term complications included abnormal lid or globe position in 26.1% of patients, reduced visual acuity in 55.2%, and persistent pain in 50.6%. Conclusion To our knowledge, this represents the first and largest clinical epidemiologic study with insight into the clinical presentation, surgical intervention, and long-term outcomes of GSW to the orbit. The results demonstrate a long-term burden of persistent pain and reduced visual acuity in patients who suffer from GSW to the globe and orbit. This study may guide patient management and communications.

Analysis of eyelid and eyebrow metrics in Iranian American adults

<h2>Summary</h2><h3>Background</h3> Achieving patient satisfaction after oculofacial surgery requires sensitivity to ethnic anthropometric variation. While differences between the Caucasian and East Asian eyelid configurations are often discussed, there is a relative paucity of discussion related to characteristics of the Middle Eastern eyelid and periocular region. This study aims to understand differences between the eyelids and periocular region of patients of mixed Iranian extraction, versus those of mixed European descent. <h3>Methods</h3> In this cross-sectional cohort study, external photographs were collected from a prospectively maintained database at an oculofacial plastic surgery practice. Ethnicity, age, gender, and photographic data were extracted from patient charts. Iranian-American patients were compared to Caucasian-American patients. From full-face photographs, brow position (pupil-to-brow, PTB), eyelid position (margin-to-reflex distance 1 and 2, MRD1 and MRD2), and tarsal platform show (TPS) were analyzed. Mixed effect ANOVA modeling was employed. <h3>Results</h3> The Iranian-American eyelid complex was found to maintain a lower MRD1 (-0.34 mm, p < 0.01), higher MRD2 (+0.48 mm, p < 0.01), and longer TPS (+0.74 mm, p < 0.01) compared to Caucasian-American patients. Further, pupil-to-brow (PTB) distance was noted to be 1.46 mm higher (p < 0.01) in Iranian-Americans. <h3>Conclusion</h3> Patients with Iranian-American ethnicity, compared to those of mixed European extraction, demonstrate distinctive eyelid anthropometric features. An understanding of these features may help to guide aesthetic surgical planning.

Tarsal Ectropion Repair With Modified Bick Eyelid Tightening and Inverting Sutures.

The authors report on a 10-year experience of correcting tarsal ectropion using a combined method of modified Bick eyelid tightening (MBLT) and inverting sutures. Retrospective, interventional case series of consecutive patients with tarsal ectropion who underwent MBLT and inverting sutures by a single surgeon (RS) between July 2010 and July 2020. Thirty-four patients, 24 of whom were female, with a mean age of 81.6 years (range 59-92) were included. Eight patients had bilateral disease. All procedures were performed under local anesthesia in an office setting. Treatment success was defined by eyelid position, symptoms, and need for reoperation. Thirty-one patients (91%) had a successful outcome. Three patients (9%) had satisfactory results with improved symptoms and mild residual ectropion, for which further surgery was not required. No patients had poor results. The mean follow-up time was 4.5 months (range 3-11 months). The inverting sutures were well tolerated in all cases and none had to be removed due to ocular surface discomfort. There were no visible scars from the inverting sutures in any patient at postoperative month 3. A combination of eyelid tightening using MBLT and inverting sutures is a simple and effective treatment for lower eyelid tarsal ectropion with minimal tissue dissection.

Effect of external eyelid weighting on eyelid and eyebrow position in normal and ptosis patients.

