Ординатура / Офтальмология / Английские материалы / Fundamentals of Clinical Ophthalmology Plastic and Orbital Surgery_Collin, Rose_2001

A-sutures 13, 13

accentuation measurement in ptosis 33 achrocordon 45

acne rosacea 108

actinomyces canaliculitis 107, 108, 108, 110, 110 adenocarcinoma 147

adenoid cystic carcinoma 142, 147 adenoma

pleiomyorphic 132, 132 sebaceous 45

adnexal benign tumours 45 adrenaline addition to anaesthesia 4

advanced trauma life support (ALTS) system 7 airgun pellet foreign body 157

amaurosis, gaze-evoked 99 amblyopia 126

from lymphangioma 129 prevention 11

in ptosis 34 anaesthesia

for cosmetic surgery 70–80

for dacyrocystorhinostomy 161–2

for endonasal dacyrocystorhinostomy 169, 169 for eye surgery 5

anatomy of eye 1–6 angiography

in intraorbital arterio-venous malformations 130 in orbital disease 106

anisometropia 126 annulus of Zinn 4, 4 anophthalmos 95–6 anterior lamella 1

repair 11

repositioning with everting sutures 29 anterior orbitotomy 133–4

anterior venous anomalies 102 antibiotic

and central ectropion 16

following dacyrocystorhinostomy 166 for orbital cellulitis 135

prophylaxis in bite wounds 9

following surgery for dysthyroid eye disease 121 anti-inflammatories following surgery for dysthyroid

eye disease 121 anti-mitotic agents 12 antitetanus prophylaxis 7 aponeurosis 2

complications 40 surgery 39–40, 40 tuck 40, 40

aponeurotic ptosis 37

arterio-venous communications, orbital 130–1 arterio-venous malformation 102, 102

ultrasonography 104

aspirin, withdrawal prior to surgery 21 astigmatism 126

B-cell lymphoma 144

basal cell carcinoma 45–7, 46, 146–7 common 46, 47

complex 47

management principles 51 radiation 53, 54

Bell’s palsy

assessment in ptosis 34 prognosis 67 symptoms 67

benign tumours 45, 123–39 misdiagnosis 52 simulating malignancy 48 types 45

Bick procedure, modified 16–17, 17

bicoronal scalp-flap for orbital decompression 117, 118, 119, 119–21

biopsies incisional 133

in orbital disease 106 of tumours 45

bite wounds 9 blepharitis

causing trichiasis 30 marginal 107–8, 108

blepharo-conjunctivitis and sebaceous gland carcinoma 49

blepharo-keratitis causing epiphora 108 blepharophimosis syndrome 35 blepharoplasty 82–5

complications 85 laser use 87 lower lid 17

skin-reduction, in dysthyroid eye disease 117 subciliary in dysthyroid eye disease 119

blepharoptosis see ptosis blepharospasm 27 blindness

following blepharoplasty 85 following lateral orbitotomy 129 from surgical optical trauma 159

blood supply to eye 5 “blowout” fracture 4, 150–5, 151

imaging 104 blue naevus 45

bone invasion of orbit, imaging 104 bone-removing orbital decompression in dysthyroid

eye disease 117–21 bony orbit 4, 4

botulinum toxin for spastic entropion 27

brain abscess and intraorbital foreign bodies 157 Breslow melanoma classification 50 bronchogenic carcinoma 103

