Pseudo-cilium of the punctum: an unusual foreign body

<!DOCTYPE html> <html lang="en-US" xml:lang="en-US"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title> Pseudo-cilium of the punctum: an unusual foreign body | Digital Journal of Ophthalmology </title> <meta name="generator" content="Open Journal Systems 3.3.0.7"> <link rel="schema.DC" href="http://purl.org/dc/elements/1.1/" /> <meta name="DC.Creator.PersonalName" content="Somya Puri"/> <meta name="DC.Creator.PersonalName" content="Nripen Gaur"/> <meta name="DC.Creator.PersonalName" content="Gautam Lokdarshi"/> <meta name="DC.Creator.PersonalName" content="Bhavya Kapoor"/> <meta name="DC.Date.created" scheme="ISO8601" content="2024-12-06"/> <meta name="DC.Date.dateSubmitted" scheme="ISO8601" content="2023-12-30"/> <meta name="DC.Date.issued" scheme="ISO8601" content="2024-12-31"/> <meta name="DC.Date.modified" scheme="ISO8601" content="2024-12-31"/> <meta name="DC.Description" xml:lang="en" content="A woman in her 40s presented to the ophthalmology outpatient department at AIIMS, Bilaspur, India, with foreign body sensation and watering in her left eye. There was no history of trauma, surgery, medication, or systemic disease. On examination, visual acuity was 6/6 in each eye. Intraocular pressure was normal. On slit-lamp examination, mild redness and chemosis of the nictitating plica semilunaris membrane and adjacent bulbar conjunctiva were present, and there was an inward-directed cilium from the upper eyelid (A, slit lamp photograph under diffuse illumination and low magnification) rubbing the conjunctiva, with localized injection. On lifting the upper eyelid to further evaluate, a cilium was observed emerging from the upper punctum, rubbing against the bulbar surface (B, under high magnification; same eyelash seen on everting lid margin). There was no associated inflammation of the punctum, skin or conjunctiva overlying the canaliculi or sac. The eyelash was removed effortlessly using epilation forceps following application of topical proparacaine 0.5% ophthalmic solution. The smooth extraction of the hair follicle indicated that it was not firmly rooted but merely lodged within the lacrimal punctum. This case highlights the importance of a careful slit-lamp examination of eyelid margins and ocular surface in areas of localized redness in patients presenting with the feeling of foreign body sensation, epiphora, or irritation."/> <meta name="DC.Format" scheme="IMT" content="application/pdf"/> <meta name="DC.Identifier" content="837"/> <meta name="DC.Identifier.URI" content="https://djo.harvard.edu/index.php/djo/article/view/837"/> <meta name="DC.Language" scheme="ISO639-1" content="en"/> <meta name="DC.Rights" content="Copyright (c) 2024 Digital Journal of Ophthalmology"/> <meta name="DC.Rights" content="https://creativecommons.org/licenses/by-nc-nd/4.0"/> <meta name="DC.Source" content="Digital Journal of Ophthalmology"/> <meta name="DC.Source.ISSN" content="1542-8958"/> <meta name="DC.Source.Issue" content="4"/> <meta name="DC.Source.Volume" content="30"/> <meta name="DC.Source.URI" content="https://djo.harvard.edu/index.php/djo"/> <meta name="DC.Subject" xml:lang="en" content="Conjuctival Chemosis"/> <meta name="DC.Title" content="Pseudo-cilium of the punctum: an unusual foreign body"/> <meta name="DC.Type" content="Text.Serial.Journal"/> <meta name="DC.Type.articleType" content="Images & Videos"/> <meta name="gs_meta_revision" content="1.1"/> <meta name="citation_journal_title" content="Digital Journal of Ophthalmology"/> <meta name="citation_journal_abbrev" content="Digit J Ophthalmol"/> <meta name="citation_issn" content="1542-8958"/> <meta name="citation_author" content="Somya Puri"/> <meta name="citation_author_institution" content="Department of Ophthalmology, AIIMS Bilaspur, Himachal Pradesh, India"/> <meta name="citation_author" content="Nripen Gaur"/> <meta name="citation_author_institution" content="Department of Ophthalmology, AIIMS Bilaspur, Himachal Pradesh, India"/> <meta name="citation_author" content="Gautam Lokdarshi"/> <meta name="citation_author_institution" content="Oculoplastic and Ocular Oncology Services, IRIS Superspeciality Eye Hospital, Orchid Medical Centre, Ranchi, Jharkhand, India"/> <meta name="citation_author" content="Bhavya Kapoor"/> <meta name="citation_author_institution" content="AIIMS Bilaspur, Himachal Pradesh, India"/> <meta name="citation_title" content="Pseudo-cilium of the punctum: an unusual foreign body"/> <meta name="citation_language" content="en"/> <meta name="citation_date" content="2024/12/06"/> <meta name="citation_volume" content="30"/> <meta name="citation_issue" content="4"/> <meta name="citation_abstract_html_url" content="https://djo.harvard.edu/index.php/djo/article/view/837"/> <meta name="citation_keywords" xml:lang="en" content="Pseudo-cillium"/> <meta name="citation_keywords" xml:lang="en" content="lacrimal punctum"/> <meta