External photograph demonstrating stable lower eyelid position. He continued with excellent eyelid position (Figure 2), but he had a foreign body sensation from an aberrant eyelash, which was ultimately removed.įigure 2. At the 5 month post-operative follow-up there was significant improvement in the ocular surface with no corneal exposure. Clinical courseīecause of the patient's significant exposure keratopathy, the decision was made to proceed with a left lower eyelid spacer graft from the hard palate in addition to a left drill hole cheek lift with repeat lateral tarsal strip and lateral tarsorrhaphy.Īt the 2 week post-operative follow-up there was minimal lagophthalmos present (around 1 mm medially) and the lower eyelid was found to be in excellent position. There is left lagophthalmos present during eyelid closure. External photograph demonstrating left lower eyelid retraction with inferior scleral show. Inferior punctate epitheliopathy and rapid tear break-up time. Left eye: Lower eyelid retraction with 3 mm of inferior scleral show and moderate lid laxity.Right eye: Rapid tear break up time and mild cataract.There is 5 mm of lagophthalmos with gentle closure and 3 mm with forced closure. Left eye: Left cranial nerve VII palsy with weakness of frontalis and orbicularis muscles.Left eye (OS): 20/25+1 and no improvement with pinhole.Visual acuity without correction, distance Past ocular historyī-cell lymphoma status post chemotherapy and radiation therapy He had persistence of tearing and blurry vision in the left eye which seemed to improve with the instillation of artificial tears. He had prior treatment by the otolaryngology service including a left temporalis fascia sling, left upper eyelid platinum gold weight and a left lateral tarsal strip. History of present illnessĪ 72-year-old male was referred to the oculoplastics service for evaluation of left lower eyelid retraction in the setting of left facial nerve palsy secondary to metastatic lymphoma and radiation therapy. Tearing and blurry vision in the left eye.

Cortorizing blinkk