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    Cosmetic eyeliner tattoo as risk factor for ocular surface disease

    Patient had allergic granulomatous reaction to blepharopigmentation

    Ophthalmology Times is pleased to announce Igor I. Bussel, MD, MS, MHA, and Deepinder K. Dhaliwal, MD (faculty sponsor), of the Department of Ophthalmology, University of Pittsburgh/UPMC Eye Center, Pittsburgh, as the second-place winner of the 2017 Resident Writer’s Award Program, sponsored by Allergan. Their entry is featured here.

    The Ophthalmology Times Resident Writer’s Award Program is a unique recognition opportunity designed to promote excellence in ocular surface disease education. It was created to acknowledge outstanding case identification and written presentation skills in ophthalmology residents.

    Mark P. Breazzano, MD, and co-authors Alia K. Durrani, MD, and Stephen J. Kim, MD, of Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, are the first-place recipients of this year’s Resident Writer’s Award Program. Their winning submission is featured at OphthalmologyTimes.com/RWAPFirst


    A 60-year-old Caucasian female was referred to UPMC Eye Center for evaluation and management of progressive eyelid ulceration and ocular surface disease. She reports developing red, irritated eyes and lesions on both eyelids about 6 months ago that have progressed to ulcerations that intermittently bleed.

    Her past ocular history was notable for bilateral myopic LASIK in 2000. Her medical history was significant for hypothyroidism and a prior episode of Clostridium difficile infection. She is a former smoker and denied alcohol or drug abuse. She has no known drug allergies and her medication list included: levothyroxine, montelukast, omega-3, multi-vitamin, and vitamin B12.

    She had been under the diligent care of a community ophthalmologist and her symptoms had not improved with conservative treatment using warm compresses, Ocusoft scrubs, bacitracin ointment, and artificial tears. An extensive variety of treatment therapies followed, including: Blephamide (Allergan Inc.), Pataday (Alcon Laboratories), and generic steroid eye drops. Besides eye drops, erythromycin and TobraDex (Alcon Laboratories) ointments as well as ketoconazole 2% shampoo, doxycycline, fish oil supplements, and vitamin C were also utilized, but had no effect on the disease process or symptomatology.

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