Severe Upper and Lower Tarsal Ectropion with Immunoglobulin G4-related Ophthalmic Disease
10.3341/jkos.2020.61.8.944
- Author:
Jun Ho OH
1
;
Byeong Jae SON
Author Information
1. Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
- Publication Type:Case Report
- From:Journal of the Korean Ophthalmological Society
2020;61(8):944-949
- CountryRepublic of Korea
-
Abstract:
Purpose:To present the first case of severe upper and lower tarsal ectropion associated with immunoglobulin G4 (IgG4)-relatedophthalmic disease.Case summary: A 37-year-old male presented with relapsed eyelid swelling and periocular inflammation in the left eye for7 years. He had severe upper and lower tarsal ectropion and a thickened upper eyelid with prolapsed conjunctival fornix. Orbitalcomputed tomography showed a poorly defined anterior orbital mass involving the lacrimal gland and upper and lower eyelids onthe left eye. The severe upper and lower eyelid ectropion was corrected by a modified spindle procedure and lateral tarsal strip.Hard, ill-defined fibrotic tissue and a mass around the lateral upper tarsal plate were discovered that required excision of themass and a biopsy. Hematologic and histopathologic findings of the orbital mass indicated IgG4-related ophthalmic disease withsevere upper and lower ectropion caused by the disease.
Conclusions:In cases of severe upper and lower eyelid ectropion caused by chronic inflammation, as seen in this case, not onlyeyelid tightening with excision of the causative mass but also a modified spindle procedure is required to prevent rotation of theeyelid.
