A 41-year-old man visited our clinic complaining of esodeviation of the right eye. He had been operated on for corneal laceration 3 years before. One month later, exodeviation of the right eye had developed. The result of computed tomography (CT) was reported as orbital abscess and cellulitis. Although antibiotic treatment was administered for 2 weeks, the exodeviation didn't improve. On ocular examinations performed in our hospital in November-2001, his right eye was esotropic and had a relative afferent pupillary defect. Vision of the right eye was decreased to 0.02. Fundus examination showed optic atrophy. A new CT scan disclosed a foreign body introduced into the right medial orbital wall, nasal cavity and ethmoidal sinus. Although foreign body was surgically removed, vision and eye movement were not improved. In the case of a patient who has undergone orbital trauma, complete history taking and physical examinations must be performed. On suspicion of a foreign body, imaging study such as CT or MRI must be performed. However, because CT findings can be variable, careful follow-up is needed.
Adult ; Eye Foreign Bodies/*radiography/surgery ; Eye Injuries, Penetrating/*radiography/surgery ; Human ; Male ; Ophthalmologic Surgical Procedures ; Orbit/*injuries/radiography ; Tomography, X-Ray Computed ; *Wood

PURPOSE: We report a simple and effective method of identifying the medial cut end of lower canalicular laceration cases. METHODS: Twenty-seven eyes with lower canalicular lacerations as a result of trauma were involved in the study. Surgery was performed within 48 hours after injury for canalicular reconstruction. Upper canalicular probing was utilized to identify the medial cut end of deep canalicular lacerations when difficulties were encountered. Total time from the initiation of the probing procedure to the identification of the medial cut end of the lower canaliculus was measured. RESULTS: A total of 27 eyes with lower canalicular lacerations were reconstructed. In 20 eyes, the medial lacerated end was located by upper canalicular probing. The mean time from initiation of the probing procedure to identification of the medial cut end of the lacerated canaliculus was 2 minutes. CONCLUSIONS: We conclude that upper canalicular probing in patients with lower canalicular lacerations significantly reduces the time from the initiation of the operation to the identification of the medial cut end of the lower canaliculus.
Adolescent ; Adult ; Aged ; Child ; Diagnostic Techniques, Ophthalmological ; Eye Injuries/*radiography/surgery ; Eyelids/*injuries ; Female ; Humans ; Intubation/methods ; Lacerations/*radiography/surgery ; Lacrimal Apparatus/*injuries/radiography/surgery ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; Time Factors

We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-year-old man (Case 4) presented with left upper eyelid retraction that developed 1 month after a lower canalicular laceration was sustained during a traffic accident. The authors performed a thyroid function test and orbital computed tomography (CT) in all cases. Thyroid function was normal in all patients, CT showed an adhesion of the superior rectus muscle and superior oblique muscle in the first case and diffuse thickening of the superior rectus muscle and levator complex in the third case. CT showed no specific findings in the second or fourth cases. Upper eyelid retraction due to superior complex adhesion can be considered one of the complications of periorbital trauma.
Accidents, Traffic ; Adult ; Eye Injuries/*complications/surgery ; Eyelid Diseases/*etiology/radiography ; Female ; Humans ; Lacerations/complications/surgery ; Lacrimal Apparatus/*injuries ; Male ; Middle Aged ; Oculomotor Muscles ; Orbital Fractures/*complications/surgery ; Tomography, X-Ray Computed