Lora R. Dagi Glass

Purpose: This study aims to characterize the final stages of eyelid development by assessing infants in the neonatal intensive care unit during a developmental period corresponding to the final weeks of gestation. Methods: Infants admitted to the neonatal intensive care unit were photographed on a weekly basis to generate a neonatal eyelid photo atlas. Morphological features of horizontal palpebral fissure, upper eyelid-to-brow, and medial and lateral intercanthal distances were measured, and the presence of vascularity and skin tones were recorded for each photograph. Results: Ninety-five photographs were obtained from a series of 19 subjects. For each of the anthropomorphic features, growth rates were determined using mixed-effects linear regression analysis. Growth rates for all features were well-described using linear growth. There were no correlations between gestational age and the presence of vascular features, although they were observed less frequently in darker skin tones. Conclusions: While infant populations are subject to variation in eyelid features, the authors report visualized changes in eyelid structures ex utero with measurement of eyelid features. Features demonstrated linear growth rates, and serial photographs offer a route for the longitudinal assessment of eyelid development in the final weeks of gestation.

Dear Editor,There is limited research examining post-upper eyelid blepharoplasty erythema and vascularity in the subacute (1–6 month) period (Figure 1). We analyzed subacute (1–6 months) postoperat...

Purpose: Current treatment approaches aimed at resolving a chalazion vary greatly among practice settings and practitioners. The authors’ objective is to provide a review of existing literature on treatment modalities aimed at resolving a chalazion. Methods: The authors conducted a review of existing peer-reviewed publications that described treatment methods aimed at resolving chalazia in patients of any age. Literature searches were conducted using PubMed, Embase, and Cochrane. A 3-stage review process was conducted by 2 trained reviewers, including an initial screening, a full-text review, and data extraction. Articles were assessed for baseline study identifiers, study design, country of origin, number of patients, demographic characteristics, types and number of treatments administered, and resolution rates. Publications were graded using the Oxford Centre for Evidence-Based Medicine levels of evidence table. Results: A total of 2814 articles were initially identified based on database queries; 39 studies met inclusion criteria for full-text review. The most represented study design was case series (15), followed by randomized controlled trials (14). Twenty-five publications discussed intralesional corticosteroid injections, 18 discussed incision or excision and curettage, 5 discussed conservative treatments, and 8 discussed topical antibiotic±steroid treatments. Both the definition of chalazion resolution and resolution rates for each treatment modality varied widely between publications. Conclusions: Procedural management of chalazia, including corticosteroid injections and surgical management, is most often studied in the literature. Fewer publications exist on the efficacy of conservative and topical treatments.

The authors present two cases of conjunctival pediatric-type follicular lymphoma. A 14-year-old Black boy and 14-year-old Black girl were each referred for evaluation of a painless salmon-colored conjunctival lesion. Both patients underwent excisional biopsy. Histopathology demonstrated follicles with germinal centers composed of atypical B-cells with high Ki67 proliferation index, positive staining for CD20, CD10, and BCL6, and negative for BCL2. This series contributes two cases to the limited literature and presents the first case reported in a female. [ J Pediatr Ophthalmol Strabismus . 2024;61(4):e33–e38.]

A care algorithm for partial globe subluxation cases with optic nerve and at least one extraocular muscle (EOM) transection is presented after a literature review was performed using key term variations of globe, ocular, subluxation, optic nerve evulsion or transection, and trauma. Partial globe subluxation cases with transection of the optic nerve and at least 1 EOM were included. Exclusion criteria included globe rupture, complete enucleation defined by a globe without at least 1 EOM attachment, or unclear details confirming optic nerve transection. Including the patient presented herein, a total of 24 patients with 26 eyes were analyzed. About 73.08% of cases underwent initial repositioning (n = 19), with 11.54% of those requiring secondary enucleation or evisceration (n = 3). Of the secondarily managed cases, 2 of the 3 cases listed pain (n = 2) and inadequate cosmesis (n = 1) as rationale. We found that 26.92% of cases underwent initial enucleation (n = 7), citing lack of visual potential and limiting later complications. Most cases favored repositioning, which was typically sustainable. Initial repositioning can improve cosmetic outcome and psychological impact. Given the low risk of later management, cases of traumatic partial subluxation with EOM and optic nerve transections should attempt initial repositioning.

Inferior rectus (IR) entrapment requires urgent surgical intervention in patients with traumatic orbital floor fracture (OFF). We evaluated 47 patients who underwent CT showing acute OFF, 10 of whom had surgically confirmed entrapment. Absent or trace dependent fluid in the ipsilateral maxillary sinus had sensitivity of 40% and specificity of 95% for entrapment. In comparison, sensitivity and specificity were 80% and 78% for IR thickening, and 70% and 59% for sinus herniation of orbital contents.

Mohs micrographic surgery (MMS) is a highly efficacious, tissue sparing method of skin cancer removal. Nevertheless, in the months to years after MMS, psychosocial distress has been described. The ...

Importance: Benchmarking attitudes surrounding parental leave among posttraining North American ophthalmologists may reveal possible areas for intervention.Objective: To evaluate perceptions of current parental leave policy and culture among posttraining North American ophthalmologists.Design, Setting, and Participants: This nonvalidated survey used a 19-item online questionnaire. A convenience sample of 186 self-identified North American–based ophthalmologists who had completed training was obtained using listservs, residency program coordinators, and social media. Data collection occurred from May to July 2022.Main Outcomes and Measures: Descriptive analysis demonstrated response frequencies. Pearson χ² comparison of means was performed for categorical variables. Two-tailed t tests were performed for continuous variables.Results: Among the 186 surveys completed, 105 respondents (56.5%) identified as female, 76 (40.9%) worked in academia, 133 (71.5%) were 1 to 20 years out of training, and 156 (83.9%) had children. Attitudes toward stop-the-clock policies, or delays in tenure/promotion/partnership review when taking leave, were mixed. Of 171 respondents, 78 (45.6%) thought that stop-the-clock policies should be optional, 39 (22.8%) thought that they should be required, and 31 (18.1%) thought that they should be removed. Of 76 academicians responding, 56 (73.7%) and 49 (64.5%) were unaware if their institution had a stop-the-clock policy for tenure review or promotion review, respectively. Male and female respondents differed in feeling comfortable with taking leave (36 of 66 [54.5%] vs 67 of 90 [74.4%], respectively; P = .04), as well as in their ratings of stress about peer perception on a scale of 0 to 10 (3.70 vs 4.81, respectively; P = .05). Private practitioners and academicians differed in confirmation of leave options for both parents (52 of 101 [51.5%] vs 49 of 69 [71.0%], respectively; P = .02) and ratings of financial stress (7.10 vs 5.43, respectively; P = .004) and research considerations (1.60 vs 3.85, respectively; P < .001).Conclusions and Relevance: Results of this survey study support the hypothesis that demographic factors affect attitudes toward parental leave among posttraining ophthalmologists; policies could be better publicized. Feelings regarding policies and leave were mixed. These findings should be viewed as hypothesis generating because the survey was not validated and the associations provided could be due to confounding factors.