Namrata sharma, urmimala ghatak rajendra prasad centre for ophthalmic sciences all india institute of medical sciences, anasari nagar, new delhi110029, india correspondence. Tarsorrhaphy is closure of the eyelids via an adhesion between the two upper and lower lid margins, which reduces corneal exposure and evaporation of the tear film while minimizing friction between the eyelid and ocular surface during blinking. Aug 09, 2017 this article covers the following tfos dews ii reports. After 4 weeks, the patients infiltrates resolved and the tarsorrhaphy was removed. Wellplanned tendon transfers are predictable in their restoration of function, so there is no. Tarsorrhaphy is a surgical procedure in which the eyelids are partially sewn together to narrow the eyelid opening it may be done to protect the cornea in cases of corneal exposure, as a treatment for graves ophthalmopathy, mobius syndrome or after corneal graft surgery. Exposure keratopathy by albert chelanga ococs 6th july, 2015. Therefore, reducing the barriers that preclude a high standard of eye care and surgery for such patients remains a challenge. The heterogeneity of the dry eye populationdiverse in both physical characteristics and clinical presentationadds much complexity to the task of determining the etiology and devising an appropriate treatment plan. For a permanent tarsorrhaphy excise a triangle of skin and eyelashes from the lower lid and a corresponding triangle of tarsal plate and conjunctiva from the upper. Education practice practice pointer assessment and management.
Ppt bacterial keratitis powerpoint presentation free to. The procedure can be done in the office and is particularly suitable for patients who are unable or unwilling to undergo other surgery. Tarsorrhaphy definition of tarsorrhaphy by medical dictionary. Temporary tarsorrhaphies are used to help the cornea heal or to protect the cornea during a short period of exposure or disease.
The frequency of viral keratitis has become greater because of the role of newer antibiotics in eliminating the bacterial flora. Ppt introduction to digital photography powerpoint. Medical knowledge, practice based learning and improvement. Introduction to digital photography an overview of digital camera technology, basic photographic techniques. The following are short quiz questions that are designed to help you judge how you are doing during the rotation. We describe the lateral tarsal strip mini tarsorrhaphy procedure that overcomes this problem. Pdf early tarsorrhaphy in conjunctival chemosis after orbit bone. Similarly a downward movement of the eyes will give a similar voltage with opposite polarities to that obtained due to the left movement. However, because of the complex structure and function of the eyelids, the potential for complications does exist. Permanent tarsorrhaphy american academy of ophthalmology.
Pdf the ophthalmologist may be the first clinician to see a patient who presents with acute facial nerve palsy. Tarsorrhaphy is closure of the eyelids via an adhesion between the two upper. Due to stigma, access to modern eye care facilities is still out of reach for many leprosy patients. Permanent tarsorraphies are used to permanently protect. Mucous membrane graft, full thickness lid resection, modified weis. Management of exposure keratopathy american academy of.
A tarsorrhaphy is used for protection of the cornea in patients with the inability to blink normally, such as in facial nerve paralysis or eyelid swelling. After 3 weeks, the tarsorrhaphy was replaced but was not associated with inflammation. Placement of other sutures done by interrupted sutures single running suture double running suture interrupted sutures recommended in infants and children, highly vascularized corneas and therapeutic keratoplasty knots buried beneath epithelium of recipient or donor preferred in donor to reduce risk of vascularization. The permanent tarsorrhaphy figure 2a f the upper and lower lids will not stay stuck together when the sutures of a temporary tarsorrhaphy lose their tension after a few weeks. This potential is commonl y known as electrooculogram. Pterygium surgery technique and complication management arie l marcovich md director of cornea service kaplan medical center, rehovot, israel no financial interest complications dellen patch with antibiotic ointment bandage contact lens tarsorrhaphy treat aggressively to avoid thinning and inflammation and reduce risk of recurrence. Common symptoms of exposure keratopathy include pain, foreign body sensation, epiphora, photophobia, and blurry vision. Skinner pavlovs dog pigeon guided missile the us navy required a weapon effective against the german battleships. Tarsorrhaphy is the surgical fusion of the upper and lower eyelid margins. The procedure can be temporary or permanent, depending on the expected length of time the tarsorrhaphy is needed. A tarsorrhaphy is the apposition of the upper and lower eyelid to each other. It is one of the safest and most effective procedures for healing difficulttotreat corneal.
The six stages included a supportive care with and without tarsorrhaphy, b planning facial reanimation, c lower eyelid and lateral canthal resuspension, d passive upper eyelid reanimation, e dynamic eyelid animation palpebral springs, and f soft tissue repositioning including eyebrow lift and blepharoplasty. Tarsorrhaphy is a simple procedure, being also very safe and effective in the management of nonhealing epithelial defects, with a success rate of 83. It also needs tears and periodic blinking to cleanse it and keep it moist. The lateral tarsal strip minitarsorrhaphy procedure. It is, therefore, an effective procedure for patients requiring prolonged surface protection for persistent corneal epithelial defects, secondary to neurotrophic keratopathy following herpes simplex or herpes zoster disease, exposure keratopathy e. Herrmann, dvm ophthalmology intern discussion topics. Retractor plication techniqueshortening of inferior retractor fascia, does not involve conjunctival operation. Advances in surgical management of ocular surface disease. Tarsorrhaphy procedure, pain, complications, infection. In a permanent tarsorrhaphy, some of the lid margin is debrided which allows the lids to stick together as they heal. Viral keratitis is a common cause for unilateral blindness in both developing and developed countries. Jul 06, 2019 electrooculography seminar report, ppt, pdf for ece students.
