Cases reported "Eyelid Diseases"

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1/6. melkersson-rosenthal syndrome: new clinicopathologic findings in 4 cases.

    OBJECTIVE: To define the clinicopathologic features of eyelid involvement in melkersson-rosenthal syndrome (MRS). methods: Four patients with eyelid edema consistent with MRS were evaluated clinically, including diagnostic imaging in 2 patients. Eyelid tissue from these patients was examined by light microscopy and immunohistochemistry. polymerase chain reaction for herpes simplex virus was performed in 1 case. RESULTS: The 3 men and 1 woman ranged in age from 33 to 74 years. All patients had insidious, painless, nonpitting eyelid edema. Three patients had unilateral edema; one had bilateral, asymmetric involvement. Ipsilateral lip edema was present in 1 case. Computed tomography demonstrated periorbital heterogeneous thickening that corresponded to the microscopic finding of scattered granulomas. All 4 patients demonstrated epithelioid granulomas inside and adjacent to dilated lymphatic vessels. polymerase chain reaction testing was negative for herpes simplex virus. CONCLUSIONS: Isolated eyelid swelling that mimics thyroid-associated ophthalmopathy may occur in MRS. Computed tomography may be useful in the diagnosis. biopsy should be performed in all cases of unexplained nonpitting eyelid edema. In the eyelid, MRS is characterized histopathologically by a granulomatous lymphangitis, a finding that seems to be unique to this condition.
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ranking = 1
keywords = ophthalmopathy
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2/6. Paracentral corneal dellen: a rare sign of graves ophthalmopathy.

    PURPOSE: To report a rare sign, paracentral corneal dellen that developed in a middle-aged female patient with graves ophthalmopathy. methods: A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The graves ophthalmopathy was classified as Grade IV according to NOSPECS classification. RESULTS: Local artificial tear film and 0.3% tobramycin eye drops were administered to both eyes. Twenty-four hours later, the left corneal dellen disappeared. CONCLUSIONS: graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure.
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ranking = 8
keywords = ophthalmopathy
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3/6. Upper eyelid retraction from inferior rectus restriction in dysthyroid orbit disease.

    Findings from orbital computed tomography scans have shown inflammatory enlargement of the levator palpebralis superioris complex to be a likely cause of eyelid retraction in dysthyroid (Graves's) ophthalmopathy. We have studied a subgroup of nine dysthyroid patients in whom the eyelid retraction occurs as a relative malposition of the globe and eyelid due to inferior rectus restriction. Our explanation of this phenomenon in nine patients is based on Hering's law. Increased innervation required for a fixating superior rectus muscle to overcome a severely restricted inferior rectus muscle causes an unrestricted levator muscle to open the eyelid abnormally wide relative to the globe. The retraction is best demonstrated with fixation of the involved eye. We have performed inferior rectus recession to correct this type of eyelid retraction in three of our patients.
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ranking = 1
keywords = ophthalmopathy
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4/6. Severe ocular injuries from orthodontic headgear.

    Dislocation of extraoral orthodontic tractional devices (headgear) resulted in penetrating ocular injuries in three eyes of two patients. An endophthalmitis caused by mixed flora developed in each injured eye. Despite medical and surgical therapy, only one eye retained useful vision two years following injury. All wearers of headgear and their families should be educated in the proper use of these devices and about the potential for severe facial injuries. Penetrating ocular injuries initially may be relatively asymptomatic. Thus, even persons with seemingly minor injuries from such devices should seek immediate and thorough ophthalmic evaluation. In eyes with penetrating injuries, culture of intraocular fluids should be performed at the time of initial repair. Because the penetrating device is heavily contaminated with oral flora, broad-spectrum antibiotics should be administered by intravenous, subconjunctival, and intravitreal injection. Such injuries, although rare, may have a grave prognosis.
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ranking = 0.0012840060141112
keywords = grave
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5/6. Unilateral eyelid retraction secondary to contralateral ptosis in dysthyroid ophthalmopathy.

    A patient with dysthyroid eye disease presented with unilateral lid retraction secondary to a contralateral ptosis. While others have reported similar findings in various underlying disease processes, to the best of our knowledge this is the first case in the literature with dysthyroid ophthalmopathy, and the first where the results of surgical management are presented. The importance of testing for secondary lid retraction by manual elevation of the ptotic partner is stressed.
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ranking = 5
keywords = ophthalmopathy
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6/6. The use of autogenous fascia lata to correct lid and orbital deformities.

    Autogenous and homologous fascia lata have been used to correct many problems in ophthalmic surgery. This paper has described the use of autogenous fascia late to correct lid retraction secondary to thyroid ophthalmopathy, cicatricial entropion and extruding orbital implants. The surgical procedures have been briefly discussed, as well as the presentation of one clinical example of each procedure the pathologic and immunologic aspects of fascia lata grafts will be reported at a later date.
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ranking = 1
keywords = ophthalmopathy
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