The purpose of this article is to report a case of upper eyelid mechanical ptosis caused by silicone oil migration in a Jordanian patient after pars plana vitrectomy and intraocular silicone oil injection. A 20-year-old male patient was referred to the oculoplastic clinic for the management of a left upper eyelid swelling and complete ptosis that developed 12 years after pars plana vitrectomy and silicone oil placement for retinal detachment secondary to perforating eye injury. Eye examination showed upper eyelid swelling and a complete ptosis induced by the weight of inflammatory tissue and silicone oil, as proved by histopathologic examination. We presumed that silicone oil had leaked through the pars plana vitrectomy ports or through a subtle traumatic perforation of the posterior segment, which might have been aggravated by increased intra-ocular pressure postoperatively. In conclusion, mechanical ptosis caused by silicone oil migration after retinal detachment surgery is rare and this is one of the few reports in the literature. RESUMENEl objetivo de este artículo es describir un caso de ptosis mecánica del párpado superior causada por el desplazamiento del aceite de silicona. Este caso se observó en un paciente jordano tras someterse a vitrectomía pars plana y a una inyección intraocular de aceite de silicona. Un paciente varón de 20 años de edad fue derivado a la unidad de oculoplastia para el tratamiento de la inflamación del párpado superior izquierdo y de una ptosis completa, aparecidas 12 años después de someterse el paciente a una vitrectomía pars plana y a la colocación de aceite de silicona para el desprendimiento de retina que se produjo a consecuencia de un traumatismo ocular perforante. En la exploración ocular se apreció una inflamación en el párpado superior, así como ptosis completa provocada por el peso del tejido inflamado y por el aceite de silicona, tal y como demuestra el examen histopatológico. Supusimos que el aceite de silicona se había filtrado a través de los puertos de la vitrectomía pars plana o a través de una leve perforación traumática del segmento posterior, hecho que podría haberse visto agravado por un aumento de la presión intraocular ocurrido tras la operación. Como conclusión: la ptosis mecánica causada por el desplazamiento del aceite de silicona inyectado para tratar un desprendimiento de retina es poco frecuente; de hecho, éste es uno de los pocos casos que se encuentran en la literatura.
Objective: To study whether there is an increase in the frequency of sensorineural hearing loss among patients suffering from primary open angle glaucoma, pseudoexfoliation syndrome and pseudoexfoliative glaucoma. Methods: This is a cross-sectional study conducted at the ophthalmology and ENT clinic of prince Ali Bin Al-Hussein military hospital between Jan.2012 and Aug 2013. All patients who attended to the ophthalmology clinic and found to have primary open angle glaucoma, pseudoexfoliation syndrome or pseudoexfoliative glaucoma were referred to the ENT clinic for hearing assessment after performing detailed ophthalmological-examination. Those results were compared with that of a control group. Results: Sensorineural hearing loss was found in 6% of patients in the control group and in 9.7% (p value > 0.05) of patients with primary open angle glaucoma. On the other hand it was found in 34.3 %(p value < 0.05) and 30.3 %(p value < 0.05) among patients with pseudoexfoliative glaucoma and pseudoexfoliation syndrome respectively. Conclusion: This study provides evidence regarding the effect of pseudoexfoliation of the eye and its severity on the frequency of sensorineural hearing loss which in turn suggests that pseudoexfoliation syndrome is a systemic disease which may have otological involvement manifested as sensorineural hearing loss.
Objectives: To evaluate the effect of oral propranolol in the treatment of infantile peri-orbital and/ or orbital capillary hemangioma. Methods: We conducted a prospective study at Prince Rashid Bin Al Hassan military hospital between 5 th of August 2012 and 29 th of January 2013. Eleven patients with peri-orbital and/or orbital capillary hemangiomas were included in this study. All patients underwent complete ophthalmic examination. Capillary hemangiomas were assessed, reporting their size, location, extension, and effect on the surrounding structures. Follow up duration ranged from two to six months. Results: The age of patients with peri-orbital and/ or orbital capillary hemangiomas ranged from three to 17 months with a mean of 7 ± 4.92 months. Male: female ratio was 1: 1.75. The upper eyelid was involved in seven (64%) cases, all of them had ptosis, three (43%) had dystopia, one (14%) had imbrication, and one (14%) had squint. The lower eyelid was involved in two (18%) cases; one of them was associated with lower lip capillary hemangioma. Orbital involvement was seen in eight (73%) cases, six (75%) of them were associated with upper eyelid involvement and two (25%) with lower eyelid involvement. Concurrent extra-ocular localization of hemangiomas was present in five (45%) cases (one in lip, one in tongue, 2 in forehead, and one in cheek). Duration of treatment ranged between one and 30 weeks with an average of 14.2 ± 11.4 SD weeks. The dose of propranolol ranged between 1-2 mg/kg with an average of 1.2 mg/kg and only one patient with upper eyelid and forehead extension needed 4 mg/kg. The color blanched in all patients after one week. The capillary hemangioma decreased in size after one week of treatment in two (18%) patients, and in all of them after one month. Complete regression of the hemangioma was seen in two (18%) cases one after two months and the other after 4 months of treatment. Five (45%) cases had astigmatism before the start of treatment (mean ±SD, 0.9 ± 0.379 D) diopters and improved to mean ±SD, 0.56 ± 0.586 D. Conclusion: Oral propranol can be used as a modality for therapy of infantile capillary hemangioma.
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