Ocular Surface Squamous Neoplasia (OSSN) is a spectrum of pre-cancerous and cancerous lesions of the conjunctival epithelium (transparent coat covering the surface of the eye).
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.
2020 has been an incredible year. For sure it has been a tough year but in all the difficult periods there are the big life lessons. The paranoia of the early days of the pandemic has given way to a little breathing space now. This pandemic has been a pause button on our lives and it was a time to take stock. It made us realise how privileged we were to have the things we had taken for for granted. It showed us what was truly important in our lives and what was the fluff in it.
After ruling out any connective tissue disorder which could also cause such a condition, I performed the Lateral Canthoplasty (Reconstructing the lateral canthus) thus restoring the ideal almond shape of the palpebral (eyelid) opening. Not just a new lateral canthus needs to be reconstructed, we also have the make sure the eyelid do not stick back together by using silicone bolsters as tissue spacers.
Epidermal Inclusion Cyst (also known as Epidermoid cyst or Sebaceous cyst) is a benign encapsulated, sub-epidermal nodule filled with keratin material. This is one of the commonest masses seen in the eyelid.
Blepharoplasty is the removal and repositioning of the skin, muscle and fat of the upper and/or lower eyelid. In the lower eyelid the incision is made along the skin just beneath the eyelashes or in the moist surface of the eyelid known as conjunctiva. This involves repositioning of prolapsed orbital fat on both sides by draping the fat to the orbital rim area- which gives an aesthetically better appearance. This technique is done with an incision on the inside of the eyelid without a skin incision making the surgery “scarless”.
Blepharoplasty is the removal and repositioning of the skin, muscle and fat of the upper and/or lower eyelid. In the upper eyelid the incision is made and hidden in the natural lid crease. In the lower eyelid the incision is made along the skin just beneath the eyelashes or in the moist surface of the eyelid known as conjunctiva.
A 48 year old patient had a painfully blind right eye for which he wanted resolution with best aesthetic outcome.