Biomedical subjects
Publications and source records attributed to D R Kulwin.
Conjunctivodacryocystorhinostomy is a much maligned procedure, and there are widely varying opinions about its efficacy and long-term success. We present our modification of the procedure used in 38 eyes of 29 patients over 10 years, with an average follow-up of 2.5 years, which has resulted in a very high rate of success.
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Upon occasion, surgical orbital decompression is indicated to treat thyroid ophthalmopathy. Of the various approaches described, we feel a combined ophthalmic-otolaryngologic technique is the safest and most effective means of decompressing the orbit.
We have examined three patients with cosmetically objectionable prominent veins in the lower eyelids. Segmental interruption of the vessels through multiple skin incisions has proved to be a satisfactory treatment.
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Suturing is the usual method employed to close retroauricular skin graft donor sites. We present our 8-year experience with 163 cases demonstrating that such donor sites can be closed with equal efficacy using skin staples. This technique is simple and takes less surgical time.
A congenital nasolacrimal mucocele, a lacrimal sac mucocele with intranasal extension, is an uncommon mass arising in the medial canthal region of the orbit. The authors describe four infants who presented with medial canthal masses and nasal airway obstruction. All underwent computed tomographic (CT) evaluation, which revealed the triad of cystic dilatation of the lacrimal sac, dilatation of the nasolacrimal duct, and an intranasal cystic mass. Appropriate therapy was determined following identification of the intranasal cystic component. Relevant discussions of the embryology, clinical presentation, and the characteristic CT findings of infants with congenital nasolacrimal mucoceles are included.
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Chronic hematic cysts of the orbit are rare causes of proptosis. They progressively enlarge causing expansion or erosion of the orbital bones and may give the appearance on computed tomography (CT) scan of a malignant orbital process. Hematic cysts have a characteristic appearance on magnetic resonance imaging (MRI) which is virtually pathognomic. The authors present two cases in which MRI was used to establish the diagnosis.
Periorbital burns require special care as compared with burns of other parts of the body. Not only is one interested in the healing and repair of the burned structures, but also in safeguarding and maintaining the function of the underlying eye.
Sebaceous carcinoma of the eyelid is a rare neoplasm usually arising from the meibomian gland. This tumor has distinctive histologic features characterized by unique foamy cytoplasm. The cases of three patients with this tumor who were treated by Mohs' surgery, followed by ophthalmologic cosmetic repair, are presented and discussed.
A case report is presented that supports the theory that traumatic deformation of the bony orbital rims, without concomitant orbital soft-tissue injury, can cause an orbital blowout fracture.
We report a series of 24 confusion eye injuries resulting from soccerball impact. Hyphema (50%), vitreous hemorrhage (29%), corneal abrasion (21%), angle recession (8%), and retinal tear (4%) were experienced. When compared with a combined hyphema series and with hockey and racquet sports, our group had fewer serious injuries and no permanent visual acuity loss resulted. Although the incidence of eye injuries is low and the use of eye protectors may be inconvenient, we strongly recommend protective eyewear be worn in competitive sports involving large and small projectiles.
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