Presentation
Some restriction, however, was still present in upward movement of the globe. [healio.com]
Congenital diaphragmatic hernia usually presents in the newborn period with cyanosis, tachypnea and respiratory failure. Delayed presentation is less common and is associated with a lower mortality rate. [monz.pl]
Lagophthalmos is present if the eyelids do not close completely. The eyelashes are normally directed away from the eye. Entropion is present if the eyelid and lashes are directed inward. [accesspediatrics.mhmedical.com]
However, some children with DRS present only with an abduction deficit,[ 16 ] and adults with DRS who present with sudden diplopia in adulthood could be misdiagnosed as acquired sixth nerve palsy.[ 17 ] A diagnosis of DRS also could be challenging in [journals.plos.org]
Eyelid retraction is considered to be present if, with the eyes in primary position, the sclera is visible above the superior corneal limbus. It is usually acquired but may be present at birth. [aao.org]
Entire Body System
- Surgical Procedure
Subconjunctival injections of botulinum toxin and several surgical procedures have been used to reduce the degree of eyelid retraction in patients with thyroid eye disease. Chang EL, RubinPA. [aao.org]
Although many studies have evaluated the advantages and disadvantages of various surgical grafts and the outcomes of surgical procedures conducted with these grafts, there have been few reports on surgical methods and outcomes for cases involving retraction [ekjo.org]
There are many surgical procedures in the management of upper eyelid retraction, and in general, they tend to weaken or lengthen the eyelid retractors [5]. [jcmrp.eg.net]
After diagnostic procedures a scheduled surgical procedure was performed on the patient. A thoracoscopy revealed displacement of the stomach, the spleen and the part of the small bowel and the large bowel into the thoracic cavity. [monz.pl]
Complications and indications are summarized in Table 1.50 Table 1 Choice of surgical technique according to the grade of ptosis and levator function Procedures There are several options available with regard to procedures. [dovepress.com]
- Pain
This first volume covers the visual sensory system, the autonomic nervous system, the ocular motor system, the eyelid, facial pain and headache, and nonorganic disease. Volume 2 covers tumors, the phacomatoses, and vascular disease. [books.google.com]
Independently from the cause, both may increase evaporation with drying of the ocular surfaces resulting in pain, tearing, and photophobia. The structural integrity of the cornea may also be damaged with possible compromise of the visual function. [karger.com]
All patients are given prescriptions for pain killers. However, rarely do patients report the need to use them. [thomaseye.com]
Symptoms can range from none to tearing or severe pain. Patients can develop vision-threatening sequellae, such as a corneal ulcer, and they may have an underlying systemic disorder. [reviewofophthalmology.com]
The presented case report describes a 9-year-old girl presenting with acute abdominal pain, nausea and vomiting caused by a left-side Bochdalek hernia. After diagnostic procedures a scheduled surgical procedure was performed on the patient. [monz.pl]
- Inflammation
This condition has some of the features of congenital orbital fibrosis and is postulated to have been due to an intrauterine infection or inflammation. REFERENCES 1. Duke-Elder S: Congenital Deformities, System of Ophthalmology, vol III, part 2. St. [healio.com]
Página 66 - Does androgen insufficiency cause lacrimal gland inflammation and aqueous tear deficiency? Página 159 - Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J 1995; 21:221-232. [books.google.es]
Moreover, chronic inflammation or intraocular surgery can lead to the same effect. Also, wearing contact lenses for long periods of time is thought to have a certain impact on the development of this condition. [en.wikipedia.org]
The causes were inflammation and bacterial infection after endonasal dacryocystorhinostomy or orbital wall reconstruction surgery through subciliary incision. [ekjo.org]
Inflammation, infection, benign and malignant tumors, and structural problems such as ectropion, entropion and blepharoptosis may occur. [aafp.org]
- Falling
The term is from Greek πτῶσις "a fall, falling." Causes [ edit ] Neurotoxic ptosis caused by botulinum toxin : a 14-year-old botulism patient with bilateral total ophthalmoplegia with ptosis (left image) and dilated, fixed pupils (right image). [en.wikipedia.org]
