Search PubMed⌕ Search

Biomedical subjects

Robert C Kersten

Publications and source records attributed to Robert C Kersten.

26 records · Page 2Linked to original sources
PubMed2002

Isolated unilateral neurogenic blepharoptosis secondary to eyelid trauma.

PURPOSE: To describe eyelid trauma as a cause of isolated neurogenic blepharoptosis. DESIGN: Observational case series. METHODS: Three previously healthy patients (two male and one female; aged 29 to 39 years) were evaluated for unilateral blepharoptosis following forceful anterior displacement of the upper eyelid. Two injuries occurred during domestic altercations and one while the patient was playing basketball. RESULTS: All three patients had complete unilateral upper eyelid ptosis with no levator palpebrae superioris function, consistent with loss of innervation. Additional findings included minimal eyelid ecchymosis, eyelid edema, and subconjunctival hemorrhage in two cases. The remainder of the examinations was unremarkable with full ocular motility and no anisocoria. Without treatment, within 2 weeks, all three patients recovered completely with normal symmetric lid height and levator function. CONCLUSIONS: Isolated neurogenic blepharoptosis may result from traumatic anterior upper eyelid displacement. Resolution is likely within 2 weeks.

Blepharoptosis↗
PubMed2002

Routine histopathologic evaluation of the lacrimal sac during dacryocystorhinostomy: how useful is it?

OBJECTIVE: To determine the usefulness of "routine" lacrimal sac biopsy to evaluate unsuspected neoplasm or systemic disease in patients with acquired nasolacrimal duct obstruction. DESIGN: Noncomparative, interventional case series with histopathologic correlation. PARTICIPANTS: Review of charts revealed histopathologic reports on 302 specimens from 258 patients who had undergone routine dacryocystorhinostomy for clinical acquired nasolacrimal duct obstruction. INTERVENTION: Dacryocystorhinostomy (DCR) with histopathologic evaluation of lacrimal sac. MAIN OUTCOME MEASURES: The following variables were extracted from the medical records: age, gender, presenting symptoms, history of predisposing conditions, lacrimal system abnormalities noted before surgery, dye disappearance test, dacryocystogram or dacryoscintillogram, appearance of the lacrimal sac during surgery, and histopathologic report of the lacrimal sac specimen. RESULTS: Findings of histopathologic evaluation of 302 lacrimal sac specimens from 170 females and 88 males who had undergone routine DCR were reviewed. Evidence of systemic disease or neoplasia involving the lacrimal sac was present in 10 specimens. All 10 positive specimens had a grossly abnormal appearing sac at the time of surgery (n = 8), a known preexisting history of systemic diseases (n = 6), or both. The remaining 292 specimens showed chronic inflammation, fibrosis, or normal mucosa. CONCLUSIONS: Only patients with known preexisting systemic disease or a grossly abnormal lacrimal sac had "positive" histopathologic findings. We recommend that lacrimal sac biopsy in patients undergoing DCR should be performed only in those with a positive history for systemic disease or an abnormal-appearing lacrimal sac during surgery.

Adolescent↗
PubMedDate not supplied

Isolated medial orbital wall fractures with medial rectus muscle incarceration.

PURPOSE: To retrospectively review and analyze cases of isolated medial orbital wall fractures with medial rectus muscle incarceration presenting to a tertiary ophthalmic plastic surgery practice from 1997 to 2005. METHODS: Retrospective chart review and literature review. RESULTS: Nine cases of isolated medial wall fracture with medial rectus muscle incarceration are presented. The most frequently encountered clinical feature was adduction deficit on the affected side. Extraocular motility improved in all patients who underwent surgery, and mean postoperative enophthalmos was minimal. CONCLUSIONS: Isolated medial orbital wall fractures with medial rectus muscle incarceration are rare. Ocular motility abnormalities were the only indication of underlying fracture in the majority of our cases. Clinicians should be alerted to the anticipated presentation of medial wall fractures with incarceration of the medial rectus muscle, including the possibility of a "white eye" and normal abduction of the traumatized eye.

Adolescent↗
PubMedDate not supplied

Periocular inflammation after retrobulbar chlorpromazine (thorazine) injection.

PURPOSE: Retrobulbar chlorpromazine injection is a relatively recently described method of pain control in nonseeing eyes. This report illustrates severe sterile inflammation as a potential complication. METHODS: In this university-based, retrospective, small case series, we reviewed the records of 2 female patients and 1 male patient (ages, 13 to 89 years) who developed severe inflammation after retrobulbar chlorpromazine injection. RESULTS: Three patients had development of severe periocular edema after retrobulbar chlorpromazine injection. Two had development of chemosis, limited extraocular motility, proptosis, and incomplete eyelid closure, necessitating temporary tarsorrhaphy. The third patient had development of facial edema involving the ipsilateral eyelids, forehead, and cheek. Strikingly, it extended to the contralateral face. All 3 patients denied discomfort. In each case, swelling was first noted the day after injection and progressed for 1 week. All were treated with topical lubrication and two with temporary tarsorrhaphy. Resolution occurred within 3 weeks in each case. CONCLUSIONS: Severe periocular inflammation can result from retrobulbar chlorpromazine injection and may manifest as chemosis, proptosis, limited ocular motility, and facial swelling that may extend well beyond the eyelids. Awareness of this potential adverse reaction is important both for patient counseling before injection and subsequent treatment. Specifically, a sterile inflammatory response should be differentiated from infection to avoid inappropriate therapy.

Adolescent↗
PubMedDate not supplied

Sclerosing idiopathic orbital inflammation.

A 5-year-old girl referred for orbital cellulitis was found to have a right orbital mass. Computed tomography revealed a mass occupying the inferotemporal orbit, extending into the maxillary sinus. Biopsy yielded a diagnosis of sclerosing idiopathic orbital inflammation. She was successfully treated with prednisone.

Biopsy↗