The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Asymmetrical skin creases

Photo by Professor Chua Chung Nen

This 45 year-old man was unhappy with his right eye because of the absence of skin crease and the fact it looked smaller than the left eye. Examination showed this to be the result of anterior descend of the pre-aponeurotic fat (most likely congenital as the absent skin crease was presnet in childhood) that had obliterated the skin crease. A skin crease incision was made that corresponded to the height of the left eye. The septum was opened and the pre-aponeurotic fat was cauterized to cause it to move posteriorly. The wound was closed with 5 6/0 vicryl sutures that picked up the levator aponeurosis.

 

Absent right skin crease and the immediate post-operative appearance.

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