This study aims to characterize the physiologic response of both eyelid and eyebrow position to increasing downward forces simulated by external weights. In this prospective observational study, both normal individuals and patients affected by ptosis were tested. External eyelid weights were placed on one upper eyelid with incrementally increasing weight from 0.2 to 2.4g. The eyelid carrying the weight was randomly selected for normal subjects and patients with bilateral ptosis, whereas for unilateral ptosis, the ptotic eyelid was utilized. Photographs were obtained at baseline and with increasing weight until MRD1 reached 0 on the weighted side or, until 2.4g was reached. Eyelid and brow position on the weighted and unweighted sides were digitally measured in millimeter. Primary outcome measures were change in the margin to reflex distance (MRD1) and pupil to brow distance (PTB) with weight on the weighted and unweighted sides for normal and ptosis subjects. The weighted eyelid MRD1 decreased linearly with increasing weight. This was true for normal and ptosis subjects. The unweighted eyelid MRD1 increased linearly with increasing weight. This was also the case for both normal and ptosis subjects. With increasing weight, PTB increased linearly on the weighted side. No significant intergroup differences were noted. In normal and ptosis subjects, when external weight on the eyelid is incrementally increased, the weighted eyelid MRD1 decreases, the unweighted eyelid MRD1 increases, and both brows elevate in a linear fashion.

The Influence of Eyelid Position and Environmental Conditions on the Corneal Changes in Early Postmortem Interval: A Prospective, Multicentric OCT Study.

In the current study, using portable optical coherence tomography, we evaluated 46 corneas of 23 individuals in a multicenter setting during the first 17 h after death. Twenty-three eyes were kept open, and twenty three were kept closed. Furthermore, the experiment was carried out for 12 samples in summer and 11 in winter. Our data show that postmortem corneal alterations largely depend on the phenomena of dehydration (in particular in open eyes) and swelling of the stroma in closed eyes, probably due in the first phase to hypoxia/anoxia and subsequently to the passage by osmosis of the aqueous humor from the anterior chamber to the corneal tissue. Our findings could have significant repercussions in forensic pathology for estimating the postmortem interval and transplantation to optimize the conservation of the tissue before the explant.

Upper Eyelid Blepharoplasty Improved the Overall Periorbital Aesthetics Ratio by Enhancing Harmony Between the Eyes and Eyebrows.

PurposeIn upper eyelid blepharoplasty, most aesthetic surgeons and patients focus on improvements in the appearance of the upper eyelids, such as changing the vertical dimension of the palpebral fissure and the width of the pretarsal crease. Nevertheless, appropriately balanced periorbital aesthetics stemming from harmony between the eyelids and eyebrows is often ignored. The aim of this study was to explore the use of upper eyelid blepharoplasty to improve the overall periorbital aesthetics by enhancing the harmony between the eyes and eyebrows in young Asian women.Patients and MethodsFrom December 2019 to December 2020, 45 young Asian female patients underwent external incision upper eyelidplasty without ptosis repair or brow lift at The Second Affiliated Hospital of Harbin Medical University. The pre- and 6-month post-operative follow-up changes in the overall periorbital aesthetics were studied retrospectively.ResultsThe vertical position of the eyebrows in the upper face and shape of the brow apex were significantly improved after surgery. As a result, the height of the upper face was increased. Furthermore, the facial width proportion and midface ratio were closer to the ideal aesthetic golden ratio due to changes in the size of the periorbital area. All patients were satisfied with the result, and they achieved excellent surgical outcomes for not only the upper eyelids but also the overall periorbital region.ConclusionThis study revealed that upper eyelid blepharoplasty, which enhances the appearance of the upper eyelids while regulating the eyelid position and shape of the eyebrows by considering the eye to eyebrow ratio, optimizes the proportion of the periorbital area and improves the overall periorbital aesthetics.

Correlation between clinical outcomes and patients' satisfaction using tarsoconjunctival - Hughes flap for the reconstruction of eyelid defects.

