Madarosis.

Madarosis may be a presenting feature of a number of vision and life-threatening conditions, including herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism. It may occur via two broad pathogenic pathways: scarring and non-scarring, which indicates the potential for lash re-growth. Madarosis may occur as an isolated finding or together with loss of other body and scalp hair. The etiology of madarosis can be further divided into dermatological, infection, endocrine, neoplastic, drug-related, congenital, and trauma. This report includes salient points in the clinical history and examination of patients with madarosis, with an emphasis on excluding or diagnosing visual or life threatening disorders associated with madarosis.

Eyelid changes in long-standing leprosy.

To describe eyelid changes in ocular leprosy, 74 patients (148 eyes or 296 eyelids) were examined, focusing on eyelid abnormalities. The adnexal examination included evaluation of the upper eyelid crease pattern, qualitative assessment of the orbicularis oculi muscle function, measurement of the distance between the corneal reflex and the upper eyelid margin (margin reflex distance), and slit-lamp biomicroscopy of the eyelashes and tarsal conjunctiva. Eyelash ptosis was a common finding associated with a multiple upper eyelid crease pattern and trichiasis. In the past, eyelash ptosis has probably been diagnosed as upper eyelid entropion or trichiasis, but in this series entropion was not observed. The distinction between eyelash ptosis, trichiasis, and upper eyelid entropion is important because the surgical management for each is different. Other true leprotic abnormalities of the eyelids are lagophthalmos and lower lid ectropion.

Enfermedad de Hansen Tuberculoide en región orbitaria / Hansen's disease tuberculoid in orbit region

La incidencia de complicaciones oculares en la Enfermedad de Hansen es mayor en la forma lepromatosa, dada por la mayor presencia del bacilo en las estructuras oculares y sus anexos, por los fenómenos reaccionales tipo 1 y 2, y por daño neurológico del V y VII par craneal. Se observan complicaciones en la córnea, conjuntiva, párpados, iris, pestañas, cejas, cuerpo ciliar, glandula lagrimal y conducto lacrimonasal, con deterioro progresivo hasta la ceguera. Se presenta más precozmente en pacientes con lepra tuberculoide y tardíamente en la forma lepromatosa. Presentamos el caso de una paciente femenina de 78 años de edad con manifestaciones clínicas única de Enfermedad de Hansen Tuberculoide en región periorbitaria izquierda, de un año de evolución