Electrolysis outcomes for eyelid trichiasis: Consultants versus trainees.

PURPOSE: To investigate the efficacy of electrolysis for the treatment of trichiasis and distichiasis and compare success rates as a function of the eyelid treated, the indication for electrolysis and seniority of the surgeon. METHODS: The medical records of all patients who underwent electrolysis for trichiasis or distichiasis from November 2015 to November 2020 were reviewed. Sex, age, indication, eyelid treated, surgeon's educational status, number of electrolysis sessions, outcome, time between sessions and time to the last follow-up were documented. RESULTS: In total, 187 patients who underwent primary electrolysis during the study period and no prior history of trichiasis treatment were included in the analysis. Attending physicians had a significantly higher success rate after the first electrolysis session than resident surgeons (P=0.048). The success rate for patients receiving treatment of their upper or upper and lower eyelids at the same time was significantly lower than the respective percentage of patients receiving treatment of their lower eyelids (P=0.005). CONCLUSION: Improved departmental efficiency could be achieved by scheduling patients with recurrent trichiasis or distichiasis, especially of their upper eyelids, after electrolysis with an attending physician. Furthermore, improved training for ophthalmology residents in electrolysis indications and techniques would be useful.

The psychological well-being and appearance concerns of patients presenting with ptosis.

PURPOSE: Ptosis affects both the function and appearance of the eyes and face, because of drooping of the eyelids. Previous research has focused on functional impairment; however, similar appearance altering eye conditions have been demonstrated to have major impacts on psychosocial functioning. METHODS: This study examines the psychological well-being and appearance concerns of patients presenting with ptosis recruited from Bristol Eye Hospital using validated questionnaires focusing on demographics and psychosocial factors before surgery. RESULTS: Patients reported higher levels of anxiety, depression, and appearance concern than population norms, with scores comparable to previous research examining the impact of other disfiguring eye conditions. Gender differences were observed, with almost half of females experiencing significant psychosocial issues related to appearance concern about their ptosis compared with 20% of males. Linear regressions revealed that the main predictor of poor adjustment to the appearance of ptosis was the level of concern an individual had regarding the negative perceptions of other people. These results implicate psychosocial factors and demographics as predictors of the development of appearance-related distress and compromised psychological well-being for patients with ptosis who are currently seeking surgery. CONCLUSIONS: This study provides clinicians with a greater understanding of the concerns of affected patients, and treatment motivations. The findings may also inform the development of patient reported outcome measures and support for patients, which targets the psychosocial impact of the condition.

Long-term efficacy of 2-0 Prolene brow suspensions for congenital ptosis.

AIMS: To highlight the long-lasting benefit of 2-0 Prolene brow suspension for congenital ptosis. METHODS: Retrospective case review of 38 paediatric cases at two centres in the United Kingdom. RESULTS: Six cases continue to have a successful functional and cosmetic result ranging from 6 to 10 years. CONCLUSIONS: Brow suspension with 2-0 Prolene can be long-lasting in some patients.

Solitary metastasis to the choroid plexus of the third ventricle mimicking a colloid cyst: a report of two cases.

Cerebral metastasis to the choroid plexus is rare and almost always occurs in the presence of multiple cerebral metastases. We present two cases of a solitary cerebral metastasis to the choroid plexus of the anterior third ventricle mimicking a colloid cyst. There appears to be an increased tendency for renal cell carcinomas to metastasis to the choroid plexus. Metastatic disease is an important differential diagnosis even for solitary lesions of the anterior third ventricle.

Ossifying fibroma of the jugum sphenoidale.

We report a rare case of an eight year old boy with an ossifying fibroma of the jugum sphenoidale who presented with rapid onset bilateral blindness. This benign tumour was initially debulked and required re-operation with decompression of both optic nerves due to progressive visual deterioration. Post-operatively, there was good visual recovery in the left eye, but visual acuity in the right eye remained at <1/60. A 17 years follow period is described, in which there has been no clinical or radiological evidence of tumour recurrence.