Aim To examine and quantify patients' satisfaction and correlate with the objective clinical presentation after the treatment and to present a comprehensive literature review on tarsoconjunctival/ Hughes flap technique. Methods A review of more than 159 peer-review articles and a combined retrospective-prospective two-centres case series of 17 patients who underwent a two-stage modified Hughes flap procedure (2019-2021) to repair a lower eyelid defect caused by epithelial cancer was conducted. All patients were followed up for a minimum of six months. Patient macroscopic evaluation of redness, lid position, retraction, trichiasis, conjunctival overgrowth, tissue inflammation/infection and hypertrophic scarring were obtained, and findings were graded on a scale of 1 to 5 or binary YES/NO scale. Patients' satisfaction using a Likert-type scale and correlation with the clinical presentation were analysed. Results Pearson correlation coefficient between patients' satisfaction and clinical presentation was 0.534. Out of 510 (the highest summed score for patients' satisfaction), the total score was 479 (93.9%); out of 187 (the highest summed score for clinical presentation), the total score was 162 (86.6%). Although both scores were high, a lower correlation coefficient and the higher satisfaction score can be explained by more realistic expectations in oncological patients compared to cosmetic ones. Conclusion Hughes flaps provide multiple benefits in the reconstruction of selected patients with large defects, especially when poor wound healing is expected, or when local advancement flaps do not provide tension-free reconstruction. The rate of complications is low and manageable, whereas additional therapy is usually observational or symptomatic.

Correlation between clinical outcomes and patients’ satisfaction using tarsoconjunctival - Hughes flap for the reconstruction of eyelid defects

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;br /&amp;gt;&amp;lt;/strong&amp;gt;To examine and quantify patients&amp;amp;rsquo; satisfaction and correlate with the objective clinical presentation after the treatment and to present a comprehensive literature review on tarsoconjunctival/Hughes flap technique.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;A review of more than 159 peer-review articles and a combined retrospective-prospective two-centres case series of 17&amp;lt;br /&amp;gt;patients who underwent a two-stage modified Hughes flap procedure (2019-2021) to repair a lower eyelid defect caused by epithelial cancer was conducted. All patients were followed up for a minimum of six months. Patient macroscopic evaluation of redness, lid position, retraction, trichiasis, conjunctival overgrowth, tissue inflammation/infection and hypertrophic scarring were obtained, and findings were graded on a scale of 1 to 5 or binary YES/NO&amp;lt;br /&amp;gt;scale. Patients&amp;amp;rsquo; satisfaction using a Likert-type scale and correlation with the clinical presentation were analysed.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;Pearson correlation coefficient between patients&amp;amp;rsquo; satisfaction and clinical presentation was 0.534. Out of 510 (the highest&amp;lt;br /&amp;gt;summed score for patients&amp;amp;rsquo; satisfaction), the total score was 479 (93.9%); out of 187 (the highest summed score for clinical presentation), the total score was 162 (86.6%). Although both scores were high, a lower correlation coefficient and the higher satisfaction score can be explained by more realistic expectations in oncological patients compared to cosmetic ones.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; &amp;lt;br /&amp;gt;Hughes flaps provide multiple benefits in the reconstruction of selected patients with large defects, especially when&amp;lt;br /&amp;gt;poor wound healing is expected, or when local advancement flaps do not provide tension-free reconstruction. The rate of complications is low and manageable, whereas additional therapy is usually observational or symptomatic.&amp;amp;nbsp;&amp;lt;/p&amp;gt;

Simplified technique for lateral canthal tendon canthopexy.

Different techniques for lateral canthal suspension have been used in the management of various eyelid malpositions. We describe a simplified technique for lateral canthal suspension and review its outcome along with a review of existing variations. We conducted a retrospective chart review of 28 eyelids in 22 patients who underwent simplified lateral canthal suspension. Demographics, symptoms at presentation, and associated eyelid malposition were noted. We evaluated the palpebral fissure and margin-reflex distance 2 (MRD2) on the preoperative and final postoperative photographs by using MEEI FACE-gram software. We also reviewed existing literature on different surgical management options for comparison. At three-month postoperative follow-up, presenting symptoms resolved in all cases. The average postoperative decease in palpebral fissure was 0.73 mm (P = 0.018) and the average decrease of the MRD2 was 1.02 mm (P = 0.0003). Recurrence occurred by three months in one eyelid (4%) with ectropion due to moderate eyelid laxity, and this case was managed with tarsal strip procedure. One patient (5%) who had bilateral surgery had asymmetric lower eyelid position and one patient (5%) had persistent edema of the operated eyelid for six months. This simplified canthal suspension is a simple and effective technique that tightens the lateral canthal tendon and improves the lower eyelid position. It can be used in various mild-to-moderate eyelid laxities and has favorable operative characteristics compared with many existing techniques.

