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Amaç: Amacımız göz kapağı ve perioküler tümörlerin demografik ve histopatolojik özelliklerini belirlemek ve karşılaştırmaktır.Gereç ve Yöntemler: Göz hastalıkları kliniğinde göz kapağı ve perioküler tümör cerrahisi geçiren hastaların tıbbi kayıtları retrospektif olarak incelendi. Veriler yaş, cinsiyet, tümör yerleşimi ve histopatolojik sonuçları içeriyordu ve benign, malign ve premalign tümörler arasında karşılaştırmalı çalışma yapıldı. Tümörün ayrıntılı bölgesi sağ ve sol veya iki taraflı, üst ve alt olarak tanımlandı. Medial ve lateral kantal tümörler ve kaş tümörleri perioküler tümörler olarak tanımlandı. İstatistiksel analiz için SPSS bilgisayar istatistik yazılımı (versiyon Chicago) kullanıldı. Anlamlı farklılıklar için ki-kare testi kullanıldı.Bulgular: Histopatolojik doğrulaması yapılan toplam 190 hasta değerlendirildi, 160'ı (%84.2) göz kapağı lezyonu ve 30'u (%15.8) perioküler lezyondu. Göz kapağı lezyonlarının 140'ı (%87.5) benign, 17'si (%10.6) malign ve 3'ü (%1.8) premalign idi. Perioküler lezyonların 20'si (%66.7) benign, 9'u (%30) malign ve 1'i (%3.3) premalign idi. Benign tümörlerin malign (p=0.03) ve premalign lezyonlara (p=0.038) göre daha genç yaşlarda ortaya çıktığı bulundu. Benign tümörlerin 110’u (%68.7) kadınlarda 50’si (%31.3) erkeklerde görüldü. Benign tümörlerin aksine malign ve premalign tümörler erkeklerde daha sıktı (p=0.003). Sağ gözde malign tümörler anlamlı derecede yüksek bulundu. Perioküler ve göz kapağı tümörleri arasında malignite açısından istatistiksel olarak anlamlı bir fark vardı (χ(2)=8.488, p=0.014). Malign tümörler perioküler lezyonlarda anlamlı olarak daha yüksek bulundu. Epidermal kist (%17.5) en sık görülen benign tümördü. Bazal hücreli karsinom en sık görülen malign tipti (%73.1).Sonuç: Erkek cinsiyeti, alt kapak yerleşimi ve yaşlılık, göz kapağı ve perioküler tümörlerde dikkat edilmesi gereken risk faktörleridir., Objective: Our aim was to determine and compare the demographic and histopathological features of eyelid and periocular tumors.Material and Methods: The medical records of the patients who had eyelid and periocular tumor surgery were retrospectively analyzed at the ophthalmology clinic. The data included age, gender, tumor location and histopathological outcomes and comparative study was performed between the benign, malignant and premalignant tumors. Detailed site of the tumor was described as right and left or bilateral, upper and lower. Medial and lateral canthal tumors and eyebrow tumors were described as periocular tumors. SPSS computer statistical software (version Chicago) was used for statistical analysis. Chi-square test was used for the significant differences.Results: A total of 190 patients with histopathologic confirmation were evaluated; 160 were (84.2%) eyelid lesions and 30 (15.8%) were periocular lesions. One hundred and forty (87.5%) of the eyelid lesions were benign, 17 (10.6%) of eyelid lesions were malignant and 3 (1.8%) of lesions were premalignant. Twenty (66.7%) of the periocular lesions were benign, 9 (30%) malignant and 1 (3.3%) was premalignant. Benign tumors were found to occur at younger ages compared to malignant (p=0.03) and premalignant lesions (p=0.038). One hundred and ten (68.7%) of benign tumors were seen in women and 50 (31.3%) in men. In contrast to benign tumors, malignant and premalignant tumors were more common in males (p=0.003). Malignant tumors were found to be significantly higher in the right eyes. There was a statistically significant difference in malignancy between periocular and eyelid tumors (χ(2)=8.488, p=0.014). Malignant tumors were found to be significantly higher in periocular lesions. Epidermal cyst (17.5%) was the most common benign tumor. Basal cell carcinoma was the most frequent malignant type (73.1%).Conclusion: Gender of male, lower lid location and senility are the risk factors that should be concerned in eyelid and periocular tumors.

