Purpose. To examine changes in the position of the lower eyelid punctum and tear meniscus height (TMH) after correction of horizontal laxity of the lower eyelid in involutional lower eyelid entropion. Methods. This prospective, observational study included 42 sides of 36 patients with involutional entropion who underwent a lateral tarsal strip procedure or transcanthal canthopexy (+ lower eyelid retractor advancement). The horizontal distance from the medial margin of the lower lacrimal punctum to the medial canthus was measured using ImageJ software. TMH was measured using anterior segment optical coherence tomography. All measurements were performed preoperatively, at postoperative 3-month and at postoperative 6-month. Results. The lower lacrimal punctum significantly shifted laterally at 3-month follow-up and slightly returned toward its original position at 6-month follow-up (Friedman’s test, P   <   0.001 ). Although the differences did not reach statistical significance, TMH in the lower eyelid increased at 3-month follow-up and then slightly decreased at 6-month follow-up (Friedman’s test, P = 0.076 ). Conclusions. The results of this study imply that lateral shift of the lower lacrimal punctum prevents effective drainage of tears accumulated in the lacrimal lake, resulting in increased TMH after correction of horizontal laxity of the lower eyelid in involutional entropion.

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Background Orbital metastasis from pancreatic tumors is extremely rare, and its clinical characteristics are still unclear. Case presentation Our case was a 73-year-old female who noticed diplopia on right gaze 3 months before referral to us. Imaging studies demonstrated a mass involving the lateral rectus muscle in the right orbit. The results of pathological examination of an excised specimen corresponded to poorly differentiated adenocarcinoma. Systemic work-up revealed pancreatic carcinoma with peritoneal metastasis. The patient underwent chemotherapy. We reviewed literature on similar cases and found 19 reported cases of pancreatic tumors metastasizing to the orbit. The results of our review indicate a tendency for formation of solitary mass without bony erosion, delayed detection of the primary pancreatic carcinoma, and poorer prognosis of such tumors, compared to metastatic orbital tumors from other lesions. Conclusions We report a rare case of metastatic orbital tumor from an unknown primary pancreatic carcinoma. Clinical characteristics of cases with metastatic pancreatic tumors seem to be different from those with metastatic tumors from the other lesions. Pancreatic tumors are frequently asymptomatic in an early stage, leading to delayed detection of the primary pancreatic carcinoma and poorer prognosis.