DOCSLIB.ORG

The Redred Eyeeye GPGP Updateupdate 20102010 -- Mrmr Vaughanvaughan Tannertanner

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Redred Eyeeye GPGP Updateupdate 20102010 -- Mrmr Vaughanvaughan Tannertanner TheThe RedRed EyeEye GPGP UpdateUpdate 20102010 -- MrMr VaughanVaughan TannerTanner www.tanner-eyes.co.uk ReadingReading WindsorWindsor Royal Berkshire Hospital Prince Charles Eye Unit Dunedin Hospital Princess Margaret Hospital Lids Conjunctiva Duration ? Sclera Cornea Uveitis Is it painful ? Glaucoma Others Is vision decreased ? StaphylococcalStaphylococcal blepharitisblepharitis • Chronic irritation • Hyperaemia and telangiectasia • Worse in mornings of anterior lid margin • Scales around base of lashes (collarettes) • Scarring and hypertrophy ComplicationsComplications ofof staphylococcalstaphylococcal blepharitisblepharitis Trichiasis Recurrent styes Tear film Marginal instability keratitis TreatmentTreatment ofof ChronicChronic BlepharitisBlepharitis 1. Lid hygiene – clean debris from lashes at night with cotton bud 2.Chloramphenicol Ointment – to lid margins at night 3. Tear substitutes - for associated tear film instability Hypromellose, Optive, Celluvisc 4. Oral Lymecycline 408 mg OD one month – very useful in most cases The Red Eye - Mr Vaughan Tanner CONJUNCTIVALCONJUNCTIVAL INFECTIONSINFECTIONS 1. Bacterial • Simple bacterial conjunctivitis 2. Viral • Adenoviral keratoconjunctivitis • Molluscum contagiosum conjunctivitis • Herpes simplex conjunctivitis 3. Chlamydial • Adult chlamydial keratoconjunctivitis • Neonatal chlamydial conjunctivitis • Trachoma The Red Eye - Mr Vaughan Tanner SimpleSimple bacterialbacterial conjunctivitisconjunctivitis Crusted eyelids and conjunctival mucopurulent discharge injection - broad-spectrum topical antibiotics Treatment - Chloramphenicol or Fucithamic (soothing base ointment) - One week only to avoid drop allergy -Suggest lubricants for persistent irritation/redness The Red Eye - Mr Vaughan Tanner ViralViral conjunctivitisconjunctivitis Usually bilateral, acute watery Subconjunctival haemorrhages and discharge and follicles pseudomembranes if severe Treatment -Tear substitutes or topical antibiotics -Fucithalmic has very good carrier gel keeping eyes comfortable The Red Eye - Mr Vaughan Tanner PostPost AdenovirusAdenovirus KeratitisKeratitis • Persistent photophobia • Focal, subepithelial keratitis • Decrease acuity • May persist for months • Following adenoviral infection Treatment - topical steroids if persists MolluscumMolluscum contagiosumcontagiosum conjunctivitisconjunctivitis • Waxy, umbilicated eyelid nodule • Ispilateral, chronic, mucoid discharge • May be multiple • Follicular conjuntivitis Treatment - excision/cautery of eyelid lesion The Red Eye - Mr Vaughan Tanner AdultAdult chlamydialchlamydial keratoconjunctivitiskeratoconjunctivitis • Infection with Chlamydia trachomatis serotypes D to K • Concomitant genital infection is common Subacute, mucopurulent follicular Variable peripheral keratitis conjunctivitis Treatment - oral tetracycline or erythromycin - Consider and send swab in all persistent conjunctivitis if sexually active The Red Eye - Mr Vaughan Tanner AllergicAllergic rhinoconjunctivitisrhinoconjunctivitis • Hypersensitivity reaction to specific airborn antigens • Frequently associated nasal symptoms • May be seasonal or perennial • Usually no treatment required Transient eyelid oedema Transient conjunctival oedema The Red Eye - Mr Vaughan Tanner VernalVernal keratoconjunctivitiskeratoconjunctivitis Frequently assoc. with atopy: asthma, hay fever and dermatitis • Recurrent, bilateral • Affects children and young adults • Itching, mucoid discharge and lacrimation Treatment • Topical mast cell stabilizers •Alomide - sodium chromoglycate •Lodoxamide •Rapitil • Topical steroids The Red Eye - Mr Vaughan Tanner ProgressionProgression ofof vernalvernal conjunctivitisconjunctivitis Cobblestone papillae Giant papillae The Red Eye - Mr Vaughan Tanner DIFFUSEDIFFUSE EYELIDEYELID DISEASEDISEASE 1. Allergic • Acute oedema • Contact dermatitis • Atopic dermatitis • Blepharochalasis 2. Infections • Preseptal cellulitis • Herpes simplex • Herpes zoster ophthalmicus • Impetigo • Erysipelas • Necrotizing fasciitis 3. Miscellaneous • Systemic causes AcuteAcute allergicallergic oedemaoedema • Causes - insect bites, urticaria and angioedema • Unilateral or bilateral • Painless, red, pitting oedema • Chemosis may be present • Self-limiting ContactContact dermatitisdermatitis • Sensitivity to topical medication – stop all drops • Unilateral or bilateral • Painless oedema and erythema • Vesiculation and crusting • Thickening if chronic AtopicAtopic dermatitisdermatitis • Associated with asthma and hay fever • Chronic itching and scratching The Red Eye - Mr Vaughan Tanner OcularOcular associationsassociations ofof atopicatopic dermatitisdermatitis Thickening, crusting and Staph. blepharitis fissuring Angular blepharitis Vernal disease in children PreseptalPreseptal cellulitiscellulitis Causes • Skin trauma or insect bites of lids or eyebrows • Spread from local infection • Upper respiratory or ear infection Signs • Usually unilateral • Tender and red • Periorbital oedema • White eye Prise lids apart – If eye white and normal VA just systemic Oral AB The Red Eye - Mr Vaughan Tanner OrbitalOrbital cellulitiscellulitis • Infection behind orbital septum • Usually secondary to ethmoiditis • Presentation - severe malaise, fever and orbital signs Admit IV AB • Severe eyelid oedema and redness • Proptosis • Painful ophthalmoplegia • Optic nerve dysfunction if advanced HerpesHerpes simplexsimplex Signs • Crops of small vesicles • Rupture and crust • Heal without scarring after 7 days Complications • Follicular conjunctivitis • Keratitis Treatment Topical acyclovir The Red Eye - Mr Vaughan Tanner HerpesHerpes zosterzoster ophthalmicusophthalmicus Painful vesicles and pustules Treatment Peri-orbital oedema - oral antivirals and Crusting ulceration ophthalmic review ? uveitis The Red Eye - Mr Vaughan Tanner SignsSigns ofof chalazionchalazion (meibomian(meibomian cyst)cyst) Painless, roundish, firm lesion May rupture through conjunctiva within tarsal plate and cause granuloma The Red Eye - Mr Vaughan Tanner AcuteAcute hordeolumhordeolum Internal hordeolum External hordeolum (acute chalazion) (stye) • Staph. abscess of meibomian • Staph. abscess of lash follicle and glands associated gland of Zeis or Moll • Tender swelling within • Tender swelling at lid margin tarsal plate • May discharge through skin TreatmentTreatment ofof chalazionchalazion If persistent – Incision and curretage Little benefit in antibiotics unless a. Cellulitis – oral b. Associated conjunctivitis - drops The Red Eye - Mr Vaughan Tanner InvolutionalInvolutional EctropionEctropion • Affects lower lid of elderly patients • May cause chronic conjunctival inflammation and thickening TreatmentTreatment ofof medialmedial ectropionectropion Mild Medial conjunctivoplasty a b The Red Eye - Mr Vaughan Tanner TreatmentTreatment ofof extensiveextensive ectropionectropionb a b Horizontal lid shortening The Red Eye - Mr Vaughan Tanner InvolutionalInvolutional entropionentropion Affects lower lid because upper lid If longstanding may result in has wider tarsus and is more stable corneal ulceration The Red Eye - Mr Vaughan Tanner PathogenesisPathogenesis ofof involutionalinvolutional entropionentropion • Canthal tendon laxity • Overriding of preseptal orbicularis • Horizontal lid laxity The Red Eye - Mr Vaughan Tanner TreatmentTreatment optionsoptions forfor involutionalinvolutional entropionentropion · Transverse everting · Weis procedure