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Epibulbar Proliferative Fasciitis, a Variant of Nodular Fasciitis: A Differential Diagnosis of Conditions With Focal or Diffuse Myxoid Stromas
Jakobiec, Frederick A. M.D., D.Sc.*; Barrantes, Paula Cortes M.D.*; Ma, Lina M.D.*; Mihm, Martin M.D.†
doi : 10.1097/IOP.0000000000001872
September/October 2021 - Volume 37 - Issue 5 - p 399-407
To describe the clinical and pathologic features of a case of epibulbar proliferative fasciitis and to compare it with other focal or diffuse myxoid lesions.
Nonosseous Periocular Manifestations of Langerhans Cell Histiocytosis: A Case Report and Systematic Review
Plemel, David J.A. M.D.*; Benson, Matthew D. M.D.*; Tong, C. Maya M.D.*; Mahmood, Muhammad N. M.D.†; Pollock, Travis J. M.D.*
doi : 10.1097/IOP.0000000000001906
September/October 2021 - Volume 37 - Issue 5 - p 408-413
Langerhans cell histiocytosis (LCH) is a disorder of dendritic cell proliferation that typically involves bone. It can be diagnostically challenging when LCH presents without bony involvement, leading to delays in diagnosis and treatment. In this study, the periocular manifestations of LCH in cases where the underlying orbital bones are not involved are described through a systematic review.
Volumetric Versus Empirical Determination of Enucleation Implant Size
Custer, Philip L. M.D., F.A.C.S.*; Maamari, Robi N. M.D.*; Huecker, Julia B. M.S.*; Gordon, Mae O. Ph.D.*,†
doi : 10.1097/IOP.0000000000001884
September/October 2021 - Volume 37 - Issue 5 - p 414-419
To compare the use of sizing implants versus intraoperative volume measurements for individualization of enucleation implant size, and to identify preoperative factors affecting the choice of implant.
Quantitative Assessment of Orbital Decompression Surgery Using Photogrammetric Stereoimaging
Murta, Fabiola M.D.*; Hyer, Jonathan N. M.B.B.S., F.R.C.Ophth.*; Haridas, Anjana M.A., F.R.C.Ophth.*; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.*,†; Ezra, Daniel G. M.D., F.R.C.Ophth.*,†
doi : 10.1097/IOP.0000000000001885
September/October 2021 - Volume 37 - Issue 5 - p 420-423
To evaluate periorbital volume changes, using quantitative photogrammetric stereoimaging, after bony orbital decompression for thyroid eye disease (TED) and compare this to changes in Hertel exophthalmometry. Tissue volumes of the upper and lower eyelids were also assessed independently.
Ophthalmic Presentation of Undiagnosed Sinonasal Masses
Vahdani, Kaveh M.D., F.R.C.Ophth.; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001887
September/October 2021 - Volume 37 - Issue 5 - p 424-430
To evaluate clinical features of patients who first present with orbital symptoms and signs due to undiagnosed sinonasal pathology.
Postoperative Blepharoptosis After Pars Plana Vitrectomy Procedure
Abdolalizadeh, Parya M.D., M.P.H.; Kashkouli, Mohsen Bahmani M.D.; Falavarjani, Khalil Ghasemi M.D.; Karimi, Nasser M.D., M.P.H.; Khademi, Behzad M.D.; Sedaghat, Ahad M.D.
doi : 10.1097/IOP.0000000000001890
September/October 2021 - Volume 37 - Issue 5 - p 431-434
To describe the frequency of blepharoptosis and factors affecting it after the pars plana vitrectomy (PPV) procedure.
Pharmaceutical and Supply Waste in Oculofacial Plastic Surgery at a Hospital-Based Outpatient Surgery Center
Bhatter, Param B.S.; Cypen, Sanja G. M.D.; Carter, Steven L. M.D.; Tao, Jeremiah P. M.D., F.A.C.S
doi : 10.1097/IOP.0000000000001891
September/October 2021 - Volume 37 - Issue 5 - p 435-438
To investigate the financial and environmental waste burden of unused disposable surgical supplies and pharmaceutical products in oculofacial plastic surgery at a hospital-based outpatient surgery center.
