Biomedical subjects
Publications and source records attributed to T H Wojno.
Lid margin splitting at the gray line with resection of the lash-bearing anterior lamella of the eyelid is a simple and effective treatment for cicatricial entropion and trichiasis. Twenty-six patients underwent this procedure with good results.
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Five patients with ocular allergy and intermittent epiphora had a temporary obstruction at the level of the lacrimal sac or canaliculus. The obstruction probably resulted from mucosal edema induced by rubbing the pruritic periocular tissues, a maneuver commonly performed by such patients. Treatment was aimed at inhibiting the allergic response with cromolyn sodium eyedrops, and patients were instructed to refrain from rubbing the periocular tissues.
The frequency of extraocular muscle (EOM) or cranial nerve (CN) palsy as the sole cause of diplopia in orbital floor blow-out fractures has not been previously determined. Of 40 blow-out fracture patients studied prospectively, seven had motility disturbances consistent with palsy of one EOM or CN. All seven patients had negative forced ductions, making entrapment, edema, or orbital hemorrhage unlikely causes of diplopia. The diplopia resolved in four patients in 1 year. Persistent diplopia is a common indication for repair of such fractures. If, however, diplopia is due only to EOM or CN palsy, orbital surgery should be deferred (in the absence of significant enophthalmos) in favor of observation and/or later strabismus surgery.
Identical twins were found to have unilateral congenital dacryocystoceles. Both were immediately probed, which resulted in resolution of one and recurrence in the second twin. The recurrent dacryocystocele was reprobed and the abnormality was resolved. Etiology and management are discussed.