;) its there...but where....

1. Chief Author :- Dr. Minal Kaur
Presenting Author:- Dr. Pushkar Dhir

2. • Ms. X 16 year old SINGLE FEMALE ,
STUDENT by profession from New Delhi
presented to OPD on 28 Jan 2015 with
C/o :- Pain(LE)
Waterring (LE)
Headache (Frontal) – Last few months
20 days

3. ..
• APPARENTLY WELL 20 DAYS
back prior when she started
having
 Pain was Dull In Nature, Present
Through Out The Day with same
intensity , Non-Radiating & was
not relieved on taking medication
 Discharge was Watery in nature ,
scanty ,non purulent .
 H/O injury with Broom Stick 25
days ago

4. RE LE
VA DISTANCE 6/6p 6/6p
NEAR N-6 N-6
ACCEPTANCE +0.50DC @180(6/6) +0.50DC @180 (6/6)
EOM
No Restriction in any Gaze
No Restriction in any gaze
Associated with MILD PAIN
LIDS NORMAL NORMAL
CONJUNCTIVA
NORMAL
Inferior Bulbar Conjunctival
Congestion with granuloma
formation and cilia impacted in it.
CORNEA CLEAR,STAIN -VE CLEAR,STAIN -VE

6. RE LE
AC QUIET, VH4 QUIET,VH4
Pupil Size & Reactn ~4mm/Normal reacting ~4mm/ Normal reacting
Lens
CLEAR Clear
IOP(Applanation,mm Hg) 12 12
Fundus Within Normal Limits Within Normal Limits

7. DISCUSSION
• Cilia(eyelash) can be found at multiple abnormal places in
eye e.g
• Lacrimal Punctum/sac (11)
• Conjunctiva(2)
• Anterior chamber(1)
• Anterior Lens Capsule (6)
• Vitreous(5)
• Predisposing Conditions:-
 Post Phacoemulsification.(4)
Scarring of conjunctiva(3).
Trauma(7)

8. Cilia/Eyelash
at
Various Places

9. Conjunctival
Granuloma(9)
Iris cyst(10)
Corneal Endothelium
Defeciency (8)
Quiet Eye

10. Management
• Cilia was removed with a suture removing forceps under topical
anesthesia and
• Antibiotic e/d 4 times a day &
• Lubricant e/d 4 times a day for 7 days was prescribed.
• On 1st Follow up:-
• Patient eye was quiet and granuloma has started resolving.

11. REFERENCES
1. L. H. Savin NOTES ON AN EYELASH CARRIED BY A PERFORATING INJURY
INTO THE POSTERIOR AQUEOUS CHAMBER Br J Ophthalmol. 1936 Nov; 20(11):
609–612.
2. J. Hamilton McIlroy AN EYELASH IN THE BULBAR SUBCONJUNCTIVAL
TISSUE Br J Ophthalmol. 1921 February; 5(2): 68–69.
3. Hunts JH1, Patrinely JR, Matoba AY, Font RL. Conjunctival cilia entrapment: an
unrecognized cause of ocular irritation. Ophthal Plast Reconstr Surg. 1997
Dec;13(4):289-92
4. Rofail M, Briner AM, Lee GA. Migratory intraocular cilium following
phacoemulsification .Clin Experiment Ophthalmol. 2006 Jan-Feb;34(1):78-80
5. Teo L, Chuah KL, Teo CH, Teoh SC. Intraocular cilia in retinal detachment Ann Acad
Med Singapore. 2011 Oct;40(10):477-9.

12. 6. R. Graham Brown CASE OF AN EYELASH PERFORATING THE CORNEAAND
ANTERIOR LENS CAPSULE Br J Ophthalmol. 1919 Apr; 3(4): 162–163.
7. Zuleyha Yalniz-Akkaya Post-traumatic cilia remaining inert in the anterior chamber for
50 years: a case report J Med Case Reports. 2011; 5: 527. Published online 2011 Oct 26.
doi: 10.1186/1752-1947-5-527
8. Intraocular cilium causing corneal endothelium cell deficiencyWei Liu, Jian Ji Hui Liu
Ruihua Wei, Shaozhen Zhao Tianjin Medical University Eye Hospital, Tianjin, China
Cjo April 2013Volume 48, Issue 2, Pages e28–e29 .
9. Kiesel RD. Conjunctival granuloma due to an imbedded cilium. Am J Ophthalmol 1961;
51: 706–708
10. H B Hoh, M J Menage, and C Dean-Hart Iris cyst after traumatic implantation of an
eyelash into the anterior chamber. Br J Ophthalmol. 1993 Nov; 77(11): 741–742.
11. R. Graham Brown Dacryolith formation around an eyelash retained in the lacrimal sac.
Br J Ophthalmol. 1976 Oct;60(10):722-5.