The Anatomy of the Frontal Process of the Maxilla in the Medial Wall of the Lacrimal Drainage System in East Asians
Chen, Zhaoyue M.D.*; Wang, Peng M.D.*; Du, Lei M.A.†; Wang, Lan M.D.‡
doi : 10.1097/IOP.0000000000001892
September/October 2021 - Volume 37 - Issue 5 - p 439-443
To investigate the anatomical structure characteristics of the frontal process of the maxilla in the medial wall of the lacrimal drainage system for endoscopic dacryocystorhinostomy based on the cone-beam computed tomography images.
Lacrimal Gland Intravascular Micrometastasis From a Human Papillomavirus-Driven Anorectal Squamous Cell Carcinoma With a Review of Metastatic Disease to the Lacrimal Gland
Neerukonda, Vamsee K. M.D.*; Jakobiec, Frederick A. M.D., D.Sc.*; Freitag, Suzanne K. M.D.†; Stagner, Anna M. M.D.*; Wolkow, Natalie M.D., Ph.D.*,†
doi : 10.1097/IOP.0000000000001894
September/October 2021 - Volume 37 - Issue 5 - p 444-449
To document a unique case of anorectal squamous cell carcinoma that was metastatic to the microvasculature of the lacrimal gland in a patient with human immunodeficiency virus and to review previously reported cases of metastases to the lacrimal gland.
Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids
Kim, Jane S. M.D.*; Ginter, Anna M.D.*; Ranjit-Reeves, Roshni M.D.*; Woodward, Julie A. M.D.*,†
doi : 10.1097/IOP.0000000000001902
September/October 2021 - Volume 37 - Issue 5 - p 450-456
To describe postoperative management following ablative carbon dioxide laser resurfacing of the lower eyelids.
Two-paired Mini-incisional Entropion Surgery for Involutional Entropion
Ozdemir, Ibrahim M.D.
doi : 10.1097/IOP.0000000000001914
September/October 2021 - Volume 37 - Issue 5 - p 457-461
The aim of this study is to describe “2-paired mini-incisional entropion surgery” for involutional entropion.
Evaluation of Antibiotic Prophylaxis for Acute Nonoperative Orbital Fractures
Esce, Antoinette R. M.D.*; Chavarri, Vanina M. M.D.*; Joshi, Amar B. M.D.†; Meiklejohn, Duncan A. M.D.*
doi : 10.1097/IOP.0000000000001915
September/October 2021 - Volume 37 - Issue 5 - p 462-464
The use of antibiotic prophylaxis for the prevention of infection in nonoperative orbital fractures is controversial, with limited high-quality evidence and inconsistent recommendations in the current scientific literature. Our primary study objective was to identify the prophylactic antibiotic prescribing pattern at our institution for nonoperative orbital fractures and to determine the effect of antibiotic prophylaxis.
Pupillary and Anterior Chamber Changes Following Upper Eyelid Blepharoplasty
Koçer, Ali Mert M.D.; Sen, Emine Malkoc M.D.
doi : 10.1097/IOP.0000000000001917
September/October 2021 - Volume 37 - Issue 5 - p 465-469
This study investigated the preoperative and postoperative pupillary and anterior chamber (AC) characteristics of patients undergoing upper eyelid blepharoplasty.
Web-Based Versus Non-Web–Based Patient Referral Patterns and Factors Affecting Them
Abdolalizadeh, Parya M.D., M.P.H.; Kashkouli, Mohsen Bahmani M.D.; Gandomi-Mohammadabadi, Alireza M.D.; Karimi, Nasser M.D., M.P.H.; Chaibakhsh, Samira Ph.D.; Jafarpour, Soheila M.D.
doi : 10.1097/IOP.0000000000001918
September/October 2021 - Volume 37 - Issue 5 - p 470-475
To analyze the 8-year (2012–2019) change in the patient referral source trends to a plastic surgery practice and the factors affecting them.
Anti-inflammatory and Antioxidant Effects of Selenium on Orbital Fibroblasts of Patients With Graves Ophthalmopathy
Kim, Bo-Yeon*; Jang, Sun-Young†; Choi, Dug-Hyun*; Jung, Chan-Hee*; Mok, Ji-Oh*; Kim, Chul-Hee M.D., Ph.D.*
doi : 10.1097/IOP.0000000000001931
September/October 2021 - Volume 37 - Issue 5 - p 476-481
In the present study, the authors investigated the effects of selenium on inflammation, hyaluronan production, and oxidative stress in primary cultured orbital fibroblasts of patients with Graves ophthalmopathy (GO).
