The author reports a case of orbital Sarcoidosis in a 70-year-old female that initially presented as diffuse swelling of the lower eyelid. The patient complained of painless swelling of the left lower lid without palpable mass, and a computerized tomography (CT) scan of the orbit was unremarkable. A serum angiotensin converting enzyme level was elevated, and hilar lymphadenopathy was noted on the chest CT. The patient underwent surgical debulking for histologic confirmation, which led to a final diagnosis of sarcoidosis involving the orbital fat. Unexplained chronic eyelid swelling without a mass should be considered a possible ophthalmic manifestation of orbital sarcoidosis.
Aged ; Biopsy ; Diagnosis, Differential ; Edema/diagnosis/*etiology ; Eyelid Diseases/diagnosis/*etiology ; Eyelids/*pathology ; Female ; Humans ; Orbital Diseases/*complications/diagnosis ; Sarcoidosis/*complications/diagnosis ; Tomography, X-Ray Computed

OBJECTIVE: To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes. METHOD: Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years. RESULT: The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up. CONCLUSION The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.
Adult ; Endoscopy ; adverse effects ; Eyelid Diseases ; diagnosis ; etiology ; therapy ; Female ; Granuloma ; diagnosis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; therapy

Child ; Edema ; diagnostic imaging ; etiology ; Emphysema ; diagnostic imaging ; etiology ; Ethmoid Bone ; diagnostic imaging ; injuries ; Eyelid Diseases ; diagnostic imaging ; etiology ; Humans ; Male ; Orbit ; diagnostic imaging ; Orbital Diseases ; diagnosis ; diagnostic imaging ; pathology ; Radiography ; Skull ; diagnostic imaging ; pathology ; Skull Fractures ; complications ; diagnostic imaging

PURPOSE: We report the case of a patient with scar sarcoidosis that developed along a previous eyelid scar. There was no evidence of ocular or systemic sarcoidosis. METHODS: A 29-year-old man presented with a mass on his right eyelid that had been present for two month. On ocular examination an erythematous, firm, and non-tender mass was diffusely palpable along the upper and lower eyelid scar. We performed an incisional biopsy of the lower lid mass. RESULTS: Histopathologic examination of the mass revealed numerous, noncaseating granulomas with multi-nucleated giant cells. The giant cells contained asteroid bodies and calcium oxalate crystals characteristic of sarcoidosis, although the patient had no other evidence of systemic sarcoidosis. The mass in the upper lid disappeared after intralesional triamcinolone injections. CONCLUSIONS: This case represents a rare occurrence of sarcoidosis that arose in an old eyelid scar. Scar sarcoidosis should be considered in the differential diagnosis of an unusual mass in a scar.
Triamcinolone/administration & dosage ; Sarcoidosis/drug therapy/etiology/*pathology ; Male ; Injections, Intralesional ; Humans ; Glucocorticoids/administration & dosage ; Follow-Up Studies ; Eyelids/injuries ; Eyelid Diseases/drug therapy/etiology/*pathology ; Eye Injuries/complications ; Diagnosis, Differential ; Cicatrix/complications/*pathology ; Biopsy ; Adult

OBJECTIVE: To investigate the clinical features and misdiagnosis of nasal NK/T cell lymphoma with outstanding performance in ocular symptoms. METHOD: Clinical data of 11 patients who had nasal NK/T cell lymphoma with the outstanding performances in ocular symptoms during 2009 to 2011 were retrospectively analyzed. RESULT: The rate of misdiagnosis in the first diagnosis and first pathological diagnosis were 72.7% and 27.3% respectively. Nasal NK/T cell lymphoma with obvious ocular symptoms developed quickly and had almost special imaging findings. CONCLUSION Nasal NK/T cell lymphoma with outstanding performance of ocular symptoms can be easily misdiagnosed. Comprehensive consideration of the clinical features, imaging findings and pathological examination do help to make accurate diagnosis early.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diagnostic Errors ; Exophthalmos ; diagnosis ; etiology ; Eyelid Diseases ; diagnosis ; etiology ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; complications ; diagnosis ; Lymphoma, Non-Hodgkin ; complications ; diagnosis ; Male ; Middle Aged ; Nose Neoplasms ; complications ; diagnosis ; Retrospective Studies ; Young Adult

PURPOSE: Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal. METHODS: A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous. RESULTS: Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection. CONCLUSIONS: Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.
Lidocaine/administration & dosage ; Lens Implantation, Intraocular ; Lens Capsule, Crystalline/injuries ; Injections/adverse effects ; Humans ; Hordeolum/*surgery ; Follow-Up Studies ; Female ; Eyelids ; Eyelid Diseases/*surgery ; Eye Injuries, Penetrating/diagnosis/*etiology/surgery ; Diagnosis, Differential ; Cornea/injuries ; Cataract Extraction ; Anesthetics, Local/administration & dosage ; Anesthesia, Local/*adverse effects ; Adult