brow see eyebrow browpexy 80–1, 80 browplasty 81

bruising after ectropion surgery 21–2 “bullhorn” dilator 179

Burkitt’s lymphoma 144 Burrow’s triangle 59

canalicular bypass tube 174, 177–9, 178 closed placement 179

canalicular configuration 3 laceration repair 11–12

canaliculo-dacycystorhinostomy 174, 175–6,

176

canaliculostomy, retrograde, dacycystorhinostomy with 176–7, 177

canthal corner, anterodisplacement 22 canthal tendons 2, 15

laxity see ectropion medial anterior 19, 19

medial posterior 19–20, 20 medial resection 20, 20 plication 18

canthloysis

for lower lid reconstruction 57, 57 for upper lid reconstruction 62, 62

canthoplasty, medial 69–70, 69 during lacrimal surgery 179–80

canthotomy

lateral, orbital decompression 117, 118, 118–19,

119, 120

INDEX

for lower lid reconstruction 57, 57 for upper lid reconstruction 62

canthus assessment 174

capillary haemangioma 45, 126–7, 126 differential diagnosis 140

carbon dioxide lasers 85–6 skin resurfacing 86–7, 87

carcinoma

metastasising to orbit 148, 148 see also malignant tumours

carotico-cavernous fistula 102, 131, 131 carotid arteries 5

carunculectomy 178

cavernous haemangioma 127–9, 127 complications 129

cellulitis

orbital 134–5, 134

in rhabdomyosarcoma 140, 140 cephalocoeles 125–6 cerebrospinal fluid leak following

dacyrocystorhinostomy 166

chalazion and sebaceous gland carcinoma 48 cheek rotation flap 60–1, 61

chemosis 102, 102, 131

in dysthyroid eye disease 115, 116 chemotherapy for idiopathic orbital inflammation

136 children

amblyopia prevention 11 malignant orbital disease 140–2

chloroma see leukaemia, acute myeloid “chocolate cysts” 129

cholesterol granuloma imaging 106 choroidal folds 99

choroidal striae 103 cicatrical entropion 22, 27

avoiding 5 diagnosis 13 treatment 13

Clark melanoma classification 50 cocaine test for Horner’s syndrome 38 Coherent CO2 laser 85

colour perception tests in orbital disease 100 computed tomography (CT) imaging

cavernous haemangioma 126, 126 dacryoadenitis 133

dermoid cysts 124

dysthyroid eye disease 113–14, 114, 114 foreign bodies 156, 156

idiopathic orbital inflammation 136 lacrimal gland carcinoma 142, 143 lacrimal sac 110

lacrimal surgery 175 lymphangioma 129 optic nerve glioma 137

optic nerve meningioma 138 orbital 104

orbital floor fracture 151, 151 orbital lymphoma 144–5, 145

INDEX

computed tomography (CT) imaging – Continued orbital varices 130

sphenoid wing meningioma 138 conformer 91

congenital clefts of skull 125–6 congenital ectropion 15–16 congenital myogenic ptosis 35–7 congenital naevus 45

congenital ocular fibrosis syndrome and ptosis 36 conjunctiva

bulbal graft 65 chemosis 102, 102

in dysthyroid eye disease 115, 116 exposure problems 16

inclusion cysts 97

prolapse and ptosis surgery 40–1 tight 73

conjunctivodacryocystorhinostomy 12 corkscrew episcleral vessels 102 cornea

abrasion in Fasanella–Servat procedure 43 exposure 16, 73

features in dysthyroid eye disease 113 limbus 1

protection 7–8, 74–7

sensation assessment in ptosis 34 cosmetic defects in facial palsy 67–8

management 68 cosmetic surgery 78–88

patient evaluation 78–80 cranial anomalies 125–6

Crawford method for eyebrow suspension 41, 41 “crocodile tear” syndrome 67, 108

cryotherapy

for malignant eyelid tumours 54 complications 54

for trichiasis 31

CT see computed tomography cutaneous horn 45

Cutler–Beard reconsutrction 63–4, 64 cyst

excision for ectropion 21 malignant 46 microphthalmos with 125 orbital benign 123–5

dacryoadenitis 100, 102, 132–4, 133 differential diagnosis 142

dacryocoele 131–2 dacryocystitis 97 dacryocystography 109–10, 110 dacryocystorhinostomy 12, 110