Management of Pediatric Acute Dacryocystitis
Prat, Daphna M.D.*,†; Magoon, Katie M.D.*; Revere, Karen E. M.D.*; Katowitz, James A. M.D.*; Katowitz, William R. M.D.*
doi : 10.1097/IOP.0000000000001932
September/October 2021 - Volume 37 - Issue 5 - p 482-487
To analyze the clinical presentation, course, and management in a large cohort of pediatric acute dacryocystitis subjects and to examine whether hospitalization and urgent surgical intervention are indeed mandatory.
Clinical Presentations, Management and Outcomes of Rhino-Orbital-Cerebral Mucormycosis (ROCM) Following COVID-19: A Multi-Centric Study
Dave, Tarjani Vivek M.D.*; Gopinathan Nair, Akshay M.D.†,‡; Hegde, Raghuraj M.D.§,?; Vithalani, Nidhi M.D.*; Desai, Savari M.D.¶; Adulkar, Namrata M.D.#; Kamal, Saurabh M.D.**; Mittal, Raman M.D.††; Bradoo, Renuka A. M.D.‡
doi : 10.1097/IOP.0000000000002030
September/October 2021 - Volume 37 - Issue 5 - p 488-495
To report clinical presentations and factors affecting outcomes in rhino-orbital-cerebral mucormycosis following COVID-19.
Surgical Technique to Retrieve a Migrated Lester Jones Lacrimal Tube
Wirth, Magdalena A. M.D., F.E.B.O., F.I.C.O.*,†; Dolman, Peter J. M.D., F.R.C.S.C.*
doi : 10.1097/IOP.0000000000001953
September/October 2021 - Volume 37 - Issue 5 - p 496-498
To describe a technique for retrieving an inferomedially migrated Jones lacrimal tube.
Re: “Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization”
Putterman, Allen M. M.D.
doi : 10.1097/IOP.0000000000002033
September/October 2021 - Volume 37 - Issue 5 - p 499
Reply re: “Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization”
Tenland, Kajsa M.D.; Berggren, Johanna M.D.; Malmsjö, Malin M.D., Ph.D.
doi : 10.1097/IOP.0000000000002034
September/October 2021 - Volume 37 - Issue 5 - p 499-500
Re: “Orbital Cellulitis in Chagas Disease: An Unusual Presentation”
Hasslocher Moreno, Alejandro Marcel Ph.D.*; Curi, Andre Luiz Land Ph.D.†
doi : 10.1097/IOP.0000000000002040
September/October 2021 - Volume 37 - Issue 5 - p 500
Reply re: “Orbital Cellulitis in Chagas Disease: An Unusual Presentation”
Hernandez-Bogantes, Erick M.D.*,†; Wu, Lihteh M.D.†,‡
doi : 10.1097/IOP.0000000000002041
September/October 2021 - Volume 37 - Issue 5 - p 500-501
Transient Eyelid Edema Following COVID-19 Vaccination
Austria, Quillan M. B.A.; Lelli, Gary J. M.D.; Segal, Kira L. M.D.; Godfrey, Kyle J. M.D.
doi : 10.1097/IOP.0000000000002042
September/October 2021 - Volume 37 - Issue 5 - p 501-502
Radiological Features of Small Lymphocytic Lymphoma Involving the Lacrimal Sac
Tong, Jessica Y. M.D., M.Med.; Juniat, Valerie M.Sc., F.R.C.Ophth.; Selva, Dinesh F.R.A.C.S., F.R.A.N.Z.C.O.
doi : 10.1097/IOP.0000000000002045
September/October 2021 - Volume 37 - Issue 5 - p 502-504
Problems in Periorbital Surgery: A Repair Manual
doi : 10.1097/IOP.0000000000002010
September/October 2021 - Volume 37 - Issue 5 - p 505
Aesthetic Abstracts
Burroughs, John M.D.*; Hwang, Catherine J. M.D.†; Nakra, Tanuj M.D., F.A.C.S.‡; Wulc, Allan M.D., F.A.C.S.§; Woodward, Julie M.D.?
