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Oculocardiac reflex associated with a large orbital floor fracture.

A 40-year-old man presented with bradycardia, left eye pain, and intermittent nausea 1 day after blunt trauma to the left orbit. Imaging revealed a large orbital floor fracture with significant herniation of orbital contents but no obvious extraocualar muscle entrapment. Oculocardiac reflex was suspected, and the fracture was repaired surgically within 24 hours of presentation. His bradycardia resolved immediately postoperatively. This case is a unique presentation of the oculocardiac reflex in a large orbital floor fracture with significant herniation of orbital contents but without extraocua…

Silent sinus syndrome with spontaneous orbital floor reconstruction.

PROBLEM: Silent sinus syndrome is rare and its pathophysiology is unclear. We report a case of silent sinus syndrome characterized by progressive enophtalmos with chronic maxillary atelectasis and asymptomatic chronic maxillary sinusitis. METHODOLOGY: The patient had no history of sinusitis, facial trauma, or sinus surgery. Computed tomography revealed opacification of the right maxillary sinus and inferior bowing of the osteopenic orbital floor. Silent sinus syndrome was diagnosed and functional endoscopic maxillary antrostomy without orbital floor reconstruction was performed. RESULTS: At …

Высший синдром трещин на орбите у герпеса зостера офтальмика.

AIM: Сообщить о случае синдрома сверхорбитальной трещины (SOFS) у пациента с герпесом зостером офтальмиком (HZO). Материалы и методы: отчет о деле. Результаты: 71-летний мужчина с HZO был опасен по отношению к несчастным случаям и экстренным жалобам на потерю зрения, двойное зрение и сонливость. Правильная визуальная привычка - считать пальцы. Не было никакого относительного афферентного вспомогательного дефекта. У него был интерстициальный кератит, птоз, проптоз и полная офтальмоплагия. Знаки указывают на HZO, осложненные SOFS. Изображение мозга и поясничные проколы подтвердили диагноз энцефа

Совпадение в аннотации оригинала
AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report. RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was n…

Spectrum of infantile esotropia in primates: Behavior, brains, and orbits.

INTRODUCTION: Recent studies of human infants have described a spectrum of early-onset esotropia, from small angle to large heterotropias. We report here a similar spectrum of early-onset esotropia in infant monkeys, with emphasis on the relationship between visuomotor deficits, central nervous system circuitry, and orbital anatomy. METHODS: Eye movements were recorded in macaque monkeys with natural, infantile-onset esotropia (n = 7) and in control monkeys (n = 2) to assess alignment, latent nystagmus, dissociated vertical deviation (DVD), and pursuit/optokinetic nystagmus (OKN) asymmetries.…

Management of diplopia secondary to neurosurgical injury of the orbital roof.

BACKGROUND: Diplopia related to neurosurgical procedures is often consecutive to oculomotor nerve lesions. We hereby report an oculomotor dysfunction secondary to an orbital roof effraction and its treatment. HISTORY AND SIGNS: Following surgery for a left anterior communicating artery aneurysm, a 45-year-old woman reported vertical diplopia associated with a left orbital hematoma. The diagnosis of third cranial nerve palsy was excluded by orbital imaging which revealed an orbital roof defect with incarceration of the levator palpebrae and superior rectus. THERAPY AND OUTCOME: As neurosurgeo…

Role of botulinum toxin A in diplopia following orbital decompression.

Diplopia following orbital decompression is a common complication in Graves' ophthalmopathy. Strabismus surgery is often required to treat the persistent diplopia. The author presents a successful treatment with botulinum toxin A injection in a case of diplopia following orbital decompression. Treatment with botulinum toxin A in the management of new-onset diplopia following orbital decompression has been suggested in a case that is not amenable to prism treatment and may eliminate strabismus surgery in some cases.

Orbital dermoid cysts presenting as subconjunctival fat droplets.

The authors report 3 cases of orbital dermoid cysts presenting with subconjunctival fat droplets. Three female patients were evaluated for conjunctival injection and yellowish granular material lying under the bulbar conjunctiva in the left eye. Slit-lamp examination showed a number of subconjunctival fat droplets in the involved eyes. Orbital CT and MRI in each case revealed a cystic mass located in the superotemporal aspect of the left orbit. The masses were excised via lateral orbitotomy in 2 patients, and a conjunctival biopsy of the granular material was performed in 1 patient. The cystic…

Primary extrasac orbital lymphoma presenting as nasolacrimal obstruction.

Primary orbital lymphoma is an unusual cause of epiphora in the elderly population. Lymphomas that give rise to nasolacrimal duct obstruction usually arise from within the lacrimal sac. Epiphora is a common presenting complaint that may be easily disregarded as a minor debilitating symptom. This case describes a 58-year-old Caucasian man presenting with epiphora due to primary extrasac orbital lymphoma, causing external mechanical compression on the nasolacrimal duct system. Although a rare presentation, it highlights the need for a thorough examination in patients presenting with epiphora. Na…

[Traumatic orbital encephalocele in an adult: report of one case].

