MEDizzy
MEDizzy
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKHalmost 2 years ago
Ptosis after Swimming in the Red Sea

Ptosis after Swimming in the Red Sea

A 52-year-old man presented with ptosis and limited ocular and eyelid elevation in his left eye (Panel A). A swollen and droopy eyelid had developed after the patient collided with a school of fish while he was swimming at a Red Sea beach 4 weeks earlier. Magnetic resonance imaging revealed a granuloma in the upper eyelid and anterior upper orbital region (Panel B), with no foreign body visible. During surgical excision of the granuloma, two transparent tubular structures pointing toward the orbital apex were detected and extricated (Panel C). These foreign bodies were thought to have pinned and immobilized the levator muscle and superior rectus muscle. Taxonomic analysis identified the objects as mandibles of the halfbeak fish. Halfbeak fish, which are members of the family Hemiramphidae, are mostly surface-dwelling fish that are common in shallow and coastal waters, including such waters in the Red Sea. Within 3 months after surgery, the ptosis and the restriction of ocular motility had resolved completely.

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