To Evaluate the Efficacy of Diagnostic Periocular Punch Biopsy: Using a 4-mm Dermatology Punch.

Purpose: The dermatological punch biopsy is a minimally invasive procedure that provides conclusive diagnosis when managing periocular lesions. It aids with establishing histological diagnosis and subtype thereby facilitating management planning and eliminates the risk of unnecessary tissue sacrifice. The present literature provides limited evidence evaluating the value of punch biopsy in diagnosing periocular lesions.

Total Anterior Staphyloma Secondary to Acanthamoeba Keratitis.

There are very few published cases of total anterior staphyloma, all of which have been reported as secondary to fungal keratitis. This study reports the clinical and histopathological findings and subsequent management of a 27-year-old healthy female patient who developed total anterior staphyloma after poor compliance with treatment for clinically diagnosed acanthamoeba keratitis. She underwent a successful evisceration with good long-term results.

Medial canthal defects following tumour excision: To reconstruct or not to reconstruct?

Laissez-faire following excision of peri-ocular tumours has been described, but is not universally well established. We describe our experience with laissez-faire for managing medial canthal defects following tumour excision and compare our outcomes with full thickness skin grafts. Retrospective comparative case series of 68 patients who underwent reconstruction of a medial canthal defect using laissez-faire with sutured Sorbsan (LFS) (n = 36) or a full thickness skin graft (FTSG) (n = 32) at the same centre.

Accuracy of clinical diagnosis of benign eyelid lesions: Is a dedicated nurse-led service safe and effective?

This article compares an independent nurse-led benign lesion service with a doctor-led one, and assesses the impact of clinician seniority on diagnostic accuracy rates. Retrospective review of benign lesions referred to a teaching hospital and managed in either a doctor- or nurse-led lid service. All lesions were diagnosed clinically, excised and then sent for histological diagnosis.

Endoscopic Medial Rectus Sling: A Window Into the Intraconal Orbital Apex.

Purpose: Surgical approaches to the medial orbit especially within the cone of orbital muscles necessitate great precision and care to avoid damage to surrounding structures-most importantly the optic nerve. The authors present a novel technique in which access to the medial orbital contents was achieved through an entirely endoscopic approach.

Methods: A 72-year-old Caucasian female presented with loss of vision in the right eye and reduced extraocular movements.

Floppy eyelid syndrome: the coventry experience.

Purpose: Floppy eyelid syndrome is a condition that is difficult to identify and diagnose and with no clear guidelines on its management. We propose a method of reliably grading this syndrome and have proposed a management algorithm based on the grading.

Materials And Methods: Retrospective data collection of patients diagnosed with Floppy eyelid syndrome and treated under the care of a single oculoplastic surgeon over a 9 year period.

Full thickness skin grafts in periocular reconstructions: long-term outcomes.

Purpose: To evaluate the outcomes of eyelid reconstruction in patients who underwent full thickness skin grafts.

Methods: A retrospective, noncomparative intervention study of patients who underwent periocular reconstruction with full thickness skin grafts between 2005 and 2011.

Results: One hundred consecutive Caucasian patients were included in the study, 54 women and 46 men.

Visual function and quality of life in patients who had undergone eye removal surgery: a patient survey.

Purpose: To measure aspects of self-reported vision-related health status and assess the impact of treatment in patients who have undergone eye removal surgery (evisceration or enucleation), using a patient administered questionnaire.

Methods: In this non-randomised, questionnaire-based cohort study, patients were identified from the Artificial Eye Service referral register from 2003 to 2010. A self-administered questionnaire based upon previously published scales was completed to measure aspects of visual function and the impact of treatment.

Atypical fibroxanthoma of the medial canthus: a rare presentation.

Purpose: Atypical fibroxanthoma (AFX) is an uncommon skin tumour occurring primarily in the head and neck. It has rarely been reported in the periocular region. We report a rare case of atypical fibroxanthoma of the medial canthus.

Rhinotillexomania: a rare cause of medial orbital wall erosion.

The authors report a rare case of medial orbital wall erosion with an orbital inflammatory mass and resultant lacrimal obstruction secondary to rhinotillexomania. A 67-year-old male with known history of compulsive nose picking (rhinotillexomania) sought treatment for complaints of watering in his OD. Examination revealed a blocked right inferior canaliculus.

Migrated periocular filler masquerading as arteriovenous malformation: a diagnostic and therapeutic dilemma.

Migration of dermal filler is a rare complication in the periocular area. We describe a case that highlights the diagnostic and therapeutic dilemmas posed. A patient presented with a bluish swelling involving the left brow, temple, and glabella.

A new technique of alfentanil-induced conscious sedation for oculoplastic surgery.

This technique describes a new painless method of injecting local anaesthetic in a highly pain-sensitive area of the body-around the eyes. We describe how a new technique using a bolus of intravenous alfentanil can help alleviate patient discomfort during the injection of the local anaesthetic and also reduce the amount of local anaesthetic injected. This also helps oculoplastic surgeons to work in a relaxed environment, whilst still utilizing the efficiencies that are provided by an ambulatory day surgery unit.

One stage management of a giant kissing naevus.

We report a one stage management of a Giant Divided Naevus of the eyelids with excellent cosmetic results.

Complications of Cicatricial Ectropion Repair with Pre-Auricular Wolfe Graft.

An 85-year-old lady presented with a severe cicatricial ectropion several months after a fall. The abnormality was corrected with a procedure that involved the use of a retroauricular skin graft. This provided resolution of her ocular symptoms.

Excision of Xanthelasmata - clamp, shave, and suture.

Xanthelasma is a common disfiguring condition, which can be difficult to treat. Various treatments have been reported previously with varying degree of success. We report a simple yet effective technique of excision of the lesions with excellent cosmetic outcome.