RESUMEN

PURPOSE: To define the regular upper eyelid anatomy and their changes during dynamic motion using ultrasonographically depicted structures. DESIGN: A cross-sectional study. METHODS: High-resolution ultrasound biomicroscopy (50MHz) was performed on 84 upper eyelids of 42 healthy volunteers without evidence of eyelid conditions. The skin-orbicularis oculi complex (SOOC), levator aponeurosis, and Müller's muscle-conjunctival complex were imaged. The thickness of these structures was measured in primary gaze and downgaze positions. RESULTS: SOOC and levator aponeurosis thickness was bigger with eyes open than with eyes closed (p < 0.01). With eyes closed, the thickness of SOOC on the pupillary midline and levator aponeurosis was positively correlated with age (p < 0.05, p < 0.01, respectively), and the thickness of levator aponeurosis and SOOC on the pupil midline was also positively correlated with BMI index (p < 0.05). Similarly, SOOC thickness on the medial and lateral canthus line is also positively correlated with BMI index and age (p < 0.05, p < 0.01, respectively). As for the differences between genders, the mean thickness of SOOC and levator aponeurosis was statistically different (p < 0.05, respectively). The magnitude of levator aponeurosis thickness in men varied more than in women in different ocular positions (p < 0.05). All measurements had an intramethod between 0.624 and 0.792, and inter-rater ICC and intrarater ICC between 0.748 and 0.850. CONCLUSIONS: Ultrasound biomicroscopy represents a noninvasive tool for the visualization of upper eyelid morphology. Expanding its application can help to understand the dynamics of upper eyelid physiological movement, aging, and disease research in different populations and evaluate surgical outcomes.

Asunto(s)

Párpados , Microscopía Acústica , Humanos , Masculino , Femenino , Párpados/diagnóstico por imagen , Párpados/anatomía & histología , Párpados/fisiología , Microscopía Acústica/métodos , Adulto , Estudios Transversales , Persona de Mediana Edad , Adulto Joven , Anciano , Valores de Referencia

RESUMEN

Viral conjunctivitis is one of the most common acute eye diseases. The fall and winter months are known to be the main season for viral infections which is also reflected in the ophthalmological outpatient clinics. Viral conjunctivitis is often accompanied by symptoms of the upper and lower respiratory tract, fever, chills, arthralgia or skin lesions. The spectrum of pathogens comprises DNA viruses such as Adeno-, Herpes simplex and Molluscum contagiosum as well as RNA viruses. Symptoms caused by pandemic pathogens such as SARS-CoV-2 and mpox viruses can also cause ocular manifestation. Viral conjunctivitis is often self-limiting leaving no residual symptoms, however an ophthalmologist should be consulted if there are inflammatory symptoms of the anterior eye accompanied by visual disturbance. It is particularly important to recognize the affection of corneal or even intraocular structures early to initiate an adequate and effective therapy. Affection of the cornea, vitreus or retina can result in temporary or permanent impairment of the field of vision and visual acuity. The diagnosis is usually made without further tests on the basis of the typical clinical presentation. Rapid tests or PCR diagnostics are also available for confirmation. In most patients the treatment is symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically. If the cornea or other ocular structures are affected by certain viruses, local as well as systemic virostatic therapy is initiated. The most important prophylactic measure is meticulous and consistent hygiene.

Asunto(s)

Conjuntivitis Viral , Conjuntivitis , Humanos , Conjuntivitis Viral/diagnóstico , Conjuntivitis Viral/tratamiento farmacológico , Conjuntivitis Viral/prevención & control , Córnea , Gotas Lubricantes para Ojos/uso terapéutico

RESUMEN

Various surgical techniques are available for the extirpation of an eye, depending on the underlying disease. Typical indications encompass tumors, inflammatory and infectious processes, glaucoma, trauma as well as congenital malformations. Surgical procedures include evisceration (resection of the intraocular space with preservation of the sclera), enucleation (extirpation of the entire eyeball including sclera and cornea) and exenteration (resection of the complete orbital soft tissue). The early detection of postoperatively manifesting complications, such as implant extrusion, conjunctivitis, postenucleation socket syndrome as well as the development of enophthalmus or ptosis, is of particular relevance in the context of postoperative care regarding functional, esthetic and social outcome. Special attention must be paid to ensuring a complication-free rehabilitation process, including the supply of a suitable, precisely fitting prosthesis or epithesis. This ensures the patient's psychosocial reintegration, in which an integrated interdisciplinary cooperation with ocularists and psychologists is essential. The latter play a particularly important role, as the psychological stress resulting from the procedure is often associated with a considerable reduction in the quality of life.

Asunto(s)

Implantes Orbitales , Humanos , Cuidados Posoperatorios , Calidad de Vida , Evisceración del Ojo/métodos , Esclerótica

RESUMEN

BACKGROUND: The correction of anomalous head posture associated with infantile nystagmus syndrome (INS) is carried out by the Kestenbaum procedure (KP) combining bilateral horizontal yoke muscle recession with resection of their antagonists or by the Anderson procedure (AP) which is confined to yoke muscle recession alone. AIM OF THE STUDY: To compare the results of highly dosed AP and KP for anomalous head turn (HT). PATIENTS AND METHODS: The AP (2013-2019) and KP (2003-2013) were used as the exclusive procedures during the respective time periods. A highly dosed AP was performed in a case series of 33 consecutive orthotropic patients with INS and KP in 19 orthotropic patients with INS. Medians and ranges (min-max) in groups AP/KP were: age at surgery 7 years (4-44 years)/6 years (4-27 years), HT 32.5° (20-45°)/30° (17-40°) and surgery on each eye AP 13 mm (10-16 mm) (standard dose), KP 10 mm (6-12 mm) + 10 mm (6-12 mm) (mean 0.6 mm/°HT). RESULTS: The HT was diminished to 10° (-3-20°)/10° (-7-20°) ca. 3 months after surgery. At the late visit (8-153 months), the residual HT was 10° (0-20°)/10° (-27-30°). The HT was reduced by 67% (20-100%)/64% (14-100%) at the last control. A residual HT ≤15° was present in 79%/81% of cases (91% after AP ≥13 mm; n = 23) and HT ≤10° in 55%/57%, (65% after AP ≥13 mm). The maximum adduction/abduction towards the recessed muscles was 30°/30° (10-37°/15-45°) after AP and 32°/30° (10-40°/12-45°) after KP. An associated head tilt was not improved by the intervention. Mean binocular visual acuity increased by <1 line in both procedures. After AP the mean increase was 1 line in children ≤6 years old and there was no increase in patients >6 years of age. CONCLUSION: The effectiveness and success rates of AP and KP were similar with the dosing used. Less invasive surgery is an advantage in favor of AP as the primary procedure.

Asunto(s)

Nistagmo Patológico , Niño , Cabeza , Humanos , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos , Postura