Kissing naevus arising from neural crest cells presenting as upper and the lower lid mass

ABSTRACTA kissing nevus is a type of congenital compound nevus that affects equal portions of the upper and lower eyelid, and it extends to the lid margins. Congenital divided nevi of the eyelids are a rare melanocytic lesion. Only 30 patients are reported in the literature. We report a 40-year-old female of rural background who presented with a large painless enlarging pigmented mass, involving both upper and lower left eyelid since the past 20 years. Complete excision of the lesion was done, and the mass sent for histopathology, which revealed a compound nevus involving both lids. Surgery removed the obstruction, which had caused decreased visual acuity and had altered the cosmetic appearance of the patient. Lesions on the upper lid cause a mechanical ptosis, covers the visual axis, which causes obstruction in vision and is cosmetically unacceptable. There is a definite risk of malignant change in the nevus giving rise to malignant melanoma, and hence they should be removed as early as possible to give better functional and cosmetic results.

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Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty

International Journal of Ophthalmology ◽

10.18240/ijo.2021.02.06 ◽

2021 ◽

Vol 14 (2) ◽

pp. 217-222

Author(s):

Shou-Long Hu ◽

◽

Ting Su ◽

Qian-Min Ge ◽

Qiu-Yu Li ◽

...

Keyword(s):

Visual Acuity ◽

Lower Eyelid ◽

Chinese Children ◽

Corrected Visual Acuity ◽

Subjective Satisfaction ◽

Upper Lid ◽

The Difference ◽

Change In Mean ◽

Dog Ears

AIM: To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children. METHODS: From 2016 to 2018, 18 children (10 males and 8 females, average age 6.2±1.7y; 30 eyes) with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study. All the children had undergone lower eyelid surgery for epiblepharon. Surgical design included using an additional incision along the upper palpebral margin, to avoid vertical scarring on the upper lid. The re-draping method was used to correct recurrent epiblepharon. Follow-up ranged from 3 to 24mo. Postoperative surgical outcomes, complications, and subjective satisfaction were evaluated. RESULTS: Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1mo. No “dog ears” or obvious scars were formed after surgery. All parents were satisfied with the cosmetic results and none complained. Mean astigmatism decreased from 2.39±0.79 diopter (D) preoperatively to 2.19±0.79 D at 6mo after surgery; however, the difference was not significant. Best-corrected visual acuity improved, although the change in mean visual acuity was not significant. No recurrence occurred during the follow-up period. CONCLUSION: This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon. The approach is characterized by a simple design, a straightforward procedure, inconspicuous scarring, and good postoperative appearance.

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Ophthalmologic evaluation in vitamin-E deficiency: A case report

European Journal of Ophthalmology ◽

10.1177/1120672120970112 ◽

2020 ◽

pp. 112067212097011

Author(s):

Daniele Sindaco ◽

Francesca Cappelli ◽

Aldo Vagge ◽

Carlo E Traverso ◽

Michele Iester

Keyword(s):

Visual Acuity ◽

Vitamin A ◽

Lower Limb ◽

Signs And Symptoms ◽

Malabsorption Syndrome ◽

Vitamin Supplementation ◽

Past Medical History ◽

Oral Vitamin ◽

Vitamin E Deficiency ◽

The Past

A 41-year-old woman has come to our attention complaining of decreased visual acuity and monocular diplopia associated with upper and lower limb hypoesthesia. Malabsorption syndrome with vitamin A and E deficiency developed after a bariatric biliopancreatic diversion. The clinical ophthalmological signs and symptoms improved after oral vitamin supplementation therapy. The past medical history is essential in the case of a patient complaining of visual symptoms compatible with vitamin deficiency in order to detect the cause and to start a prompt therapy to avoid irreversible neurological and visual sequelae. The clinical features of our case closely resemble other cases described in the literature of patients affected by vitamin A and E deficiency secondary to malabsorption syndrome.

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The Use of Fascia Lata Free Graft for Lateral Canthus Reconstruction Following Mohs Lower Lid Surgery

Surgeries ◽

10.3390/surgeries1020009 ◽

2020 ◽

Vol 1 (2) ◽

pp. 77-81

Author(s):

Rafal Nowak

Keyword(s):

Lower Eyelid ◽

Advancement Flap ◽

Fascia Lata ◽

Free Graft ◽

Periosteal Flap ◽

Lateral Canthus ◽

Fascia Lata Graft ◽

Free Skin Graft ◽

Upper Lid ◽

Lid Surgery

We present a case of a 75-year-old patient who underwent reconstruction of the lower eyelid and lateral canthus following removal of 80% of the lower eyelid due to basal cell carcinoma. A Hughes transconjunctival eyelid-sharing flap was used to form the posterior lamella, and a free skin graft from the ipsilateral upper lid was used to recreate the anterior lamella. The lateral canthal ligament was reconstructed using a free fascia lata graft. A periosteal flap was not used due to local scarring that was the result of previous multiple lateral canthal surgeries. Skin preservation in the lateral canthal area and additional horizontal support for the lower eyelid were achieved by using a local advancement flap. This two-stage surgery produced excellent functional and cosmetic effects. Fascia lata free graft can be an alternative to the periosteal flap for reconstruction of the lateral canthal ligament when use of the lateral orbital periosteum is not feasible.

