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Updated: Mar 20, 2026

In Vivo Confocal Microscopy in the Diagnosis and Management of Dry Eye: A Focus on Imaging Protocols and Interpretation
Published on: November 11, 2025
Irregularly luscious lashes: difficult to say but a sinister sign to miss
Ahmed Hamroush1, David Cheung2
1University Hospital of North Midlands, Stoke-on-Trent, UK.
Abstract:
We present a case of an 84-year-old man with advanced glaucoma on multiple unilateral glaucoma medication. He had 2 years history of unilateral ocular irritation thought to be related to his medication. Patient was referred to an oculoplastic clinic and found to have segmental eyelash loss partially masked by hypertrichosis caused by glaucoma medications. His symptoms were initially thought to be related to drop-induced blepharitis. A clinical diagnosis of possible basal cell carcinoma (BCC) was made and the incisional biopsy showed infiltrative micronodular BCC. The patient underwent Mohs micrographic surgery and eyelid reconstruction with a Hughes flap and full thickness skin graft. Timely diagnosis of BCC requires a high index of suspicion, particularly when the signs are subtle.
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