name="citation_keywords" xml:lang="en" content="Eyelash in Punctum"/> <meta name="citation_keywords" xml:lang="en" content="Foreign-body"/> <meta name="citation_keywords" xml:lang="en" content="Conjuctival Chemosis"/> <meta name="citation_pdf_url" 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Archives </a> </li> <li> <a href="https://djo.harvard.edu/index.php/djo/issue/view/85"> Vol. 30 No. 4 (2024) </a> </li> <li class="active"> Images & Videos </li> </ol> </nav> <article class="article-details"> <header> <h1 class="page-header"> Pseudo-cilium of the punctum: an unusual foreign body </h1> </header> <div class="row"> <section class="article-sidebar col-md-4"> <h2 class="sr-only">Article Sidebar</h2> <div class="cover-image"> <img class="img-responsive" src="https://djo.harvard.edu/public/journals/1/submission_837_839_coverImage_en_US.jpg" alt="Pseudo-cilium of the punctum." > </div> <div class="download"> <a class="galley-link btn btn-primary pdf" role="button" href="https://djo.harvard.edu/index.php/djo/article/view/837/622"> <span class="glyphicon glyphicon-lock" aria-hidden="true"></span> <span class="sr-only"> Requires Subscription </span> PDF </a> </div> <div class="list-group"> <div class="list-group-item date-published"> <strong>Published:</strong> Dec 6, 2024 </div> <div class="list-group-item keywords"> <strong> Keywords:</strong> <div class=""> <span class="value"> Pseudo-cillium lacrimal punctum Eyelash in Punctum Foreign-body Conjuctival Chemosis </span> </div> </div> </div> </section> <div class="col-md-8"> <section class="article-main"> <h2 class="sr-only">Main Article Content</h2> <div class="authors"> <div class="author"> <strong>Somya Puri, MBBS</strong> <div class="article-author-affilitation"> Department of Ophthalmology, AIIMS Bilaspur, Himachal Pradesh, India </div> </div> <div class="author"> <strong>Nripen Gaur, MD</strong> <div class="article-author-affilitation"> Department of Ophthalmology, AIIMS Bilaspur, Himachal Pradesh, India </div> </div> <div class="author"> <strong>Gautam Lokdarshi, MD</strong> <div class="article-author-affilitation"> Oculoplastic and Ocular Oncology Services, IRIS Superspeciality Eye Hospital, Orchid Medical Centre, Ranchi, Jharkhand, India </div> </div> <div class="author"> <strong>Bhavya Kapoor, B Optom</strong> <div class="article-author-affilitation"> AIIMS Bilaspur, Himachal Pradesh, India </div> </div> </div> <div class="article-summary" id="summary"> <h2>Abstract</h2> <div class="article-abstract"> <p>A woman in her 40s presented to the ophthalmology outpatient department at AIIMS, Bilaspur, India, with foreign body sensation and watering in her left eye. There was no history of trauma, surgery, medication, or systemic disease. On examination, visual acuity was 6/6 in each eye. Intraocular pressure was normal. On slit-lamp examination, mild redness and chemosis of the nictitating plica semilunaris membrane and adjacent bulbar conjunctiva were present, and there was an inward-directed cilium from the upper eyelid (A, slit lamp photograph under diffuse illumination and low magnification) rubbing the conjunctiva, with localized injection. On lifting the upper eyelid to further evaluate, a cilium was observed emerging from the upper punctum, rubbing against the bulbar surface (B, under high magnification; same eyelash seen on everting lid margin). There was no associated inflammation of the punctum, skin or conjunctiva overlying the canaliculi or sac. The eyelash was removed effortlessly using epilation forceps following application of topical proparacaine 0.5% ophthalmic solution. The smooth extraction of the hair follicle indicated that it was not firmly rooted but merely lodged within the lacrimal punctum. This case highlights the importance of a careful slit-lamp examination of eyelid margins and ocular surface in areas of localized redness in patients presenting with the feeling of foreign body sensation, epiphora, or irritation.</p> </div> </div> <div class="item downloads_chart"> <h3 class="label"> Downloads </h3> <div class="value"> <canvas class="usageStatsGraph" data-object-type="Submission" data-object-id="837"></canvas> <div class="usageStatsUnavailable" data-object-type="Submission" data-object-id="837"> Download data is not yet available. </div> </div> </div> </section> <section class="article-more-details"> <h2 class="sr-only">Article Details</h2> <div class="panel panel-default how-to-cite"> <div class="panel-heading"> How to Cite </div> <div class="panel-body"> <div id="citationOutput" role="region" aria-live="polite"> <div class="csl-bib-body"> <div class="csl-entry"><div class="csl-left-margin">1.</div><div class="csl-right-inline">Puri S, Gaur N, Lokdarshi G, Kapoor B. Pseudo-cilium of the punctum: an unusual foreign body. <i>Digit J Ophthalmol</i>. 2024;30(4). 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Pseudo-cilium of the punctum: an unusual foreign body | Digital Journal of Ophthalmology