Ptosis

Aim: Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by congenital ptosis in conjunction with rapid and involuntary elevation of the affected upper eyelid upon contraction of the ipsilateral external pterygoid muscle. Selecting an approach to the surgical management of eyelid malposition in this syndrome is challenging and requires careful discussion with each patient's family. In this systematic review, we describe reported surgical approaches, assess outcomes data, and attempt to identify areas of consensus in the management of MGJWS. Methods: Twenty-seven peer-reviewed studies were identified, describing a variety of interventions. Results: The most commonly-used surgical techniques included: bilateral levator excision with bilateral frontalis sling, unilateral levator excision with bilateral or unilateral frontalis sling, the Neuhaus/Lemagne method, and levator plication surgery. However, no clear outcomes-based consensus regarding choice of surgical approach was identified, highlighting the ongoing role of surgeon and family preference in the selection of management strategy. Further, there was considerable variability in the literature for reporting outcome measures, including grading schemes for ptosis and jaw-wink. Conclusion: The existing literature on management of MGJWS does not enable the development of an evidence-based consensus algorithm regarding the selection of an appropriate surgical technique. The disorder is

— Superior orbital fissure syndrome (SOFS) is a rare disease. So when a case of this came at Aravind Eye Institute, a detailed case report was prepared to publish. A 56 years old male patient, a known case of prostatic malignancy with skeletal metastasis presented with ptosis, exotropia, diminished pupillary reflex and limitations in extraocular movements of left eye. MRI brain revealed diffuse skull base and leptomeningeal metastasis. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy.

Da scoprire : https://it.wikipedia.org/wiki/Chirurgia_plastica La ptosi del seno è caratterizzata da un seno in posizione troppo bassa, spesso "disabitato" nella parte superiore con cedimento della ghiandola mammaria e distensione della pelle. La ptosi del seno esiste fin dall'inizio o dopo una significativa perdita di peso o a seguito di una gravidanza allattante. Isolata è una ptosi pura. Ma può essere associato ad un certo grado di ipertrofia mammaria. La ptosi del seno si osserva anche quando il seno è troppo piccolo (ipoplasia o ipotrofia mammaria). Prendere un appuntamento Quando considerare una cura per la ptosi? Il seno può essere cedevole dopo la perdita di peso o la gravidanza e l'allattamento al seno. Possono essere trattati con la chirurgia estetica. Se la guaina cutanea è troppo vuota, il chirurgo procede contemporaneamente al posizionamento delle protesi mammarie o del grasso autologo (Lipomodellamento del seno). I benefici di un trattamento per la ptosi La chirurgia della ptosi del seno è anche chiamata mammoplastica o chirurgia della ptosi del seno, è una procedura chirurgica che permette di sollevare i seni che cadono nella giusta posizione. La chirurgia estetica per la ptosi del seno non è coperta dalla previdenza sociale o da una mutua assicuratrice. La chirurgia della ptosi del seno può essere eseguita dalla fine della crescita e per tutta la vita. La chirurgia della ptosi del seno si tradurrà in due seni armoniosi e ben modellati. L'intervento chirurgico rimuoverà la pelle in eccesso, rimetterà a fuoco il volume ghiandolare e solleverà la ghiandola e posizionerà l'areola e il capezzolo nella posizione corretta. Per correggere questo problema di cedimento del seno o ptosi del seno, il seno viene rimodellato agendo sull'involucro cutaneo e sul tessuto ghiandolare. Per saperne di più sulla procedura di trattamento della ptosi Le procedure chirurgiche che permettono la correzione della ptosi del seno e quindi di rimodellare il seno in modo armonioso sono variabili a seconda dell'importanza della ptosi. In tutti i casi, l'adattamento dell'involucro cutaneo richiede il taglio e la rimozione della pelle. Ci sono quindi cicatrici localizzate sul seno e quindi visibili. La cicatrice può avere tre parti, si dice che sia a forma di T rovesciata: una cicatrice circolare intorno all'areola tra la pelle marrone e la pelle bianca (cicatrice peri-areolare) quasi costantemente, una cicatrice verticale situata tra il polo inferiore dell'areola e la piega sottomammaria.