This entity could possibly fall into the category of congenital orbital fibrosis as described by Leone and Weinstein, although two of their four cases had ptosis and all had enophthalmos and involvement of the extraocular muscles. [healio.com]
DEFINITION • Ptosis (from Greek Ptosis -to "fall") is a drooping or falling of the upper or lower eyelid. 5. CLASSIFICATION OF PTOSIS A. Congenital B. Acquired 1. 2. 3. 4. 5. Neurogenic Myogenic Aponeurotic Mechanical Neurotoxic C. Pseudotosis 6. [slideshare.net]
Duane syndrome falls under the larger heading of strabismus (misalignment of the eyes) under the sub-classification of incomitant strabismus (misalignment of the eyes that varies with gaze directions) and subheading of what was previously termed extraocular [rarediseases.org]
Ectropion Eyelid falls away or is pulled away from its normal apposition to the globe. [kjophthal.com]
- Swelling
On average, by one week after surgery, approximately 70-80% of the swelling will have dissipated and after two weeks, close to 90% of the swelling will have dissipated. The remaining 10% will decrease over the next few weeks to perhaps a month. [thomaseye.com]
Case 9 :-Male, aged 10 years, following a blunt injury to the right upper lid in 1948, developed a swelling of the right eyes. With time as the swelling subsided ptosis appeared on the right side [Figure - 22]A and the eye became hypotropic. [ijo.in]
Periorbital swelling may narrow the fissure, and lid defects such as dermatochalasis and blepharochalasis allow skin folds to droop over the lid and mimic narrowing, though the position of the actual lid margin is normal. [neuroophthalmology.ca]
Gastrointestinal
- Overeating
Jankovic has published over 900 original articles and chapters, and edited or co-edited over 50 books and volumes, including several standard textbooks such as “Neurology in Clinical Practice”, “Principles and Practice of Movement Disorders”, and “Hyperkinetic [books.google.com]
Eyelid retraction occurs when the upper eyelid remains at an abnormally high level over the eye or the lower eyelid rests at a particularly low position. [edow.com]
In epicanthal folds, the upper eyelid folds over the inner corner of the eye. In cryptophthalmos, the skin grows entirely over the eye, meaning there are no eyelids. [loyolamedicine.org]
All complications of blepharoptosis were noted in form of cosmetic appearance, under correction, lid fold, and bell's phenomenon, synkinetic movement, lid lag, lagophthalmos, lid notching, entropion, prolapsed of fornix, over correction, exposure keratitis [medical-dictionary.thefreedictionary.com]
There are several tiny stitches that are placed that will dissolve over the first one to two weeks. These procedures are usually covered by insurance. [thomaseye.com]
Eyes
- Strabismus
Orthoptic examinations were requested to assess the presence of strabismus. Mild exophoria with foveal fusion was found. [scielo.br]
Keywords Duane syndrome Retraction Strabismus Esotropia Exotropia References 1. Duane A. [link.springer.com]
Duane Retraction Syndrome is a congenital strabismus syndrome occurring in isolated or syndromic forms. [eyewiki.aao.org]
[…] itself; once the restriction is treated (e.g. strabismus surgery), the degree of retraction often decreases. [drkathleenalbrecht.com]
- Blepharoptosis
Ptosis BLEPHAROPTOSIS contributed by Amber Sheikh, University of Saskatchewan, and Jason Barton, University of British Columbia, Jan 2009 Blepharoptosis is an abnormally low upper lid position (Table 1). [neuroophthalmology.ca]
Some of the most common eyelid problems in children include blepharoptosis, lid retraction, canthal dystopias, entropion, ectropion, epicanthal folds, cryptophthalmos, and colobomas. [loyolamedicine.org]
Paediatric blepharoptosis: a 10-year review. Eye (Lond). 2009;23(7):1554–1559. 6. Lee V, Konrad H, Bunce C, Nelson C, Collin JR. Aetiology and surgical treatment of childhood blepharoptosis. Br J Ophthalmol. 2002;86(11):1282–1286. 7. [dovepress.com]
Blepharoptosis Drooping of the margin of the eyelid, or blepharoptosis, may also cause functional vision loss, depending on the severity of the condition ( Figure 15 ). [aafp.org]
The most common eyelid abnormality in children is ptosis (blepharoptosis), which causes drooping of the eyelid. The upper eyelid normally rests just below the junction of the cornea and sclera (the limbus) superiorly. [accesspediatrics.mhmedical.com]
- Lacrimation
The training involves plastic and reconstructive surgery of the periorbital and facial tissues including eyelids & eyebrows, cheeks, orbit, and lacrimal (tear) system. [drimtiazchaudhry.com]