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Surgical Management of the Paralyzed Eyelid

Ear Nose & Throat Journal ◽

10.1177/014556139307201008 ◽

1993 ◽

Vol 72 (10) ◽

pp. 692-701 ◽

Cited By ~ 12

Author(s):

Monte S. Keen ◽

John D. Burgoyne ◽

Scott L. Kay

Keyword(s):

Critical Analysis ◽

Lower Eyelid ◽

Facial Nerve Paralysis ◽

Upper Eyelid ◽

Nerve Paralysis ◽

Eyelid Closure ◽

Corneal Abrasion ◽

Tarsal Plate ◽

Analysis Of Results ◽

Upper Lid

The most devastating sequelae of the facial nerve paralysis is the loss of eye lid function. The inability to blink, lubricate and protect the globe can lead to exposure keratitis, corneal abrasion and even the loss of vision. Eyelid closure is approximately 85% upper eyelid and 15% lower eyelid. In order to ensure adequate protection of the globe, deficiencies of both eyelids must be addressed. We report our experience with 20 patients with eyelid paralysis. Upper lid reanimation was performed by the placement of gold lid weights on the tarsal plate. Lower lid reanimation procedures included lateral canthopexy and horizontal lid shortening. A discussion of the above-mentioned procedures, the timing of the procedures and a critical analysis of results will be included. A comprehensive approach to the management of the paralyzed eye will be presented.

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Achondroplasia Associated with Bilateral Keratoconus

Case Reports in Ophthalmological Medicine ◽

10.1155/2012/573045 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ammar M. Al Mahmood ◽

Hind M. Al Katan ◽

Ghada Y. Al Bin Ali ◽

Samar A. Al-Swailem

Keyword(s):

Visual Acuity ◽

Rare Case ◽

Penetrating Keratoplasty ◽

Slit Lamp ◽

Poor Vision ◽

The Past ◽

Uncorrected Visual Acuity ◽

Hard Contact ◽

Slit Lamp Biomicroscopy ◽

Contact Lens Fitting

We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating keratoplasty (PKP) in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA) was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

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The role of insulin-like growth factor-II mRNA-binding protein 3, cyclooxygenase-2, and galectin-3 in differentiating malignant melanoma from benign melanocytic lesion

Journal of the Egyptian Womenʼs Dermatologic Society ◽

10.1097/01.ewx.0000466247.39861.4a ◽

2015 ◽

Vol 12 (3) ◽

pp. 203-211

Author(s):

Rania A. El-Tatawy ◽

Safinaz H. El-Shorbagy

Keyword(s):

Growth Factor ◽

Malignant Melanoma ◽

Binding Protein ◽

Melanocytic Lesion ◽

Insulin Like Growth Factor ◽

Factor Ii ◽

Mrna Binding Protein ◽

Galectin 3 ◽

Mrna Binding

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Squamous Papilloma over Lid Margin: An Uncommon Presentation

International Journal of Advanced and Integrated Medical Sciences ◽

10.5005/jp-journals-10050-10044 ◽

2016 ◽

Vol 1 (3) ◽

pp. 128-130

Author(s):

Pranav Gupta ◽

Etti Goyal ◽

A Dokania ◽

Y Rizvi

Keyword(s):

