Air regurgitation in patients on continuous positive airway pressure (CPAP) therapy following dacrocystorhinostomy with or without Lester-Jones tube insertion.

Aim: To describe air regurgitation as a complication in patients on continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) following dacryocystorhinostomy (DCR) surgery with or without Lester-Jones tube (LJT) insertion.

Methods: A retrospective review of all patients with air regurgitation on CPAP therapy who previously underwent a DCR/LJT procedure. Patient demographics, lacrimal surgical history, CPAP therapy and outcome were recorded.

Orbital metastasis: clinical features, management and outcome.

Purpose: To review the clinical features, treatment, outcome and survival of metastatic tumors of the orbit.

Materials And Methods: Retrospective, non-comparative, chart review of 80 patients with orbital metastasis treated in four tertiary orbital centres in Australia.

Results: The study included 80 patients of which, 44 were male with a mean age of 60 years.

Genetic testing in orbital tumors.

Objective: This review aims to discuss the clinical application of cytogenetic and molecular testing in the diagnosis and prognosis of orbital tumors and, in so doing, highlight the basis of these methods, their advantages, and limitations.

Summary: Specific chromosomal aberrations are detected in many lymphoproliferative neoplasms, soft tissue tumors, and in a few benign tumors of the orbit. Detection of these characteristic chromosomal translocations is most helpful to refine the diagnosis and classification, especially when the tumor is poorly differentiated and shows overlapping morphological features with another tumor type.

Cilial entropion: surgical outcome with a new modification of the Hotz procedure.

Purpose: To report the surgical outcome with a new modification of the Hotz procedure for cilial entropion repair.

Design: Retrospective case series.

Participants: Forty-nine lower eyelids of 29 patients (22 female, 7 male; average age 8.

Prevalence and determinants of age-related macular degeneration in central Sri Lanka: the Kandy Eye Study.

Aims: To determine the prevalence, associations and risk factors for age-related macular degeneration (ARMD) in central Sri Lanka.

Methods: The study was a population-based, cross-sectional survey of residents aged > or = 40 years in rural Sri Lanka. ARMD was assessed on dilated fundoscopy using the International Age-Related Maculopathy Epidemiology Study Group classification system.

Intubation in routine dacryocystorhinostomy: why we do what we do.

The role of intubation in routine dacryocystorhinostomy (DCR) surgery is unclear, with there being little evidence in favour of this practice, which appears to have largely come about as a result of history, anecdote and the evolution of DCR surgery. In this paper, a brief history of intubation in DCR surgery is presented and the evidence base is analysed.

Bilateral trochlear nerve palsies following dorsal midbrain haemorrhage.

Bilateral trochlear nerve palsies without other signs of dorsal midbrain syndrome following spontaneous midbrain haemorrhage is extremely rare. We report the case of a 37-year-old man with bilateral trochlear nerve palsies causing superior oblique palsies (SOP) from dorsal midbrain haemorrhage which recovered with conservative management. The report highlights the need for imaging in patients with spontaneous bilateral superior oblique (BSO) motility deficits.

Prevalence and causes of visual impairment in a Brazilian population: the Botucatu Eye Study.

Background: This paper reports population-based data on the prevalence and causes of visual impairment among children and adults in Botucatu, Brazil.

Methods: A population-based cross-sectional study was conducted involving a random start point and then systematic sampling of an urban Brazilian population in the city of Botucatu. There were approximately 3,300 individuals aged 1 to 91 years who were eligible to participate in the study.

Absence of lateral palpebral raphe in Caucasians.

Classical anatomical teaching reports the presence of the lateral palpebral raphe formed at the union in the preseptal and orbital parts of the orbicularis oculi muscle, or by the tendon adhering these to the underlying zygomatic bone. The lateral palpebral raphe has been shown to be absent in Asian cadavers. The current study uses both evidence from the anatomical dissection of five eyelids from three Caucasian cadavers, and histological assessment of the lateral canthus of 13 eyelids from seven Caucasian cadavers to illustrate the absence of the lateral palpebral raphe in Caucasian population.

Management of congenital nasolacrimal duct obstruction.

Our review aims to provide an update of management protocols for congenital nasolacrimal duct obstruction (CNDO). Although early probing performed before the age of 1 year was traditionally recommended, many reports have since confirmed high frequencies of spontaneous resolution during the first year of life. Accordingly, a 'wait-and-see' approach, combined with conservative therapies, is judged to be the best option in infants aged<1 year.

Peripheral branching of levator superioris muscle and Müller muscle origin.

Purpose: To examine the structure of the distal levator superioris muscle and the origin of the Müller muscle.

Design: Experimental dissectional study.

Methods: Specimens from 10 postmortem upper eyelids and orbits of 7 white cadavers (6 right eyes and 4 left eyes; age range, 78 to 101 years of age at death; age average, 87.