Periocular region is the feature rich region around the eye which may include features like eyelids, eyelashes, eyebrows, tear duct, eye shape, skin texture and many more. Periocular region based authentication system is a good trade-off between face and iris based biometric authentication systems as they need high user cooperation. This paper provides a comprehensive survey of periocular biometrics and a deep insight of various aspects such as utility of periocular region as a stand-alone modality, periocular region and its fusion with iris, application of periocular region in smart phone authentication and the role of periocular region in soft biometric classification etc. The paper also provides an outlook over possible future research in the area of periocular biometrics.

Intravascular papillary endotelial hyperplasia is a bening vascular lesion that rarely involves the periocular region, nevertheless, it should be considered in the differential diagnosis of a periorbital mass. It is histopatologically characterized by intravascular fibrous papillary fronds covered by endothelial cells. Histopathological differentiation from angiosarcoma can be challenging but is very important to avoid aggressive treatments. Complete surgical excision is frequently curative. Uncompleted excision can lead to recurrences. We describe the clinical and histological findings of intravascular papillary endotelial hyperplasia in the left lower lid of a 72-year-old woman who had a painless mass since 15 years ago, that caused hypertropia of her left eye. Histopathological examination revealed intralesional calcification, which is not an usual feature in this entity. The patient underwent complete surgical resection of the mass and there was no evidence of recurrence after 5 months of follow-up after surgery.

The global pandemic of novel coronavirus that started in 2019 has seriously affected daily lives and placed everyone in a panic condition. Widespread coronavirus led to the adoption of social distancing and people avoiding unnecessary physical contact with each other. The present situation advocates the requirement of a contactless biometric system that could be used in future authentication systems which makes fingerprint-based person identification ineffective. Periocular biometric is the solution because it does not require physical contact and is able to identify people wearing face masks. However, the periocular biometric region is a small area, and extraction of the required feature is the point of concern. This paper has proposed adopted multiple features and emphasis on the periocular region. In the proposed approach, combination of local binary pattern (LBP), color histogram and features in frequency domain have been used with deep learning algorithms for classification. Hence, we extract three types of features for the classification of periocular regions for biometric. The LBP represents the textual features of the iris while the color histogram represents the frequencies of pixel values in the RGB channel. In order to extract the frequency domain features, the wavelet transformation is obtained. By learning from these features, a convolutional neural network (CNN) becomes able to discriminate the features and can provide better recognition results. The proposed approach achieved the highest accuracy rates with the lowest false person identification. © 2022 CRL Publishing. All rights reserved.