Histopathological Examination ◽

Cosmetic Result ◽

Complete Excision ◽

Squamous Papilloma ◽

Uncommon Presentation ◽

Body Sensation ◽

Stratified Squamous Epithelium ◽

Upper Lid ◽

Schiøtz Tonometry

ABSTRACT Papilloma is a histopathological term describing tumors of a classical finger-like or cauliflower morphology. Though benign, they carry profound malignancy potential and can present at numerous anatomical locations, such as skin, cervix, esophagus, respiratory tract, breast duct, etc. Papillomas over conjunctiva are not frequently encountered and carry special significance. A 60-year-old diabetic female presented with a left upper lid marginal sessile mass of 9 months duration with mild epiphora and foreign body sensation. On examination, a solitary, fleshy, sessile, polypoidal mass measuring 1 × 1 cm was seen, with irregular cauliflower-like surface present over lateral aspect of left upper lid, firm in consistency with raised edges. Visual acuity in right eye was 6/18→6/9 and left eye 6/36→6/9, intraocular pressure (IOP) was 14.6 mm Hg in both eyes by Schiotz tonometry. Complete excision of the lesion employing microsurgical technique with close apposition of lid margin using 6-0 Vicryl sutures was done under local anesthesia (LA). Histopathological examination revealed stratified squamous epithelium forming papillae with variable goblet cells supported by prominent branching fibrovascular cores in the center. A satisfactory cosmetic result was achieved. Follow-up of 6 months did not reveal any recurrence. A satisfactory functional and cosmetic result achieved. Squamous papillomas over lid margin are uncommon presentations. Even though benign they carry morbidity potential in the form of chronic epiphora, corneal erosions, and lid deformities if inadequately managed. How to cite this article Goyal E, Gupta P, Dokania A, Rizvi Y. Squamous Papilloma over Lid Margin: An Uncommon Presentation. Int J Adv Integ Med Sci 2016;1(3):128-130.

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Surgical management of pterygium in a rural hospital using bare sclera versus conjunctival autograft technique

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171845 ◽

2017 ◽

Vol 5 (5) ◽

pp. 2076

Author(s):

Dinesh P. ◽

Sundip Shenoy ◽

Nidhi Pandey ◽

Pavan Kumar Reddy D.

Keyword(s):

Visual Acuity ◽

Connective Tissue ◽

Medical Sciences ◽

Visual Axis ◽

Recurrence Rates ◽

Conjunctival Autograft ◽

Corrected Visual Acuity ◽

Department Of Ophthalmology ◽

Best Corrected Visual Acuity ◽

Conjunctival Autografting

Background: Pterygium is defined as a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over limbus onto the cornea. Commonly seen among farmers, fishermen, stone cutters and welders. Both blue and ultraviolet light have been implicated in its causation. Histologically the true Pterygium shows elastotic degeneration of the subconjunctival connective tissue. Pterygium warrant treatment when they encroach the visual axis, induces significant astigmatism or become cosmetically bothersome. My present study was undertaken to evaluate the efficacy, safety and recurrence rates of conjunctival autograft and bare sclera techniques in treatment of progressive true pterygium in a rural hospital.Methods: The prospective study was done in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Mandya District, Karnataka, India. The study was conducted for a period of 18 months. About 70 patients who presented with progressive pterygium were included in the study.Results: In our study pterygium recurred in 10 cases (14.28%), among which pterygium recurred in 8 cases (22.85 %) using bare sclera technique and in 2 patients (5.71%) using conjunctival autograft technique, best corrected visual acuity remained stable in 37 cases (52.85 %), improved in 33 cases (47.14 %) and worsened in none (0%) of the cases.Conclusions: Conjunctival autografting is a safe and effective procedure in the management of pterygium. The recurrence rate following limbal conjunctival autografting is significantly lower than that following primary conjunctival closure by bare sclera technique.

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Cultivated Oral Mucosa Epithelium in Ocular Surface Reconstruction in Aniridia Patients

BioMed Research International ◽

10.1155/2015/281870 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 22

Author(s):

Dariusz Dobrowolski ◽

Boguslawa Orzechowska-Wylegala ◽

Bogumil Wowra ◽

Ewa Wroblewska-Czajka ◽

Maria Grolik ◽

...

Keyword(s):

Visual Acuity ◽

Oral Mucosa ◽

Amniotic Membrane ◽

Single Cells ◽

Autologous Transplantation ◽

Visual Axis ◽

Corneal Surface ◽

Ocular Surface Reconstruction ◽

3T3 Fibroblasts ◽

Mucosa Epithelium

Purpose. Efficacy of cultivated oral mucosa epithelial transplantation (COMET) procedure in corneal epithelium restoration of aniridia patients.Methods. Study subjects were aniridia patients (13 patients; 17 eyes) with irregular, vascular conjunctival pannus involving visual axis who underwent autologous transplantation of cultivated epithelium. For the procedure oral mucosa epithelial cells were obtained from buccal mucosa with further enzymatic treatment. Suspension of single cells was seeded on previously prepared denuded amniotic membrane. Cultures were carried on culture dishes inserts in the presence of the inactivated with Mitomycin C monolayer of 3T3 fibroblasts. Cultures were carried for seven days. Stratified oral mucosa epithelium with its amniotic membrane carrier was transplanted on the surgically denuded corneal surface of aniridia patients with total or subtotal limbal stem cell deficiency.Outcome Measures. Corneal surface, epithelial regularity, and visual acuity improvement were evaluated.Results. At the end of the observation period, 76.4% of the eyes had regular transparent epithelium and 23.5% had developed epithelial defects or central corneal haze; in 88.2% of cases visual acuity had increased. VA range was from HM 0.05 before the surgery to HM up to 0.1 after surgery.Conclusion. Application of cultivated oral mucosa epithelium restores regular epithelium on the corneal surface with moderate improvement in quality of vision.

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