sutures (temporary) (permanent) The Red Eye - Mr Vaughan Tanner AcuteAcute dacryocystitisdacryocystitis Usually secondary to nasolacrimal duct obstruction • Tender canthal swelling • Mild preseptal cellulitis • May develop into abscess • Systemic antibiotics • DCR after acute infection is controlled MarginalMarginal keratitiskeratitis • Hypersensitivity reaction to Staph. exotoxins • May be associated with Staph. blepharitis • Unilateral, transient but recurrent Subepithelial infiltrate Circumferential spread Bridging vascularization separated by clear zone followed by resolution Treatment - short course of topical steroids The Red Eye - Mr Vaughan Tanner BacterialBacterial keratitiskeratitis --referrefer • Contact lens wear • Chronic ocular surface disease • Corneal hypoaesthesia Expanding oval, yellow-white, Stromal suppuration and dense stromal infiltrate hypopyon Treatment - topical ciprofloxacin 0.3% or ofloxacin 0.3% HerpesHerpes simplexsimplex epithelialepithelial keratitiskeratitis • Dendritic ulcer with terminal bulbs • Stains with fluorescein • No steroids Treatment • Aciclovir 3% ointment x 5 daily The Red Eye - Mr Vaughan Tanner HerpesHerpes simplexsimplex disciformdisciform keratitiskeratitis • Central epithelial and stromal oedema • Folds in Descemet membrane • Small keratic precipitates Treatment - topical steroids with antiviral cover The Red Eye - Mr Vaughan Tanner EpiscleritisEpiscleritis andand ScleritisScleritis • Maximal congestion • Maximal congestion of of episcleral vessels deep vascular plexus The Red Eye - Mr Vaughan Tanner SimpleSimple episcleritisepiscleritis • Common, benign, self-limiting but frequently recurrent • Typically affects young adults • Seldom associated with a systemic disorder sectorial diffuse Treatment – Conservative, topical steroids, systemic NSAIDS The Red Eye - Mr Vaughan Tanner DiffuseDiffuse anterioranterior nonnon--necrotizingnecrotizing scleritisscleritis • Relatively benign - does not progress to necrosis • Widespread scleral and episcleral injection refer Treatment • Oral NSAIDs • Oral steroids if unresponsive AnteriorAnterior necrotizingnecrotizing
Load more

Recommended publications
  • T20 FUNCTIONAL UPPER EYELID BLEPHAROPLASTY Policy Author
    Policy T20 Blepharoplasty THRESHOLD POLICY – T20 FUNCTIONAL UPPER EYELID BLEPHAROPLASTY Policy author: West Suffolk CCG and Ipswich and East Suffolk CCG, with support from Public Health Suffolk. Policy start date: January 2008 Subsequent reviews July 2012 September 2014 February 2017 Next review date: February 2020 1. Policy Summary 1.1 Blepharoplasty is considered a low priority treatment and will only be funded by Ipswich and East Suffolk CCG & West Suffolk CCG when the following criteria are met. It will not be funded for cosmetic reasons. 1.2 This policy doesn’t apply to anyone <19 years of age. 2. Eligibility Criteria 2.1 Upper eyelid blepharoplasty is considered medically necessary for the following indications: a) To repair defects predisposing to corneal or conjunctival irritation such as entropion or pseudotrichiasis. OR b) To treat periorbital sequelae of thyroid disease, nerve palsy, blepharochalasis, floppy eyelid syndrome and chronic inflammatory skin conditions. OR c) To relieve symptoms of blepharospasm or significant dermatitis on the upper eyelid caused by redundant tissue. OR d) Following skin grafting for eyelid reconstruction. OR e) At the same time as ptosis correction for the upper eyelid if the surplus skin is felt to be excess on lifting the ptotic eyelid 2.2 For all other individuals, the following criteria apply: a) Documented patient complaints of interference with vision or visual field related activities such as difficulty reading or driving due to upper eye lid skin drooping, looking through the eyelids or seeing the upper eye lid skin AND b) There is redundant skin overhanging the upper eye lid margin and resting on the eyelashes when gazing straight ahead AND S:\Clinical Quality\00 Chief Nursing Office\Clinical Oversight Group\POLICIES\T\Policies\T20 blepharoplasty\T20 Blepharoplasty E.docx 1 Policy T20 Blepharoplasty c) Supporting evidence from visual field testing that eyelids impinge on visual fields reducing field to 120° horizontally and/or 40° or less vertically.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2013/0172829 A1 BADAW (43) Pub
