PURPOSE: This study is to evaluate the clinical features of ischemic ophthalmoplegia including the frequency of the paralyzed cranial nerve, the difference in frequency according to the causative disease, the clinical feature of the iridoplegia in cases of the third cranial nerve involvement, and the feature and time of recovery. METHODS: We retrospectively reviewed the medical records of 26 eyes of 26 patients who had been diagnosed with ischemic ophthalmoplegia caused by diabetes mellitus (DM) or hypertension (HT). RESULTS: Twelve patients had DM, 5 patients had HT, and 9 patients had both diseases. Three patients were revealed to have DM or HT during the work-up for searching the cause of ophthalmoplegia. The third cranial nerve was most frequently paralyzed, followed by the 6th and 4th cranial nerves. The opthalmoplegia was preceded or accompanied by ocular pain or headache in 10 patients. In patients with the third cranial nerve paresis, ptosis was the first to be recovered and adduction limitation was the last to be recovered. Of the 3 patients who had iridoplegia, one patient with complete iridoplegia did not recover completely until 9 months whereas 2 patients with incomplete iridoplegia had complete recovery after one and two months, respectively. Seventy-three point seven percent of patients with ischemic ophthalmoplegia completely recovered 4.3 months after onset, and there was no difference in the recovery time among the paralyzed nerves. CONCLUSIONS: There was no difference in the frequency of the paralyzed nerve according to the causative disease, and the complete iridoplegia showed slower recovery than incomplete one. Most patients with ischemic ophthalmoplegia caused by DM or HT recovered spontaneously and did not need any further treatment.
Cranial Nerves ; Diabetes Mellitus* ; Headache ; Humans ; Hypertension* ; Medical Records ; Oculomotor Nerve ; Ophthalmoplegia* ; Paresis ; Retrospective Studies

PURPOSE: This study is to evaluate the visual prognosis and the frequency of the reoperation according to the refractive power. METHODS: We retrospectively reviewed the medical records of the 19 eyes of 19 patients with retinal detachment caused by macular hole. Patients were classified into 2 groups based on their refractive power, the high myopia group; six patients with -6 diopters or more, and the non-high myopia group; 13 patients with less than -6 diopters. The mean refractive power was -13.4 diopters in high myopia group and+0.19 diopters in non-high myopia group. All patients had vitrectomy and fluid-gas exchange at first operation and silicone oil injection was performed in cases with recurred retinal detachment after 2nd operation. RESULTS: The retina was successfully reattached in all of the 19 eyes and reoperation was needed for achieving retinal reattachment in 4 eyes (21.1%). Three eyes of high myopia group (50%) and one eye of non-high myopia group (7.3%) were reoperated and 2 eyes in high myopia group needed silicone oil injection. Non-high myopia group showed improved visual acuities as compared with preoperative visual acuity (P<0.05, paired t-test). At the last follow up, macular hole was reopened in 3 eyes (15.8%) but the retina was not detached and the 3 eyes showed worse visual acuities than the others with closed macular hole. CONCLUSIONS: Accordingly, the high myopia group had higher incidences of reoperation and worse visual outcome and only one third of the high myopia group needed silicone oil injection, even though these patients may not need silicone oil injection at the first operation.
Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Myopia ; Prognosis* ; Reoperation ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Retrospective Studies ; Silicone Oils ; Visual Acuity ; Vitrectomy

PURPOSE: Benign mixed tumor of the accessory lacrimal gland is a very rare neoplasm, with only one case with presumed origin of Wolfring's gland in domestic literature. We report our experience with a case of a nodular lesion of the lateral lower eyelid which is completely excised and histologically diagnosed as benign mixed tumor from Krause's gland. METHODS: A 68 year-old woman presented with 1 cm-sized subcutaneous mass in right lateral lower eyelid. A hard non-tender movable mass was palpated. After 6 months of observation, the mass was excised through subciliary skin incision. RESULTS: The mass was located deep to the subcutaneous tissue, inferior to lower border of tarsal plate, and was adherent to inferior forniceal conjunctiva. Round 1.2 cm-sized yellow-pink mass was completely excised. Histologic examination showed many glandular elements embedded in a myxoid ground substance, and glandular structures were composed of two layers of inner cuboidal and outer polygonal cell. It was diagnosed as benign mixed tumor from accessory lacrimal gland of Krause. CONCLUSIONS: In any case presenting lower eyelid mass lesion, benign mixed tumor of accessory lacrimal gland should be considered as one of the differential diagnosis.
Aged ; Conjunctiva* ; Diagnosis, Differential ; Eyelids ; Female ; Humans ; Lacrimal Apparatus* ; Skin ; Subcutaneous Tissue

