Eyelid Retraction Following Orbital Surgery (Kennerdell Case 14, PPT)

Anatomy: Inferior rectus muscle structure; Tarsal plate; Eyelid. Disease Diagnosis: Graves Ophthalmopathy. Presenting Symptom: Graves' disease marked by a right hypotropia and a vertical diplopia in the primary position of gaze. Limited upgaze with the right eye as the result of restriction of movement of the right inferior rectus. Ocular Movement: Limited upgaze with the right eye. Treatment: Surgery on right inferior rectus: recession of 7 mm. Transplantation of tarsus from the upper lid into the right lower lid where it is attached to the inferior border of the lower tarsus and the conjunctival edge providing a spacer to elevate the margin of the lower lid.