    US 2013 0172829A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2013/0172829 A1 BADAW (43) Pub. Date: Jul. 4, 2013 (54) DRY EYE TREATMENT SYSTEMS (52) U.S. Cl. CPC .................................... A61F 9/0008 (2013.01) (71) Applicant: SIGHT SCIENCES, INC., San USPC .......................................................... 604/294 Francisco, CA (US) (72) Inventor: Paul BADAWI, San Francisco, CA (US) (57) ABSTRACT (73) Assignee: SIGHT SCIENCES, INC., San Dry eye treatment apparatus and methods are described Francisco, CA (US) herein which generally comprise a patch or strip affixed to the skin of the upper and/or lower eyelids to deliver heat or other (21) Appl. No.: 13/645,985 forms of energy, pressure, drugs, moisture, etc. (alone or in combination) to the one or more meibomianglands contained (22) Filed: Oct. 5, 2012 within the underlying skin. The treatment strip or strips include one or more strips configured to adhere to an under Related U.S. Application Data lying region of skin in proximity to one or both eyes of a (63) Continuation-in-part of application No. 13/343,407, subject such that the one or more strips allow for the subject filed on Jan. 4, 2012. to blink naturally without restriction from the one or more patches. Moreover, the one or more Strips may be configured Publication Classification to emit energy to the underlying region of skin and where the one or more strips are shaped to follow a location of one or 51) Int.nt. CC. more me1bOm1amibomiam gland S COnta1nedined W1thinwithin the underlyingunderW1n A6DF 9/00 (2006.01) region of skin.
    [Show full text]
  • ANTERIOR CORNEAL MOSAIC*T by A
    Br J Ophthalmol: first published as 10.1136/bjo.52.9.659 on 1 September 1968. Downloaded from Brit. J. Ophthal. (1968) 52, 659 ANTERIOR CORNEAL MOSAIC*t BY A. J. BRON Moorfields Eye Hospital, City Road Branch, London THE corneal anatomy has received intensive study in recent years, but an aspect of its structure which is readily observed clinically has received little attention in the literature. In all normal corneae, after the instillation of fluorescein into the conjunctival sac, a striking mosaic pattern may be observed on the surface of the corneal epithelium after massage of the cornea through the lids. This pattern will be referred to as the anterior corneal mosaic. It was first observed by the author in patients whose eyes had been padded for corneal disease. It was noted in some that a mosaic pattern appeared after the instilla- tion of fluorescein. This pattern disappeared in a short period of time, but could readily be re-induced by pressure on the cornea through the lids. It is the purpose of this paper to describe the characteristics of the anterior corneal mosaic and to discuss its significance. This pattern was studied by Fischer (1928), and has since been re-studied by Schweitzer (1967). Methods Induction of the Mosaic A drop of 2 per cent. fluorescein is instilled into the conjunctival sac and the cornea is viewed with the cobalt beam of the slit lamp. If necessary the fluorescein is diluted to produce a bright fluorescence. A thumb is placed on the upper lid of the eye under examination and with the eye in the straight-ahead position, the lid is moved up and down over the cornea with light or moderate pressure applied to the globe.