Purpose: Botulinum toxin (BTX) injections are used in cosmetic surgery to efface facial wrinkles. Botulinum toxin relaxes the muscle by preventing the release of the neurotransmitter acetylcholine at the neuromuscular junction located at the posterior muscle surface causing local muscle paralysis. The purpose of this study is to provide anatomic knowledge of muscle belly depths of the frontalis, corrugator supercilii, procerus, and orbicularis oculi muscles in an attempt to improve the efficacy of BTX treatment of glabellar, forehead, and lateral eyelid rhytides. Methods: Six-millimeter punch biopsies were obtained from 7 fresh cadavers. Biopsies were taken from the corrugator supercilii, frontalis, procerus, and orbicularis oculi muscles at the sites of routine BTX injection. Specimens were fixed in formalin, and representative H&E-stained sections were used to measure muscle surface depths by light microscopy equipped with digital camera that includes a digital micrometer. One-way analysis of variance test analyses were used to identify statistical differences between measured muscle depths. Results: The measured anterior muscle depth of the corrugator supercilii, frontalis, procerus, and orbicularis oculi was found to be 4.2 ± 0.6, 3.9 ± 0.6, 2.9 ± 0.4, and 2.3 ± 0.7 mm, respectively. The anterior muscle surface of the corrugator supercilii and frontalis was found to be deeper than that of the procerus and orbicularis oculi ( P < .001). The posterior surface depth of the corrugator supercilii, frontalis, procerus, and orbicularis oculi was found to be 6.6 ± 0.8, 5.1 ± 0.7, 4.9 ± 0.7, and 3.8 ± 1.0 mm, respectively. The posterior surface depth of the corrugator supercilii was found to be significantly deeper than that of the frontalis, procerus, and orbicularis oculi ( P < .001); the posterior surface depth of the frontalis and procerus was deeper than that of the orbicularis oculi ( P < .001). The muscle belly width of the corrugator supercilii, frontalis, procerus, and orbicularis oculi measured 2.5 ± 0.9, 1.1 ± 0.4, 2.0 ± 0.6, and 1.5 ± 0.5 mm, respectively. The corrugator supercilii was found to be thicker than the frontalis and orbicularis oculi, while the procerus was found to be thicker than the frontalis ( P < .001). Conclusion: The findings above demonstrate statistical differences in the posterior muscle surface depth of the corrugator supercilii, frontalis, procerus, and orbicularis oculi which can be used clinically to improve BTX injection efficacy when used to efface facial rhytides.

Sebaceous carcinoma (SC) is a rare, aggressive malignancy. Most lesions occur in the periocular region, with few cases presenting with extraocular lesions. Here, we report a case of an 89-year-old woman with a 3-month history of a rapidly growing giant extraocular SC. The diagnosis was based on skin biopsy findings. We advised the patient to undergo surgical excision of the carcinoma. However, the patient and her family rejected our proposed surgical treatment, opting for topical traditional Chinese medicine as alternative treatment. The patient subsequently died of unknown causes at home, four months after the first visit. This case of treatment failure emphasizes the importance of early detection and treatment for these aggressive tumors.

The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick’s classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm2, a repetition rate of 1.7–2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

Background: The reconstruction of the upper eyelid and the periorbital region is a challenge for the surgeon. The aims of this reconstruction are to guarantee protection to the eyeball, maintain the visual field, and restore the function of the eyelid without damaging other anatomical structures. In this study, the authors describe the use of a propeller myocutaneous flap based on the small vertical branches of marginal, peripheral ed superficial arcade, for the reconstruction of the upper eyelid or periorbital region. Materials and methods: The authors enrolled 3 patients (Caucasian), between 2018 and 2019, and subjected to reconstructive surgery with the propeller myocutaneous flap of the periorbital region at the Plastic Surgery Unit of the University of Messina. The vascularization of the flap was demonstrated through an anatomical study conducted on cadavers at the dissection laboratories of the University of Bordeaux 2. Results: The authors have shown that the myocutaneous flap represents a valid alternative for loss of substance coverage and reconstruction of the upper eyelid or periorbital region, allowing the achievement of a good aesthetic and functional result. Follow up: Patients were followed up at 3-6-12 months. No complications were reported (flap retraction, periocular region deformity, donor site morbidity). Furthermore, at the last visit, the scars were almost invisible. Conclusions: The use of the propeller myocutaneous flap of the upper eyelid is a valid reconstructive alternative to the standard techniques described so far for the reconstruction of the periorbital region.

