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18years old boy, right side upper eye lid extremely difficult since to the birth. Chief Complaints Vision problems, no any other complain. History Extremely difficult right upper eye lid since birth. Vitals Puls 72 bpm SpO2 99% Physical Examination One side vision (left eye) normal. Physically fitness positive for walking, running, cycling, reading and riding. Investigations Please suggest essential investigation. Diagnosis Please suggest, what should be done? Management Please suggest management???

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Diagnosis - Plexiform Neurofibromatosis Plexiform neurofibromas represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1) in which neurofibromas arise from multiple nerves as bulging and deforming masses involving also connective tissue and skin folds. In this case it is involving right upper eyelid It needs surgical excision

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Dermoid haemagioma

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Differential diagnosis Neurofibroma Lacrimal gland tumour Dermoid cyst

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CRYPTOPHTHALMOS NOT crytophthalmos

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ptosis

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This is perhaps crytophthalmos. The condition is extremely rare. The skin passes continuously from the eyebrow over the hidden eye to the cheek.

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Drooping eye. Abnormal low-lying or drooping upper-eyelid. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid. Recommended surgery. Glasses that can hold the eyelid up, called a ptosis crutch, are another option. This treatment is often most effective when the droopy eyelid is only temporary. Glasses may also be recommended if you aren't a good candidate for surgery.

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Probably lipomatous swelling Rx surgery

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CONG CLOSURE OF R ETE BALL BY OBLONG OVAL UNLID SWELLING WHICH IS LIKE A FLAB HOUNG DOWN AND IN PRICEES R EYE IS COVERED NEEDS OCULOPLATIC SURGERY AND EXAMINATION OF EYE BALL GOR ANY ASSOCIATED CONG EYE SNAMOLIES

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PTOSIS Paralysis of superior oblique nerve Collection of supra orbital fat Surgical correction is possible Adv mri rt orbit

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