    [Show full text]
  • Policy 96018: Blepharoplasty, Blepharoptosis Repair, and Brow
    Policy: 96018 Initial Effective Date: 11/22/1996 SUBJECT: Blepharoplasty, Blepharoptosis Repair, and Annual Review Date: 11/16/2020 Brow Ptosis Repair Last Revised Date: 11/16/2020 Prior approval is required for some or all procedure codes listed in this Corporate Medical Policy. Definition: The term blepharoplasty refers to a collection of surgical procedures that involve removal of redundant eyelid tissue (skin, muscle, and fat). Although the primary indication for blepharoplasty is to improve the eyelid appearance, redundant lax eyelid tissue (dermatochalasis) can obstruct the superior visual field and interfere with activities of daily living in some individuals. In these cases, blepharoplasty may be considered in order to produce functional improvement in vision. The pathophysiology of dermatochalasis has not been well described, but much of the process appears to involve skin changes associated with the aging process. Less commonly, systemic disorders such as Ehlers-Danlos syndrome may predispose patients to develop dermatochalasis at a younger age. Clinical manifestations are mainly cosmetic, but in severe cases eyelid tissue may obstruct the superior visual field. The most common symptoms include difficulty reading and loss of peripheral vision when driving. Blepharoplasty may help to improve function for patients with clinically significant dermatochalasis. Blepharochalasis is sometimes confused with dermatochalasis. Though similar in nomenclature, these two disorders are quite different in presentation and etiology. Blepharochalasis is a rare condition characterized by intermittent, recurrent eyelid edema, resulting in relaxation of the eyelid tissue and resultant atrophy. The lower eyelids are less commonly involved. Blepharochalasis typically presents in adolescence or young adulthood, with intermittent attacks that occur less commonly as the person ages.
    [Show full text]
  • Eyelids (2 Lec.)
    Eyelids (2 lec.) Dr Abdulmelik shallal Anatomy: Eyelids are thin movable curtains composed of skin on their anterior surface and mucus membrane (conjunctiva) on the posterior surface, they contain: 1- Smooth muscles (Müller's muscles). 2- Striated muscles (Orbicularis oculi and Levator palpebrae superioris "LPS"). 3- Dense fibrous plates (Tarsal plates). 4- Glands. 5- Nerves and blood vessels. 1 The contents of the lid are distributed as follows: the anterior surface is made of skin which has a round edge with the lid margin, the subcutaneous tissue, muscular layer, the submuscular (areolar tissue) layer, the orbital septum which end as a tarsal plate (that forms the architecture of lid) and finally the conjunctiva (palpebral) which is situated most posterior. The free margin of the eyelids contains: 1- The lashes (Cilia). 2- Grey line. 3- Orifices of Meibomian glands. 4- Mucocutaneous junction 5- Superior and inferior puncti of Naso-Lacrimal System (NLS). Muscles of the eyelids: 1- Orbicularis oculi muscle: It is a thin oval sheet of concentric striated muscle surrounding the palpebral fissure. It can be divided into: a- Peripheral (orbital) part: This is involved in forceful closure of lids. b- Central (palpebral) part: This is involved in involuntary blinking, voluntary nonforceful closure and participates in forceful closure with the orbital part. c- Muscle of Rioland's: this part is represented by the gray line of lid margin. d- lacrimalis muscle: that attached to the fundus of lacrimal sac. This part is involved in pumping action of lacrimal drainage system. Nerve supply: Sensory: Ophthalmic branch of trigeminal nerve Motor: Facial nerve.
