-
Orbit (Amsterdam, Netherlands) Apr 2022Epiphora remains an often difficult to manage ocular complaint for ophthalmologists in all subspecialties. This review seeks to examine the safety and efficacy of... (Review)
Review
PURPOSE
Epiphora remains an often difficult to manage ocular complaint for ophthalmologists in all subspecialties. This review seeks to examine the safety and efficacy of botulinum toxin injection for management of chronic epiphora.
METHODS
The authors conducted a Pubmed search for studies on the use of lacrimal and transplanted salivary gland botulinum toxin injections for the management of epiphora within the past 20 years. Studies included had a minimum of four glandular injections.
RESULTS
The authors identified 14 studies and divided them by indication for injection; either functional epiphora, non-functional epiphora, or mixed studies. Seven studies examined injections for cases of functional epiphora, four for non-functional epiphora, and four for mixed cases. The number of glandular injections reported ranged from 4 to 65. Side effects reported were limited to diplopia, eyelid or lacrimal gland hematoma, papillary conjunctivitis, dry eye, ptosis, and bleeding.
CONCLUSIONS
Glandular botulinum toxin injection should be considered as a viable treatment strategy for both functional and nonfunctional epiphora. From the studies reviewed, botulinum toxin injection was shown to be effective in both children and adults. Injection can be performed in the outpatient setting, is minimally invasive, technically easy to administer, has a favorable side effect profile, and good efficacy. Furthermore, repeat injections can be performed with similar efficacy.
Topics: Adult; Blepharoptosis; Botulinum Toxins, Type A; Child; Humans; Injections; Lacrimal Apparatus; Lacrimal Duct Obstruction; Treatment Outcome
PubMed: 34396904
DOI: 10.1080/01676830.2021.1966810 -
Journal of Plastic, Reconstructive &... Dec 2010
Topics: Blepharoptosis; Eyelids; Humans; Minimally Invasive Surgical Procedures; Ophthalmologic Surgical Procedures; Suture Techniques
PubMed: 20646977
DOI: 10.1016/j.bjps.2010.05.028 -
CMAJ : Canadian Medical Association... Oct 2015
Topics: Blepharoptosis; Canada; Humans; National Health Programs; Physical Examination
PubMed: 26009586
DOI: 10.1503/cmaj.140579 -
Head & Face Medicine Jun 2010Eyelid bags are considered a sign of ageing, but they often appear prematurely due to the variety of causes that favor them. This brief report describes the case of a...
Eyelid bags are considered a sign of ageing, but they often appear prematurely due to the variety of causes that favor them. This brief report describes the case of a patient who was referred to us for the correction of a second degree bilateral palpebral ptosis that the patient had suffered from for several years and that in recent months had worsened to the point of interfering with vision and who, aside from modest eyelid bags, presented a massive protrusion of "preocular" fatty tissue. Despite the indication of classic blepharoplasty through a lower lid incision and, therefore, the possibility of removing excess skin, the patient opted instead only for the removal of the bulging fat. The patient's postoperative results were normal and the patient was extremely satisfied with both the correction of the ptosis and the "rejuvenating" effect of removing the protruding orbital fat in the eyelid.
Topics: Aged; Blepharoplasty; Blepharoptosis; Humans; Male; Treatment Outcome
PubMed: 20565888
DOI: 10.1186/1746-160X-6-9 -
Eye (London, England) Sep 2020Childhood blepharoptosis may cause cosmetic and functional problems in children, but there is a paucity of studies about its epidemiology. This study aimed to...
PURPOSE
Childhood blepharoptosis may cause cosmetic and functional problems in children, but there is a paucity of studies about its epidemiology. This study aimed to investigate the prevalence of childhood blepharoptosis and associated risk factors in a representative Korean population.
METHODS
This cross-sectional nation-wide study analysed the data set acquired from the Korea National Health and Nutrition Examination Survey 2008-2012. A total of 8218 children aged 3-18 years were included. The prevalence of childhood blepharoptosis, defined as a margin reflex distance (MRD) of < 2 mm in either eye, was estimated, and the risk factors were identified using multivariate logistic regression analysis.
RESULTS
The mean age of participants was 11.3 ± 0.1 years, and 52.8 ± 0.6% were boys. The overall prevalence of childhood blepharoptosis in Korea was 8.0% (95% CI, 6.9-9.1%). Boys exhibited a higher prevalence of blepharoptosis than girls at most of ages. Levator function increased with age in the normal general population. The proportion of subjects exhibiting MRD1 ≥ 4.0 mm also increased significantly with age (p < 0.001). Male gender, higher body mass index, and urban residency were significantly associated with childhood blepharoptosis.
CONCLUSIONS
The prevalence of childhood blepharoptosis is higher in urban obese boys. The increase of levator function with age should be considered in evaluations of childhood ptosis.
