UNASSIGNED: This study aimed to investigate the microscopic structure and characteristics of nevi on the conjunctiva of the lacrimal caruncle by in vivo confocal microscopy.
UNASSIGNED: In total, four patients with nevi growing on the lacrimal caruncle conjunctiva were recruited. The morphological characteristics of the nevi were evaluated by in vivo confocal microscopy before excision surgery; the results were compared with histopathological analyses of the surgical specimens.
UNASSIGNED: The nevi of the four patients were all located at the conjunctiva of the lacrimal caruncle, with a slightly nodular surface, mixed black and brown color, and clear boundary. The nevi were round and highly protruded on the surface of the lacrimal caruncle, with an average diameter of 4.5 ± 1.29 mm. Under in vivo confocal microscopy, the pigmented nevus cells on the conjunctiva of the lacrimal caruncle were observed to be clustered in nests with irregular boundaries. The cells were round or irregular, with clear cell boundaries, hyper-reflective at the periphery, with low reflectivity in the center. Vascular crawling was observed in some regions. Histopathological analysis showed that nevus cells were roughly equal in size and distributed in a nodular pattern. Melanin granules were observed in the cytoplasm. No atypia or mitotic figures of the cells were found.
UNASSIGNED: This study revealed that the microstructure of nevi growing on the conjunctiva of the lacrimal caruncle can be identified by in vivo confocal microscopy.

This report included three cases of lymphoproliferative disorders developing from the lacrimal caruncle. The first case was an 11-year-old boy with reactive lymphoid hyperplasia in the left lacrimal caruncle. The second case was an 80-year-old woman with reactive lymphoid hyperplasia in the right lacrimal caruncle. The third case was a 77-year-old man with follicular lymphoma in the left lacrimal caruncle. Our literature review of cases with lacrimal caruncular lesions showed 11 reported cases with reactive lymphoid hyperplasia and 17 with malignant lymphoma. There had been no previous report on follicular lymphoma in the lacrimal caruncle.

Infrared thermography (IRT) can be used to identify stressors associated with greyhound racing procedures. However, factors unrelated to stress may influence measurements. Validation of an eye side (right or left) and a reference point on the eye is required if IRT is to be standardised for industry use. Infrared images of greyhound heads (n = 465) were taken pre-racing and post-racing at three racetracks. Average temperature was recorded at seven different locations on each eye. A multivariate analysis model determined how several factors influenced eye temperature (ET) pre-racing and post-racing. As expected, ET increased after racing, which may be attributed to physical exertion, stress and arousal. The right eye and lacrimal caruncle had the highest sensitivity to temperature changes and could be considered reference points for future studies. Additionally, dogs that raced later had higher ET, and Richmond racetrack had the lowest pre-race ET, but the highest post-race ET. This may suggest that arousal increases as the race meet progresses and certain track attributes could increase stress. Furthermore, ET increased as humidity increased, and higher post-race ET was associated with light-coloured, young and low-performing dogs. Environmental and biological factors need to be considered if IRT is to become accurate in the detection of canine stress and monitoring of greyhound welfare.

Objective:To explore the indications , surgery method and effect for the treatment of medial rectus muscle entrapment with endoscopic surgery.Method: Eight medial rectus muscle entrapment patients were enrolled in this study,3 cases underwent obital medial wall fracture reposition and medial rectus muscle adhesion decomposition surgery through endonasal endoscope,and 5 cases received obital medial wall fracture reposition surgery with endoscope through nasal cavity and lacrimal caruncle conjunctival incision. Result:The diplopia disappeared and eyeball abduction function recovered in 6 cases of medial rectus muscle entrapment patients within 2 months,and 1 case with each surgery had mild diplopia and eyeball incomplete abduction left.Conclusion:Adopting endonasal endoscopic surgery or dual approaches surgery with endonasal endoscopic and transcaruncular surgery were ideal methods for medial rectus muscle entrapment diseases.Surgery with endoscope has the characteristics of clear field and less damage.The surgery should be performed whithin 3 weeks, and the entrapment of medial rectus muscle can be resoved effectively.

