Psychological and functional outcomes of horizontal squint surgery in adults with no preoperative diplopia using Quality-of-Life AS-20 questionnaire.

Background: Corrective squint surgery has a significant psychological impact, affecting both the quality of life and mental health of patients. This study highlights the quantitative and subjective assessment of both the psychological and functional outcomes of squint surgery in adults having horizontal strabismus with no preoperative diplopia using a Quality-Of-Life Adult Strabismus 20 (QOL AS-20) questionnaire.

Method: The study is a retrospective cohort study on patients with uncomplicated, horizontal squint; with no vertical deviation and was conducted as part of a departmental clinical audit.

At-risk patient documentation and naloxone dispersal for a rural statewide EMS "Naloxone Leave Behind" program.

Objectives: For successful Naloxone Leave Behind (NLB) programs, Emergency Medical Services (EMS) must identify patients at-risk for opioid overdose. We describe the first year of Vermont's NLB program and report rates of EMS documentation of at-risk patients with subsequent distribution of NLB kits in the subgroup of those refusing transport to an emergency department (ED).

Methods: This retrospective cohort review of all EMS encounters over 1 year compared on-scene EMS documented to retrospective chart reviewidentified at-risk patients eligible for NLB kit dispersal.

Richter Syndrome Presenting as Subcutaneous Nodules and a Dermal Plaque.

Richter syndrome (RS) describes a phenomenon in which a patient with chronic lymphocytic leukemia (CLL) develops an aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL). Reports of cutaneous RS remain exceedingly rare. We report a 61-year-old woman with relapsed/refractory CLL presenting with several subcutaneous nodules on her arms and legs and a single dermal plaque on her abdomen.

Evaluating the Effectiveness of Lacrimal Gland Botulinum Toxin Using the TEARS Score.

Purpose: Botulinum toxin (BoNTA) lacrimal gland injections are one treatment option for managing epiphora. Outcomes for epiphora in existing studies are subjective and lack grading. This study utilized validated grading instruments to evaluate the efficacy of BoNTA lacrimal gland injections.

Perifolliculitis mimicking basal cell carcinoma.

We present a case of a periocular painless perifolliculitis clinically mimicking basal cell carcinoma (BCC), excised by margin-controlled excision. This case reminds readers that perifolliculitis as a response to rosacea can mimic BCC. The value of diagnostic biopsy and dermoscopy to support management planning and avoid unnecessary surgery is discussed.

Lower eyelid lengthening in facial nerve palsy: when is a periosteal flap required?

Background/aims: To present a case series of patients with facial nerve palsy (FNP) undergoing lower eyelid surgery where inadequate horizontal tarsal length was encountered and managed with a periosteal flap.

Methods: A two-centre retrospective, non-comparative case series of all patients with FNP who underwent lower eyelid periosteal flap procedures. Theatre records identified all such procedures performed by, or under the supervision of, one of two surgeons (RM, BCP) between November 2018 and November 2020.

Bringing Eyelid Surgery in Line with International Guidelines Regarding Peri-Operative Antibiotic Agents: A Pilot Study.

International guidelines advise against prophylactic antimicrobial agents for primarily closed surgical incisions, but most oculoplastic surgeons report using chloramphenicol ointment. We evaluated baseline surgical site infection (SSI) rates in patients undergoing eyelid surgery who received prophylactic chloramphenicol ointment post-operatively. Withdrawal of prophylaxis was then prospectively audited to establish whether infection rates changed in a clinically meaningful way.

Oral nicotinamide for non-melanoma skin cancers: A review.

There has been much interest in the role of oral nicotinamide supplementation in reducing the incidence of non-melanoma skin cancers. This article reviews the hypothesised mechanisms of action of nicotinamide, and the available literature outlining its role for this purpose. There have been five randomised controlled trials (RCT), one histopathological study and two case series exploring the effect of oral nicotinamide supplementation on UV-induced immunosuppression of the skin, and incidence of actinic keratoses and non-melanoma skin cancers (NMSC).

Bacteriostatic preserved saline for pain-free periocular injections: review.

We review evidence regarding the use of 0.9% benzyl alcohol in 0.9% sodium chloride solution for periocular injections ('preserved saline') including botulinum toxin A injections and local anaesthesia.

Bilateral Paraneoplastic Orbital Myositis Associated With Malignant Melanoma and Multiple Myeloma.