Three-dimensional (3D) stereophotography area measurements are essential for describing morphology in the periocular region. However, its reliability has not yet been sufficiently validated. The objective of this study was to evaluate the reliability of 3D stereophotogrammetric area measurements in the periocular region. Forty healthy volunteers had five flat paper objects placed at each of the seven periocular positions including the endocanthion and the upper medial, upper middle, upper lateral, lower medial, lower middle, and the lower lateral eyelid. Two series of photographic images were captured twice by the same investigator. Each image of the first series was measured twice by the same rater, while images of both series were measured once by a second rater. Differences between these measurements were calculated, and the intrarater, interrater, and intramethod reliability was evaluated for intraclass correlation coefficients (ICCs), mean absolute differences (MADs), technical errors of measurements (TEMs), relative errors of measurements (REMs), and relative TEM (rTEM). Our results showed that 21.2% of all ICCs were considered as excellent, 45.5% were good, 27.3% were moderate, and 6.1% were poor. The interrater ICC for the endocanthion location was 0.4% on a low level. MAD values for all objects were less than 0.3 mm2, all TEM were less than 1 mm2, the REM and rTEM were less than 2% for all objects, showing high reliability. 3D stereophotogrammetry is a highly reliable system for periocular area measurements and may be used in the clinical routine for planning oculoplastic surgeries and for evaluating changes in periocular morphology.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Giant cell tumor of soft tissue (GCTST) is a rare neoplasm genetically unrelated but histopathologically indistinguishable to its osseous counterpart. Histologically, GCTST is characterized as a multinodular proliferation of bland histiocytoid mononuclear cells intermixed with osteoclast-like giant cells. GCTST most commonly presents as a soft-tissue mass located in the extremities of middle-aged adults. In this report, we describe a case of a dermal GCTST arising in the periocular region of a 3-year-old girl. This is the youngest patient diagnosed with GCTST reported in the literature and is also singular because of its anatomic location: Only a handful of head and neck GCTSTs have been reported to date. Furthermore, GCTST most often presents as a superficial or deep soft-tissue mass and much less commonly as a dermal-based skin tumor, as was our case. On microscopic examination, the resected lesion demonstrated classical features including numerous osteoclast-like giant cells embedded in a background of mononuclear ovoid cells which displayed brisk mitotic activity and were surrounded by variable stromal hemorrhage. Tumor cells presented a vaguely fascicular arrangement. Immunohistochemical profile demonstrated positivity for smooth muscle actin and CD68 and negativity for desmin, myo-D1, S100, HMB-45, Melan-A, p16, and NKIC3. The unusual characteristics of this case emphasize the clinicopathologic heterogeneity of GCTST.

Objectives. Basal cell carcinomas (BCCs) are malignant tumors which rarely metastasize, are slow-growing, and extensively locally destructive. BCCs more than 5 cm in diameter are defined as giant. Most often they arise as a result of neglect, as the patient avoids, delays, or refuses to see a doctor. The large tumor diameter and consequently of the post-excisional defect make these lesions difficult to treat surgically with respect to selecting the surgical reconstruction technique. Method. We studied a group of 9 patients, aged 60 to 85 years, diagnosed with giant basal cell carcinomas (GBCCs) with periocular location in which surgery was indicated. Results. In all cases, complete excision with histologically clear margins was performed and for the coverage of the remaining defect various, complex, and sometimes two-stage reconstructive techniques were used. Conclusions. Giant cell carcinoma of the periocular region requires extensive and risky surgery, especially when performed on the elderly. Early referral to a doctor avoids all these risks, in all cases the pathological diagnosis was nodular BCCs. The aesthetic and functional outcomes were good to very good, and the patients reported being highly satisfied.

Traditionally, second intent healing (SIH) in the periocular region is reserved for small and/or concave defects, particularly those located on the medial canthus. The purpose of this study was to identify factors impacting outcomes of SIH for periocular tumors following Mohs micrographic surgery (MMS). Retrospective analysis was performed of all periocular lesions treated with MMS followed by SIH from a single academic surgical center over a 5-year period. Data regarding tumor characteristics and follow-up was recorded. The modified Manchester scale was utilized to evaluate scar outcomes. Of the 39 tumors included, 14 (35.9%) were located on the lower eyelid, 12 (30.8%) on the upper eyelid, 6 (15.4%) on the lateral canthus, and 7 (17.9%) on the medial canthus. Involvement of the eyelid margin was seen in 11 (28.2%) of cases. The average defect diameter and area were 1.3 cm and 1.04 cm-squared. Twenty-three cases (59.0%) healed with optimal results. Larger defects were significantly associated with poorer outcomes of SIH (odds ratio 0.205, p = 0.017 by multivariate analysis). Anatomic location, involvement of the lid margin, age, and follow-up interval were not significant factors; however, medial canthus defects were least likely to heal with optimal results. On average, medial canthal lesions were larger in size (mean diameter 1.76 cm, mean area 1.97 cm-squared). This retrospective study suggests that periorbital defects in all locations with area less than 1.04 cm2 heal well by SIH. In this cohort, larger lesions on the medial canthus healed with worse outcomes.

