Iconoclastic observation on eyelash dandruff.
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Cilia may be carried into the eye following a penetrating injury. Such a case of a cilium in the anterior chamber is described. The cilium was discovered years later following an injury. A cilium was noted to extend through the cornea into the anterior chamber barely touching the anterior lens capsule. Although the lens surface directly directly adjacent to the foreign body was clear, an anterior capsule lens opacification and area of posterior syncechia were noted at the 3 o'clock meridian. The eye was quiet with no cell or flare noted. The vision was 20/20.
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OBJECTIVE: The authors noted that many of their patients with the floppy eyelid syndrome had a unique finding of eyelash ptosis and lashes that curled in many directions. The purpose of this study was to determine how many of these patients had this physical finding. DESIGN: Case series. PARTICIPANTS: The authors retrospectively reviewed the charts and photographs of eight consecutive patients with the floppy eyelid syndrome. They also examined four new patients with floppy eyelid syndrome. INTERVENTION: Surgical tightening of 13 upper lids was performed in 9 patients. MAIN OUTCOME MEASURES: Relief of symptoms and normalization of eyelash position. RESULTS: All of the 12 consecutive patients with floppy eyelid syndrome demonstrated eyelash ptosis with loss of eyelash parallelism. All patients treated with surgical shortening of the affected eyelid were asymptomatic at follow-up. CONCLUSIONS: The authors have identified a new physical finding in the floppy eyelid syndrome: eyelash ptosis with loss of eyelash parallelism. The authors believe that this new physical finding is characteristic of the floppy eyelid syndrome, and will aid in the timely diagnosis and treatment of this sometimes obscure syndrome.
Although the clinical properties of propofol have been studied extensively, the pharmacodynamics have not yet been described fully. We studied the propofol concentration-effect relationships for loss of eyelash reflex, loss of consciousness, and hemodynamic changes in 18 female patients, ASA physical status 1, aged 20-49 yr. Propofol was given by computer-controlled infusion. The initial target concentration of 0.5-1 microgram/ml was increased every 12 min by 0.5-1 microgram/ml until the patients lost consciousness. Every 3 min, loss of eyelash reflex and loss of consciousness were tested and an arterial blood sample was taken for analysis of the blood propofol concentration. The concentration-response relationships for loss of eyelash reflex and loss of consciousness were defined by fitting a sigmoid Emax function (where Emax = the maximum effect that can be reached; i.e., 100% of the patients showing loss of eyelash reflex or loss of consciousness) to the response/no response data versus the propofol concentration, using nonlinear regression. The effect of propofol on hemodynamic parameters was analyzed by linear regression. The propofol concentrations at which 50% and 90% of the patients showed loss of eyelash reflex were 2.07 and 2.78 micrograms/ml, respectively. The corresponding values for loss of consciousness were 3.40 and 4.34 micrograms/ml. The systolic and diastolic blood pressure decreased with increasing blood propofol concentration. The correlation coefficients for the decrease in systolic and diastolic blood pressure versus the blood propofol concentration were r2 = -0.663 and r2 = -0.243, but heart rate did not change. In conclusion, propofol concentrations inducing loss of eyelash reflex are less than those inducing loss of consciousness.
PURPOSE: To determine the efficacy of an 810-nm diode laser in the treatment of trichiasis. METHODS: Noncomparative interventional prospective study of 87 patients, providing 153 eyelids with darkly pigmented trichiatic eyelashes, treated with the 810-nm diode laser. The number of trichiatic eyelashes was counted before and after treatment. Patients were followed for 6 months with monthly examinations. RESULTS: Immediately after laser treatment, the average number of trichiatic eyelashes per patient was reduced from 3.50 (standard deviation, 4.20) to 0.40 (standard deviation, 1.0). Forty-one patients were followed for 3 or more months (minimum of 90 days; maximum, 443 days; standard deviation, 77.23 days). Among these patients, the average number of eyelashes per patient was reduced from 3.58 (standard deviation, 4.15) to 0.73 (standard deviation, 1.60). The paired t tests demonstrated a statistically significant difference between numbers of eyelashes before and after laser treatment irrespective of gender, age, or location of eyelashes. CONCLUSIONS: The 810-nm diode laser is an effective tool in treating trichiasis.