anaesthesia 161–2 endonasal 168–73

indications 168–9

postoperative management and complications 170–2

results 168 technique 169–70

complications 166–7, 166 indications 161

and Jones canalicular bypass tube 177–9 post-operative management 165–6

with retrograde canaliculostomy 176–7, 177 surgical technique 162–5

vasoconstriction and haemostasis 162 dacryops see dacryocoele

debridement, minimal 8 dermatofibroma 45 dermis

benign tumours 45

fat (dermofat) grafts 14, 92–3 complications 93

dermoid cysts 100, 101 benign 123–4, 124 imaging 106

dermolipoma, benign 124–5 Dexon sutures 8

diplopia

following blepharoplasty 85

following surgery in dysthyroid eye disease 121 in orbital floor fracture 151

in orbital disease 99 dirt removal 7–8 distichiasis 31

Down’s syndrome, ectropion 15

down-gaze restriction in orbital floor fracture 151,

152

drainage see lacrimal drainage

dry eye following surgery for lacrimal gland carcinoma 143

duction test 100

dural shunts 130–1, 131 low-flow 102, 102

dysthyroid eye disease 100, 102, 112–22 features 112–14, 113

pathogenesis 112

postoperative management and complications 121 treatment 114–21

see also thyroid orbitopathy

ear cartilage harvesting 30 ecchymosis in orbital disease 99 ectropion 15–23

acquired 16

caused by entropion surgery 22 central 16–17

cicatricial 21 avoiding 5 diagnosis 13 treatment 13

classification 15 complications 21–3 congenital 15–16

entropion following surgery for 22–3 following blepharoplasty 85 involutional 16

lateral 17–18

management 68 mechanical 20 medial 18–20 paralytic 21

and ptosis surgery 41 punctal 108

recurrent 22

electrolysis for trichiasis 31 encephalocoeles 126

endonasal lacrimal surgery 168–73, 171–2 enophthalmos 99, 150, 151

following enucleation 94

following surgery in dysthyroid eye disease 121 entropion 24–31

acquired 25, 26

caused by ectropion surgery 22 cicatricial 22, 27, 29 classification 25

congenital 25 involutional 25, 27 spastic 27

surgery

ectropion following 22 for lower lid 27–9

for upper lid 29–30 enucleation 89–91, 91

indications 12, 89 from injury 157, 158

volume deficiency following 94–5 eosinophilic granuloma 142 epiblepharon 25

epidermis, benign tumours 45 epidermoid cysts, benign 123–4 epiphora

assessment 107–9 in ectropion 18

in orbital disease 100 episcleral vessels, corkscrew 102 episcleritis 134

Erbium YAG laser 85–6, 87–8 estheioneuroblastoma 147 ethibond 9

ethmoid fracture 151

mucocoele 125, 125

ethmoidoectomy incision, Lynch external 117–18, 119 everting technique

for ectropion 27–8 for entropion 8

see also ectropion; entropion evisceration 89, 90

Ewing’s sarcoma, metastatic 144 excretory system of eye 3–4 exenteration 91, 146, 147 exophthalmos 150

expanders for congenital small socket 96 exposure symptoms in orbital disease 100 extraconal space 4, 5

extraocular muscles

INDEX

damage 157

features in dysthyroid eye disease 113 function measurement in ptosis 33–4

eye ointment for central ectropion 16 eye socket see socket

eyebrow

configuration analysis 78 lift, direct 68, 72–3, 72 ptosis 79, 80

suspension in 41–2 surgery, cosmetic 80–82

coronal lift 81–2 direct lift 81

endoscopic forehead and brow lift 82 internal fixation 80–1, 80

mid forehead list 81 temporal lift 81

eyelash distorted 30 dysplastic 30 follicles 25 ptosis 41

see also trichiasis eyelid

anatomy 1–3, 1, 24–5, 24–5 assessment for cosmetic surgery 78–9 asymmetry following blepharoplasty 85 basal cell carcinoma 45–7, 46

common patterns 46, 47 complex 47

management principles 51 benign tumours 45

closure, causes of inadequacy 73–4 strength measurement in ptosis 34

ectropion see ectropion entropion see entropion

fatiguability measurement in ptosis 34 features in dysthyroid eye disease 113 full-thickness loss 65

guard 7–8

inversion see entropion Kaposi’s sarcoma 50, 50

management principles lacerations 10–11

lag in thyroid orbitopathy 101 laxity 16

causing epiphora 108 malignant tumours 146–7

cryotherapy 54 features 44

management principles 50–3

Mohs’ micrographic surgery 51, 52, 54–5 radiation 52, 53–4

margin 1 melanoma 49–50

management principles 52–3 metastatic tumours 50

management principles 53

movements, aberrant/synkinetic, in ptosis 34

INDEX

eyelid – Continued oriental 25

peaked, in Fasanella–Servat procedure 42 position measurement in ptosis on downgaze 35 problems causing discharge following surgery 97 rare tumours 50