Chronic Blepharitis

Blepharitis represents a frequent inflammatory condition of the lids including the lid margin, which can be apparent in adults and children. Chronic blepharitis is therapeutically challenging. According to the anatomic localization, blepharitis can be graded in anterior and posterior forms. Blepharitis can lead to severe symptoms and complications, mainly dry eye disease, corneal complications and defective lid position. The pathogenesis of chronic blepharitis is not fully understood so far, however, multifactorial disease proceedings are supposed, which include systemic diseases (mainly dermatological disorders), habitual bacteria and infections. In all these processes inflammatory changes are the common final path.Therapeutic strategies include topical and systemic therapies, however evidence levels are generally low and patients are often resistant to therapy. Basic therapeutic measures are warm compresses, lid hygiene and lubricants. Topical anti-inflammatory drugs comprise corticosteroids and ciclosporin A. Topical and systemic antibiotics are commonly used. Systemic intake of omega-3 fatty acids is often recommended due to its anti-inflammatory potential.

Estimation of the Prevalence of Uncorrected Refractive Error and Other Ocular Morbid Conditions in School Children of Industrial Area in a Non-metro City in India

PurposeThis study aims to estimate the prevalence of uncorrected refractive error and ocular morbid conditions in school-going children of the Pimpri Chinchwad Municipal Corporation (PCMC) industrial belt.MethodsOcular examination was done in a well-equipped mobile clinic on school premises in the presence of a school teacher using visual acuity (VA) charts, autorefractometer, retinoscope, and handheld slit lamp. For the age group of 5-6 years, Lea symbols and HOTV charts were used, and for the age group of >7 years, Snellen’s chart was used. A detailed anterior segment examination was done to see lid position, the presence of any lid swelling, conjunctival congestion, conjunctival xerosis, corneal opacity, and lens opacity, and findings of previous eye surgery were noted. Spectacle correction was given to these students if they were found to have a significant refractive error.Children requiring intervention other than refractive correction were referred to a tertiary hospital.ResultsA total of 3,054 school children were examined. Most were between the age group of 11-15 years (2,448 (80.2%)), with a mean age of 12.45 ± 2.022 years; 1,470 (48.1%) were male children. A total of 368 (12.04%) children had uncorrected refractive error. Myopia was seen in 204 (6.68%) children, hypermetropia in 16 (0.52%) children, and astigmatism in 148 (4.85%) children. On classification, simple myopic astigmatism (SMA) was found in 73 (2.39%) children, compound myopic astigmatism (CMA) in 38 (1.24%) children, simple hypermetropic astigmatism (SHA) in 13 (0.34%) children, and compound hypermetropic astigmatism (CHA) in 16 (0.52%) children. Moreover, 121 children had ocular morbid conditions. Ocular morbidity with decreased vision was seen in 52 (1.7%) children with preexisting refractive error and 12 (0.39%) with amblyopia, and strabismus was seen in eight (0.26%) children. Five (0.16%) children had lens disorder, and five (0.16%) had no improvement with glasses despite normal anterior segment.ConclusionThere was a high prevalence of uncorrected refractive error. Early detection of uncorrected refractive error and ocular morbidity will improve overall performance in school-going children.

Apraclonidine-An eye opener.

Pharmacological testing with apraclonidine eye drops induces a typical reversal of anisocoria in patients with Horner's syndrome. Moreover, apraclonidine was observed to have an elevating effect on the upper eyelid in Horner's syndrome as well as in healthy subjects, which is thought to be mediated by alpha-1 adrenergic receptors present in the Muller's muscle. We aim to quantitatively investigate the effect of apraclonidine on eyelid position in patients with Horner's syndrome compared to physiological anisocoria based on infrared video recordings from pupillometry. We included 36 patients for analysis who underwent binocular pupillometry before and after apraclonidine 1% testing for the evaluation of anisocoria. Vertical eyelid measurements were taken from infrared videos and averaged from multiple pupillometry cycles. Receiver operating characteristic curves were calculated to determine the optimal cutoff value for change in eyelid aperture pre- and post-apraclonidine. A decrease of inter-eye difference in the aperture of >0.42mm was discriminative of Horner's syndrome compared to physiological anisocoria with a sensitivity of 80% and a specificity of 75%. Our data confirm an eyelid- elevating effect of the apraclonidine test, more pronounced in eyes with a sympathetic denervation deficit. Measuring eyelid aperture on pupillometry recordings may improve the diagnostic accuracy of apraclonidine testing in Horner's syndrome.