Eyelash inversion in epiblepharon: Is it caused by redundant skin?

Purpose: To evaluate the effect of redundant lower eyelid skin on the eyelash direction in epiblepharon.

Materials And Methods: Asian patients with epiblepharon participated in this study. The lower eyelid skin was pulled downward in the upright position with the extent just to detach from eyelash roots, and the direction of the eyelashes was examined.

Overriding of the preseptal orbicularis oculi muscle in Caucasian cadavers.

We aimed to microscopically examine whether Caucasian eyelids demonstrate overriding of preseptal orbicularis oculi muscle (OOM) over the pretarsal OOM in both lower and upper eyelids. Full thickness sections of 13 lower eyelids and 11 upper eyelids from seven Caucasian cadavers were examined. In the lower eyelids, all 13 specimens demonstrated clear overriding of preseptal OOM over the pretarsal OOM.

Exophthalmometric values and their biometric correlates: The Kandy Eye Study.

Background: To determine normal exophthalmometric values for a Sri Lankan population and investigate their demographic, physical, refractive and ocular biometric correlates.

Methods: The Kandy Eye study was a population-based, cross-sectional study. By randomized cluster sampling, 1721 eligible participants, who were 40 years old and over were identified; 1375 participated.

Lower zinc-alpha2-glycoprotein production by adipose tissue and liver in obese patients unrelated to insulin resistance.

Context: Zinc-alpha2 glycoprotein (ZAG) has been proposed as a new candidate in the pathogenesis of obesity, but most of the information stems from studies performed in rodents and in vitro assays.

Objective: The main aim of the study was to compare serum levels of ZAG and its expression (mRNA levels and protein) in adipose tissue and the liver between obese and nonobese subjects. The relationship between ZAG and insulin resistance was also explored.

The levator aponeurosis contains smooth muscle fibers: new findings in Caucasians.

Purpose: To examine the microscopic structure of the upper eyelid of Caucasians, in particular looking for evidence of the presence of smooth muscle fibers and the microscopic nature of the levator aponeurosis.

Methods: Full-thickness sagittal sections of central upper eyelids from 11 postmortem upper eyelids of 7 Caucasians (age range 78-101 years at death; mean age 87.7 years) were examined.

Upper eyelid anatomy: an update.

Eyelid surgery necessitates a thorough knowledge of eyelid anatomy. Recent contributions to the literature have significantly advanced our understanding of eyelid anatomy. In this review, we present an update of the anatomy and the implications for upper eyelid surgery.

Lower eyelid anatomy: an update.

The gross anatomy of the lower eyelid is analogous to that of the upper eyelid, however, the lower eyelid has a more simplified structure with less dynamic movement. Common malpositions of the lower eyelid include entropion and ectropion, rehabilitative surgery of which requires a thorough understanding of lower eyelid anatomy. Furthermore, precise anatomic knowledge is a prerequisite for both reconstructive and cosmetic lower eyelid surgery in order for it to be performed appropriately.

Orbital septum attachment on the levator aponeurosis in Asians: in vivo and cadaver study.

Purpose: To examine the anatomic relationships between the preaponeurotic fat pad, orbital septum, and the distal end of the anterior layer of the levator aponeurosis (DEALLA) in relation to the superior tarsal plate border.

Design: Prospective, clinical case series and experimental anatomic study.

Participants: Twenty-two upper eyelids in 11 Asian patients (average age, 76.

Vertical lid split approach for optic nerve sheath decompression.

We describe a vertical lid split orbitotomy approach to perform optic nerve sheath fenestration which was done in a patient with idiopathic intracranial hypertension. A vertical lid split incision was used to enter the superomedial orbit and approach the optic nerve sheath. This approach resulted in a successful nerve sheath fenestration, with improvement in the patient's symptoms.

Prevalence and determinants of angle closure in central Sri Lanka: the Kandy Eye Study.

Purpose: To determine the prevalence and determinants of angle closure in the Kandy District of central Sri Lanka.

Design: Population-based, cross-sectional study.

Participants: Inhabitants aged 40 years or more from villages in the Kandy District were selected by randomized cluster sampling; 1721 eligible participants were identified, and 1375 participated in the study.

Common sequence variation in the VEGFA gene predicts risk of diabetic retinopathy.

Purpose: Vascular endothelial growth factor (VEGF) is a multifunctional cytokine that plays a role in angiogenesis and microvascular permeability. This study was conducted to determine whether common sequence variation in the VEGFA gene plays a role in the development of diabetic retinopathy (DR).

Method: Five hundred fifty-four subjects with diabetes mellitus (DM) including 190 type 1 DM (T1DM) and 364 type 2 DM (T2DM) were recruited.