Modified impression method of artificial eye fitting.
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Seven patients with basal cell epithelioma of the eyelids, canthi, or periorbital skin who were initially treated by Mohs' chemosurgery or by fresh-staged excisions developed complications directly referable to the initial method of excision. Five patients achieved excellent results. Methods of one-staged complete excision and plastic reconstruction were used when tumor excision was incomplete. When excision was complete, secondary reconstructive surgery was sometimes necessary to assuage the effects of healing by granulation.
In a study of lower eyelid movement, resting position, and tone in 185 normal white patients ranging in age from 15 to 89 years, the mean vertical eyelid excursion from downgaze to upgaze was 5.29 mm. There was, however, a decrease in vertical eyelid movement with age of 0.05 mm/yr. The mean horizontal lower eyelid excursion with eyelid closure or gentle blink was 3.3 mm and horizontal eyelid movement decreased 0.015 mm/yr. The decrease in vertical and horizontal eyelid movement with aging was closely correlated with the increase in eyelid laxity in elderly patients (P less than .001). The lower eyelids of elderly patients rested against the globe at a position inferior to that of younger patients, a finding that correlated with increased eyelid laxity (P less than .001).
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The case of a 40-year-old tube pedicle, raised in 1939 and subsequently lost to follow-up, is presented together with a description of its appearance and eventual modified use to accomplish its original purpose.
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PURPOSE: To report a patient with severe corneal and conjunctival toxicity from long-term, habitual use of hydrogen peroxide as an eye wash. DESIGN: Observational case report. INTERVENTION AND TESTING: Serial examinations of the cornea, conjunctiva, and ocular adnexa were done. Penetrating keratoplasty with amniotic membrane transplantation was performed. MAIN OUTCOME MEASURES: Ocular inflammation, pain, and visual acuity outcome. RESULTS: Bilateral corneal and conjunctival inflammation and scarring mimicking ocular-cicatricial pemphigoid were noted. Formation of a descemetocele after starting treatment with low-dose topical steroids required emergent penetrating keratoplasty with amniotic membrane transplantation. CONCLUSIONS: This is the first reported case of ocular surface toxicity in a patient after deliberate chronic use of high-dose hydrogen peroxide. It highlights the value of obtaining a thorough medical and social history and the importance of direct questioning about the use of any medications or agents on the eyes before making a diagnosis or initiating therapy.