Complications pterygium surgery technique and complication. Tarsorrhaphy is indicated after corneal surgery to provide support to the globe, and after eyelid surgery to allow the normal eyelid to act as a splint for the operated eyelid to reduce distortion, cicatrix, and suture line dehiscence. Decreased lubrication of the ocular surface due to inadequate eyelid closure or decreased blink frequency can lead to exposure keratopathy. The drawstring tarsorrhaphy was performed in the intensive care unit setting. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Tarsorrhaphy is a surgical procedure in which the eyelids are partially sewn together to narrow. The size of the primitive guidance systems available rendered any weapon ineffective. Jun 14, 2019 tarsorrhaphy decreases horizontal lid opening by fusing the eyelid margins together, increasing support of the precorneal lake of tears and improving coverage of the eye during sleep. May 05, 2011 placement of other sutures done by interrupted sutures single running suture double running suture interrupted sutures recommended in infants and children, highly vascularized corneas and therapeutic keratoplasty knots buried beneath epithelium of recipient or donor preferred in donor to reduce risk of vascularization. Treatment options for paralytic ectropion lubrication with tear substitutes in mild cases botulinum toxin injection into levator muscle for corneal exposure temporary tarsorrhaphy in patients with poor bells phenomenon medial canthoplasty if medial canthal tendon is intact medial wedge resection to correct medial. Leads to consequent drying and damage to the corneal epithelium. Etiology, sign and symptoms, and management including investigations and treatment of dry eyes.
If mild to moderate upper eyelid laxity is present, suspension of the strip can result in upper eyelid overhang with lower eyelid and eyelash imbrication. May 08, 2012 blepharoplasty is a widely practiced successful operation. The remainder are drained via the nasolacrimal system. The eye in leprosy international textbook of leprosy. The drawstring temporary tarsorrhaphy technique cornea. Even though both dna and rna viruses are responsible for keratitis, common corneal infections are caused by. To evaluate the safety and efficacy of temporary tarsorrhaphy using super glue in the management of corneal disorders.
Tarsorrhaphy is a rare procedure in which the eyelids are partially sewn together to narrow the opening. Exposure keratopathy in exposure keratopathy, there is failure of the lids normal wetting mechanism, due to disease process that limit eyelids closure. B, view of the tarsus of the upper and lower eyelids. Chemosis is a common occurrence after orbital reconstruction surgery by the transconjunctival approach. Request pdf tarsorrhaphy to evaluate indications, success rate, and complications of tarsorrhaphy in a cohort of cornea and external disease patients. Tarsorrhaphy is the joining of part or all of the upper and lower eyelids so as to partially or completely close the eye. Dry eye ppt free download as powerpoint presentation. Performing a tarsorrhaphy community eye health journal.
A free powerpoint ppt presentation displayed as a flash slide show on id. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Cpt codes for laceration repair laceration cpt medicare 110% medicare 120% medicare simplesuperficialscalp, neck, axillae, external genitalia, trunk, extremities 2. Corneal ulcers were treated by temporary tarsorrhaphy along with topical atropine 1% 3 or 4 times a day for 3 days then once or twice a day for 1 week, topical broadspectrum antibioticciprofloxacin eye drops i. Schosters clinical ophthalmology rotation self assessment quizzesexaminations. Scribd is the worlds largest social reading and publishing site. Tendon transfers usually should be recommended within a few weeks after injury in cases in which the prognosis for neurologic recovery resulting from repair is poor, muscles have been destroyed, or nerve grafts were required to restore nerve continuity. Place a temporary tarsorrhaphy to protect the globe from exposure. The permanent tarsorrhaphy figure 2af the upper and lower lids will not stay stuck together when the sutures of a temporary tarsorrhaphy lose their tension after a few weeks. Benitezdelcastillo, md phd d, reza dana, md e, sophie x. Role of temporary tarsorrhaphy using super glue in the. Tfos dews ii management and therapy report lyndon jones, fcoptom phd a, laura e.
The intensive care nurses were able to open the tarsorrhaphy to apply the necessary antibiotic drops. The staged management of ophthalmic complications of facial. All patients were managed at the institute of ophthalmology. Temporary tarsorrhaphy using super glue technique is a quick, painless and effective outdoor procedure in providing temporary relief in the management of different keratopathies, dry eyes and exposure keratopathy. Pain at presentation was taken as a baseline and following the procedure it was. With appropriate case selection, thorough discussion with surgical candidates, and careful surgical technique, most of these can be avoided. There are many conditions that impair these functions and threaten the eye, specifically the cornea, with drying.
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