Pharmacologic treatment of Myasthenia Gravis presents challenges due to poor tolerability in some patients. Conventional ptosis crutches have limitations such as interference with blinking which causes ocular surface drying, and frequent irritation of the eyes. To address this problem, a modular and adjustable ptosis crutch for elevating the upper eyelid in Myasthenia Gravis patients has been proposed as a non-surgical and low-cost solution. Areas covered: This paper reviews the literature on the challenges in the treatment of Myasthenia Gravis globally and focuses on a modular and adjustable ptosis crutch that has been developed by the Medical Device Laboratory at the University of Cape Town. Expert commentary: The new medical device has potential as a simple, effective and unobtrusive solution to elevate the drooping upper eyelid(s) above the visual axis without the need for medication and surgery. Access to the technology is provided through an open source platform which makes it...

Amblyopia is a childhood eye condition with low vision in one or rarely both eyes, due to suppression at the visual cortex, that persists after rectification of risk factor at eye level. For an amblyopic child, the visual inputs from the amblyopic eye (AE) is suppressed at the brain. This leads to reduced visual acuity and poor or complete loss of stereopsis. Conventional clinical tests such as Worth 4-dot test and Bagolini striated lens test can only detect the presence of suppression but cannot quantify the extent of suppression, which is important for quantifying and identifying the effectiveness of treatments for amblyopia. In this paper, we propose a possible cost-effective and child-friendly method for quantifying the level of ocular suppression in amblyopia. The procedure is based on the fact that for amblyopic subjects, there is an asymmetry in the amount of ocular suppression experienced by the AE and this suppression leads to an inferior performance of the AE in an image recognition task. Preliminary studies performed on six each of control and amblyopic subjects are presented in this paper. We have shown that the absolute value of the deviation of the ratio of accuracies of both eyes in an image recognition task from unity can be used as a measure of the suppression. Paired t-test revealed a significant difference between the means of the accuracies of amblyopic and fellow eyes (p=0.03) in the case of amblyopic subjects. Equivalence test done using ‘two-one-sided t-tests’ procedure shows that the equivalence of the accuracies of left and right eyes for control is statistically significant (p = 0.008, symmetric equivalence margin of 5 percentage points).

To compare the results of two different frontalis sling surgery techniques with silicon rod for ptosis: Fox's single pentagon technique and a modification of Crawford's double triangle technique. In a randomized clinical trial, 52 eyes of 50 patients with severe ptosis and poor levator function (≤4 mm) were randomly assigned to the Fox group or the modified Crawford group. Cosmetic outcome, functional success, and lagophthalmos were compared. The patients achieved a fair to good cosmetic outcome by subjective grading and a fair outcome by objective grading in both groups. The intergroup difference was not statistically significant (P > 0.05). However, patients with preoperative lateral droop had better cosmetic outcome in the modified Crawford group. Mean increase in marginal reflex distance 1 (MRD-1) was 4.0 ± 1.7 mm in the Fox group and 3.7 ± 1.1 mm in the modified Crawford group. Change in MRD-1 within groups was significant (P < 0.0001); however, the difference in ...

Blepharoptosis (ptosis) is defined as the abnormal drooping of the upper eyelid and is a feature of many conditions. It can be in isolated or syndromic form, bilateral or unilateral and congenital or acquired. Previously we have carried out linkage analysis on a family with dominantly inherited congenital bilateral isolated ptosis and found the condition to be linked to a region of approximately 20 megabases of chromosome Xq24-Xq27.1 with a cumulative LOD score of 5.89. We now describe further analysis using array comparative genomic hybridisation (array CGH), fluorescence in situ hybridisation (FISH), long range PCR and sequencing. This has enabled us to identify and characterise at the level of DNA sequence an insertional duplication and rearrangement involving chromosomes 1p21.3 and a small quasipalindromic sequence in Xq27.1, disruption of which has been associated with other phenotypes but which is cosegregating with X-linked congenital bilateral isolated ptosis in this family. This work highlights the significance of the small quasipalindromic sequence in genomic rearrangements involving Xq27.1 and the importance of comprehensive molecular and molecular cytogenetic investigations to fully characterise genomic structural complexity.