reconstruction 55–65 lower 56–62 upper 62–5

retractors 1,2 tight 73

reattachment to tarsal inferior border 20–1 sebaceous gland carcinoma 48–9, 48

management principles 52 signs in orbital disease 101–2

skin preservation in exenteration 91 squamous cell carcinoma 47–8, 48 management principles 51–2

stability 24–5

surgery, cosmetic 82–5

see also under ectropion; entropion tightening, decisions 15

tissue loss 157, 158

trauma and reconstruction 7–14 tissue preservation 8

see also lower eyelid and upper eyelid

facial asymmetry analysis 78 facial palsy see seventh nerve palsy

facial soft tissue and bone clefting 104, 105 facial trauma, tissue preservation 8 Fasanella–Servat procedure 38, 42–3, 42 fascia lata for eyebrow suspension 41

fascial sling, lower lid, following enucleation 95 fat

excision problems 85 pads, eyelid 2

fatiguability of eyelid measurement in ptosis 34 festoons in thyroid orbitopathy 101

fibroblast activity and scarring 12 fibrosarcoma, orbital 144, 144 fingernail clubbing 103

Fitzpatrick’s classification for skin colouring 79 “flying man” incision 35

follicular keratosis, inverted 45 forceps 9

foreign bodies intraorbital 156–7 removal 7–8

fornix, interior, shallowing following enucleation 95 Fox method for eyebrow suspension 41, 41

frontalis muscle action measurement in ptosis 34, 35 full-thickness composite graft 64

gaze-evoked amaurosis 99 glands of Krause 3 glands of Moll 25

glands of Wolfring 3 glands of Zeiss 25

glioma, optic nerve 137, 137 globe

displacement in orbital disease 98–9, 99, 100 “frozen” 47

removal see enucleation rupture 150

gold weight implantation in seventh nerve palsy 68, 71–2, 72

Goldenhar’s syndrome 124 graft see skin graft granuloma

cholesterol, imaging 106 eosinophilic 142

formation from dermofat graft 93 pyogenic 45

Graves’ hyperthyroidism 112 “grey line” of lid margin 1

haemangioma

capillary 45, 126–7, 126 cavernous 127–9, 127 complications 129 haemangiopericytoma 144

imaging 106 orbital 148–9

haematoma subperiosteal 159

following dacyrocystorhinostomy 165, 166 following ectropion surgery 22

following orbital floor repair 153–4 orbital 159

on weapon removal 10

haemostasis for dacyrocystorhinostomy 162 haemostats 9

hair follicle, benign tumours 45 hair growth on dermofat graft 93 hard palate

harvesting 30 spacer 76, 77

Hashimoto’s thyroiditis 112

head posture, compensatory, measurement in ptosis 34

Hering’s law 33

histiocytoma, malignant fibrous 144 histiocytosis, Langerhans cell 141–2 history taking in orbital disease 98–103 Horner’s syndrome

miosis 33 ptosis 37–8

Hughes’ flap 58–60, 58–9

hydroxyamphetamine test for Horner’s syndrome 38 hydroxyapatite for orbital implant 92 hypermetropia 99

hyperthyroidism see Graves’ hyperthyroidism hypoglobus following surgery in dysthyroid

eye disease 121

idiopathic orbital inflammation 135–7, 136 implant see orbital implant

incision

for canaliculo-dacyrocystorhinostomy 176 for dacyrocystorhinostomy 163, 167

for eye surgery 5, 6

for lower lid surgery 1, 5

see also specific types, e.g. Mustarde’s “flying man” incision

incisional biopsy 133 infection

following dacyrocystorhinostomy 166, 167 following orbital floor repair 154, 154

inflammatory disease, benign orbital 134–7 infraorbital nerve hypoaesthesia following orbital

floor repair 154 intranasal examination 109 intranasal tumour 109, 109 intraocular disease 102–3 intraocular tumours 148