Evaluation of Bicanalicular Nasolacrimal Duct Intubation as an Adjunct in Surgical Ectropion Correction.

Background and Objectives: We aimed to analyze and compare the outcomes of conventional ectropion surgery procedures with and without concurrent bicanalicular nasolacrimal duct intubation to identify if the combination of procedures could serve as a novel surgical approach to treat lower eyelid ectropion. Materials and Methods: A retrospective review of all patients who underwent surgical correction for lower eyelid ectropion at the Cantonal Hospital of Aarau between January 2019 and December 2020 was performed. Patient medical records were examined for etiology, surgical correction technique and intra- and postoperative complications. The postoperative punctal position, the pre- and postoperative epiphora and reoperation rate were also documented. Two study groups consisting of cases with isolated and combined procedures were compared, with respect to postoperative punctual and lower lid position. Results: A total of 53 lower eyelids (35 patients) were included in this study. Six months postoperatively, the correct punctum position (p = 0.1188) and improvement of epiphora (p = 0.7739) did not significantly differ between the two groups. More complications were seen in the nasolacrimal duct intubation group (p = 0.0041), which consisted of cheese wiring and one tube dislocation. Conclusion: In our study, bicanalicular nasolacrimal intubation during ectropion surgery does not seem to improve the outcome of ectropion surgery and is, therefore, not recommended on a routine basis.

Changes in Lower Eyelid Positions After Blepharoplasty and Levator Advancement Surgery.

To investigate changes in the upper and lower eyelid positions using information from before and immediately after surgery in patients who underwent upper blepharoplasty and ptosis surgery. We retrospectively reviewed the clinical records of patients who underwent upper blepharoplasty with a diagnosis of dermatochalasis and patients who underwent levator advancement or levator resection with a diagnosis of congenital or aponeurotic ptosis. The marginal reflex distance 1 (MRD1), marginal reflex distance 2 (MRD2), palpebral fissure height (PFH), and operation time were also investigated. In the dermatochalasis group, the preoperative mean MRD1, MRD2, and PFH were 1.94±1.27, 4.71±0.95, and 6.65±1.65mm, respectively. Mean MRD1, MRD2, and PFH values immediately after surgery were 1.80±0.79, 4.22±0.90, and 6.02±1.34mm, respectively. In the ptosis group, the preoperative mean MRD1, MRD2, and PFH values were 0.27±1.34, 5.73±1.13, and 5.99±1.94mm, respectively. Postoperative mean MRD1, MRD2, and PFH were 1.76±1.13, 4.22±1.01, and 5.98±1.60mm, respectively. It is important to remember that MRD2 could decrease during surgery. Therefore, to prevent overcorrection after upper eyelid surgery, MRD1 (not the overall PFH) should be considered to determine the appropriate extent of surgery during the procedure.

