The consequences of abandonment of the bandage lens patient--the cause of an inflammatory iris nodule simulating metastasis from a transitional cell tumor of the bladder.
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Congenital tarsal kink is a rare condition. The folded edge of the upper tarsus, or the inturned lashes, may traumatize the cornea causing ulceration. We describe a case of unilateral upper eyelid horizontal tarsal kink associated with distichiasis and congenital corneal ulceration. Several different surgical treatment options have been previously alluded to in the literature including lamellar tarsoplasty, full-thickness eyelid fracture, and rotation and excision of the kink with tarsal reapposition. Repair by means of eyelid everting sutures via an anterior lamellar approach is presented as a novel technique to correct this congenital anomaly.
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Included in the discussion is the management of anomalies of abnormal formation of the lid folds, disorders of differentiation of the lid margins, and disorders of tissue differentiation. Also discussed are lid involvement with bacterial lesions and viral diseases.
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BACKGROUND: Trachoma is a leading cause of blindness in the developing world and is most prevalent among people who live in poor rural communities in arid locations. METHODS: We analysed the results of surveys of trachoma prevalence in Marakissa, a rural village in The Gambia. These surveys were undertaken in 1959, by the Medical Research Council, and in 1987 and 1996 by the Gambian National Eye Care Programme. FINDINGS: During this 37-year period, the prevalence of active inflammatory trachoma among children aged 0-9 years fell from 65.7 cases per 100 children in 1959 to 2.4 cases per 100 children in 1996. The prevalence also fell dramatically among people of 10-19 years (52.5 to 1.4 per 100) and among people of 20 years and older (36.7 to 0 cases per 100). INTERPRETATION: The dramatic fall in disease occurrence was paralleled by improvements in sanitation, water supply, education, and access to health care in the village. Of particular importance is that the decline in trachoma occurred without any trachoma-specific intervention.
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The introduction and use of newer surgical materials, better surgical instruments, finer suture materials, and improved optical equipment have allowed us to advance certain techniques in ophthalmic surgery and ophthalmic plastic surgery. In oculoplastic surgery, fascia lata and sclera are but a few of these materials used with greater frequency. In this paper, a number of techniques are described depicting the use of fascia lata and sclera. A histologic study of these materials after variable periods of implantation is presented.
Following enucleation or evisceration surgery, the anatomy and physiology of the orbit are changed. These changes affect not only the cosmetic appearance of the anophthalmic patient but also the function of the socket and the prosthesis. Surgical techniques for primary enucleation and evisceration surgery and correction of early and late complications are described. During the course of this century many operations and prosthetic devices have been advocated. A brief summary of these is given as well as detailed surgical descriptions of techniques the author believes have proven successful over the years.
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This article deals with the unique skin disorders seen only in the Shar-Pei. The difference between skin diseases in Shar-Pei and other breeds is described. Prevention and treatment are discussed. Suggestions are given to alter the breed's anatomy slightly to decrease the genetic predisposition to certain dermatoses.
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Although many ophthalmic procedures can be performed on the standing horse, the decision to perform a procedure under sedation rather than general anesthesia must be made on the basis of the temperament of the horse, severity of the injury, and skill of the veterinarian. For example, veterinarians who are not comfortable with small suture material may find accurate repair of an eyelid laceration easier after general anesthesia rather than attempting to handle this suture in a moving patient. Correct use of nerve blocks and topical anesthesia will greatly facilitate examination, diagnosis, and treatment, and, in addition, will serve to prevent further damage to the eye during these procedures.