doi : 10.1097/IOP.0000000000002062
September/October 2021 - Volume 37 - Issue 5 - p 506-508
Oculoplastic Abstracts
Ali, Mohammad Javed M.D.*; Bernardini, Francesco P. M.D.†; Savar, Aaron M.D.‡; McNab, Alan A. M.D.§; Tawfik, Hatem A. M.D.?
doi : 10.1097/IOP.0000000000002035
September/October 2021 - Volume 37 - Issue 5 - p 509-510
Primary Synovial Sarcoma of the Orbit: A Case Report and Update on Diagnostic Techniques
Gervasio, Kalla A. M.D.*; Ramesh, Sathyadeepak M.D.†; Sivalingam, Meera D. M.D.*; Markovitz, Michele M.D.*; Milman, Tatyana M.D.*,‡
doi : 10.1097/IOP.0000000000001937
September/October 2021 - Volume 37 - Issue 5 - p e155-e157
Synovial sarcoma is a malignant mesenchymal tumor that most commonly occurs in the deep soft tissue of the extremities in adolescents and young adults. Primary periocular synovial sarcoma is extremely rare with only 11 previously reported cases. We describe a 23-year-old woman who presented with a 1-year history of painful, progressive right upper eyelid swelling. She was subsequently found to have a superomedial orbital mass on CT scan. Pathologic evaluation revealed a spindle cell neoplasm with SS18 (SYT) rearrangement by fluorescence in situ hybridization studies, consistent with a monophasic synovial sarcoma. This case describes the clinical, radiographic, histopathologic, and molecular cytogenetic features of this rare orbital neoplasm, with an emphasis on the emerging diagnostic techniques and novel therapies.
Ocular Adnexal MALT Lymphoma in Association With Rosai–Dorfman Disease in a Child
Kim, Minji B.S.*; Levitt, Alexandra E. M.D., M.P.H.*; Latchmansingh, Kerri-Ann J. M.D.†; Tse, David T. M.D.*,‡; Choi, Catherine J. M.D., M.S.*,‡
doi : 10.1097/IOP.0000000000001941
September/October 2021 - Volume 37 - Issue 5 - p e158-e160
A 12-year-old boy presented with persistent proptosis and periorbital swelling after a school altercation. MRI revealed a mass in the right superonasal orbit extending along the orbital roof to the frontal bone and right frontal sinus, and intracranially to the dura of the right frontal lobe. Immunohistochemistry revealed CD20- and CD43-positive B cells consistent with a low-grade B-cell lymphoma. The patient was diagnosed with stage I ocular adnexal MALT lymphoma and treated with radiation therapy, followed by systemic chemotherapy. However, an enhancing orbital and intracranial mass remained on follow-up imaging, leading to a repeat biopsy, which was consistent with a diagnosis of Rosai–Dorfman disease. This is the first reported pediatric case of ocular adnexal MALT lymphoma with subsequent development of Rosai–Dorfman disease.
New-Onset of Inflammatory Bowel Disease in a Patient Treated With Teprotumumab for Thyroid Associated Ophthalmopathy
Ashraf, Davin C. M.D.*; Jankovic, Ivana M.D.†; El-Nachef, Najwa M.D.‡; Winn, Bryan J. M.D.*; Kim, Grace E. M.D.§; Kersten, Robert C. M.D.*
doi : 10.1097/IOP.0000000000001943
September/October 2021 - Volume 37 - Issue 5 - p e160-e164
A patient with thyroid-associated ophthalmopathy was treated with teprotumumab and developed symptoms concerning for inflammatory bowel disease after her sixth infusion. Colonoscopy was performed, and mucosal biopsies identified evidence of active colitis consistent with a diagnosis of ulcerative colitis. Despite treatment with budesonide and mesalamine, the patient continued to be symptomatic one and a half months after cessation of teprotumumab and required infliximab to achieve good control of her inflammatory bowel disease. This case represents the first report of new-onset inflammatory bowel disease arising during treatment with teprotumumab.
