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D.S. Bardenstein; A Novel Method for Examination of the Inner Eyelid . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2425.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe a novel technique for examining the inner eyelid surface in situations where standard methods such as distraction and eversion are impossible (such as massive tumor) or dangerous to eyelid integrity (post full thickness lid reconstruction). Methods: Examination is performed at the slit lamp biomicroscope for magnification and the use of cobalt illumination for detection of fluorescein. A small nasopharyngeal mirror is cleaned and the ocular surface is topically anesthetized. Illumination is supplied either indrectly by the slit lamp reflected by the examining mirror, or directly by a light source aimed at the area to be examined. The lid is gently distracted up and away from the globe and the mirror placed behind and below the lid and adjusted to visualize the inner lid and fornix. Slit lamp photography can be successfully performed with this technique. Conditions in which this technique is applicable include: recent full thickness eyelid surgery, post-tarsorrhaphy, eyelid immobilization from tumor infiltration or scar and taut lids secondary to exophthalmos. Results:Using this technique, examination of the palpebral surface of the lid has been successfully performed on over 30 patients. It was possible to examine this surface to a vertically greater extent compared to distraction or eversion. Analyzed or detected problems include: involvement of conjunctival surface by tumor, eyelid wound dehiscence, eyelid suture related corneal abrasion and suspected foreign body. Conclusions:This newly described technique which is safe straightforward and comfortable, allows the conjunctival surface of the eyelid to be examined in a variety of difficult situations with a high degree of success.
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