PURPOSE: To report a case of eyeball displacement into the ethmoid sinus followed by early surgical intervention and good visual recovery. CASE SUMMARY: A 46-year-old female visited our hospital after she injured the right side of her face. Her visual acuity could not be measured and computed tomography revealed displacement of the right eyeball into the ethmoid sinus, as well as right medial orbital wall fracture and rupture of the right medial rectus muscle. She underwent surgical reduction of the herniated eyeball and surgical correction of the medial orbital wall fracture within 20 hours after the accident. Eighteen months after the surgery, visual acuity of the right eye improved from light perception to 20/28, and her color vision and visual field of the right eye improved to normal range. CONCLUSIONS: Displacement of the eyeball in the orbital wall fracture is very rare, and eyeball displacement into the ethmoid sinus is even rarer. We achieved good visual outcome through early surgical intervention. The early anatomical reduction of the displacement and wall fracture may promote improved final visual outcome in other similar cases.
Color Vision ; Ethmoid Sinus* ; Female ; Humans ; Middle Aged ; Orbit ; Reference Values ; Rupture ; Visual Acuity ; Visual Fields

PURPOSE: As orbital involvement in multiple myeloma is rare, the correct diagnosis is usually difficult. We report a case of multiple myeloma which involved the orbit, and which presented with unilateral ptosis. METHODS: A 35-year-old man was referred for the evaluation of ptosis of the left eyelid for 1 month. The levator function was normal, and there was no proptosis. Orbital computerized tomography (CT) revealed an orbital mass lesion involving the superior orbital ridge with intracranial extension. RESULTS: Excisional biopsy was performed through craniotomy and superior orbitotomy. Histopathologic examination and immunostaining result suggested a diagnosis of a plasmacytoma. The diagnosis of multiple myeloma was confirmed through bone marrow aspiration and biopsy showing diffuse infiltration of plasma cells. CONCLUSIONS: We experienced a case of multiple myeloma, which is rare in the orbit presenting unilateral ptosis. In addition, the possibility of orbital mass should be considered as an unusual cause of unilateral, acquired, progressive ptosis.
Adult ; Biopsy ; Bone Marrow ; Craniotomy ; Diagnosis ; Exophthalmos ; Eyelids ; Humans ; Multiple Myeloma* ; Orbit ; Plasma Cells ; Plasmacytoma

PURPOSE: To investigate the long term survival of orbital fat grafted on a Medpor(R) implant as a method of preventing porous polyethylene orbital implant (Medpor(R)) exposure in anophthalmic sockets. METHODS: In one orbit in each of 8 rabbits, a small amount of retrobulbar orbital fat was grafted between the anterior surface of the Medpor(R) implant and overlying conjunctiva, during the enucleation and Medpor(R) implantation procedure. Two rabbits were sacrificed at 2, 4, 8 and 12 weeks postoperatively and grafted orbital fats were examined by light microscopy. RESULTS: Grafted orbital fat was well-maintained at 2 and 4 weeks, postoperatively. However, fat amounts were significantly reduced at 8 weeks, and viable fat was barely visible at 12 weeks. CONCLUSIONS: In rabbits, orbital fat grafted on Medpor(R) implants was gradually resorbed, and the fat-occupied volume was not maintained.
Time Factors ; Rabbits ; Porosity ; *Polyethylene ; *Orbital Implants ; *Graft Survival ; Follow-Up Studies ; *Biocompatible Materials ; Animals ; Adipose Tissue/cytology/*transplantation