Atypical, Extremely Rapid Growth of Pediatric Orbital Neurilemmoma
Vahdani, Kaveh M.D., F.R.C.Ophth.*; Luthert, Philip J. F.R.C.Path.†; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.*
doi : 10.1097/IOP.0000000000001958
September/October 2021 - Volume 37 - Issue 5 - p e164-e167
Solitary orbital neurilemmoma—a benign tumor of Schwann cells in a peripheral nerve-sheath—are typically very slow growing and present in middle age; in the absence of neurofibromatosis, they are almost never seen in childhood. We describe the clinical presentation, imaging, pathology, and management of this tumor in a 12 years old—the tumor growing extremely rapidly over 5 months and without any evidence of cystic degeneration, hemorrhage, or sarcomatous features. The possibility of tumor growth having been accelerated by prior biopsy is discussed.
Adult-Onset Xanthogranuloma With Frontal Nerve and Intracranial Involvement
Shapira, Yinon M.D.*,†; Juniat, Valerie M.Sc., F.R.C.Ophth.*,†; Smith, Caroline M.B.B.S., F.R.C.P.A., F.R.A.C.P., Ph.D.‡; Selva, Dinesh DHSc FRANZCO*,†
doi : 10.1097/IOP.0000000000001964
September/October 2021 - Volume 37 - Issue 5 - p e167-e170
Adult-onset xanthogranuloma (AOX) typically affects the preseptal and anterior orbital regions. The authors report a 49-year-old man with a 6-month history of unilateral AOX, demonstrating diffuse extraconal and intraconal orbital involvement, including the lacrimal gland and extraocular muscles. There was frontal nerve enlargement, intracranial and pterygopalatine fossa involvement. Investigations excluded IgG4 disease and Erdheim–Chester disease. This case illustrates that AOX may be added to the causes of orbital nerve enlargement and may demonstrate intracranial extension.
Development of Herpes Zoster Ophthalmicus in an Immunocompetent Pediatric Patient Following Facial Trauma
Kamboj, Alisha M.D., M.B.A.*; Hwang, Christopher J. M.D., M.P.H.*; Mokhtarzadeh, Ali M.D.*; Harrison, Andrew R. M.D.*,†
doi : 10.1097/IOP.0000000000001970
September/October 2021 - Volume 37 - Issue 5 - p e170-e172
Herpes zoster ophthalmicus (HZO) is a neuro-oculo-dermic infection caused by reactivation of latent varicella zoster virus in the dorsal root ganglia of the ophthalmic division of the trigeminal nerve. Although a rare diagnosis in an otherwise healthy, vaccinated pediatric patient, this entity may occur with increasing frequency among those with preceding trauma, particularly in the month prior to presentation. Herein, we highlight a case of HZO in a vaccinated, immunocompetent adolescent in the setting of recent facial trauma.
Aspiration as a Novel Technique to Address Facial and Periocular Myiasis
Lu, Jonathan E. M.D.; Mohan, Sukriti M.P.H.; Pfeiffer, Margaret L. M.D.; Clark, Bhavishya S. M.D.; Chang, Jessica R. M.D.
doi : 10.1097/IOP.0000000000001979
September/October 2021 - Volume 37 - Issue 5 - p e172-e173
Suction aspiration, which has not yet been described in the treatment for myiasis in the periorbital and facial regions, was used to achieve rapid resolution of maggot burden in a 78-year-old patient who presented with a large ulcerated squamous cell carcinoma of the face. This technique also facilitates submission of parasite samples for further analysis. Suction aspiration had no complications, such as significant residual ruptured maggots in the wound or eye injury. Suction aspiration is a safe and efficient technique to reduce maggot burden that has advantages over classic myiasis treatments, especially near the eyes and airway.
Disseminated Coccidioidomycosis With Orbital Osteomyelitis and Periorbital Abscess
Reed, Donovan S. M.D.*; Kostosky, Nicole B.S.†; Epstein, Aliza M.D.*; Blaydon, Sean M.D.*,‡; Durairaj, Vikram M.D.*,‡; Somogyi, Marie M.D.*,‡
doi : 10.1097/IOP.0000000000001981
September/October 2021 - Volume 37 - Issue 5 - p e173-e176
Coccidioidomycosis osteomyelitis involving the orbital bones is exceedingly rare and is often misdiagnosed initially as other inflammatory or infectious conditions. No clear guidelines currently exist regarding appropriate management. The authors present an atypical presentation of disseminated coccidioidomycosis in an immunocompetent child with frontal bone superotemporal orbital rim osteomyelitis and associated periorbital abscess, successfully managed with surgical debridement through an upper eyelid crease incision.
