University of Iowa Health Care

Ophthalmology and Visual Sciences

EyeRounds Online Atlas of Ophthalmology

Contributor: William Charles Caccamise, Sr, MD, Retired Clinical Assistant Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry

Expanded text by Brendan K. Penaluna, May 5, 2017

*Dr. Caccamise has very generously shared his images of patients taken while operating during the "eye season" in rural India as well as those from his private practice during the 1960's and 1970's. While the quality of his images are not up to today's higher web standards, many of his images are significant for their historical perspective and for techniques and conditions seen in settings in undeveloped areas.

Xanthoma (xanthelasma) - left upper lid

Xanthelasma is a lesion composed of lipid-laden histiocytes, and may be a sign of hyperlipidemia. In this image, xanthelasma can be seen on the medial aspect of the upper lid, seen as the slightly-raised yellow-plaque. Currently, there are several approaches to cosmetically treat xanthelasma. One solution is the use of green laser; however, green laser cosmetic therapy for xanthelasma can result in depigmentation. As a result, green laser therapy for xanthelasma should be avoided in patients with highly pigmented skin. Alternatively, surgical excision or Ultrapulse CO2 ablation can be used to remove the plaques. Because xanthoma is a consequence of underlying hyperlipidemia, it is important to consider prescribing a lipid-lowering agent such as a statin or PCKS9 inhibitor.

xanthelasma - left upper lid - closeup of previous Atlas photo


Chong N. Chapter 23. Lasers in Ophthalmology. In: Riordan-Eva P, Cunningham ET, Jr. eds. Vaughan & Asbury's General Ophthalmology, 18e New York, NY: McGraw-Hill; 2011. Accessed April 17, 2017.

Pathania V, Chatterjee M. Ultrapulse Carbon Dioxide Laser Ablation of Xanthelasma Palpebrarum: A Case Series. Journal of Cutaneous and Aesthetic Surgery. 2015;8(1):46-49. doi:10.4103/0974-2077.155084.


originally posted 2/8/2008

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Ophthalmic Atlas Images by, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

last updated: 05/05/2017
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