Summary Background: Application of distant skin flaps in facial defect reconstruction has limitations such as leaving a patch like appearance and being restricted by the length of the vascular pedicles. Leveraging the abundance of blood supply from superficial muscular aponeurotic system (SMAS), a local skin flap pedicled by SMAS can be used to avoid the aforementioned problems. Herein, we report the clinical application as well as the anatomical study of SMAS-pedicled skin flaps. Methods: This study enrolled patients who underwent facial defect reconstruction surgery between 2013 and 2018 using SMAS-pedicled skin flaps. The flaps were designed according to the size and location of the defect. A follow-up was performed to evaluate the treatment outcomes and incidence of adverse events. In addition, six cadaveric heads were used to perform an anatomical study on the distribution and blood supply of SMAS. Results: Twenty-three cases underwent the defect reconstruction surgery in the frontal regions (three cases), temporal region (four cases), periocular region (four cases), nasal region (seven cases), and other regions (five cases). All the flaps survived well. During the follow-up period up to 12 months, the flaps showed a satisfactory appearance, blood supply, and elasticity. The distribution and blood supply of SMAS at different anatomical regions have been successfully observed. Abundant vascular networks could be found in the SMAS layer. Conclusion: Based on the broad distribution of SMAS and the abundant blood supply, an SMAS-pedicled skin flap could be flexibly designed and versatilely used to reconstruct post-traumatic or post-excisional facial defects.

Objective The management of advanced basal cell carcinoma (BCC) in the periocular region remains a clinical challenge. Vismodegib (ErivedgeTM) has been approved in 2013 by Health Canada for adult patients with “histologically confirmed metastatic BCC or locally advanced BCC inappropriate for surgery or radiation.” An expert consensus was sought to create a standardised approach in the use of this novel treatment. Methods Fourteen practicing oculoplastic surgeons across Canada were involved in formulating and reviewing guidelines until consensus was reached. A consultancy meeting was followed by further ratification of guidelines over email. Two voting surveys were performed of the group to objectively assess agreement over each statement within the guidelines. Ratification continued until at least two-thirds of the group agreed on every guideline statement. Results The guidelines summarize 21 statements in a major and minor criteria format. A multidisciplinary team review is suggested for each patient with the involvement of recommended specialists. The internal survey revealed 100% agreement over 9 statements, 91.7% agreement over 8 statements, 83.3% agreement over 4 statements, and 2 statements had 66.7% and 58.7% agreement each. All statements with less than 91.7% agreement were surveyed again, and they were kept, modified, or removed on the basis of a consensus of over 66.7%. Conclusions These guidelines serve to act as a framework for physicians considering vismodegib for the medical management of patients with advanced or metastatic periocular BCC. Future applications, including neoadjuvant uses of the drug, may become apparent through further research.

Most of the prominent features of human face are present in the ocular area, referred as the periocular region. Complex and dense features in these regions makes it a candidate to be used as a biometric trait. This paper discusses an effective method for periocular recognition using non-overlapped blockwise interpolated local binary pattern (iLBP) features. For a given periocular image, an iLBP coded feature image is obtained and further divided into four equal non-overlapping sub-regions. From each sub-region having iLBP pattern, eight bin histogram features are calculated. A single feature vector is formed by concatenating blocked histograms of each non-overlapping region. Binned histogram based feature is also extracted using Phase Intensive Global Pattern (PIGP) features for comparison of results. Experiments are conducted on UBIRIS.v1 and UBIPr.v2 datasets. From the experiments, it is observed that selected histogram feature bins through the proposed approach provide a more compact representation of periocular image and size of the feature vector is also reduced with significant improvement in performance.