Extraocular Muscle Enlargement and Proptosis Associated with Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Barkley, Michael R. M.B.B.S.*; Ben Artsi, Elad M.D.*; McNab, Alan A. D.Med.Sc., F.R.A.N.Z.C.O.*,†; Hardy, Thomas G. F.R.A.N.Z.C.O.*,‡
doi : 10.1097/IOP.0000000000001982
September/October 2021 - Volume 37 - Issue 5 - p e176-e178
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an inflammatory neuropathy, which commonly causes peripheral neuropathy. It has rarely been associated with cranial nerve hypertrophy and neuro-ophthalmic manifestations. Proptosis secondary to cranial nerve hypertrophy has been reported in association with CIDP. The authors present a case of a 67-year-old man with CIDP who presented with bilateral proptosis, strabismus, and episodes of globe subluxation. The proptosis was mainly attributed to significant enlargement of the extraocular muscles, in addition to bilateral enlargement of the trigeminal nerves. There has been no published case of CIDP with associated enlargement of extraocular muscles without a history of underlying hyperthyroidism, inflammation, or malignancy. This may represent a new clinical finding in CIDP and adds to the limited literature on the neuro-ophthalmic and orbital associations of CIDP. The proptosis was managed with an uncomplicated bilateral orbital decompression.
Conjunctival Exophytic Schneiderian-type Papillomas: A Rare Occurrence
Charles, Norman C. M.D.*,†; Stagner, Anna M. M.D.‡; Raju, Leela V. M.D.*; Belinsky, Irina M.D.*
doi : 10.1097/IOP.0000000000001983
September/October 2021 - Volume 37 - Issue 5 - p e179-e181
Conjunctival papillomas are common tumors that exhibit an exophytic growth pattern, comprised of multiple filiform fronds of squamous epithelium that contain fibrovascular cores. The inverted (endophytic) variety of papilloma, often termed “Schneiderian,” rarely occurs on the conjunctiva, with only 15 cases reported to date. Endophytic and exophytic papillomas are well described arising in the sinonasal Schneiderian epithelium where a low rate of malignant transformation may occur in the endophytic type; malignant transformation in exophytic sinonasal papillomas is exceedingly rare. The authors describe 2 cases of exophytic conjunctival papillomas with the morphology of a sinonasal or Schneiderian-type papilloma. Both were pink, sessile acquired growths in women in the sixth decade of life involving the inferior conjunctival fornix or nasal limbus. Nonkeratinizing squamous epithelium along with numerous goblet cells, intraepithelial mucinous cysts, and microabscesses were present. Immunohistochemistry showed reactivity for cytokeratin 7 and wild-type staining for p16 and p53, paralleling the findings in common conjunctival papillomas; both were also driven by low-risk human papillomavirus.
Eyelid–Cheek Junction Soft-Tissue Perineurioma: Case Report and Controversies
Zhao, Lily D. M.D., F.R.C.S.C.*; Jarrar, Faisal S. B.Sc.†; Hussain, Ahsen A. M.D., F.R.C.Ophth‡; Hyrcza, Martin D. M.D./Ph.D., F.R.C.P.C.§; Harvey, John T. M.D., F.R.C.S.C.*
doi : 10.1097/IOP.0000000000001986
September/October 2021 - Volume 37 - Issue 5 - p e181-e184
Perineurioma is a rare soft-tissue tumor with characteristic histologic and immunohistochemical features. The diagnosis; however, can be met with certain challenges. A 71-year-old woman presented with an enlarging painless mass in the right lower eyelid–cheek junction. The lesion presented as a raised overhanging trunk-shaped mass. An excisional biopsy and local reconstruction were performed. The overall morphology and immunohistochemical findings were most supportive of a cellular soft-tissue perineurioma, with differential diagnoses including dermatofibroma. To the authors’ knowledge, this is the first histopathologically reported case of a superficially occurring soft-tissue perineurioma in the eyelid–cheek junction. The authors discuss the presentation, relevant literature, and controversies associated with this diagnosis.
Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration
Weber, Johannes M.D.*,?; Flatz, Lukas M.D.†,?; Sommacal, Andreas M.D.‡,?; Varde, Meghana Anika M.S.§,?
doi : 10.1097/IOP.0000000000001991
September/October 2021 - Volume 37 - Issue 5 - p e184-e187
A 59-year-old male patient who suffered from a systemically metastasized, large extrascleral uveal melanoma recurrence of the left eye presented with active hemorrhage from the tumor. He had undergone proton beam irradiation for an epithelioid ciliary body melanoma 4 years before presentation and was lost to follow-up. Magnetic resonance angiography showed vascularization of the lesion via the ophthalmic and maxillary artery. Selective transarterial embolization of the tumor was conducted with polyvinyl alcohol microparticles followed by coiling of the supplying arteries. The bleeding stopped after 2 days and the tumor started to become necrotic. As tumor removal was the primary wish of the patient at this point in time, exenteration was carried out a week later without significant blood loss, intraoperative or postoperative complications. Socket healing was adequate, and the patient reported improved quality of life. He refused systemic palliative treatment and died 3 months after the intervention.
Osseous Metaplasia of the Eyelid in a Child
Charles, Norman C. M.D.*,†; DeMaria, Lauren N. M.D.*; Viriya, Elizabeth T. M.D.*
doi : 10.1097/IOP.0000000000001999
September/October 2021 - Volume 37 - Issue 5 - p e187-e188
Osteoma cutis is a term applied to bone formation in the dermis or subcutaneous tissue. It is deemed primary when occurring de novo without prior disease or secondary when associated with pre-existing inflammation, neoplasia or trauma. The authors describe a longstanding focal calcified and ossified lesion of the upper eyelid in a healthy 10-year-old girl along with a sterile corneal ulcer. The lesion most likely represented an ossified tarsal cyst or chalazion.
Diplopia After Migraine Surgery
Celik Buyuktepe, Tuna M.D.*; Bingöl Kiziltunç, Pinar M.D.†; Atilla, Huban M.D.†
doi : 10.1097/IOP.0000000000002000
September/October 2021 - Volume 37 - Issue 5 - p e188-e190
A 46-year-old man with refractory migraine headache was treated with decompressive migraine surgery of the supraorbital and supratrochlear nerves. Postoperatively, he reported diplopia that got better on left head tilt. After ophthalmological examination, a diagnosis of right superior oblique palsy was made. The aim is to report the first case of superior oblique muscle or trochlea damage that may have occurred because of inadvertent entry through the orbital septum into the right superior orbit.
Aberrant Regeneration of Cranial Nerve 3 Following Schwannoma Resection
Chen, Pauline D.O.*; Beaulieu, Robert M.D.†,‡,§; Black, Evan M.D., F.A.C.S., F.A.A.C.S.†,‡,§
doi : 10.1097/IOP.0000000000001858
September/October 2021 - Volume 37 - Issue 5 - p e191
Intramuscular Orbital Schwannoma With Cystic Degeneration: Serial Changes in MRI Signal Characteristics
Van Horn, Adam N. M.D.*; Prevedello, Luciano M. M.D., M.P.H.†; Schoenfield, Lynn M.D.‡; Cho, Raymond I. M.D., F.A.C.S.*
doi : 10.1097/IOP.0000000000001916
September/October 2021 - Volume 37 - Issue 5 - p e192
A Case of Neglected, Recurrent Adenoid Cystic Carcinoma of Parotid Gland
Low, Adeline M.B.B.S.*; Kadir, Azida Juana M.Ophthal.*; Wong, Kum Thong F.R.C.Path.†; Choo, May May F.R.C.S., M.Med.*
doi : 10.1097/IOP.0000000000001947
September/October 2021 - Volume 37 - Issue 5 - p e193
Blindness Secondary to Odontogenic Orbital Cellulitis During the COVID-19 Dental Shutdown
Sheils, Catherine R. M.D.; Cypen, Sanja G. M.D.; Tao, Jeremiah P. M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000002020
September/October 2021 - Volume 37 - Issue 5 - p e194