    [Show full text]
  • Eyelid Conjunctival Tumors
    EYELID &CONJUNCTIVAL TUMORS PHOTOGRAPHIC ATLAS Dr. Olivier Galatoire Dr. Christine Levy-Gabriel Dr. Mathieu Zmuda EYELID & CONJUNCTIVAL TUMORS 4 EYELID & CONJUNCTIVAL TUMORS Dear readers, All rights of translation, adaptation, or reproduction by any means are reserved in all countries. The reproduction or representation, in whole or in part and by any means, of any of the pages published in the present book without the prior written consent of the publisher, is prohibited and illegal and would constitute an infringement. Only reproductions strictly reserved for the private use of the copier and not intended for collective use, and short analyses and quotations justified by the illustrative or scientific nature of the work in which they are incorporated, are authorized (Law of March 11, 1957 art. 40 and 41 and Criminal Code art. 425). EYELID & CONJUNCTIVAL TUMORS EYELID & CONJUNCTIVAL TUMORS 5 6 EYELID & CONJUNCTIVAL TUMORS Foreword Dr. Serge Morax I am honored to introduce this Photographic Atlas of palpebral and conjunctival tumors,which is the culmination of the close collaboration between Drs. Olivier Galatoire and Mathieu Zmuda of the A. de Rothschild Ophthalmological Foundation and Dr. Christine Levy-Gabriel of the Curie Institute. The subject is now of unquestionable importance and evidently of great interest to Ophthalmologists, whether they are orbital- palpebral specialists or not. Indeed, errors or delays in the diagnosis of tumor pathologies are relatively common and the consequences can be serious in the case of malignant tumors, especially carcinomas. Swift diagnosis and anatomopathological confirmation will lead to a treatment, discussed in multidisciplinary team meetings, ranging from surgery to radiotherapy.
    [Show full text]
  • Its Not Just Dry Eye NCOS2021
    5/31/21 DISCLOSURES CORNEA ENDOTHELIOPATHIES NOPE, THAT’S NOT JUST DRY EYE: PRIMARY SECONDARY OTHER CORNEAL DISEASES • Corneal guttata • Contact lens wear • Fuchs dystrophy • Surgical procedures • Posterior Polymorphous Dystrophy (PPD) • Age related Cecelia Koetting, OD FAAO • Congenital hereditary endothelial dystrophy • Iatrogenic (im munodeficiency) (CHED) • Glaucoma induced Virginia Eye Consultants • Iridocorneal endothelial syndrome (ICE) • Ocular inflammation Norfolk, VA 1 2 3 OTHER CORNEAL CORNEAL FUNCTION • Keratoconus • Central cloudy dystrophy of Francois • Pellucid marginal degeneration • Thiel-Behnke corneal dystrophy • Shields the eye from germs, dust, other harmful matter • Lattice Dystrophy • Ocular Bullous pemphigoid WHY IS THE CORNEA IMPORTANT? • Contributes between 65-75% refracting power to the eye • Recurrent corneal erosion (RCE) • SJS • Filters out some of the most harmful UV wavelengths • Granular corneal dystrophy • Band Keratopathy • Reis-Bucklers corneal dystrophy • Corneal ulcer • Schnyder corneal dystrophy • HSV/HZO • Congenital Stromal corneal dystrophy • Pterygium • Fleck corneal dystrophy • Burns/Scars • Macular corneal dystrophy • Perforations • Posterior amorphous corneal dystrophy • Vascularized cornea 4 5 6 CORNEAL ANATOMY CORNEA Epithelium Bowmans Layer • Cornea is a transparent, avascular structure consisting of 6 layers • A- Anterior Epithelium: non-keratinized stratified squamous epithelium; cells migrate from BRIEF ANATOMY REVIEW Stroma basal layer upward and periphery to center • B- Bowmans Membrane:
    [Show full text]
  • Involutional Type of Entropion in a Child with Cutis Laxa
    1432 Br J Ophthalmol 2000;84:1432–1438 Br J Ophthalmol: first published as 10.1136/bjo.84.12.1432 on 1 December 2000. Downloaded from LETTERS TO THE EDITOR Involutional type of entropion in a child with cutis laxa EDITOR,—The diVuse elastic tissue disease called cutis laxa (CL) is a serious, even lethal systemic illness, involving not only the skin but connective tissues throughout the body.1 The skin hangs in loose folds, producing the appearance of premature ageing. Internal manifestations such as emphysema, ectasia of the aorta, and multiple hernias are usually present. We report a child with cutis laxa, who presented with an unusual ophthalmic mani- festation of the disease. CASE REPORT Our patient, who is nowa4yearoldboyand Figure 2 Eyelid tissue stained for elastic fibres showing marked granular degeneration of the elastic the third child to a normal first degree cousin fibres. Aldehyde-fuscin, ×400. couple, was noted to have redundant skin and a hoarse cry at the age of 3 months. Skin biopsy Surgical correction was carried out using a arrangements; hence the term “generalised was consistent with cutis laxa (elastin stain lateral tarsal strip in addition to two full elastolysis”. showed focal thickening of the elastic fibres thickness lid sutures. A small piece of resected Goltz and coworkers suggested an imbalance with tapered ends). His 7 month old sister was eyelid tissue was sent for pathological examina- between the circulating pancreatic elastase and also diagnosed as having cutis laxa at 3 months tion. its inhibitor (pancreatic elastase inhibiting sub- of age. Her ophthalmic examination revealed Staining for elastic tissue revealed marked stance, EIS), with a diminution of the latter in no abnormalities.
