Upper eyelid epiblepharon Here is another young patient, 18 years old, finishing school. Upper eyelid epiblepharon. This is his better eye, a little short sighted with obvious topographic cone, refracts to better than 6l6 Severe cone other eye, count fingers. The treatment I “dispensed” in October 2021 was cognitive…it cost him nothing…..STOP RUBBING. Note the …
Ectropion exacerbation Have a look at what happens to this man’s complete ectropion when he contracts his eyelid….the ectropion worsens. Now imagine what happens when he lies down in bed. That is why redness and discharge are problematic overnight. He is booked for repair. Unilateral ectropion nocturnal rubbing This man has significant ectropion on ONE …
Eye rubbing anxiety Eye rubbing anxiety This is a very interesting presentation of keratoconus in a young man diagnosed with ADHD who is very anxious. Blurry vision noted incidentally in the left eye and had been told to have cross linking. It was a very intense consultation, and I noted he was very enophthalmic….look at …
Atypical lesion – spindle tumour. Atypical lesion – spindle tumour. When you see atypical lid lesions, be suspiciousThis 30 year old man came in with a history of progressive growth of a central lower lid tumour over 6 months. It has a very atypical appearance.It is always tempting to shave such things, but if you …
Orbital fat prolapse You will probably see a lot of Orbital fat prolapse, another presentation of fat around the eye region. This is prolapse of the retrobulbar orbital fat. It passes through a weakness TEMPORALLY, where lacrimal gland interrupts the tenons to gain access to conjunctiva. It presents in older age group, and is another …
Eyelid retraction after decompression Eyelid retraction after decompression Patients, particularly females, notice their face. This lady has severe disfigurement after thyroid eye disease. After I have fixed the orbits and adjusted her upper eyelids, she still notes the lower eyelid retraction on her right side. Have a look at the right lower eyelid…it slopes down …
Superior Limbic Keratitis (SLK) This is the appearance of superior limbic keratitis (SLK). Note the inflammation, vascularisation and filaments at the limbus. Survey of Ophthalmology has just done a review of this condition. Unfortunately, no new information.Be on the lookout for SLK as it can happen after ptosis surgery that is conducted from the back …
Watery Eye It is important to remember that watery eye symptoms and signs are rarely symmetrical in patients with bilateral symptoms. This image shows it well….tear volume seems increased symmetrically, but overflow is assymetrical. Patients have difficulty interpreting their symptoms! Once you explain it to them, they understand… If you are suffering from symptoms , …
Peripunctal BCC – Requiring Mohs Just a reminder to look out for lumps and bumps like this Peripunctal BCC – requiring Mohs. This 50 year old man has a nodular Basal cell carcinoma (BCC) below his left punctum, and I will arrange Mohs surgical excision and oculoplastic reconstruction to clear the tumour and restore aesthesis. …
Recurrent ptosis This lovely lady came to see me with “recurrent” ptosis. She had successful surgery in 2009, and said that it failed 5 years later. During the consult, she kept touching her eyes, so I asked her if she rubbed…she said she wasn’t sure. So the key question to ask next is this: if …