Topics: Blepharoptosis; Child; Cross-Sectional Studies; Female; Humans; Male; Nutrition Surveys; Prevalence; Republic of Korea; Retrospective Studies; Risk Factors
PubMed: 31772383
DOI: 10.1038/s41433-019-0697-3 -
BMJ (Clinical Research Ed.) May 1991
Topics: Blepharoptosis; Esthetics; Eye, Artificial; Humans; Postoperative Complications
PubMed: 2043828
DOI: 10.1136/bmj.302.6786.1208-a -
British Medical Journal Jun 1973
Topics: Blepharoptosis; Electromyography; Female; Humans; Mandible; Mastication
PubMed: 4733246
DOI: No ID Found -
Eye (London, England) Jun 2017PurposeThis study aimed to evaluate the prevalence and associated factors of involutional blepharoptosis in a nationwide representative sample in...
PurposeThis study aimed to evaluate the prevalence and associated factors of involutional blepharoptosis in a nationwide representative sample in Korea.MethodsCross-sectional study 20 941 Korean men and women 40 years of age and older who participated in last 2 years (2008 and 2009) of the 4th wave of the Korean National Health and Nutrition Examination Survey (KNHANES) IV and the first 2 years (2010 and 2011) of KNHANES V. Ocular examinations were performed by ophthalmologists trained in procedure and grading methods, and blepharoptosis was defined as a marginal reflex distance <2 mm on either eye.ResultsThe prevalence of involutional blepharoptosis in the Korean adult was 13.5% (95% CI: 12.1%, 14.9%). It was increasing along with aging (5.4% among 40's and 32.8% in people over 70 years old). A statistically significant negative association between levator function and blepharoptosis was found. With right eye, while only 5.4% (95% CI: 4.5%, 6.2%) had blepharoptosis among people whose levator function was excellent (≥12 mm), 71.4% (95% CI: 60.0%, 85.9%) of people whose levator function was poor (≤4 mm) had blepharoptosis. Hypertension, diabetes, higher body mass index (BMI), and lower education had statistically significant association with blepharoptosis adjusting all other confounders.ConclusionsThe distribution and proportional changes of levator function and marginal reflex distance 1 (MRD1) with aging implicate a contributory role of muscular degeneration. Strong association with hypertension, diabetes, BMI, and education level suggests that etiology of involutional blepharoptosis would be multifactorial and further investigation would be necessary to determine precise mechanism and contribution of factors.
Topics: Adult; Age Factors; Aged; Blepharoptosis; Body Mass Index; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hypertension; Male; Middle Aged; Nutrition Surveys; Overweight; Prevalence; Republic of Korea; Retrospective Studies; Risk Assessment; Risk Factors
PubMed: 28338663
DOI: 10.1038/eye.2017.43 -
JNMA; Journal of the Nepal Medical... Jul 2021Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation...
Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation in the cavernous sinus or superior orbital fissure of unknown etiology. We presented a 67-year-old female with Tolosa-Hunt Syndrome. She had a right-sided headache and periorbital pain with double vision. Examination showed right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the area of the ophthalmic division of the trigeminal nerve. Magnetic resonance imaging of head and orbit showed altered signal intensity changes in the optic nerve and lateral rectus muscle. After steroid therapy, pain and ptosis were significantly improved in 72 hours. Tolosa-Hunt Syndrome is a diagnosis of exclusion, with clinical presentation, normal investigations, magnetic resonance imaging findings, and response to steroid therapy crucial in making the diagnosis.
Topics: Aged; Blepharoptosis; Female; Humans; Magnetic Resonance Imaging; Pain; Tolosa-Hunt Syndrome
PubMed: 34508416
DOI: 10.31729/jnma.5700 -
Eye (London, England) Jun 2020We studied the difference in the corneal biomechanical parameters of ptotic and fellow eyes in patients with congenital blepharoptosis. The correlations between corneal...
OBJECTIVES
We studied the difference in the corneal biomechanical parameters of ptotic and fellow eyes in patients with congenital blepharoptosis. The correlations between corneal biomechanical parameters and demographic or ocular parameters, and the changes after surgery were also researched.
METHODS
The corneal biomechanical parameters were measured by Corvis ST tonometry. The central corneal thickness (CCT), axial length (AL) and keratometry measurements were performed with LenStar LS900, and intraocular pressure (IOP) by non-contact applanation tonometry. The parameters were evaluated for the effect of ptosis and the relationship of corneal biomechanical parameters. These examinations were repeated 6 months after blepharoptosis surgery.
RESULTS
Twenty-nine patients were enroled. The Corvis ST parameters (Deformation amplitude [DA], A1 times, and A1 velocity), CCT, IOP with NCT, IOP with corrected, differed significantly between ptotic and fellow eyes. CCT was significantly positively correlated with Length A1 and IOP with Corvis, and negatively correlated with IOP corrected by Corvis of the ptotic eyes. The same tendency was found in the fellow eyes. Six months after the ptosis surgery, the differences in corneal biomechanics parameters between ptotic eyes and fellow eyes were not significantly changed.
CONCLUSIONS
Congenital blepharoptosis causes significant corneal biomechanical changes measured by Corvis ST. The ptotic eyes had thicker and less deformable corneas. The differences in corneal biomechanics between ptotic eyes and fellow eyes were mostly related to CCT changes. Six months after surgery, these differences in corneal biomechanics did not change significantly.
Topics: Biomechanical Phenomena; Blepharoptosis; Cornea; Corneal Pachymetry; Humans; Intraocular Pressure; Tonometry, Ocular
PubMed: 31558826
DOI: 10.1038/s41433-019-0586-9