intraocular pressure, raised, in orbital disease 102, 103 intraoperative care 5

intraorbital arterio-venous malformations 130 intraorbital foreign bodies 156–7

Ishihara colour plates 100

jaw-wink in ptosis 34, 38 Jones procedure 18, 28

canalicular bypass tube 174, 177–9, 178 closed placement 179

Kaposi’s sarcoma 50, 50 management principles

Kearns Sayre syndrome and ptosis 36 keratectomy and evisceration 89 keratitis

following orbital roof fractures 155 from dacryoadenitis 134

keratitis sicca in pleiomyorphic adenoma 132 keratoacanthoma 45

Kuhnt–Symanovsky type procedure 17

lacerations to eyelid 10–11 lacrimal canal obstruction 174 lacrimal drainage disease 106–11

anatomy 3–4, 3 ancillary tests 109–11

damage following orbital floor repair 154 and endonasal anastomosis 168 examination 107–9

history taking 107, 107 problems causing discharge 97 scintigraphy 110–11, 111 surgery and trauma 174–81

assessment 174–5 surgical options 175–81 external 161–7

laser-assisted and endonasal 168–73, 171–2 syringing 108–9, 109

lacrimal gland 3, 5 carcinoma 142–3

INDEX

disease, benign 131–4 tumours 102

lacrimal instruments 9 lacrimal pump 4, 4 lacrimal sac 3

mucocoele 108 stone 110

tumour imaging 110 lagophthalmos

following blepharoplasty 85 following orbital roof fractures 155

following upper eyelid reconstruction 62 and proptosis 100

in ptosis 34, 40

in thyroid orbitopathy 101 lamellae, eyelid 1, 24, 24

repair 11

repositioning with everting sutures 29 lamina papyracea breakdown 146 Langerhanas cell histiocytosis 141–2 lasers

lacrimal surgery 168–73, 172 oculoplasty surgery 85–8

incisional surgery 87 skin resurfacing 86–8

lash see eyelash

lateral canthal tendon 2 lateral orbitotomy 127–9, 128

lateral tarsal strip for ectropion 17–18, 18 lateral tarsorrhaphy 68–9, 69

Lazy-T procedure 18, 19, 19 Le Fort fractures 155 leiomyosarcoma 144

lentigo senilis 45 lentigo simplex 45 Lester Jones see Jones

leukaemia, acute myeloid 141, 141 levator muscle

dysgenesis in ptosis 35

function measurement in ptosis preservation in upper lid reconstructin 62

laceration repair 10 resection 39, 39

complications 40–1 levator palpebrae superioris 2

lines of minimum skin tension 5, 6 liposarcoma 144

Lisch nodules 102, 102 lower eyelid

blepharoplasty 83–5

anterior approach 83–4, 84 external direct 84–5 transconjunctival 84

cicatricial retraction following orbital floor repair 154

displacement in dysthyroid eye disease 117 fascial sling following enucleation 95 laxity 79

causing epiphora 107, 108

INDEX

lower eyelid – Continued following enucleation 94

lesion excisions 1, 5 reconstruction 56–62

margin rotation and inversion 64–5 retractors 3, 24

recession 76–7 swinging flap 118

lymphadenopathy and orbital disease 103 lymphangiomas 129–30

lymphatic drainage from eye 5 lymphoid hyperplasia 144 lymphoid tumours 50

management principles 53 lymphoma in adults, orbital 144–6, 145

Lynch external ethmoidoectomy incision 117–18,

119

magnetic resonance imaging cavernous haemangioma 126 dysthyroid eye disease 114, 114 foreign bodies 156

optic nerve glioma 137 orbital 105–6

malignant orbital disease 140–9 malignant tumour

clinical signs of malignancy 44 features 44

management and repair following excision 44–66 management principles 50–3

types 44

Marcus Gunn jaw-winking ptosis 38 margin–reflex distance (MRD) 32–3, 32 masquerade syndrome 48

mattress sutures 8 maxillary fractures 155 maxillary nerve 5 mechanical ptosis 38 medial canthal tendon 2

