Blepharophimosis ptosis epicanthus inversus (BPES) is a relatively rare congenital disorder, which usually presents with classical eye manifestations. In some cases, it is associated with premature ovarian failure (POF). BPES is of two types, type I and type II. Type I is associated with POF along with eyelid malformations, while Type 2 has only eyelid malformations. Here, we report a family of BPES, in whom two sisters presented with secondary amenorrhea. On eye examination, they have blepharophimosis, ptosis, epicanthus inversus and telecanthus. Investigations revealed hypergonadotropic hypogonadism. Their father also has similar eye manifestations. Diagnosis of BPES type I was made and both were started on hormone replacement therapy. To make timely diagnosis of BPES, every patient with POF should specifically be checked for eye manifestations.
Blepharophimosis, Ptosis, and Epicanthus Inversus ; Blepharophimosis

Cranial nerve (CN) III palsy is rarely caused by intraorbital compression, let alone from a subgaleal abscess. We present a case of a hypertensive 55-year-old man with an acute isolated pupillary-sparing left CN III palsy from a left subgaleal abscess with associated pterional osteomyelitis and frontotemporal mass. This is the first reported such case and the third reported case of a chronic spontaneous subgaleal abscess. A seemingly routine case of an acute, pupillary-sparing, isolated CN III palsy from hypertension turned out to be a rare case in terms of etiology of the palsy and of the source of the abscess.
Cranial Nerve III ; palsy ; ptosis ; ophthalmoplegia

To evaluate the efficacy of hochuekkito on genital prolapse, 37 patients with genital prolapse or descending organs were studied. Hochuekkito (7.5g/day) was administered to all patients without confirming their Sho. Change of subjective symptoms, consequence of disease, relation between efficacy and grade of prolapse, and adverse effects were evaluated. The mean age of patients was 68.7 years. The mean number of parities was 2.5. No patient was nulliparious, or had over 5 parities. Total efficacy rate for subjective symptoms was 48.9%. The treatment was also effective for those who had suffered from vaginal prolapse after total hysterectomy. At endpoint, six of 37 patients continued taking hochuekkito. Six of 37 patients stopped taking Kampo after all their symptoms had disappeared. Ten of 37 patients received surgery. Nine of 37 patients were set with ring pessaries. Five of 37 patients discontinued their drugs beyond endpoint of their own accord. Adverse events were observed in only one patient. Hochuekkito was considered a useful Kampo drug for those who are suffering from genital prolapse, and do not want to be set with ring pessaries or receive surgery.
Ptosis ; symptoms <1> ; Medicine, Kampo ; Genital ; Surgical aspects