{"title":"Nasolacrimal Duct Obstruction in the Patients Receiving Treatment for Cancer.","authors":"Vasily D Yartsev, Eugenia L Atkova","doi":"10.1097/IIO.0000000000000458","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000458","url":null,"abstract":"The lacrimal drainage system consists of the upper and lower puncta, canaliculi, lacrimal sac, and the nasolacrimal duct that opens into the inferior meatus. With nasolacrimal duct obstruction, constant tearing occurs, which may be accompanied by inflammation in the tear ducts and on the ocular surface. Classification of nasolacrimal duct obstruction implies their division into primary and secondary acquired.1 The latter may be a consequence of systemic cytostatic therapy, as well as radiation exposure in the treatment of patients with cancer, and patients seek medical attention after successful antitumor therapy.2,3 The frequency of chemotherapeutic and radiation agents in the management of patients with tumors has been increasing, and so is the reported frequency of secondary nasolacrimal duct obstruction.4,5 Although the mechanism is unclear, it is presumed to be associated with the contact of a toxic agent with the affected surface.6–9 This can be either through the drug secreted in the tears or reaching the tear ducts systemically from the blood.7,8,10 The tear fluid is a blood ultrafiltrate, where some components can be in higher concentrations than in blood. Once the drugs gain adequate access to the tear ducts, their toxicity on the mucous membranes results in undesirable effects.11,12","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"137-145"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Tear Trough and Lower Lid Folds: Etiology and Implications for Treatment.","authors":"Michelle A J Ting, Daniel G Ezra","doi":"10.1097/IIO.0000000000000455","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000455","url":null,"abstract":"The lower eyelid tear trough deformity is a common cosmetic concern presenting to the oculoplastic surgeon. In contrast to the smooth convexity of the transition between the lower eyelid and upper cheek seen in children and young adults, older patients can develop a double convex lid-cheek profile due to deepening of the nasojugal fold (“the tear trough”) (Fig. 1). This is typically due to age-related laxity of the supporting tissues of the face, although the process can also be accelerated by conditions associated with periocular inflammation and orbital fat expansion such as thyroid eye disease.1 The uneven contour often contributes to the appearance of dark circles by creating shadow irregularities, resulting in patients seeking a reduction of “eye bags” or “dark circles” which contribute to a tired and aged appearance. The tear trough is a challenging area to treat due to the complexity of the underlying anatomy and its variation between patients, as well as the range of surgical and nonsurgical approaches available.2–7 Furthermore, intervention in this area carries several potential risks, which the clinician must first know how to minimize, and how to treat should they occur. Here, we aim to review the anatomy of the tear trough region, aided by reference to cadaveric anatomic studies in the literature, and to relate these findings to rejuvenation methods, providing an anatomic approach clinical aesthetic lower eyelid treatments.","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"13-33"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnosis and Management of Dysthyroid Optic Neuropathy.","authors":"Yasuhiro Takahashi, Aric Vaidya","doi":"10.1097/IIO.0000000000000452","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000452","url":null,"abstract":"Dysthyroid optic neuropathy (DON) is the most serious manifestation of thyroid eye disease (TED). According to the EUGOGO clinical guidelines, DON is classified as “sight-threatening” TED.1 The incidence of DON ranges from 4% to 8% in all cases of TED.2 Permanent and irreversible vision loss develops in 30% of cases without treatment,3 whereas vision can be rescued after prompt diagnosis and accurate management in most cases. This paper reviews the diagnosis and management of DON.","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"233-248"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xincen Hou, Alexander C Rokohl, Wanlin Fan, Yongwei Guo, Mohammad Javed Ali, Ludwig M Heindl
{"title":"Periocular Malignancies and Postoperative Eyelid Reconstruction.","authors":"Xincen Hou, Alexander C Rokohl, Wanlin Fan, Yongwei Guo, Mohammad Javed Ali, Ludwig M Heindl","doi":"10.1097/IIO.0000000000000475","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000475","url":null,"abstract":"Among the periocular malignancies, basal cell carcinoma (BCC) and squamous cell carcinoma are the most common in the west. In contrast, sebaceous and Merkel cell carcinomas are the most aggressive. Premalignant tumors include actinic keratosis, Bowen’s disease, and keratoacanthoma. Eyelid malignancies should be treated differently than other cutaneous tumors of the same cell type because of the particular anatomic concerns of the periocular area and the effect of surgical excision and reconstruction on ocular protection and visual function. The most common treatment is surgical excision, and the following reconstruction of eyelid defects is a critical step. This is because the deformity caused by the disease or surgery can significantly affect the patient’s appearance. It can affect the patient’s perception of themselves and others, as well as the patient’s psychological and social personality. Several surgical treatment options for eyelid reconstruction include various flaps, grafts, and combinations. The objectives of eyelid reconstruction after carcinoma removal have been to protect the cornea, restore the integrity of the lid lamellae, restore normal lid movement, and produce the desired aesthetic outcome.1 The present article provides an overview of the classification of periocular malignancies and discusses the indications, strengths, and weaknesses of the surgical procedures that are currently accessible.","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"147-162"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The \"Eyelid Lift\" in Lower Blepharoplasty Surgery.","authors":"Francesco P Bernardini, Brent Skippen","doi":"10.1097/IIO.0000000000000471","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000471","url":null,"abstract":"Esthetic rejuvenation of the periocular area is an effective intervention to address facial aging and tired eyes.1 The importance of the lower eyelids, located crucially in the center of the face, cannot be underestimated. Lower eyelid aging is influenced by gravity and globe weight, responsible for the various clinical manifestations that can be subclassified as: (1) volume changes, represented by eyelid bags and orbito-malar hollowing; (2) skin changes, including skin excess and descent; (3) laxity changes, manifested by eyelid margin rounding, infero-lateral scleral show, lateral canthal angle medialization, and negative canthal tilt. Laxity changes, by widening the youthful narrow palpebral fissure, further contribute to loss of perceived attractiveness.2 Lower blepharoplasty is a commonly performed aesthetic oculoplastic surgical procedure. Traditionally, lower blepharoplasty surgery focused mainly on addressing volume changes and skin excess to achieve effacement of the eyelid/cheek junction with most authors advocating routine adjunctive ancillary procedures to prevent downward displacement of the lower eyelid.3 The authors believe that the added risks of these supporting procedures can overcome the potential benefits and should ideally be avoided at the time of primary blepharoplasty. The authors have previously reported a lower blepharoplasty surgical technique that mimics the effect of digital elevation of the eyelid skin, hence the name “Eyelid Lift,” which addresses volume, skin, and laxity changes simultaneously, whilst at the same time avoiding adjunctive supportive procedures.4","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}