Página 66 - Does androgen insufficiency cause lacrimal gland inflammation and aqueous tear deficiency? Página 159 - Lemp MA. Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J 1995; 21:221-232. [books.google.es]
Lacrimal puncta, through which tears flow into the tear drainage system. FIGURE 1. Lacrimal puncta, through which tears flow into the tear drainage system. [aafp.org]
- Diplopia
Unilateral eyelid retraction is caused chiefly by thyroid eye disease but may also occur from aberrant regeneration of the third nerve (see Chapter 8, on diplopia), Marcus Gunn jaw-winking syndrome (see Fig 11-10), and idiopathic levator fibrosis. [aao.org]
Ocular myasthenia Ptosis • • • Insidious, bilateral but asymmetrical Worse with fatigue and in upgaze Ptotic lid may show ‘twitch’ and ‘hop’ signs Diplopia • Intermittent and usually vertical 26. [slideshare.net]
Unilateral or bilateral ptosis can develop with/without diplopia along with other ocular motor dysfunctions. Infantile myasthenia gravis occurs when antibodies are transferred to the neonate by the mother with myasthenia gravis. [pedclerk.bsd.uchicago.edu]
In addition to hair loss and a wide-eyed stare or proptotic appearance, physical findings may include localized myxedema (particularly pretibial), irritative keratoconjunctivitis, lid lag, diplopia, tachycardia, hyperactive reflexes, and smooth, warm, [medical-dictionary.thefreedictionary.com]
It presents with a variety of clinical features including diplopia, anisometropia, and amblyopia. 378.71 Duane's syndrome [1] Disease Duane Retraction Syndrome, also known as Stilling-Turk-Duane Syndrome, was originally described by Alexander Duane in [eyewiki.aao.org]
- Dry Eyes
It can also help reduce evaporative loss which often leads to dry eye. [edow.com]
Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes. CLAO J 1995; 21:221-232. [books.google.es]
Expression of human (3-defensins in conjunctival epithelium: relevance to dry eye disease. // Invest Ophthalmol Vis Sci. 2003. - Vol. 44(9). - p. 3795-3801. 93. Nowak M., Marek B. et al. [dissercat.com]
Exposure of the infracorneal bulbar conjunctiva in lower eyelid retraction can cause various complications such as dry eyes, exposure keratitis, and corneal ulcer. [ekjo.org]
Bilateral blepharospasm is most commonly the result of dry eyes, corneal irritation or benign essential blepharospasm. Brain imaging is not required. Benign essential blepharospasm may be caused by an overexcitatory drive of the basal ganglia. [aafp.org]
Skin
- Ulcer
Infantile ulcerative keratitis secondary to congenital entropion. Cornea 1997;16:32–4. 3 DeRespinis PA, Caputo AR, Wagner RS, et al. Duane's retraction syndrome. Surv Ophthalmol 1993;38:257–88. 4 Cross HE, Pfaffenbach DD. [nature.com]
If severe, blepharitis may result in corneal infiltrates or ulcers. Rarely, sebaceous cell carcinoma may masquerade as unilateral or bilateral intractable blepharitis. [aafp.org]
There may be ulcerations of the area, bleeding, crusting, and distortion of the skin. Oftentimes, cancer can masquerade and appear very benign. This often leads to undue delays at diagnosis and treatment. [thomaseye.com]
Patients can develop vision-threatening sequellae, such as a corneal ulcer, and they may have an underlying systemic disorder. [reviewofophthalmology.com]
Amniotic membrane grafts for nontraumatic corneal perforations, descemetoceles, and deep ulcers. // Ophthalmology. 2002. -Vol. 109(4).-p. 694-703. 120. Stephenson CM, Brown BZ. [dissercat.com]
- Erythema
The upper eyelid overlap or imbrication resolved spontaneously after 4-5 days along with the resolution of eyelid edema and erythema [Figure 3]. [jcnonweb.com]
Acute external hordeolum with erythema and lump present at the lash line. FIGURE 5. Acute external hordeolum with erythema and lump present at the lash line. [aafp.org]
- Hypertrichosis
[…] of eyelid H02.861 Hypertrichosis of right upper eyelid H02.862 Hypertrichosis of right lower eyelid H02.863 Hypertrichosis of right eye, unspecified eyelid H02.864 Hypertrichosis of left upper eyelid H02.865 Hypertrichosis of left lower eyelid H02.866 [icd10data.com]
Musculoskeletal
- Fracture
Use of resorbable mesh and fibrin glue for restoration in comminuted fracture of anterior maxillary wall. Arch Craniofac Surg 2018;19:175–180. Kontio R, Lindqvist C. Management of orbital fractures. [jkma.org]
[…] of nasal bones) S02.3 안와 바닥의 골절(Fracture of orbital floor) 제외:안와(orbit) NOS(S02.8) 안와 천정(orbital roof)(S02.1) S02.4 협골 및 상악골의 골절(Fracture of malar and maxillary bones) 상악골(Superior maxilla) 위턱(뼈)(Upper jaw (bone)) 협골(Zygoma) S02.5 치아의 파절(Fracture of [dic.impact.pe.kr]
