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Photo Essay
October 2007

Full-Thickness Eyelid Defect in a Trigeminal Trophic Syndrome

Arch Ophthalmol. 2007;125(10):1438-1439. doi:10.1001/archopht.125.10.1438

A 60-year-old woman had a spontaneous full-thickness left central eyelid defect 20 years after trigeminal ablation treatment for trigeminal neuralgia. Twenty years prior, a short time following the ablation, she developed ulceration of the alar margin on the left side (Figure 1). In June 2006, she had an infected neurotrophic corneal ulcer, which was treated topically by antibiotics with gradual improvement. A week later, an oval, 8 × 5-mm, full-thickness eyelid defect (including the skin, orbicularis muscle, and the palpebral conjunctive) was seen in her central left upper eyelid, 10 mm above the eyelid margin, and the globe was seen through the defect (Figure 2).

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