PURPOSE: To investigate the surgical results of an ear cartilage graft and supplemental procedures for correcting lower lid retraction combined with entropion in anophthalmic patients. METHODS: We reviewed retrospectively the medical records of 7 anophthalmic patients with lower lid retraction and entropion, who received a posterior lamellar ear cartilage graft and one or both of lateral tarsal strip or eyelash-everting procedure between March 1998 and March 2003. Preoperative and postoperative lid and socket statuses were also investigated. RESULTS: Ear cartilage grafts were performed in all 7 patients, lateral tarsal strips in 6, and eyelash-everting procedures in 5. Postoperative follow-up durations ranged from 4 to 28 months (average 12.6 months). Retractions were corrected during follow-up in all patients. There were no cases of entropion immediately after surgery. However, the eyelashes of the lower lid returned to an upright position in 4 patients, but not so severe as to touch the ocular prosthesis, and thus did not require surgical correction during follow up. CONCLUSIONS: Lower lid retraction combined with entropion in anophthalmic patients can be corrected effectively using an ear cartilage graft with selective, supplemental procedures.
Retrospective Studies ; Male ; Humans ; Female ; Eyelid Diseases/*etiology/*surgery ; Entropion/*etiology/*surgery ; Ear Cartilages/*transplantation ; Child, Preschool ; Child ; Anophthalmos/*complications ; Adult

PURPOSE: To investigate the possibility of expanded polytetrafluoroethylene (e-PTFE) as a wrapping material for porous polyethylene orbital implant. METHODS: Two groups of 6 female New Zealand albino rabbits underwent enucleation with placement of a 12 mm porous polyethylene orbital implant wrapped in simple e-PTFE in one group (group 1) and macro-porous e-PTFE in the other group (group 2). Histopathologic sections of the implants obtained at 4, 6, 8 weeks were compared on the extent of fibrovascular ingrowth, percentage of the area of proliferated vessel, and grade of fibrosis between the two groups. RESULTS: There was no implant exposure or severe inflammation in group 1 and 2 during the observation. The extent of fibrovascular ingrowth differs only at 4 weeks. Group 1 showed less fibrovascular ingrowth (until outer 1/3) at anterior half compared with posterior one, but there was no difference between anterior and posterior half in group 2 (until middle 1/3). The percentage of the area of the proliferated vessels was higher in group 2 than group 1 at both anterior and posterior half, and the anterior/posterior ratio of the area of vessels was also higher in group 2 than group 1. The grade of fibrosis was higher in group 2 than group 1 at 4, 6, and 8 weeks. CONCLUSIONS: Macro-porous e-PTFE almost didn't disturb fibrovascular ingrowth into the orbital implant, so macro-porous e-PTFE can be used safely as a wrapping material for porous polyethylene orbital implant.
Female ; Fibrosis ; Humans ; Inflammation ; New Zealand ; Orbit* ; Orbital Implants* ; Polyethylene* ; Polytetrafluoroethylene* ; Rabbits

No abstract available.
Adult ; Behcet Syndrome/*complications/diagnosis ; Follow-Up Studies ; Humans ; Male ; Optic Disk/*pathology ; Optic Neuritis/diagnosis/*etiology ; Time Factors ; Visual Acuity

PURPOSE: Amyloidosis involving the lacrimal gland is a very rare condition. We report our experience with a case of primary localized amyloidosis of the lacrimal gland. METHODS: A 36-year-old woman presented with a palpable mass on the right temporal upper eyelid of 1-month duration. The non-tender, firm, and movable mass was palpable on the area of the right lacrimal gland. There were no abnormalities on slit-lamp biomicroscopic and fundus examinations, nor was proptosis or limitation of extraocular movement seen. Excisional biopsy through Krnlein operation and histopathologic examination were followed by orbital computerized tomography (CT). RESULTS: CT scan revealed a homogeneous soft tissue mass containing focal calcification in the right lacrimal gland. Hematoxylin and eosin stained sections showed pink amorphous hyaline deposits and Congo red-stained sections demonstrated dichroism and birefringence under polarized light microscopy, consistent with the diagnosis of amyloidosis. In an additional study, no systemic involvement was noted. CONCLUSIONS: In any case presenting temporal upper eyelid swelling and homogeneous mass containing focal calcification involving the lacrimal gland on CT scan, amyloidosis should be differentiated and it is necessary to confirm the diagnosis through biopsy and systemic work-up.
Adult ; Amyloidosis* ; Biopsy ; Birefringence ; Congo ; Diagnosis ; Eosine Yellowish-(YS) ; Exophthalmos ; Eyelids ; Female ; Hematoxylin ; Humans ; Hyalin ; Lacrimal Apparatus* ; Microscopy, Polarization ; Orbit ; Tomography, X-Ray Computed