Новые возможности неинвазивного лечения инфантильной гемангиомы век у детей

Purpose. Clinical evaluation of effectiveness of transdermal application of Timolol solution 0.25% in treatment of infantile hemangioma (IH) of eyelids in infants. Material and methods. 30 infants (2 to 3 months) with IH of eyelid. In all children, the pathological process of eyelids was unilateral and was characterized by rapid growth. The course of treatment consisted of topical medication on tumor by applying betaadrenergic blocker Timolol maleate 0.25% to hemangioma area. Depending on size of hemangioma and rate of regression, duration of course of treatment varied from 2 to 6 months. Results. All 7 children with small IH of eyelid showed complete regression of the neoplasm after 3–4-month course of treatment, in all patients with medium-sized IH of eyelid – only after 5-month course of treatment. In patients with IH of eyelids large size, recovery occurred only after 6 months of treatment: in 13 children, complete normalization of position of upper eyelid was noted, and only in 3 children, ptosis decreased to functionally harmless 1st degree. Conclusion. Based on the conducted studies, topical applications of Timolol solution 0.25% in infants with IH of eyelid can be considered as safe and effective alternative to oral administration of beta-blockers and other systemically administered drugs – corticosteroids, interferon. It has been established that a non-invasive method of topical treatment of capillary IH of eyelids with a nonselective beta-blocker is clinically justified, easy to perform, administered doses of drug do not cause systemic and local complications and ensure stable tumor regression. The results of study allowed us to standardize the optimal timing of the use of Timolol maleate solution 0.25%, depending on the size of IH: for small sizes – 4 months, for medium sizes – 5 months, for large – at least 6 months. Key words: infantile hemangioma, Timolol, topical medication

Treatment Of Senile Entropion: A Comparison Of Standard And Modified Surgical Technique.

The aim of this study is to compare the postoperative functional outcomes of two different surgical techniques for the correction of senile lower lid entropion. It was a Quasi experimental study, carried out at BHY Hospital, Karachi, Pakistan from January to December 2018. This study recruited fifty patients belonging to either gender with an age range of 60-70 years having unilateral lower lid senile entropion. All the patients were briefed about the study dynamics and divided into two groups with twenty-five patients in each group via convenience-based sampling technique. Those with a prior history of lid surgery or bleeding diathesis were excluded from the study. Patients of group A underwent the standard Weis surgical procedure whereas Group B patients underwent a modified surgical approach using an external tamponade. Main outcome measure was the rectification of abnormal lid position to the normal level. All the patients were followed for a period of six months postoperatively. Study approval was obtained from the institutional ethical review board. This study included a total of fifty patients with twenty-five patients in each group. Mean age was 64.5±3.23 years. Recurrence was observed in 32% patients of group A and 4% patients of group B. The modified surgical technique for entropion repair using an external tamponade has a favourable outcome with minimal recurrence and symptomatic relief.

Evaluation of Eyelid Position and Discharge from Eyes among Patients Admitted In Adult Intensive Care Unit of a Tertiary Care Hospital

Background: Present study was done to evaluate eyelid position and Discharge from eyes among Patients admitted in Adult Intensive Care Unit. Material and Methods: It was a prospective observational study carried in AICU over period of one year by Department of Ophthalmology, Dr. RPGMC Kangra at Tanda. All the patients who were admitted in AICU greater than 48 hours between ages of 18-65 years were included and evaluated for socio-demographic information like age, gender etc. Thorough ophthalmic examination was also done for eyelid position and eye discharge and analyzed using epi info v7 software. Results: A total of 126 patients were included in the study. Mean age of the study participants was 41.8 years. 64.3% of the patients were males while 35.7% were females. 26.2% of the right eyes had grade 3 eyelid positions at 48 hour, 67% at the end of first week, 64% at the end of second week and at the end of fourth and fifth week, none of the right eyes had grade 3 eyelid position. 24.6% of the left eyes had grade 3 eyelid positions at 48 hours 67% At the end of first week, 64% at the end of second week and At the end of fourth and fifth week, none of the left eyes had grade 3 eyelid position. Rate of mucopurulent discharge was 14.2% and 11.9% in right and left eyes respectively at 48 hours. At the end of first week, the rate of mucopurulent discharge was 59.2% in the right eyes and 63% in left eyes. At the end of second week, the rate of mucopurulent discharge was 18.2% and 36.4% in right and left eyes respectively. Three right eyes out of 5 eyes and one left eye out of 5 eyes showed mucopurulent discharge at the end of third week. At the end of fourth and fifth week, none of the eyes showed mucopurulent discharge Conclusion: Eye care which may include lubrication with eye drops, administration of broad-spectrum antibiotics, taping of eye lids and regular examination by ophthalmologists can markedly reduce eye related complications among AICU admitted patients.