laceration repair 11

medial canthoplasty 69–70, 69

during lacrimal surgery 179–80, 180 medial wall

fracture 150–5

removal in dysthyroid eye disease 115–16, 116 medial wedge resection 70–1, 70

meibomian gland

eyelash growing from 31 tumours 146–7

melanoma 49–50 fungating 147, 147

management principles 51–2 nodular malignant 50, 50 orbital imaging 106

uveal malignant 148 meningioma

optic nerve 103, 137, 138 sphenoid wing 137–8, 138

meningocoeles 126

meningo-encephalocoeles 126 Merkel cell tumour 50, 51

MERRF see myoclonic epilepsy and ragged red fibre syndrome

mesenchymal tumours 143–4 metastatic orbital disease 148, 148 microphthalmos 96

with cyst 125 mid-face fracture 155–6

miosis measurement in ptosis 33 mitochondrial myopathy and ptosis 36

Mohs’ micrographic surgery for malignant eyelid tumours 51, 52, 54–5

“morning glory syndrome” 126 MRI see magnetic resonance imaging mucocoele

frontal 100 imaging 106 lacrimal sac 108

paranasal sinus 124, 125 mucormycosis 102

in orbital disease 99

mucosal flaps in dacyrocystorhinostomy 164–5,

164–5

mucous membrane graft for contracted socket 96 harvesting 30

with distal margin rotation 29–30 with tarsal dissection 29

Müller’s muscle 2

surgery in seventh nerve plasy 68, 71, 71 muscular dystrophy and ptosis 36 Mustarde’s “flying man” incision 35

cheek rotation flap 60–1, 61 myasthenia gravis and ptosis 36 mycosis fungoides 50 mydriasis in ptosis 33

myoclonic epilepsy and ragged red fibre syndrome and ptosis 36

myogenic ptosis 35–7 myositis, orbital 135, 136

pain with 98

myotonic dystrophy and ptosis 36

naevocellular naevus 45 naevus 45

malignant 46 nasal mass 102 nasojugal fold 1

nasolacrimal duct 3–4 obstruction surgery 161–7 stenosis 108

needle holders 9 nerve supply to eye 5

neural lesions, benign 137–8 neurilemmomas 137

malignant 148 neuroblastoma 140, 141, 141 neurofibroma 45

plexiform 137 neurofibromatosis

Lisch nodules 102, 102 peripheral 102, 103

neurogenic ptosis 37–8 neurological examination 150 neuropathy, optic 134

neuropraxia following lateral orbitotomy 129 non-Hodgkin’s B-cell lymphoma 144

NOSPECS classification of dysthyroid eye disease 112–13

nylon sutures 8

ocreotide scintigraphy in orbital disease 106 ocular balance and ductions 100

ocular duction following lateral orbitotomy 129 ocular fibrosis syndrome, congenital, and ptosis 36 ocular measurement in ptosis 35

oculopharyngeal dystrophy and ptosis 36 oculoplastic instruments 9

ophthalmia, sympathetic, prevention 12 ophthalmic nerve 5

optic canal decompression 158–9 optic nerve

activity score in dysthyroid eye disease 113 compression 99

injury 157–8, 158 lesion imaging 105 meningioma 103

neuropathy following orbital roof fractures 154 tumours, benign 137, 138

orbicularis fibres, lacerations near 10 orbicularis muscle 2, 24, 25

function and corneal exposure 73 spasm 15

orbita anatomy 4–5

anomalies 125–6

arterio-venous communications 130–1 benign vascular anomalies 126–31 blowout fractures imaging 104 cellulitis 134–5, 134

from mucocoele 125

in rhabdomyosarcoma 140, 140 decompression, bone-removing, in dysthyroid eye

disease 117–21

in dysthyroid eye disease 115 disease 98–106

ancillary tests 103–6 benign 123–39 benign cysts 123–5 examination 100–3 history taking 98–100 malignant 140–9 metastatic 148, 148

presenting symptoms 98 exenteration 146, 147

fat

causing MRI problems 105

INDEX

prolapse following dacyrocystorhinostomy 166 haemorrhage 159

imaging 105, 106

imaging in dysthyroid eye disease 113–14 inflammation, treatment in dysthyroid eye disease