    [Show full text]
  • Official Newsletter of APSOPRS 2016 Volume 2 Issue 4
    Official Newsletter of APSOPRS 2016 Volume 2 Issue 4 Asia-Pacific Society of Ophthalmic Plastic and Reconstructive Surgery President Message: Hirohiko Kakizaki APSOPRS President Dear APSOPRS colleagues, Hirohiko Kakizaki (Japan) Season’s greetings during mid-summer! It has been 2 years since the new council APSOPRS Vice-Presidents started, and now at the last Hunter Yuen (Hong Kong, SAR) corner. Gangadhara Sundar (Singapore) The first thing we did was Kasturi Bhattacharjee (India) the move of the secretariat from Singapore to Japan. The most important matter was managing the members. At the time, the number of the official members were only 77, which means only Editor 77 members paid the fee to the society. The society Audrey Looi (Singapore) had 197 past (unpaid) members, though. I was very surprised at this reality as the APSOPRS is the representative society in this area and an affiliated Editorial Board society of APAO. In addition, the APSOPRS has been a reciprocal society of the ASOPRS. This matter was Ashok Grover (India) simply caused by the bothersome payment system. We before had only two methods of payment: one Kelvin Chong (Hong Kong, SAR) was the direct payment at a conference venue and Yoon-Duck, Kim (South Korea) the other was via bank transfer, the latter of which needs a complicated procedure. We therefore Lily Li Dong Mei (China) simplified the payment system using the Paypal via Raoul Henson (Philippines) web. As a result, the number of the paying members has increased to 112 by now. This is not Sunny Shen (Singapore) enough, of course, so please invite your colleagues and try to catch up with the ASOPRS and ESOPRS! In relation to this membership management, we have launched the “life membership” system.
    [Show full text]
  • Eleventh Edition
    SUPPLEMENT TO April 15, 2009 A JOBSON PUBLICATION www.revoptom.com Eleventh Edition Joseph W. Sowka, O.D., FAAO, Dipl. Andrew S. Gurwood, O.D., FAAO, Dipl. Alan G. Kabat, O.D., FAAO Supported by an unrestricted grant from Alcon, Inc. 001_ro0409_handbook 4/2/09 9:42 AM Page 4 TABLE OF CONTENTS Eyelids & Adnexa Conjunctiva & Sclera Cornea Uvea & Glaucoma Viitreous & Retiina Neuro-Ophthalmic Disease Oculosystemic Disease EYELIDS & ADNEXA VITREOUS & RETINA Blow-Out Fracture................................................ 6 Asteroid Hyalosis ................................................33 Acquired Ptosis ................................................... 7 Retinal Arterial Macroaneurysm............................34 Acquired Entropion ............................................. 9 Retinal Emboli.....................................................36 Verruca & Papilloma............................................11 Hypertensive Retinopathy.....................................37 Idiopathic Juxtafoveal Retinal Telangiectasia...........39 CONJUNCTIVA & SCLERA Ocular Ischemic Syndrome...................................40 Scleral Melt ........................................................13 Retinal Artery Occlusion ......................................42 Giant Papillary Conjunctivitis................................14 Conjunctival Lymphoma .......................................15 NEURO-OPHTHALMIC DISEASE Blue Sclera .........................................................17 Dorsal Midbrain Syndrome ..................................45
    [Show full text]
  • Freedman Eyelid Abnormalities
