Diverticulum ; diagnosis ; Eyelids ; pathology ; Fistula ; diagnosis ; Humans ; Infant ; Male

Blepharoptosis following pterigium excision is a rare complication, and there is no published report on its etiology, incidence, and surgical pathology. We report 4 cases of persistant blepharoptosis following pterigium surgery. The main clinical features are high or absent upper lid crease, thinning of ptotic eyelid above tarsal plate, good levator function, 2-3mm of ptosis degree, abnormal drooping of upper eyelid at downward gaze, and deepening of the upper sulcus. They have a specific anatomic defect in the aponeurosis of levator palpebrae superioris(LPS) muscle. It has been assumed that eyelid speculum leads to injury of upper border of tarsal plate and disinsertion of aponeurosis of LPS muscle in the patient who had vulnerable aponeurosis of LPS muscle during surgery. Disinsertion of aponeurosis of LPS muscle from its epitarsal attachment was discovered during blepharotosis surgery and it was repaired anatomically to correct the blepharoptosis.
Blepharoptosis* ; Eyelids* ; Humans ; Incidence ; Pathology, Surgical ; Pterygium* ; Surgical Instruments*

PURPOSE: To assess the occurrence and characteristics of benign eyelid and conjunctival tumors. METHODS: We histopathologically analyzed 80 consecutive cases of benign eyelid (56 cases) and conjunctival (24 cases) tumors between April 2000 and November 2002. All eyelid and conjunctival tumors were confirmed histopathologically. Age, sexual distribution, occurrence and location were analyzed. RESULTS: The mean ages were 42.32+/-16.27 SD in benign eyelid tumors, and 29.71+/-18.60 SD in benign conjunctival tumors. The sexual distribution revealed 23 males and 33 females in benign eyelid tumors, and 12 males and 12 females in benign conjunctival tumors. About the location, lower lid was most frequent site of benign eyelid tumors, responsible for 27 (48.2%) of the 56 cases, and medial conjunctiva was the most frequent site of benign conjunctival tumors, responsible for 14 (58.3%) of 24 cases. Shave biopsy was performed in eyelid margin tumors. Excisional biopsy was performed in other eyelid tumors and conjunctival tumors. The frequency of benign eyelid tumors was noted in this order: intradermal nevi 25 cases (44.6%), seborrheic keratoses 9 cases (16.1%), and compound nevi 6 cases (10.7%), and frequency of benign conjunctival tumors was noted in this order: compound nevi 7 cases (29.2%), and intradermal nevi 6 cases (25.0%). CONCLUSIONS: From the Results of this study, we hope that this report provides a basic source for diagnosis and therapy of the benign eyelid and conjunctival tumors.
Biopsy ; Conjunctiva ; Diagnosis ; Eyelids* ; Female ; Hope ; Humans ; Keratosis, Seborrheic ; Male ; Nevus ; Nevus, Intradermal ; Pathology

Cutaneous horn is a morphologic designation for a projectile, conical, dense hyperkeratotic nodule that resembles the horn of an animal. The lesion varies in size from only a few millimeters to several centimeters, in color(white or yellowish) and in form (straight, curved, or twisted). It arises from a wide range of epidermal lesions, which include benign lesions, premalignant lesions and malignant lesions. An 83-year-old women came to our clinic with a giant cutaneous horn on the right chin and a small horn on the left upper eyelid. The patient had no palpable cervical lymph node. A wide elliptical skin incision was made and the horn was totally excised. In pathology, the giant cutaneous horn on the right chin revealed a moderately differentiated squamous cell carcinoma with subcutis invasion at its base. "Giant cutaneous horns" have often been associated with invasive squamous cell carcinoma. Cutaneous horns are common lesions usually found on the face, rarely larger than 2cm. As large cutaneous horns are often associated with underlying malignancy, histopathologic examination of the base of the lesion is necessary to rule out carcinoma and full excision is recommended.
Aged, 80 and over ; Animals ; Carcinoma, Squamous Cell* ; Chin ; Eyelids ; Female ; Horns* ; Humans ; Lymph Nodes ; Pathology ; Skin

Child ; Cranial Nerves ; pathology ; Eyelids ; Female ; Humans ; Male ; Ophthalmoplegia ; etiology ; Polyradiculopathy ; complications

We report two patients with unilateral vertical retraction syndrome. Magnetic resonance imaging (MRI) of the orbits of the two cases showed similar size and location of the orbital structure, but with dramatically different strabismus type. MRI sagittal reconstruction of the orbits suggested that abnormal muscle tissue arised from the inferior rectus, which might be associated with retraction and narrowing of the palpebral fissure and atypical strabismus as well.
Child ; Eyelids ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Oculomotor Muscles ; physiopathology ; Orbit ; pathology ; Strabismus ; pathology ; Syndrome

BACKGROUNDBlepharophimosis ptosis epicanthus inversus syndrome (BPES) is a rare congenital ophthalmic disorder, characterized by congenital eyelid malformation including bilateral ptosis, shortening of the horizontal eyelid fissure, epicanthus inversus, and increased distance between the inner canthi. In this research, we studied the histological structure and ultrastructure of medial canthal ligament of patients with BPES.