115

inflammatory disease, benign 134–7 idiopathic 135–7, 136 inflammatory syndrome 102 lobe tumours 132

myositis 135, 136

roof fracture 155–6, 155 septum 2

soft tissues injury 157–9 trauma 150–60

surgical 155, 159, 159 tumour, imaging 104, 106

rare primary malignant, in adults 148–9 secondary 146–8

signs 103 varices 129, 130, 130

orbital floor fracture 150–5

assessment 151–2 complications 153–5 management 152 repair 152–3

trauma imaging 104, 104 orbital implant 90–1, 91–2

volume calculation 91–2, 91 materials 92, 92 complications 92, 94–5 migration 92

replacement 94 extrusion 96

in orbital floor fracture 152–3, 153, 154, 154 causing discharge 96–7

see also prosthesis orbitotomy

anterior 133–4 lateral 127–9, 128

orthoptics assessment in orbital floor fracture 151 osseous lesions, benign 137–8

osteosarcoma, orbital 143–4

pagetoid pattern of sebaceous gland carcinoma 49, 52 pain in orbital disease 98

palatal varices 102 palpebral aperture 32 palpebral lobe tumours 132

papillary reaction tests in orbital disease 100 paranasal sinus

mucocoeles 125, 125 tumours 147–8

patient

evaluation for cosmetic surgery 78–80 preparation for eye surgery 5 self-assessment in dysthyroid eye disease 113 survey and resuscitation in trauma 7

INDEX

peau d’orange effect in dermis–fat grafting 14 pentagon excision for central ectropion 16–17, 17 periorbital oedema in thyroid orbitopathy 101 periorbital signs in orbital disease 101–2 periosteal flap for lower eyelid reconstruction 60 PET see positron emission tomography phenylephrine test in ptosis 35

pigmentary benign lesions 45 pilomatrixoma 45

pleiomyorphic adenoma 132, 132 plication for ectropion 18, 19, 19

pneumatocoele following orbital floor repair 154, 154 positron emission tomography in orbital disease 106 post-caruncular transconjunctival orbital

decompression 117 post-enucleation syndrome 94–5 posterior lamella 1

advance following lid split 29, 30 lengthening 29–30

repair 11 pre-aponeurotic fat pad 2 presbyopia, premature 99 proptosis 73, 131, 150

in dysthyroid eye disease 113, 115–17 following surgical trauma to orbit 159 and lagophthalmos 100

in orbital disease 98–9

in thyroid orbitopathy 101

under/over correction in dysthyroid eye disease 121

prosthesis causing discharge 96–7 see also orbital implant

pseudocapsule breach 132 pseudoepitheliomatous hyperplasia 54 pseudoptosis 38

ptosis 32–43 aponeurotic 33, 37 assessment 32–5 brow 79, 80 classification 35–8

following blepharoplasty 85 following enucleation 94, 95 mechanical 38

myogenic 25–7 neurogenic 37–8 props 43

repair 11

S-shaped 132–3, 133 surgical correction 39–43

pulsation 99

punctal ectropion 18–19, 108 pupil size measurement in ptosis 33

Quickert’s procedure 28

radiography for weapon demonstration 9 radio-iodine adverse effects 113 radiotherapy 53–4

complications 53, 54

for dysthyroid eye disease 115

for idiopathic orbital inflammation 137 for orbital lymphoma 145

for orbital metastases 148

for sebaceous gland carcinoma 52 Ramsay–Hunt syndrome 67

rectus muscle attachment to orbital implant 91 “red eye”

from dural shunts 130 management 68 painful 67

refraction measurement in ptosis 34 retention cyst 131

retinoblastoma, extraocular extension 148 retractors see eyelid retractors retrobulbar masses 99 rhabdomyosarcoma 140–1, 140

differential diagnosis 126 rhinostomy 164, 164

saline irrigation 8

“salmon patch” lesion 100, 101, 144, 145 sarcoma, orbital 143–4

scalp-flap, bicoronal, for orbital decompression 117, 118, 119, 119–21

scarring

following dacyrocystorhinostomy 162, 163, 167 management 12–14

minimising formation 5 Schwannomas 137

scintigraphy, lacrimal drainage 110–11, 111 scissors 9

scleral defect 158

scleral spacer donation 76 scleritis 134

sebaceous gland benign tumours 45 carcinoma 48–9, 48

management principles 51–2 seborrhoeic keratosis 45 secretory system of eye 3 semicircular flap