Background The three-dimensional surface imaging system is becoming more common in plastic surgeries. However, few studies have assessed three-dimensional periocular structures and surgical outcomes. This study aimed to propose a standardized three-dimensional anthropometric protocol for the periocular region, investigate its precision and accuracy, and determine the three-dimensional periocular anthropometric norms for young Caucasians. Methods Thirty-nine healthy young Caucasians (78 eyes) were enrolled. Three-dimensional facial images were obtained with a VECTRA M3 stereophotogrammetry device. Thirty-eight measurements in periocular regions were obtained from these images. Every subject underwent facial surface capture twice to evaluate its precision. A paper ruler was applied to assess its accuracy. Results Sixty-three percent of measurements in linear distances, curvatures, angles, and indices were found to reach a statistically significant difference between sexes (p ≤ 0.05, respectively). Across all measurements, the average mean absolute difference was 0.29 mm in linear dimensions, 0.56 mm in curvatures, 1.67 degrees in angles, and 0.02 in indices. In relative error of magnitude, 18 percent of the measurements were determined excellent, 51 percent very good, 31 percent good, and none moderate. The mean value of the paper-ruler scale was 10.01 ± 0.05 mm, the mean absolute difference value 0.02 mm, and the relative error of magnitude 0.17 percent. Conclusions This is the first study to propose a detailed and standardized three-dimensional anthropometric protocol for the periocular region and confirm its high precision and accuracy. The results provided novel metric data concerning young Caucasian periocular anthropometry and determined the variability between sexes.

A novel method for person identification based on the fusion of iris and periocular biometrics has been proposed in this paper. The challenges for image acquisition for Near-Infrared or Visual Wavelength lights under constrained and unconstrained environments have been considered here. The proposed system is divided into image preprocessing data augmentation followed by feature learning for classification components. In image preprocessing an annular iris, the portion is segmented out from an eyeball image and then transformed into a fixed-sized image region. The parameters of iris localization have been used to extract the local periocular region. Due to different imaging environments, the images suffer from various noise artifacts which create data insufficiency and complicate the recognition task. To overcome this situation, a novel method for data augmentation technique has been introduced here. For features extraction and classification tasks well-known, VGG16, ResNet50, and Inception-v3 CNN architectures have been employed. The performance due to iris and periocular are fused together to increase the performance of the recognition system. The extensive experimental results have been demonstrated in four benchmark iris databases namely: MMU1, UPOL, CASIA-Iris-distance, and UBIRIS.v2. The comparison with the state-of-the-art methods with respect to these databases shows the robustness and effectiveness of the proposed approach.

Iris and face are two most popular biometric traits. Unfortunately, their performance can be degraded when these systems encountered with non-ideal images. The primary motivation of this paper is to analyze the usability of a new feature rich biometric trait known as periocular region (nearby region around the eye) for two different non-ideal scenarios 1) Matching of images with different pose variation and 2) Matching of different side of periocular images (Left eye to Right eye & Right eye to Left eye). In this paper, seven different off-the-shelf deep learning based Convolutional Neural Networks (CNN) using transfer learning approach are implemented on UBIPr database. Experimental results demonstrated that for images with pose variation VGG 19 obtained maximum recognition accuracy while for matching of two different side of periocular region Res Net 18 outperform others. As an additional contribution, a novel approach for the use of mirror images to improve the matching accuracy of two different side of periocular region is also presented.

Gun-related eye injuries are relatively common in the context of gunshot wounds to the head and neck. Many of the fundamental principles of gunshot wound management apply to the care of these patients, but the complex anatomy and functional relationships of the periocular region do pose special challenges. We provide a focused primer for physicians seeking a more in-depth understanding of gun-related eye injuries and present 3 representative cases outlining the spectrum of pathology, provide a focused review of the relevant ballistics concepts, and discuss the management of injuries to the periocular soft tissues, orbital structures, and globe. We found that good cosmetic and functional results can often be achieved with appropriate early intervention, but visual prognosis may remain guarded despite optimal treatment.