Paraneoplastic extraocular muscle enlargement has been reported in a small number of patients with cancers including breast or lymphoma, usually presenting with bilateral multiple muscle involvement. Such myositis may be autoimmune. Furthermore, orbital inflammation is a recognized complication of immune-modulation therapy used to treat melanoma, such as ipilimumab.

Multi-disciplinary team meetings with specialist radiologists may improve pre-operative clinico-radiological diagnostic accuracy in patients requiring orbital biopsy and offer reciprocal educational opportunities.

Background: Accurate pre-operative diagnosis of orbital lesions supports appropriate prioritisation of patients into available theatre time. We examine the accuracy of pre-operative clinico-radiological diagnosis in a tertiary centre with weekly dedicated orbital clinics and associated multi-disciplinary team meetings.

Methods: A retrospective case notes review was undertaken for all patients who had an orbital biopsy performed at Bristol Eye Hospital between 2007 and 2017.

Anterior approach ptosis surgery: comparison of absorbable polyglactin sutures and non-absorbable polyester sutures. Does Vicryl stand the test of time?

Purpose: To determine whether the long-term success of ptosis surgery is influenced by the use of absorbable or non-absorbable sutures to advance the levator aponeurosis onto the tarsal plate.

Methods: Multi-centre retrospective comparative study of re-operation rates in primary anterior approach ptosis surgery using absorbable polyglactin sutures (Vicryl) and non-absorbable polyester sutures (Ethibond). The Medisoft audit tool was used to identify all patients who underwent primary ptosis surgery for aponeurotic ptosis, performed by five oculoplastic consultants within a 7-year period, across two NHS Ophthalmology departments.

-induced orbital cellulitis with intracranial involvement: a case report and review of the literature.

We report a case of a 17-year-old female who presented with orbital cellulitis and meningeal involvement secondary to severe paranasal sinusitis with positive blood culture for . The patient recovered after a 2-month course of systemic antibiotics and functional endoscopic sinus surgery.-induced orbital cellulitis is a rare entity, with only 5 previous cases reported in the literature, which are reviewed here as well.

Lymphoma and inflammatory disorders presenting in the orbit- a comparison of characteristics from a 10-year series in a tertiary hospital.

Background/aims: To explore differences in clinical presentations and outcomes between patients with biopsy-proven orbital lymphoma and orbital inflammatory disease.

Methods: Clinical records of all patients who underwent orbital biopsy at Bristol Eye Hospital during a 10-year period were reviewed. Comparisons were made between patients diagnosed with orbital lymphoma and orbital inflammatory disease (OID).

The highs and lows of Medisoft as an audit tool: lessons from a 5-year upper eyelid ptosis audit.

Background: Increasing demand for surgeon accountability requires regular audit of individual and institutional performances. Electronic record systems proclaim efficient audit systems, but how does Medisoft live up to the hype? We present our experiences and examine how well Medisoft's audit suite meets clinical audit needs.

Methods: Medisoft audit suite was used to audit all ptosis procedures undertaken during 2010-14 in Gloucestershire Hospitals NHS Foundation Trust.

Vaccination in pediatric cancer survivors: Vaccination rates, immune status, and knowledge regarding compliance.

Background: Vaccination recommendations for childhood cancer survivors are ambiguous. Limited data exist on vaccination rates and patient/caregiver knowledge of vaccination postchemotherapy.

Procedure: A single-institution study of childhood cancer survivors treated from 1996 to 2018.

Cutaneous metastases: A great imitator.

Neoplastic cells originating from a primary cancer can uncommonly spread to the skin, where they suggest a poor prognosis for the patient. In women, melanoma, breast, ovarian, oral cavity, and lung are the most common primary sources; in men, melanoma, lung, colon, and squamous cell carcinoma of the head and neck predominate. The classic presentation of cutaneous metastases is a firm, painless, flesh-colored to an erythematous dermal nodule (or nodules); however, several other presentations, including inflammatory, cicatricial, and bullous lesions, have been reported.

A Combined , and Clinical Approach to Characterize Novel Pathogenic Missense Variants in PRPF31 in Retinitis Pigmentosa.

At least six different proteins of the spliceosome, including PRPF3, PRPF4, PRPF6, PRPF8, PRPF31, and SNRNP200, are mutated in autosomal dominant retinitis pigmentosa (adRP). These proteins have recently been shown to localize to the base of the connecting cilium of the retinal photoreceptor cells, elucidating this form of RP as a retinal ciliopathy. In the case of loss-of-function variants in these genes, pathogenicity can easily be ascribed.