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JAMA Ophthalmology Clinical Challenge
October 2018

Suspicious Eyelid Lesion

Author Affiliations
  • 1Scheie Eye Institute, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2018;136(10):1193-1194. doi:10.1001/jamaophthalmol.2018.0105

A 76-year-old man was referred to an oculoplastic surgeon for evaluation of trichiasis. The patient complained of 6 months of worsening tearing and crusting of both eyes that was worse on the left. Three weeks before the evaluation, he was seen by his primary ophthalmologist, who epilated 2 misdirected eyelashes of the patient’s left lower eyelid and recommended eyelid scrubs and artificial tears. The patient tried this treatment, but his symptoms did not improve. His ocular history was significant for cataracts, proliferative diabetic retinopathy, and macular degeneration. He had a medical history of basal cell carcinoma of his left cheek and brow, both removed several years previously. His medical history also included type 2 diabetes with diabetic neuropathy.

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