Background Three-dimensional (3D) imaging has become increasingly popular in aesthetic surgery. However, few studies have emphasized its application in the periocular region. Objective To provide evidence supporting the reliability of generalizing periocular measurements obtained using caliper-derived direct anthropometry and 2-dimensional (2D) photogrammetry to 3D stereophotogrammetry. Materials and methods Periocular surfaces were captured using a stereophotogrammetry system for 46 normal Caucasian individuals. Twenty-two periocular variables were directly, 2-dimensionally, and 3-dimensionally measured. Reliability of these measurements was evaluated and compared with each other. Results The results revealed that, for direct (intra-rater reliability only), 2D, and 3D anthropometry, overall intra-rater and inter-rater intraclass correlation coefficient estimates were 0.88, 0.99 and 0.97, and 0.98 and 0.92, respectively; mean absolute differences were 0.84 mm, 0.26 and 0.36 units, and 0.35 and 0.67 units, respectively; technical error of measurement (TEM) estimates were 0.85 mm, 0.25 and 0.36 units, and 0.32 and 0.65 units, respectively; relative error measurement estimates were 6.46%, 1.69% and 2.74%, and 1.67% and 5.11%, respectively; and relative TEM estimates were 6.25%, 1.62% and 2.78%, and 2.12% and 5.12%, respectively. Conclusion Stereophotogrammetry and the authors' landmark location protocol yield very good reliability for a series of 2D and 3D measurements.

Introduction: Intravascular papillary endothelial hyperplasia (IPEH) is a rare proliferation of endothelial cells with uncertain etiology related to thrombus formation. Diagnosis is usually confirmed histopathologically. This condition has been previously described in the periocular region but not in the conjunctiva. Methods: It is a retrospective case series in which we evaluated seven patients with histopathologically confirmed IPEH cases. Data regarding the demographics, clinical presentation, radiological description, histopathological features including any IHC staining, suspected underlying vascular etiology, management options, and follow up outcome were collected. Results: A total of seven cases of histologically confirmed IPEH were included. Five out of seven patients were male (71.4%). The age range was between 6 and 69 years with a median age of 36 years. Three cases involved the eyelid (42.8%) and another three were found in the conjunctiva (42.8%). Pre-existing underlying vascular lesions were observed in all patients, five malformations (mostly lymphatic-venous) and two conjunctival hemorrhagic lymphangiectasis. All cases were treated with excisional biopsy with no signs of recurrence within an average of 7 months follow up. Conclusions: Periocular IPEH is a rare tumor that is likely to coexist with underlying vascular lesions and thrombus formation. We are reporting its existence in the conjunctiva for the first time. Therefore, pathologists should be aware of the histopathological spectrum of this lesion.

Recognition of individual identity using the periocular region (i.e., periocular recognition) has emerged as a relatively new modality of biometrics and is a potential substitute for face recognition when facial occlusion happens, e.g., when wearing a mask. Moreover, many application scenarios occur at nighttime, such as nighttime surveillance in law reinforcement. We therefore study the topic of periocular recognition at nighttime using the infrared spectrum. However, the useful and effective area for periocular recognition is quite limited compared to that of face recognition since only the eyes are exposed. As a result, the performance of periocular recognition algorithms is relatively low. This issue of limited area poses a serious challenge even though many state-of-the-art face recognition algorithms yield high performance. This situation is even more deteriorated when periocular recognition is performed at nighttime. Thus, we in this paper propose an image super-resolution (SR) based technique for nighttime periocular recognition in which we enlarge the small-sized periocular image to have a larger effective area while retaining a high image quality. Super-resolution of the periocular images is achieved by a CNN model which first conducts interpolation of the periocular area to an expected size and then finds a nonlinear mapping between the input low quality periocular image and the output high quality periocular image. To validate our method, we compare our deep learning-based SR method with the original case of none SR involved at all, as well as the other two cases using traditional SR methods, namely bilinear interpolation and bicubic interpolation. In terms of quality metrics such as PSNR and SSIM as well as recognition metrics such as GAR and EER, our method significantly outperforms all the other three methods.