METHODSThirty patients with BPES who received plastic surgery at the Zhongshan Ophthalmic Center from March 2006 to January 2008 were studied. There were 17 males and 13 females with an average age of (8.73 +/- 3.37) years (3 - 31 years). The medial canthal ligaments of patients were collected during the plastic surgery to analyze the histological structure by hematoxylin and eosin (HE), Congo red, van Gieson's (VG), Masson trichrome and aldehyde-fuchsin staining. The ultrastructures of the medial canthal ligaments were also analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Fifteen samples of medial canthal ligament from healthy persons with an average age of (9.02 +/- 3.12) years (6 - 30 years) were collected as a control group.

RESULTSMorphological and histological study showed that the medial canthal ligaments of BPES patients were composed of collagen fibers, a few elastic fibers and striated muscles. The collagen fibers assemblies were disorganized and the fibrous connective tissues were undergoing hyaline degeneration. The karyopycnosis of fibroblasts was located among the collagen fibrils and the numbers of fibroblasts were decreased. Ultrastructural study with SEM showed that the collagen fibers were larger than normal, irregular and loose. Parts of the collagen fibers were broken and had a coarse surface. Ultrastructural study with TEM showed that the fibroblasts had less cytoplasm, fewer organelles and the nucleus displayed pyknosis.

CONCLUSIONSThe medial canthal ligament in BPES patients is composed chiefly of collagen fibers. The collagen fibers of medial canthal ligaments in BPES patients are disorganized and hyaline degeneration is present. The study revealed that the medial canthal ligament of BPES patients might have congenital dysplasia.

Adolescent ; Adult ; Blepharophimosis ; genetics ; pathology ; Blepharoptosis ; genetics ; pathology ; Child ; Child, Preschool ; Eyelids ; abnormalities ; pathology ; ultrastructure ; Female ; Humans ; Male ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Syndrome

PURPOSE: A rapid, portable, and noninvasive means of detecting increased intracranial pressure (IICP) is desirable when conventional imaging methods are unavailable. The purpose of this study was to show that ultrasonographic measurement of the optic nerve sheath diameter (ONSD) can accurately predict the presence of IICP. METHODS: We performed a prospective study of emergency department patients suspected of having IICP due to possible focal intracranial pathology. The ONSD was measured 3 mm behind the globe using a linear probe on the closed eyelids of supine patients. For each patient, the mean of the two ONSD measurements was calculated, and the brain computed tomography (CT) was evaluated for signs of IICP. RESULTS: One hundred patients were enrolled; 31 had CT results consistent with IICP, and their mean ONSD was 6.30 mm; the mean ONSD of patients who didn't show signs of IICP on CT was 4.50 mm. The sensitivity and the specificity for the ONSD, when compared with CT results, were 100% and 98.6%, respectively. CONCLUSIONS: The evaluation of the ONSD is a simple noninvasive procedure, and is a potentially useful tool in assessing and monitoring patients suspected of having IICP.
Brain ; Emergencies* ; Emergency Service, Hospital ; Eyelids ; Humans ; Intracranial Pressure* ; Optic Nerve* ; Pathology ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography*

Epiblepharon is a commonly encountered congenital anomaly in Asian infants and children. It causes symptoms of ocular irritation and inferior punctate corneal epithelial erosion. Surgical correction may be needed if ocular irritation symptom and corneal pathology persist with age. A series of 185 lower eyelid epiblepharon in 98 Korean children underwent lower eyelid crease reforming technique. Surgical treatment included excision of redundant skin and pretarsal orbicularis muscle with lid everting suture by anastomosis of the subcutaneous tissue and inferior tarsal border including capsulopalpebral fascia. With a minimum follow-up of 12 months, a total of 37 [20%]eyelids developed recurrence of cilia touch, and then 9 [4.8%]eye-lids needed further surgery.
Asian Continental Ancestry Group ; Child ; Cilia ; Eyelids* ; Fascia ; Follow-Up Studies ; Humans ; Infant ; Pathology ; Recurrence ; Skin ; Subcutaneous Tissue ; Sutures

OBJECTIVETo compare the clinical effect of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions. Methods: From Jul. 2010 to May 2012, 268 cases (Group A) received double eyelid blepharoplasty with central minimal incision, while 102 cases (Group B) underwent double eyelid blepharoplasty with three minimal incisions. Photos were taken immediately, and 1,2, 4, 8,12 weeks after operation. Operation time, recovery time and postoperative complications were evaluated and recorded. The operation time and recovery time were analyzed by Wilcoxon rank sum test. The postoperative complications were analyzed by chi square test. The satisfactory degree was analyzed by t test.

RESULTSThe operation time in Group A was (25.63 ± 3.74) min, compared with that (29.90 ± 4.13) min in Group B (Z = -8.011, P <0.01). Meanwhile, the recovery time in Group A was shorter than that in Group B (Z = -15.887, P <0.01). The occurrence rate of postoperative complications,including hematoma,recurrence and scar hyperplasia in Group A was also lower than that in Group B. At the same time, the satisfactory degree in Group A was(97.302 ± 1.764), which was higher than that(88.628 10.880) in Group B (t = 12.650, P <0.05).

CONCLUSIONSThe double eyelid blepharoplasty with central minimal incision, which is suitable for all cases except those who has serious blepharochalsais, has more advantages than double eyelid blepharoplasty with three minimal incisions.

Blepharoplasty ; adverse effects ; methods ; Cicatrix ; pathology ; Eyelids ; surgery ; Hematoma ; Humans ; Hyperplasia ; Photography ; Postoperative Complications ; Prospective Studies ; Recurrence