PURPOSE: Demodex is a mite commonly found in eyelash hair follicles and sebaceous glands of healthy people. Due to the fact this mite has also been reported in many chronic cases of blepharitis, we aimed to investigate the incidence of infestation with this mite in healthy people and in patients with chronic blepharitis, in addition to evaluating the response to the different treatments used for blepharitis. METHODS: 105 subjects without blepharitis were selected as a control group and 20 subjects diagnosed as having chronic blepharitis were selected as patients. Epilated eyelashes were observed under microscope in both groups of patients. Those with overpopulation of mites were treated with ether lid and eyelash scrubs and 2% mercury oxide ointment. RESULTS: The incidence of Demodex infestation in the control group was 0.08 mites per eyelash, whereas in the patients with chronic blepharitis the incidence was 0.69 mites per eyelash; this difference was statistically significant (p=0.006). All the mites found were Demodex folliculorum except in one patient where the mite was identified as Demodex brevis. After 3-8 weeks of specific treatment the number of mites per eyelash decreased dramatically (0.03, with p=0.001). Two patients were intolerant of the therapy. CONCLUSIONS: In this study the incidence of Demodex in patients with blepharitis was very high, when compared with normal subjects, showing a clear association between blepharitis and Demodex infestation. Treatment with mercury oxide ointment was satisfactory in controlling the infection, despite difficulty in its application and occasional toxicity.
In two patients, after a perforating wound of the eye, a cilium was found in the vitreous. In the first patient one end of a cilium was stuck in the retina, the other end floated freely in the vitreous of the right eye. During a 5-year follow-up no inflammatory signs were observed. Visual acuity remained 1.0. In the second patient a large metal foreign body was removed from the vitreous of the left eye immediately after the injury. A week later, while parsplana vitrectomy was being performed for a vitreous haemorrhage caused by the trauma, an eyelash was discovered in the vitreous, but it could not be removed. During the follow-up period, which included the removal of a traumatic cataract, the eyelash caused no inflammatory reaction. A year later the visual acuity of the left eye was 1.0. In the literature 17 reports were found of cases with one or more eyelashes in the posterior segment of the eye. In 5 cases this was discovered on clinical examination. Once the eyelash was spontaneously extruded from the bulbus, once panophthalmia developed after the injury. In 3 cases the eye could be saved, twice with useful visual acuity, in spite of retention of the eyelash.
BACKGROUND: Propofol and alfentanil often are combined during induction of anesthesia. However, the interaction between these agents during induction has not been studied in detail. The influence of alfentanil on the propofol concentration-effect relationships was studied for loss of eyelash reflex, loss of consciousness, and hemodynamic function in 20 unpremedicated ASA physical status 1 patients aged 20-55 yr. METHODS: Patients were randomly divided into four groups to receive a computer- controlled infusion of alfentanil with target concentrations of 0, 50, 200, or 400 ng/ml (groups A, B, C, and D, respectively). While the target concentration of alfentanil was maintained constant, patients received a computer- controlled infusion of propofol, with an initial target concentration of 0.5-1 microgram/ml, that was increased every 12 min by 0.5-1 microgram/ml. Every 3 min, the eyelash reflex and state of consciousness were tested an an arterial blood sample was taken for blood propofol and plasma alfentanil determination. The propofol-alfentanil concentration-response relationships for loss of eyelash reflex and loss of consciousness were determined by nonlinear regression, and for the percentage of change in systolic blood pressure and heart rate by logistic regression. RESULTS: The patient characteristics did not differ significantly among the four groups. The patients in groups A and B continued to breathe adequately, whereas all patients in groups C and D required assisted ventilation. End-tidal carbon dioxide partial pressure remained less than 46 mmHg in all patients. With plasma alfentanil concentrations increasing from 0 to 500 ng/ml, the EC(50) of propofol decreased from 2.07 to 0.83 microgram/ml for loss of eyelash reflex and from 3.62 to 1.55 microgram/ml for loss of consciousness. With plasma alfentanil concentrations increasing from 0 to 500 ng/ml, the blood propofol concentrations associated with a 10% decrease in systolic blood pressure and heart rate decreased from 1.68 to 0.17 microgram/ml and from 2.36 to 0.04 microgram/ml, respectively. CONCLUSIONS: Alfentanil significantly reduces blood propofol concentrations required for loss of eyelash reflex and loss of consciousness. In addition, alfentanil enhances the depressant effects of propofol on systolic blood pressure and heart rate. Hemodynamic stability, therefore, does not increase in patients receiving propofol in combination with alfentanil compared to those receiving propofol as the sole agent for induction of anesthesia.