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Getting hooked: Eyelash in lacrimal punctum
Saudi Journal of Ophthalmology (2017) xxx, xxx–xxx
Photo Essay
Getting hooked: Eyelash in lacrimal punctum Swati Singh a,⇑; Purvasha Narang b; Vikas Mittal b
A 23-year-old female presented with redness, discharge and irritation in right eye for past 4 days with constant watering. She was diagnosed with nodular episcleritis elsewhere.
Everted eyelid showed an eyelash dislodged into upper lacrimal punctum with its root protruding onto the surface (Fig 1B). Area of conjunctival epithelial defect corresponded
Fig. 1. A, Slit lamp image showing right nasal bulbar conjunctival congestion with a localized elevated nodule medially. B, Root of lash follicle impacted into upper lacrimal punctum. C, Slit lamp image (16) under cobalt blue filter showing an area of fluorescein uptake (borders marked) corresponding to lash-surface contact in closed eyelid. D, Removed lash follicle (held in forceps) with thin mucoid strand over its surface.
Her best corrected visual acuity was 6/6 in both eyes. Slit lamp evaluation revealed sectoral congestion localized to right nasal bulbar conjunctiva with fluorescein uptake in an area of 4 ⁄ 1.8 mm temporal to plica semilunaris (Fig 1A).
to the area of lash-surface touch in a closed eyelid (Fig 1C). Eyelash was removed with the help of atraumatic forceps (Fig 1D). Irrigation via lower punctum was patent.
Received 8 February 2017; accepted 9 May 2017; available online xxxx. Ó 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of Saudi Ophthalmological Society, King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). http://dx.doi.org/10.1016/j.sjopt.2017.05.004 a b
Ophthalmic Plastic Services, Sanjivni Eye Care, Ambala, India Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala, India
⇑ Corresponding author at: Ophthalmic Plastic surgery, Dacryology and Ocular, Oncology services, Sanjivni Eye Care, Ambala, India. e-mail address: [email protected] (S. Singh). Peer review under responsibility of Saudi Ophthalmological Society, King Saud University
Production and hosting by Elsevier
Access this article online: www.saudiophthaljournal.com www.sciencedirect.com
Please cite this article in press as: Singh S., et al. Getting hooked: Eyelash in lacrimal punctum. Saudi J Ophthalmol (2017), http://dx.doi.org/10.1016/j. sjopt.2017.05.004
2
Comment Eyelash arrest in lacrimal punctum is a very rarely seen phenomenon. Unrecognised retained intraocular foreign bodies in young children can present as unilateral conjunctivitis/keratoconjunctivitis.1 Eyelash impaction in lacrimal punctum has been reported only once in literature where conjunctival granuloma was excised along with lash removal.2 In our case, eyelash removal alone resolved the symptoms promptly. Careful ocular evaluation with everted eyelid inspection should be performed to rule out hidden foreign bodies.
S. Singh et al.
Conflict of interest The authors declared that there is no conflict of interest.
References 1. Kalavathy CM, Parmar P, Kaliamurthy J, Jesudasan CA, Thomas PA. Keratoconjunctivitis caused by an unusual retained conjunctival foreign body: a frequently unrecognized entity. Indian J Ophthalmol 2014;62 ():633–5. 2. Boase AJ. Eye-lash in the lacrimal punctum. Br J Ophthalmol 1949;33 ():513.
Please cite this article in press as: Singh S., et al. Getting hooked: Eyelash in lacrimal punctum. Saudi J Ophthalmol (2017), http://dx.doi.org/10.1016/j. sjopt.2017.05.004
Photo Essay
Getting hooked: Eyelash in lacrimal punctum Swati Singh a,⇑; Purvasha Narang b; Vikas Mittal b
A 23-year-old female presented with redness, discharge and irritation in right eye for past 4 days with constant watering. She was diagnosed with nodular episcleritis elsewhere.
Everted eyelid showed an eyelash dislodged into upper lacrimal punctum with its root protruding onto the surface (Fig 1B). Area of conjunctival epithelial defect corresponded
Fig. 1. A, Slit lamp image showing right nasal bulbar conjunctival congestion with a localized elevated nodule medially. B, Root of lash follicle impacted into upper lacrimal punctum. C, Slit lamp image (16) under cobalt blue filter showing an area of fluorescein uptake (borders marked) corresponding to lash-surface contact in closed eyelid. D, Removed lash follicle (held in forceps) with thin mucoid strand over its surface.
Her best corrected visual acuity was 6/6 in both eyes. Slit lamp evaluation revealed sectoral congestion localized to right nasal bulbar conjunctiva with fluorescein uptake in an area of 4 ⁄ 1.8 mm temporal to plica semilunaris (Fig 1A).
to the area of lash-surface touch in a closed eyelid (Fig 1C). Eyelash was removed with the help of atraumatic forceps (Fig 1D). Irrigation via lower punctum was patent.
Received 8 February 2017; accepted 9 May 2017; available online xxxx. Ó 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of Saudi Ophthalmological Society, King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). http://dx.doi.org/10.1016/j.sjopt.2017.05.004 a b
Ophthalmic Plastic Services, Sanjivni Eye Care, Ambala, India Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala, India
⇑ Corresponding author at: Ophthalmic Plastic surgery, Dacryology and Ocular, Oncology services, Sanjivni Eye Care, Ambala, India. e-mail address: [email protected] (S. Singh). Peer review under responsibility of Saudi Ophthalmological Society, King Saud University
Production and hosting by Elsevier
Access this article online: www.saudiophthaljournal.com www.sciencedirect.com
Please cite this article in press as: Singh S., et al. Getting hooked: Eyelash in lacrimal punctum. Saudi J Ophthalmol (2017), http://dx.doi.org/10.1016/j. sjopt.2017.05.004
2
Comment Eyelash arrest in lacrimal punctum is a very rarely seen phenomenon. Unrecognised retained intraocular foreign bodies in young children can present as unilateral conjunctivitis/keratoconjunctivitis.1 Eyelash impaction in lacrimal punctum has been reported only once in literature where conjunctival granuloma was excised along with lash removal.2 In our case, eyelash removal alone resolved the symptoms promptly. Careful ocular evaluation with everted eyelid inspection should be performed to rule out hidden foreign bodies.
S. Singh et al.
Conflict of interest The authors declared that there is no conflict of interest.
References 1. Kalavathy CM, Parmar P, Kaliamurthy J, Jesudasan CA, Thomas PA. Keratoconjunctivitis caused by an unusual retained conjunctival foreign body: a frequently unrecognized entity. Indian J Ophthalmol 2014;62 ():633–5. 2. Boase AJ. Eye-lash in the lacrimal punctum. Br J Ophthalmol 1949;33 ():513.
Please cite this article in press as: Singh S., et al. Getting hooked: Eyelash in lacrimal punctum. Saudi J Ophthalmol (2017), http://dx.doi.org/10.1016/j. sjopt.2017.05.004