Eye case help please

RE: Eye case help please

Joyce Whitehead — Tue, 24 Sep 2019 18:13:06 GMT

Thank you Evelyn, I had a feeling I should.

RE: Eye case help please

Evelyn Barbour-Hill — Tue, 24 Sep 2019 17:12:09 GMT

[quote user="Joyce Whitehead"](Unrelated question, should Horners have an apostrophe as it is presumably named after Horner?) [/quote]

Not only should you place an apostrophe, you should refer to Horner's Syndrome.

RE: Eye case help please

Joyce Whitehead — Tue, 24 Sep 2019 15:40:57 GMT

Thanks for the replies. I suspect as with many cases that money may be the final issue. I agree Neil that my feeling was to get the dry eye under control, as I’m sure healing will be compromised otherwise if I correct the cherry eye.

I will also also attempt to localise the Horners as that wasn’t something I thought of. I’ve asked the owners to look back at photos to see if they can work out how long he has had the Horners as I suspect it may be long term. (Unrelated question, should Horners have an apostrophe as it is presumably named after Horner?)

RE: Eye case help please

Neil Wheadon — Tue, 24 Sep 2019 11:12:21 GMT

Personally

Dry Eye, then Cherry Eye, then Horners

Logic being operating on an eye that is better lubricated post op

The horners is tricky, many are idiopathic and resolve, so finding the area is academically interesting (and quite easy) but what are you then going to do if not ideopathic? I guess you could find the location then radiograph the middle ear at cherry eye surgery if indicated?

Neil

RE: Eye case help please

Francisco Gomez — Mon, 23 Sep 2019 16:10:57 GMT

I would first confirm with phenylephrine and find out what 'order' your Horner's is (just in case it's not Horner's or you have something more serious going on). Once you are comfortable you're dealing with a likely idiopathic one, then I would 'pocket' that gland.

I get you're dealing with many unknowns here: you won't know that the Horner's is idiopathic for sure or if the cherry eye will recur. So in this case, if your client refuses surgery on the grounds of little guarantees, I think it would be acceptable to use ciclosporine + lubrication for the time being and keeping a close eye.

In some days you might have more knowledge about how his Horner's are likely to be and then you'd be in a better position to offer surgery.

I don't have experience on cherry eye and Horner's at the same time so I am unsure how the tissues will contribute to surgery success or otherwise.

RE: Eye case help please

Francisco Gomez — Mon, 23 Sep 2019 16:08:49 GMT

I would first find out what 'order' your Horner's is. Once you are comfortable you're dealing with a likely idiopathic one, then I would 'pocket' that gland.

In some days you might have more knowledge about how his Horner's are likely to be and then you'd be in a better position to offer surgery.

I don't have experience on cherry eye and Horner's at the same time so I am unsure how the tissues will contribute to surgery success or otherwise.

RE: Eye case help please

Joyce Whitehead — Mon, 23 Sep 2019 13:32:27 GMT