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An 8-year-old with a unilateral droopy eyelid
Digital Journal of Ophthalmology 2022
Volume 28, Number 1
February 4, 2022
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Maxwell G. Su, MD | Baylor Scott & White Hospital, Temple, Texas Jana Waters, MD | Baylor Scott & White Hospital, Temple, Texas Matthew Recko, MD | Baylor Scott & White Hospital, Temple, Texas
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| Treatment | The etiology of the patient’s mechanical ptosis was considered to be most likely a benign neoplasm of the orbit. The risks, benefits, and alternatives of surgical removal including observation, additional imaging, and referral were discussed with the family, and the patient’s parents decided to proceed with removal. The patient underwent anterior orbitotomy with lesion excision (Figure 3). A 2.5–3 cm vascular lesion (Figure 4) was resected from an area anterior to the levator palpebrae superioris muscle. The lesion was sent to pathology for histological and immunochemical identification.
The patient returned 15 days later for a postoperative evaluation. His visual acuity was 20/20 in each eye, and his left eye external examination showed normal eyelid structure and position, with a healing scar in the left upper lid. Subsequent magnetic resonance imaging (MRI) showed unremarkable orbits without evidence of residual mass or abnormal enhancement. | |
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Figure 3.
Intraoperative image of an orbitotomy with removal of lesion (left upper eyelid).
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Figure 4.
A, Gross specimen of tan-colored tumor showing globular morphology with capsule. B, Gross specimen of capsule showing outer layer and inner layer of cellular tissue; small vessels are present throughout.
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