[…] repair Repair of orbital floor fracture #1 (02:30) Repair of orbital floor fracture #2 (04:21) Orbital floor fracture repair with placement of a porous polyethylene titanium implant (02:30) Repair of orbital floor fracture using headlight mounted cam [webeye.ophth.uiowa.edu]
The causes of the former were congenital (1) and ptosis operation (1), and of the latter were strabismus surgery (1), necrotizing blepharitis (1), blow-out fracture (1), anophthalmic socket contracture (1), cicatricial entropion (1), and lower lid blepharoplasty [scinapse.io]
Lid retraction following blow-out fracture of the orbit. [medtextfree.wordpress.com]
- Torticollis
Surgical intervention is indicated in cases of large primary gaze deviation, significant torticollis, marked upshoots or downshoots, or significant globe retraction. [link.springer.com]
Congenital mild ptosis without serious refractive errors, strabismus, amblyopia, or abnormal torticollis should only be considered for cosmetic reasons focusing on the psychological impact of the ptosis on the child. [dovepress.com]
There was no ocular torticollis. Primary Position : There was right sided ptosis [Figure - 3]A dating from birth. The right eye was hypotropic with its visual axis directed downwards [Figure - 3]B. Visual acuity : R. E. 6/9 and L. [ijo.in]
- Muscle Weakness
Congenital ptosis with associated weakness of superior rectus muscle. 3. Blepharophimosis syndrome, – which comprises congenital ptosis, blepharophimosis, telecanthus and epicanthus inversus. 4. [slideshare.net]
- Muscular Atrophy
Rarely, ptosis is part of a familial syndrome of peroneal muscular atrophy, parkinsonism, and sometimes dementia (33, 34). 3. [neuroophthalmology.ca]
Neurologic
- Confusion
To avoid the confusion associated with the variations in the definition of these ocular signs, we simply describe our findings as follows: In our patient, the upper eyelid margin remained retracted after its initial slow and minimal downward movement [frontiersin.org]
The inconsistent thickness of the nerve along the entire cisternal segment and variable age ranges may also confuse interpretation of the thickness of the abducens nerve. [journals.plos.org]
Because of its hidden position, it might be intraoperatively confused with other structures of the levator complex or mistaken as if frequently happens with the transverse ligament. [dovepress.com]
- Dystonia
AAN) Movement Disorders Research Award, sponsored by the Parkinson’s Disease Foundation, the Guthrie Family Humanitarian Award, presented by the Huntington’s Disease Society of America, the Tourette Syndrome Association Lifetime Achievement Award, the Dystonia [books.google.com]
• Blepharospasm : – is a focal dystonia causing involuntary eye closure; – levator function is normal. • In apraxia of lid opening, – the patient has difficulty in voluntarily initiating lid elevation although there is no levator impairment or blepharospasm [slideshare.net]
Ptosis complicates 8% of botulinum toxin treatments of blepharospasm or facial dystonia (37). Lambert-Eaton syndrome tends to spare the extraocular muscles. b) Ptosis from disorders of the muscle This occurs in both congenital and acquired forms. [neuroophthalmology.ca]
[…] repositioning appliance (하악 전방 재위치 장치) 하악을 최대 교두간위 전방으로 유도하거나 위치시키는 구강내 장치물 mandibular arch (하악 궁) mandibular block (하악 신경 전달 마취) mandibular branch (하악지, 하악 분지) mandibular closure (하악 폐구) mandibular depressor (하악 하인근) mandibular division (하악 분지) mandibular dystonia [dic.impact.pe.kr]
- Insomnia
Generally the effects observed are in an opposite direction from those produced by the drug; e.g., the withdrawal syndrome from central nervous system depressants such as barbiturates and benzodiazepines consists of insomnia, restlessness, tremulousness [kmle.co.kr]
Treatment
Upper lid retraction: its diagnosis and treatment.// Int Ophthalmol Clin. 1978. - Vol. 18. - p. 75-86. 17. Buffman FV, Rootman J. Upper lid retraction: its diagnosis and treatment.// Int Ophthalmol Clin. 1978. - Vol. 18. - p. 75-86. 18. [dissercat.com]
Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout. [books.google.com]
Prognosis
The format includes the CPT codes for billing purposes, short description of the condition, etiology/incidence, course/prognosis, laboratory findings, differential diagnosis; prophylaxis, treatment (local and systemic, surgical or other), miscellaneous [books.google.com]
Etiology
