Oculoplastic

A chronic infection of the lacrimal canaliculus, most commonly caused by Actinomyces israelii. It forms concretions (sulfur granules) within the canaliculus and presents as unilateral refractory conjunctivitis. First-line treatment is canaliculotomy and curettage under local anesthesia, followed by topical new quinolone and systemic penicillin.

Comprehensive explanation of chalazion (non-infectious chronic granulomatous inflammation of the meibomian gland): definition, symptoms, classification, diagnosis (differentiation from sebaceous gland carcinoma), treatment (warm compresses, steroid injection, transconjunctival/transcutaneous excision), pathophysiology, and prognosis.

An inflammatory disease of the lacrimal gland, broadly classified into acute (viral or bacterial) and chronic (associated with systemic diseases or IgG4-related). Acute cases present with redness, swelling, and tenderness of the lateral upper eyelid; chronic cases show painless bilateral lacrimal gland enlargement. IgG4-related dacryoadenitis responds well to steroid therapy.

Dacryocystorhinostomy (DCR) is a definitive surgery for epiphora and dacryocystitis caused by nasolacrimal duct obstruction. A bony window is created between the lacrimal sac and the nasal cavity to form a new tear drainage pathway. In the external approach, a bone window of approximately 1×1 cm is made, and the reocclusion rate is less than 10%, indicating a high success rate. This article describes the procedural steps under general anesthesia, preoperative nasal management, mucosal flap suturing, and stent placement.

This article explains the definition, symptoms, diagnosis (evaluation based on MRD-1), differential diagnosis (distinction from ptosis), treatment (upper eyelid skin excision, subbrow skin excision), pathophysiology, and prognosis of dermatochalasis.

Explanation of the causes, classification, symptoms, diagnosis, and treatment of ectropion (a condition where the eyelid turns outward). It is classified into four types: involutional, paralytic, cicatricial, and mechanical. Surgical treatments such as the lateral tarsal strip procedure and Kuhnt-Szymanowski procedure are mainly discussed.

Comprehensive explanation of the definition, classification, symptoms, diagnosis, and surgical treatment of entropion (congenital, involutional, cicatricial, spastic, mechanical). Detailed description of key points in surgical technique selection such as the Hotz procedure, Jones modification, and lateral tarsal strip procedure.

Trichiasis is a condition in which eyelashes grow abnormally toward the eye, while epiblepharon is a congenital condition in which excess skin causes the eyelashes to contact the cornea. Treatment options include eyelash removal, electrolysis, hair root resection, and modified Hotz procedure, selected based on severity and cause.

Comprehensive explanation of the definition, epidemiology, pathophysiology, diagnosis, and treatment of floppy eyelid syndrome (FES). Details the association with obstructive sleep apnea, clinical evaluation of tarsal laxity, and from conservative therapy to surgery.

A nonspecific inflammatory disease of unknown cause occurring in the orbit, formerly called "orbital inflammatory pseudotumor." It is defined pathologically by three conditions: nonspecific inflammation, no response to antibiotics, and marked response to steroids. Oral prednisolone is the first-line treatment, tapered over 3 to 6 months. For refractory cases, radiation therapy or methotrexate may be tried.

A systemic disease in which fibroinflammatory lesions rich in IgG4-positive plasma cells occur in the orbit. Painless swelling of the lacrimal gland is the most common symptom (86%), and the mainstay of treatment is steroid tapering therapy or immunosuppressive therapy with rituximab. The 2023 revised diagnostic criteria added a warning about optic neuropathy.

Lacrimal tube intubation is a surgery to recanalize the lacrimal pathway by placing a silicone tube in cases of obstruction or stenosis of the punctum, canaliculus, or nasolacrimal duct. Tube insertion using DEP/SEP perforation under dacryoendoscopy and SGI has become widespread, with a long-term survival rate of 94% for grade 1 canalicular obstruction. Complications include cheese-wiring, submucosal misinsertion, and granulation formation.

Lagophthalmos is a condition in which the eyeball is exposed due to incomplete eyelid closure, caused by facial nerve palsy, scarring, proptosis, etc. There is a risk of progression from corneal epithelial damage to perforation, and management is staged from conservative treatment to surgical intervention.

Explains the causes, classification, diagnosis, and treatment of nasolacrimal duct obstruction (epiphora in adults). Covers lacrimal endoscopy, DCR (dacryocystorhinostomy), tube intubation indications and outcomes, and management of drug-induced lacrimal duct obstruction.

Orbital blowout fracture is a condition in which the orbital floor or medial wall is fractured due to blunt trauma to the eye, with main symptoms of diplopia, enophthalmos, and restricted eye movement. In closed fractures with entrapment of extraocular muscles, emergency surgery within 24 hours is required.

This article explains the definition, imaging diagnosis, and surgical treatment of cavernous hemangioma, a representative benign orbital tumor in adults. It is an encapsulated vascular mass commonly found within the muscle cone, with characteristic delayed enhancement on dynamic MRI. The standard surgical procedure is complete en bloc excision via a lateral orbitotomy, and the prognosis after complete resection is favorable.

An infection of the soft tissues within the orbit posterior to the orbital septum. Most commonly spreads from sinusitis and frequently occurs in children. It presents with proptosis, ophthalmoplegia, and vision loss, requiring prompt antibiotic therapy and, if necessary, surgical drainage.

Orbital fracture repair is a surgery to reduce incarcerated tissue and reconstruct the bony wall for fractures of the orbital floor and medial wall caused by blunt ocular trauma. Closed (trapdoor) fractures are common in children and require emergency surgery due to extraocular muscle entrapment. Selection of reconstruction materials such as titanium mesh, absorbable plates, and autologous bone is important.

Acute infectious inflammation of the eyelids and periorbital soft tissues anterior to the orbital septum. Unlike orbital cellulitis, it does not involve proptosis or ophthalmoplegia. Main causes include sinusitis, trauma, and insect bites, and it commonly occurs in children. Mild cases can be managed with oral antibiotics on an outpatient basis, but progression to orbital cellulitis must be monitored.

A comprehensive explanation of the definition, classification by cause (congenital, aponeurotic, neurogenic, myogenic, pseudoptosis), diagnosis, surgical technique selection, and conservative treatment (oxymetazoline eye drops) of blepharoptosis.

A condition that causes epiphora due to narrowing or occlusion of the punctum, the tear drainage opening. It is classified into congenital punctal agenesis and acquired types (inflammatory, drug-induced, age-related, traumatic). Main acquired causes include Stevens-Johnson syndrome, ocular cicatricial pemphigoid, anticancer drug S-1, and glaucoma eye drops. First-line treatment is punctal dilation or incision; for recurrent occlusion, silicone tube intubation is performed.

Acute purulent inflammation of the sebaceous glands (Zeis glands), sweat glands (Moll glands), or meibomian glands of the eyelid. It is broadly classified into external and internal hordeolum, with Staphylococcus aureus as the main causative bacterium. Treatment primarily involves antibiotic eye drops, and incision and drainage are performed when an abscess forms.