KIAWAH ISLAND, S.C. — An oculoplastic surgeon shared pearls to help the general ophthalmologist diagnose and treat oculoplastic disorders in a presentation here.
The first recommendation given by Andrew S. Eiseman, MD, at Kiawah Eye 2012 was for ophthalmologists to use all of their examination skills.
“I make sure that adequate lighting is available when I enter the room and carefully look at the patient’s entire face when I am greeting the patient. This is a simple but important part of the exam that can be very helpful,” Dr. Eiseman said.
He discussed the case of a man who presented with a large orbital mass as well as a saddle nose deformity. The literature shows a 10 times more frequent diagnosis of Wegener’s granulomatosis in patients with an orbital mass and saddle nose deformity, he said.
“When one encounters the combination of nasal deformity plus either orbital mass or nasolacrimal disorder, one must be highly suspicious of Wegener’s granulomatosis,” Dr. Eiseman said.
In cases of lid notch and skin tag, he advised surgeons to have a low threshold for ordering biopsies.
“Lid notch, especially in patients with prior history of skin cancer, even without mass, lash loss, or meibomian gland destruction, should make clinicians highly suspicious and create a low threshold for referral or biopsy,” Dr. Eiseman said.
In cases of skin tag, surgeons should always take a photograph before biopsy, even with a cell phone camera, he said.
- Disclosures: No products or companies are mentioned that would require financial disclosure.