The format includes the CPT codes for billing purposes, short description of the condition, etiology/incidence, course/prognosis, laboratory findings, differential diagnosis; prophylaxis, treatment (local and systemic, surgical or other), miscellaneous [books.google.com]
Thyroid ophthalmopathy has been shown to be among the most common etiologies of eyelid retraction in adults and children.[2] It may be unilateral or bilateral and may occur in the setting of elevated thyroid function tests or euthyroidism. [medscape.com]
The etiology may be involutional, cicatricial, spastic or, rarely, congenital. [reviewofophthalmology.com]
There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. [content.sciendo.com]
Etiology Congenital Congenital ptosis is usually unilateral and does not progress. It is associated with absence or diminution of the levator palpebrae superiors muscle. Other ophthalmologic findings may include amblyopia and strabismus. [pedclerk.bsd.uchicago.edu]
Epidemiology
Medicine (274) Microbiology (239) Genetics (206) Neurology (171) Surgery, Traumatology and Orthopaedics (150) Histology, Embryology (148) Immunology, Allergology (127) Gastroenterology and Hepatology (120) Cardiology, Angiology (114) Biophysics (113) Epidemiology [portal.mefanet.cz]
[…] induced ptosis) [2] Partial deficiency of adduction [4] Oblique movement with attempts at adduction [4] Upshoot or downshoot of globe with adduction (Leash Phenomenon) [2] Widening of palpebral aperture with abduction [2] Deficiency of convergence [4] Epidemiology [eyewiki.aao.org]
Differences in epidemiological and clinical characteristics between various types of Duane retraction syndrome in 331 patients. J AAPOS. 2008;12(6):576–80. PubMed CrossRef Google Scholar 13. Huber A. Electrophysiology of the retraction syndrome. [link.springer.com]
Epidemiology and prevention of Graves' ophthalmopathy. // Thyroid. 2002. - Vol. 12(10). - p. 855-60. [dissercat.com]
Limb reduction defects in Emilia Romagna, Italy: epidemiological and genetic study in 173,109 consecutive births. J. Med. Genet., 27, 353-357. Donnai, D., Hughes, H. E., Winter, R. M. (1987). Postaxial acrofacial dysostosis (Miller) syndrome. J. [oandplibrary.org]
Pathophysiology
Paediatrics, Neonatology (386) Medical Chemistry and Biochemistry (335) Internal Medicine (332) Physiology and Pathophysiology (306) Infectology (299) Pathology and Forensic Medicine (274) Microbiology (239) Genetics (206) Neurology (171) Surgery, Traumatology [portal.mefanet.cz]
As DRS type 3 partly share the same pathophysiology with type 1 and 2 DRS, the classification of DRS may have to be revised according to MRI findings. [journals.plos.org]
[…] additional skin (flap or graft), release any vertical scar bands, horizontally tighten eyelid Paralytic Horizontally tighten eyelid, possibly reinforced by periosteal flap or fascial sling; palpebral spring Entropion Congenital Depends upon specific pathophysiologic [reviewofophthalmology.com]
[…] manner with incomplete penetrance and variable expressivity [2] General Pathology Duane Retraction Syndrome results from an absent or dysplastic abducens motor neurons with aberrant innervations of the lateral rectus muscle by the oculomotor nerve. [7] Pathophysiology [eyewiki.aao.org]
Blepharochalasis syndrome: a proposed pathophysiologic mechanism. Can J Ophthalmol. 1992;27:10-5. 50. Koursh DM, Modjtahedi SP, Selva D, Leibovitch I. The blepharochalasis syndrome. Surv Ophthalmol. 2009 Mar-Apr;54(2):235-44. 51. Sieb J, Hartmann A. [neuroophthalmology.ca]
Prevention
The clinical features and management are discussed in the hope that recognition of this clinical entity will prevent unnecessary investigation. Full text Full text is available as a scanned copy of the original print version. [ncbi.nlm.nih.gov]
Microbiology (239) Genetics (206) Neurology (171) Surgery, Traumatology and Orthopaedics (150) Histology, Embryology (148) Immunology, Allergology (127) Gastroenterology and Hepatology (120) Cardiology, Angiology (114) Biophysics (113) Epidemiology, Preventive [portal.mefanet.cz]
Wies procedure Transverse eyelid split + everting sutures – eyelid is split transversely to create fibrous tissue scar barrier which prevents the upward movement of preseptal muscle. [kjophthal.com]
Epidemiology and prevention of Graves' ophthalmopathy. // Thyroid. 2002. - Vol. 12(10). - p. 855-60. [dissercat.com]
The fissure on that side was 4 millimeters larger and lagophthalmos was present At the time of levator recession surgery, the muscle was found to have a restriction at the medial and lateral horns preventing downward excursion. [healio.com]