UNASSIGNED: Surgical punctal occlusion is indispensable for the treatment of severe dry eye in cases where punctal-plug insertion is not applicable due to an enlarged or deformed punctum. However, permanent punctal occlusion is difficult in some cases. In our aim to establish a more reliable punctal occlusion, we have devised a new surgical approach for punctal occlusion.
UNASSIGNED: This study involved 20 puncta of 12 eyes of 12 patients (1 male and 11 females; mean age: 65.2 years) with severe aqueous-tear-deficient dry eye. A new surgical procedure for punctal occlusion using fibrous tissue from under the lacrimal caruncle into the diathermy-induced deepithelialized canaliculus as supporting tissue for punctal closure was performed. In all patients, the assessment of eye symptoms, as well as the condition of punctal occlusion by slit-lamp biomicroscopy, tear volume (tear-meniscus radius [TMR] measurement by meniscometry), the condition of precorneal tear film (graded by interferometry [IG]), measurement of fluorescein breakup time (FBUT), and scoring of ocular surface staining (fluorescein score of area [FSA] and density [FSD], and lissamine green score [LGS]) were performed, and the preoperative and 6-month-postoperative values were compared.
UNASSIGNED: In regard to the postoperative improvement of symptoms, 11 patients showed remarkable improvement, 1 patient showed improvement, and no reopening of the closed punctum was found in any patient. Test values were all significantly improved post surgery (all: P<0.05) as compared to those prior to surgery (respective values [mean ± SD], and the pre- and postoperative P-values were: TMR (mm) [0.18±0.08; 0.56±0.28, P=0.002], IG [4.3±0.9; 2.7±0.8, P=0.009], FBUT [0.4±0.6; 4.1±2.9, P=0.004], FSA [1.6±0.7; 0.7±0.9, P=0.03], FSD [2.7±0.7; 0.6±0.7, P=0.003], and LGS [5.1±2.7; 1.1±2.1, P=0.005]). Moreover, no postoperative complications were observed.
UNASSIGNED: The findings of this study showed that our novel surgical procedure for punctal occlusion is highly successful and that it results in improved and more complete punctal occlusion.

A 65-year-old man was referred to our hospital for the treatment of a lesion on the medial lacrimal canthus of both eyes. He had a history of perinuclear anti-neutrophil cytoplasmic antibodies, i.e., pANCA-positive interstitial pneumonia. Orbital magnetic resonance imaging excluded space occupying lesions, and laboratory testing excluded thyroid-related diseases. The masses were excised, and histopathological examinations showed sebaceous gland hyperplasia and inflammatory changes around the gland. In addition, the specimen from the left eye showed a retention cyst possibly caused by an infection. It was also possible that the use of steroid was involved in the development of the lesions. A relationship between the ANCA and the lesions was not completely eliminated.

BACKGROUND: This is the third reported case of a steatocystoma simplex in the lacrimal caruncle.
METHODS: A 60-year-old male presented with a history of a slowly progressing mass in the right lacrimal caruncle since several years before his initial visit. At the first examination, a yellowish, relatively smooth surface mass was observed in the right lacrimal caruncle. The caruncular mass was completely removed under local anesthesia. The pathological findings of this mass were consistent with a steatocystoma. At the 6-month follow-up, there was no sign of recurrence or development of the steatocystoma or any other masses.
CONCLUSIONS: Although steatocystoma simplex rarely occurs in the lacrimal caruncle, it needs to be considered as a possible diagnosis for patients with a mass lesion in the caruncle.

OBJECTIVE: The purpose of this study was to identify the location of the trochlea in order to prevent injury during orbitofacial surgery and to determine the reliability of the lacrimal caruncle as a visible external landmark for the trochlea at the superomedial orbital rim.
METHODS: Fifty-one orbits from 27 embalmed cadavers were dissected. The lacrimal caruncle and supraorbital notch/foramen were used as external and bony landmarks, respectively. The location of the trochlea was determined with respect to these structures, and the size of trochlea was measured.
RESULTS: The trochlea was 3.6 mm wide and 5.6 mm long, with a flange breadth of 5.4 mm. The vertical distance from the apex of the lacrimal caruncle to the superolateral tip of the trochlea was 15.8 mm, and that from the top of the supraorbital notch/foramen to the bottom of the trochlea was 11.4 mm. As the coefficient of variation and standard deviation were smaller for DCT (11.5 and 1.8, respectively) than for DST (17.0 and 1.9, respectively), it appears that the lacrimal caruncle is a reliable landmark.
CONCLUSIONS: In contrast to the supraorbital notch, the lacrimal caruncle allows easy identification and serves as a reliable and visible external landmark for the prediction of the location of trochlea. The trochlea was located directly at 15.8 mm (i.e., approximately 1.5 cm) superior to the lacrimal caruncle. This anatomical study has yielded accurate measurements of the location of the trochlea, which may facilitate a safer orbitofacial surgery by preventing morbidity associated with trochlea injury.