Karakteristik Klinis Pasien Ptosis Yang Telah Dilakukan Operasi Di Pusat Mata Nasional Rumah Sakit Mata Cicendo

Introduction Ptosis is a condition of abnormal upper eyelid position in the primary gaze resulting in a decrease palpebral fissure width. Comprehensive assessments including history taking, physical and thorough eye examination are essential to determine the diagnosis and to decide the most appropriate management of ptosis according to the underlying etiology. The surgical intervention used in ptosis patients is based on the result of the physical examination. Purpose To describe the clinical characteristic of ptosis patient whom underwent surgical intervention at National Eye Center Cicendo Eye Hospital. Methods A descriptive retrospective study was conducted from medical records of ptosis patient after surgical intervention at National Eye Center Cicendo Eye Hospital, from January 2018 to December 2020. Results A total of 91 patients were reviewed. The median age was 19 years old, gender dominated by women. Of these patients, 66 (72.5%) patients had congenital ptosis and unilateral in 80 (87.9%) cases. Results obtained severe ptosis was the highest in ptosis degree as for 72 (79.1%). In total, 58 (63.7%) patients having moderate levator function. Levator resection repair technique was the method of choice in 51 (56%) patients. Conclusion The most commonly found clinical characteristics in ptosis patients whom underwent surgical intervention was severe degree ptosis and congenital ptosis.

The changes in lower lid position &amp; laxity post cataract surgery

To evaluate the changes relating to lower lid position and laxity after cataract surgery.This is prospective study evaluating the lower eyelid position of patients who underwent cataract surgery from June to September 2019. Data collected includes duration of the cataract surgery, the duration of the speculum remaining insitu. Also we included measurements relating to the distraction test, distance of the lower lacrimal punctum from the inner canthus, and margin reflex distance 2 (MRD2) were performed 1 day, 2 weeks &amp; 3 months post surgery. The data was analysed in Microsoft Excel &amp; SPSS software. The study sample comprised 109 cataract patients, all of whom were of South Indian ethnicity, 68 (62.3%) were female with a median age of 74 years, and 67 (61.4%) had surgery in their left eye. The distraction test before surgery was 6.5 ± 0.2 mm, with mild increase after 1 day (7.3 ± 0.3 mm), sustained after 14 days (7.5 ± 0.2 mm), and decreasing after 3 months (7.0 ± 0.5 mm) to a level similar to the initial values (P = 0.02). The lower (lacrimal) lid punctum distance from the inner canthus preoperatively was 6.5 ± 0.3 mm and 7.4 ± 0.2 on day 1 post operatively, 7.2 ± 0.3 two weeks post operatively, 7.0 ± 0.4 mm at 3 months postoperatively (P = 0.04) [Table 1]. The MRD2 preoperatively was 5.0 ± 0.1 mm, 5.4 ± 0.1 mm at 1 days postoperatively, 5.2 ± 0.2 mm at 2 weeks, and 5.4 ± 0.3 mm at 3 months after surgery (P = 0.02). : An increase in lower lid laxity was noted on distraction test &amp; lacrimal lower punctum distance post cataract surgery. Although such a change is expected in the common cataract surgery age group, there seems to be a definite increment noted in the post surgery group.

Reconstruction of full thickness lower eyelid defects using a lateral advancement flap with Z-plasty and periosteal strip

ABSTRACT Purpose To describe a single stage technique of reconstruction of full thickness lower eyelid defects using a lateral advancement flap and Z-plasty combined with a lateral periosteal strip. Methods A retrospective case series of six patients who underwent reconstruction using this technique is presented documenting surgical technique, clinical photographs and postoperative outcomes. Results All six patients demonstrated good eyelid position and cosmesis following reconstruction. Conclusion A lateral advancement flap with Z-plasty combined with a periosteal strip is an effective technique to close lower eyelid defects of up to eighty percent of eyelid width, providing a good structural and aesthetic outcome.