Dermoid cyst (also known as choristoma) is a benign tumor growing out of a embryonic suture line. The tumour consists of normal cells occurring in an abnormal location. It is usually diagnosed in children when it is first visible but it is not uncommon to have adults coming to the clinic to know if it can be removed.
While acute symptoms have debilitating morbidity with sight threatening features, the after effects of TED can have long lasting eye abnormalities like protruding eyeballs, squint, staring look and inability to close eyes causing eye dryness. Surgery can take care of many of these after effects.
Hering’s Law for the eyelids: There is reflexive descent of the contralateral upper eyelid after the ipsilateral surgical correction of unilateral ptosis. Hering’s law is explained by considering the two eyes as paired organs and it follows that the muscles moving it will work in co-ordination.
Coloboma can present with eyelid coloboma, iris coloboma or choroidal coloboma, a combination of the three or all three. Eyelid colobomas part of goldenhar syndrome is usually in the upper eyelid, resulting incomplete closure resulting in exposure keratopathy which can then turn into a corneal ulcer as in our case.
The MRI scan showed a large intraconal well defined mass sitting right next to the optic nerve causing mass effect which in turn was causing diminution of vision. My working differentials going into surgery- based on location and imaging was Cavernous Hemangioma, Fibrous Histiocytoma, Dermoid cyst, Schwannoma among others.
Crowds gather at the election rallies and religious gatherings.
Politicians showing their hypocrisy by encouraging both,
While demonizing you for getting afflicted.
In any case,
You were not killed by a virus but murdered by the state!
Canalicular lacerations are missed quite often during evaluation of periocular injuries due to Road traffic accidents, assaults and animal bites in busy emergency rooms. At the same time, surgical repair of canalicular laceration can be very frustrating experience as the distal end of the lacerated canaliculi can become very illusive to locate. After locating theContinue reading “(Eye)Lid off with Canal(iculus) in tow!”
The staring look of eyelid retraction in TED can be very awkward for patients while meeting people and in photos of themselves. This eyelid malposition can be easily corrected with a 30 minute procedure done under local anaesthesia with very predictable outcomes. This lady was very pleased with the outcome of the surgery as she’s back to her beautiful Pre-TED self.
There is a mystical hole in the wall – of the orbit. An ancient myth among oculoplastic and maxillofacial surgeons alike-that once an Orbito- zygomatico-maxillary complex (OZM) fracture or commonly known as ZMC fracture is reduced, the orbital floor fracture automatically gets reduced and there is no need to repair the floor of the orbit. This was classic textbook teaching. However, this is true of only a small percentage of ZMC fractures.
Droopy Eyelid Surgery or Ptosis correction surgery is more art than science. I’m sure all Oculoplastic Surgeons agree it is a challenge to treat patients with ptosis. Each case is so different that it is almost feels like you are starting from scratch. While challenging, it is also among the most satisfying Oculoplastic conditions to treat.