for lower eyelid reconstruction 57, 58 for upper lid reconstruction 62–3, 63 sensory disturbance in orbital disease 100

seventh nerve

aberrant regeneration 38 palsy 15, 16, 21, 67–73

assessment 67–8 management 68 prognosis 67 surgery 68–73

silk sutures 8

single photon emission CT in orbital disease 106 sino-orbital cavity following exenteration 146 sino-orbital tumour 102

sinus

mucocoeles imaging 106 paranasal, mucocoeles 125, 125

sinusitis following surgery for dysthyroid eye disease 121

skin

analysis for cosmetic surgery 79 crease measurement in ptosis 33, 33 eyelid, anatomy 1–2

graft to eyelids 1, 11, 13 for entropion 27

full-thickness composite 64–5 see also eyelid reconstruction

necrosis following dacyrocystorhinostomy 167,

167

resurfacing, laser 86–8, 87 tag 45

tight, causes 73 see also dermis

skull, congenital clefts 125–6 Smith’s Lazy-T procedure 19 socket

complications following dermofat graft 93 congenital small 95–6

contracted 95–6 acquired 96 causes 96 discharging 96–7

lining problems causing 97 preparation for dermofat graft 93 surgery 89–97

volume-deficient, following enucleation 94–5

soft tissue

diagnosis in orbital disease 106 injury, orbital 157–9

loss in eyelid repair 11 preservation 8

redistribution in medial canthoplasty 180, 180 repair, principles 7–8

spacer for eyelid retractor recession 74, 76–7 SPCET see single photon emission CT sphenoid wing meningioma 137–8, 138 spiradenoma, eccrine 45

squamous carcinoma 47–8, 48, 146, 147 management principles 51–2

stab wounds 9–10 Steristrips 8 steroid therapy

adverse effects 113

in dysthyroid eye disease 115 following optic nerve injury 158

for idiopathic orbital inflammation 137 “strawberry naevus” 126, 126

subciliary blepharoplasty in dysthyroid eye disease 119

subconjunctival lesion, “salmon patch” 100, 101 subperiosteal haematoma 159

subperiosteal implant following enucleation 94 subperiosteal space 4, 5

superior limbus 1

superior transverse ligament 3

INDEX

surgical rehabilitation in dysthyroid eye disease 115–17

surgical spaces of orbit 4–5 sutures

adjustable, in ptosis surgery 40, 40 everting 25, 27–8, 28, 29

for browpexy 80 for browplasty 81

for canalicular repair 12

for dacyrocystorhinostomy 163, 163, 165, 167 and Jones canalicular bypass tube 178

for eyelid laceration repair 10 inverting 20–1, 21

for lower eyelid reconstruction 56–61 for orbital exenteration 146

removal 8 types 8–9

for upper eyelid reconstruction 62–5 for wound closure 8

see also specific types

sweat gland benign tumours 45 “Swiss cheese” pattern biopsy 143

symblepharon following enucleation 95 synkinesis 68

syringoma 45

systemic disease 102–3, 103

T cell lymphoma 144

T lymphocytes in Graves’ disease 112

tarsal dissection with or without mucous membrane grafting 29

tarsal eversion, total 20–1 tarsal margin split 29 tarsal plates 3

tarso-conjunctival diamond excision 18, 19 tarso-conjunctival free graft 60 tarso-conjunctival flap

pedicle 58–60, 58–9 sliding 63

tarsorrhaphy, lateral 68–9, 69 in dysthyroid eye disease 117

tarsotomy 71, 72 tarsus 15

tattoo of tissues, prevention 7 tear film

assessment in ptosis 34 staining 108

tears

overflow in ectropion 17, 18 production/drainage, defective 97, 106–11

telecanthus, traumatic 180 temporalis transfer surgery 68 Tensilon test in myasthenia gravis 36 Tenzel flap 57, 58

Tenzel’s lateral canthal sling modification 17–18 third nerve palsy and ptosis 37

thyroid orbitopathy 99, 100, 101, 101, 103 imaging 104, 104, 106

see also dysthyroid eye disease