Australian Doctor Australian Doctor 24th November 2017 | Page 24

How to Treat – Eyelid and lacrimal disorders
from page 22
in situ for two months to allow
healing to occur without fibrosis
blocking the newly formed out-
flow pathway. In cases of com-
bined canalicular blockage, other
manoeuvres with stents (silicone
or glass) may be required.
In children, nasolacrimal duct
obstruction is due to delayed
canalisation and often resolves
spontaneously. Crigler massage
can be performed while awaiting
spontaneous resolution and possi-
bly aids in resolution of the mem-
branous obstruction by increasing
hydrostatic pressure.
Online resources
EyeWiki, the Eye Encyclopedia
Eyewiki.aao.org
Conclusion
Case study
JIM, 70, has been treated by his
GP for blepharitis for some time.
He is referred to an ophthalmolo-
gist for a unilateral well-defined
nodule on his right upper eyelid.
The ophthalmologist manages
him surgically for a chalazion with
incision and curettage.
He returns to the ophthal-
mologist several months later,
complaining that the lesion has
recurred. The lesion is firm, seems
to arise from the tarsal plate and
appears to be a chalazion that
might have ruptured or been
incised anteriorly.
After infiltration of local anaes-
thetic, an incision and curettage
via a posterior approach is per-
JIM HAD RECENTLY
UNDERGONE A
COLONOSCOPY, WHICH
EXCLUDED COLORECTAL
CARCINOMA.
formed. The lesion is not typically
productive, and curettings and a
small biopsy are sent for histologi-
cal examination.
The histology reveals features
typical of sebaceous gland carcino-
mas. Jim has recently undergone
a colonoscopy, which excluded
colorectal carc