Abstract. Phthiriasis palpebrarum is a rare type of eyelid infestation. In the present study, a 63-year-old woman presented with a case of phthiriasis palpebrarum, which was initially misdiagnosed as anterior blepharitis. The patient had a 2-month history of repeated episodes of itching and burning sensations and moderate pain in both eyes that were not improved by antibiotic and corticosteroid eye drops. Slit lamp examination revealed lice and nits anchored to the eyelashes. All eyelashes were removed from the base along with lice and nits. The patient recovered fully within 2 weeks with no further management, and no evidence of lice or nits was found at the follow up. In conclusion, the findings of the present study suggests that patients presenting with itching of the eyelids and with clinical findings resembling seborrhea accumulation on the eyelashes should be carefully examined by prolonged observation with a slit lamp.

The aim of the present study was to observe the histopathological changes of immunoglobulin G4-related orbital diseases (IgG4-RODs), summarize the clinical manifestations and imaging features of the IgG4-RODs of the eyelids and explore the early diagnosis of IgG4-RODs. Between June 2011 and May 2015, 23 patients with non-specific orbital inflammation in the Department of Ophthalmology at the First Central Hospital of Tianjin were recruited. The serum IgG4 titer in 9 patients ranged from 4.58 to 46.70 g/l (reference value, 0.03-2.01 g/l), with an average value of 21.93±2.18 g/l. Notably, the degree of increase in the 9 patients with IgG4-RODs was different, but all were >1.35 g/l. A total of 6 cases of infraorbital nerve thickening were observed. In addition, there were 3 cases of extraocular muscle thickening and 1 patient with IgG4-ROD had an orbital tissue lesion extending along the inferior temporal septum to the left pterygopalatine fossa, with left sacral fissure widening and involvement of the left maxillary sinus. The study revealed that the thickening of the inferior orbital nerve may be a characteristic of IgG4-ROD. Therefore, on the basis of biopsy and serological examination in the clinic, early diagnosis can be combined with imaging examination, clinical manifestation and laboratory examination, so as to reduce misdiagnosis and missed diagnosis.

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