    1/16/2018 1 1/16/2018 Upper Lid Lower Lid Protractors Retractors: Levator m. 3rd nerve function Muller’s m. Cranial Nerve VII function Sympathetic Function Inferior Tarsal Muscle Things to Note Lid Apposition to Globe Position of Lid Margins MRD = 3‐5 mm Canthal Insertions Brow Positions 2 1/16/2018 Ptosis Usually age related levator dehiscence, but sometimes a sign of neurologic, mechanical orbital or inflammatory disease Blepharospasm Sign of External Irritation or Neurologic Disease 3 1/16/2018 First Consider Underlying Orbital Disease Orbital Cellulitis, Pseudotumor, Wegener’s Graves Ophthalmopathy, Orbital Varix Orbital Tumors that can mimic inflammatory process: Lacrimal Gland CA, Lymphoma, Lymphangioma, etc. Lacrimal Gland – Dacryoadenitis or tumor Sinus Mucocele Without Inflammatory Appearance, consider above but also… Allergic Eyelid Edema Hormonal Shifts Systemic Disorder – Cardiac, Renal, Hepatic, Thyroid with edema Cutaneous Lymphoma Graves Ophthalmopathy –can just have lid edema w/o inflammatory appearance Lymphedema after trauma, surgery to lids or orbit (e.g. lymphatics in lateral canthus) Traumatic Leak of CSF into upper eyelid (JAMA Oph 2014;312:1485) Blepharochalasis Not True Edema, but might mimic it: Dermatochalasis, Hidden Eyelid or Sub‐Conjunctival Mass, Prolapsed Orbital Fat When your concerned about: Orbital Cellulitis Orbital Pseudotumor Orbital Malignancy Vascular – e.g. CC fistula Proptosis Chemosis Poor Motility Poor Vision Pupil abnormality – e.g. RAPD Orbital Pseudotumor 4 1/16/2018 Good Vision Good Motility
    [Show full text]
  • Toxic Keratopathy Following the Use of Alcohol-Containing Antiseptics in Nonocular Surgery
    Research Brief Report Toxic Keratopathy Following the Use of Alcohol-Containing Antiseptics in Nonocular Surgery Hsin-Yu Liu, MD; Po-Ting Yeh, MD; Kuan-Ting Kuo, MD; Jen-Yu Huang, MD; Chang-Ping Lin, MD; Yu-Chih Hou, MD IMPORTANCE Corneal abrasion is the most common ocular complication associated with nonocular surgery, but toxic keratopathy is rare. OBSERVATION Three patients developed severe toxic keratopathy after orofacial surgery on the left side with general anesthesia. All patients underwent surgery in the right lateral tilt position with ocular protection but reported irritation and redness in their right eyes after the operation. Alcohol-containing antiseptic solutions were used for presurgical preparation. Ophthalmic examination showed decreased visual acuity ranging from 20/100 to 20/400, corneal edema and opacity, anterior chamber reaction, or stromal neovascularization in the patients’ right eyes. Confocal microscopy showed moderate to severe loss of corneal endothelial cells in all patients. Despite prompt treatment with topical corticosteroids, these Author Affiliations: Department of Ophthalmology, National Taiwan 3 patients eventually required cataract surgery, endothelial keratoplasty, or penetrating University Hospital, College of keratoplasty, respectively. After the operation, the patients’ visual acuity improved to 20/30 Medicine, National Taiwan University, or 20/40. Data analysis was conducted from December 6, 2010, to June 15, 2015. Taipei, Taiwan (Liu, Yeh, Huang, Lin, Hou); Department of Pathology, National Taiwan University Hospital, CONCLUSIONS AND RELEVANCE Alcohol-containing antiseptic solutions may cause severe College of Medicine, National Taiwan toxic keratopathy; this possibility should be considered in orofacial surgery management. University, Taipei, Taiwan (Kuo). Using alcohol-free antiseptic solutions in the periocular region and taking measures to protect Corresponding Author: Yu-Chih the dependent eye in the lateral tilt position may reduce the risk of severe corneal injury.
    [Show full text]