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KMID : 0360220200610080944
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Journal of the Korean Ophthalmological Society
2020 Volume.61 No. 8 p.944 ~ p.949
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Severe Upper and Lower Tarsal Ectropion with Immunoglobulin G4-related Ophthalmic Disease
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Oh Jun-Ho
Son Byeong-Jae
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Abstract
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Purpose: To present the first case of severe upper and lower tarsal ectropion associated with immunoglobulin G4 (IgG4)-related ophthalmic disease.
Case summary: A 37-year-old male presented with relapsed eyelid swelling and periocular inflammation in the left eye for 7 years. He had severe upper and lower tarsal ectropion and a thickened upper eyelid with prolapsed conjunctival fornix. Orbital computed tomography showed a poorly defined anterior orbital mass involving the lacrimal gland and upper and lower eyelids on the left eye. The severe upper and lower eyelid ectropion was corrected by a modified spindle procedure and lateral tarsal strip. Hard, ill-defined fibrotic tissue and a mass around the lateral upper tarsal plate were discovered that required excision of the mass and a biopsy. Hematologic and histopathologic findings of the orbital mass indicated IgG4-related ophthalmic disease with severe upper and lower ectropion caused by the disease.
Conclusions: In cases of severe upper and lower eyelid ectropion caused by chronic inflammation, as seen in this case, not only eyelid tightening with excision of the causative mass but also a modified spindle procedure is required to prevent rotation of the eyelid.
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KEYWORD
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Immunoglobulin G4-related ophthalmic disease, Modified spindle procedure, Upper and lower eyelid ectropion
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