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A case report of demodicosis.

We report on a patient who had an excessive number of mites (Demodex folliculorum) on his eye lashes, i.e. 10 mites on eight lashes examined. A review of three previous reports suggested that one mite for every two lashes represents an over population of this nearly ubiquitous mite. Greasy scales on the lashes and foamy tears suggested that seborrhea was present as well as demodicosis. The primary symptoms of itching was relieved after one week of treatment with mercuric oxide ointment and lid scrubs, although the number of mites was not reduced. Treatment for an additional two weeks did reduce the mite number. We therefore recommend continuing treatment for demodicosis for at least three weeks even if symptoms abate sooner.

Aged↗

[Repair of orbital exenteration cavities].

Several plastic surgical procedures can attenuate the unsightly effects of a disinhabited empty orbit. Only the imperatives of follow-up or very poor general status can still justify spontaneous epithelialisation, which we prefer to split skin graft. In other cases, apart from the exceptional indications of preservation of the eyelids and conjunctival sac, closure by flap is the technique of choice: temporo-frontal flap in cases of simple exenteration and temporo-jugal for the superficial plane and medio-frontal for the deep plane in radical exenterations. In young adults, when the resection is limited to the orbit, after flap closure, conjunctival reconstruction by means of a mucosal graft can be attempted without preliminary temporalis muscle transposition, as the orbital cavity is filled spontaneously and sufficiently by fibrous tissue.

Eye Enucleation↗

Cryosurgery for trichiasis.

A series of 41 cases of trichiasis was treated with cryosurgery using a standard retinal cryoprobe. The failure rate was approximately 50 per cent. The results should be improved by using properly designed equipment capable of cooling the lash follicles to -20 degrees C, and ensuring that this temperature is achieved by using a tissue thermocouple. A double freeze-thaw cycle should be used and a long-acting local anaesthetic containing adrenaline. The main complication is depigmentation which is a problem only with heavily pigmented patients. Cryosurgery does have potential for the treatment of trichiasis.

Adolescent↗

Preoperative topical antibiotics and lash trimming in cataract surgery.

Fifty patients admitted for cataract extraction had their lids and conjunctive cultured two days preoperatively, on the morning of surgery, and on each of the first four postoperative mornings. Multiple topical preoperative antibiotics given for forty-eight hours before surgery produced a marked reduction in the periocular bacterial flora, an effect which persisted throughout the postoperative period. Lash trimming prior to surgery did not alter the periocular bacterial flora present on the morning of surgery or at any time during the first four postoperative days. While multiple preoperative topical antibiotics may reduce the incidence of postoperative endophthalmitis through suppression of periocular bacterial flora, no such role can be postulated for lash trimming.

Administration, Topical↗