Orbital roof fractures after head injury is rare. Traumatic encephaloceles in the orbital cavity are even rarer, with only 24 cases published to date. We report the case of an adult with a post-traumatic orbital encephalocele. One day after a road traffic accident with head injury, the patient developed progressive pulsatile proptosis. Computed tomography and magnetic resonance imaging revealed an isolated blow-in fracture of the orbital roof with herniation of the left frontal lobe into the orbit. Neurosurgery to repair the orbital defect led to full recovery.

Our experiences managing a rare cranio-orbital cleft.

A unilateral upper lateral orbital cleft, fitting the description of the extremely rare Tessier cleft number 9 is reported. The management and surgery of this patient are discussed, and the relevant literature is reviewed. The usefulness of three-dimensional computed tomography reconstructions and plastic models in planning the surgery is discussed.

[Orbital approach for treatment of carotid-cavernous sinus fistula].

CASE REPORT: A male patient with a left carotid-cavernous sinus fistula (CCSF) and two previous attempts of embolization via the femoral vein was treated with embolization through the superior ophthalmic vein (SOV). DISCUSSION: The main modality of treatment for CCSF is intervention radiology. This aims to occlude the fistula via an arterial route, through the cavernous sinus, or via a venous route, through the inferior petrosus sinus. However, the CCSF is also accessible through the SOV.

Reconstruction of orbital wall defects with bioactive glass plates.

PURPOSE: Synthetic bioactive glass (BAG) is used in many surgical applications. Special bioactive glasses do not favor microbial growth. This study evaluated the clinical outcome of bioactive glass plates in reconstructive orbital surgery. PATIENTS AND METHODS: In a retrospective series of 49 patients, 35 orbital floors and 6 orbital medial and superior walls were reconstructed after fronto-orbital trauma, and 8 patients were treated with BAG plates after fronto-orbital tumor resection. These patients were evaluated in terms of reconstruction materials, complications, and functional outcomes.…

Lateral rectus restriction secondary to traumatic orbital exostosis.

Bony exostoses can occur at the site of a fracture but are rare in facial bones. We report a case of lateral rectus restriction secondary to a traumatic exostosis in the lateral orbital wall with resolution of diplopia after surgical removal of the lesion. Although orbital masses may cause extraocular muscle restriction, to our knowledge, restriction secondary to an exostosis has not been previously reported. A bony exostosis should therefore be included in the differential diagnosis of mechanical restriction of extraocular muscle movement, and surgical treatment is recommended in symptomatic …

Missed diagnosis of a wooden intra-orbital foreign body.

Intraorbital foreign bodies often present a confusing clinical picture. Wooden foreign bodies are notorious for remaining quiescent for a long time, before presenting with a variety of complications. The wound of entry may often be small and self-sealing. Wooden foreign bodies also show a propensity to break during attempted removal. Intraorbital wood is often not detected by standard diagnostic tests like the computed tomography scan, adding to the diagnostic dilemma. The presence of an intraorbital mass with a discharging sinus should evoke suspicion of a retained organic foreign body, regar…

Idiopathic orbital inflammatory disease successfully treated with rituximab.

We report a case of a 66-year-old Caucasian female with a diagnosis of idiopathic orbital inflammatory disease (OID) refractory to azathioprine therapy. The coexistence of diabetes mellitus represented a relative contraindication to chronic prednisone use. After two infusions of rituximab, a chimeric anti-CD20+ antibody, ophthalmic signs and symptoms remarkably improved. To our knowledge, this is the first case of idiopathic OID successfully treated with rituximab.

Rare presentation of fungal orbital cellulitis in an immunocompetent infant.

A 3-month-old infant presented with unilateral proptosis. Ophthalmic and physical examinations, computed tomography, and histopathologic examination of a biopsy specimen were performed. Histopathologic examination confirmed fungal orbital cellulitis. The patient responded to 6 weeks of antifungal therapy. Fungal orbital cellulitis should be included in the differential diagnosis for infants with proptosis.

Unsuspected breast carcinoma presenting as orbital complication of rhinosinusitis.

We report a rare clinical presentation of breast carcinoma metastasis to the ethmoid sinuses, orbit and cavernous sinus in a 70-year-old lady with unsuspected breast carcinoma who presented with clinical features of acute ethmoiditis, orbital cellulitis and cavernous sinus thrombosis. The patient underwent endoscopic ethmoidectomy and histology of the necrotic tissue from the ethmoidal cells was positive for endovascular neoplastic emboli. Subsequent examination revealed a large mass in the left breast, tethered to the skin, which was histologically confirmed to be a carcinoma. The patient die…

Endoscopic versus external repair of orbital blowout fractures.

OBJECTIVES: This study evaluates the usefulness of endoscopic repair compared to external repair in the treatment of blowout fracture (BOF) of the orbit. STUDY DESIGN AND SETTING: This retrospective study comprised 100 patients who had had surgical repair of orbital BOF since 1992. Forty-eight of the 100 had undergone endoscopic repair, 48 patients had had external repair, and four patients underwent surgery that combined the two approaches. The two basic approaches were evaluated and compared with respect to technique, results and complications. RESULTS: Endoscopically, transnasal and trans…