To evaluate and compare intraoperative pain during upper eyelid blepharoplasty (UEB) between on first and second operated eyelids. Methods:In this cross-sectional observational study, the patients were divided into 2 groups, with group 1 representing 40 patients whose surgery was first started on the right and group 2 representing the other 40 patients who started surgery on the left first. UEB was performed to all patients by the same surgeon under the same and equal amount of local anesthesia. Degree of pain felt during surgery on first and second operated eyelid was evaluated with the Visual Analogue Scale (VAS) and Wong Baker Facial Pain Expression Scale (WBFPES) of all patients immediately after surgery and was compared using paired t-test.Results: There were 20 female and 20 male patients in both groups. In group 1, the VAS value was 2.8 ± 1.5, WBFPES value was 2.7 ± 1.6 UEB in the first operated eyelid and the VAS value was 4.1 ± 1.8, WBFPES value was 3.9 ± 1.8 UEB in the second operated eyelid. A significant difference was found between pains felt during first and second operated eyelid UEB regarding VAS and WBFPES values, respectively in group 1 (p=0.003 and p=0.002). In group 2, the VAS value was 1.9 ± 1.0, WBFPES value was 2.0 ± 1.0 UEB in the first operated eyelid and the VAS value was 3.0 ± 1.5, WBFPES value was 2.8 ± 1.6 UEB in the second operated eyelid. A significant difference was found between pains felt during first operated and second operated eyelid UEB regarding VAS and WBFPES values, respectively in group 2 (p=0.009 and p=0.005). Conclusion:To the best of our knowledge, this study is the first to evaluate which eyelid is more painful during surgery in UEB. Patients tend to feel more pain during surgery on the second operated eyelid. Therefore, surgeons should consider using local anesthetics with more volume or longer duration in the second operating eyelid in light of this information and patients should be given detailed information about pain.

A 53-year-old man who has stage 4 non-small cell lung carcinoma and treated with Dabrafenib-Trametinib combination chemotherapy; presented with decreased bilateral visual acuity. We checked out slit lamp examination, fundoscopy, optical coherence tomography and fundus fluorescein angiography. In slit lamp biomicroscopy; bilateral posterior synechiae, granulomatous keratic precipitates and + 4 cells in the anterior chamber were detected. Cystoid macular edema and subretinal fluid accumulation were revealed in optical coherence tomography. Dabrafenib and Trametinib treatments were discontinued and systemic methylprednisolone, topical corticosteroid and topical cyclopentolate were started. His best corrected visual acuity was increased from counting fingers from 2 m to 0,9 bilaterally and cystoid macular edema and serous retinal detachment were completely regressed as a result of systemic and topical corticosteroid treatment.

A 33-year-old female patient who followed up in an external center with the diagnosis of optic neuritis 2 years ago, had complaints of decreased vision and headache for 1 week. In our examination, visual acuity was counting fingers from 2 meters in the right eye and 1.0 in the left eye with a Snellen chart. Bilateral anterior segment was normal in slit-lamp examination. Color vision was 0/12 in the right eye and 12/12 in the left eye. In dilated fundus examination, optic nerve head edema was present in the right eye, while the optic nerve, macula and retina of the left eye were normal. In the visual field, an inferior arcuate visual field defect was observed in the right eye. Anti Toxoplasma IgM resulted in 1,240 IU/mL (positive) and IgG 90.5 IU/mL (positive). Optical coherence tomography showed pigment epithelial detachment adjacent to the optic disc. Trimethoprim/sulfamethoxazole 800/160 mg 2x1, azithromycin 1000 mg loading followed by 500 mg 1x1 (1 week) was started. On the 3rd day of the treatment, prednisolone 1mg/kg/day weekly reduction regimen was started. There was a macular star appearance with hard exudates in the macula with a rapid recovery with treatment. At the 6th month follow-up, visual acuity was 0.5 in the right eye and 1.0 in the left eye, while anterior segment slit-lamp examination was normal. In dilated fundus examination, the temporal part of the optic disc was pale and macular hard exudates were present in the right eye; and the left was normal.