Posterior lamellar gold-weight extrusion

We report a case of a man who had undergone gold eyelid loading for lagophthalmos 22 years earlier. During examination for a complaint of foreign body sensation in the operated eye, the gold weight was found under the palpebral conjunctiva. Although extrusion of a gold weight through the skin anteriorly is well recognized, posterior extrusion has not been previously reported. Although such an extrusion involves tarsal plate erosion, the patient's complaints in this case were minor, probably due to the chronic nature of the process. This finding should serve to draw the attention of surgeons using gold eyelid loading to the possible, albeit rare, complication of posterior extrusion.