Adolescent ; Encephalocele ; etiology ; Humans ; Male ; Meningocele ; etiology ; Neurofibromatosis 1 ; complications ; diagnosis ; therapy ; Orbital Diseases ; etiology

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

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

OBJECTIVETo investigate the relationship of sphenoid disease and orbital apex syndrome and to improve the diagnosis of sphenoid disease.

METHODSTwelve patients with sphenoid disease manifesting orbital apex syndrome from 2000 to 2004 were retrospectively analyzed, especially the processes of both diagnosis and treatment. The factors which may lead to misdiagnosis were discussed.

RESULTSAll the twelve patients failed to be correctly diagnosed at the ophthalmology department. Having been undergone CT or MRI, seven cases of sphenoiditis, three cases of polyps of sphenoidal sinus and two cases of sphenethmoid mucocele were confirmed respectively. All of the patients underwent endoscopic sphenoid surgery. The symptoms of the patients were improved or disappeared after the operations.

CONCLUSIONSThe sphenoid disease with orbital apex syndrome was easily misdiagnosed. The possible causes of misdiagnosis were: low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT or MRI are the gold standards of diagnosis of sphenoid disease. Endoscopic sinus surgery is effective and safe technique for the treatment of the disease.

Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Orbital Diseases ; diagnosis ; etiology ; Paranasal Sinus Diseases ; complications ; diagnosis ; Retrospective Studies ; Sphenoid Sinus ; Syndrome ; Treatment Outcome

OBJECTIVE: To investigate the diagnostic and therapeutic methods of orbital apex syndrome caused by sinus diseases and to achieve earlier diagnosis and timely treatment. METHOD: Clinical data of 6 cases in our department from January 2008 to March 2012 were retrospectively analyzed. RESULT: All cases had surgical treatment. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. The postoperative pathology showed 2 cases with fungal sphenoiditis, 2 cases with ethmoid mucocele and 2 cases with sphenoid mucocele. CONCLUSION Orbital apex syndrome caused by sinus diseases is very rare. The possible causes of misdiagnosis are low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT, MRI or intranasal endoscopy can greatly improve the diagnosis of the disease. Endoscopic sinus surgery is a safe and effective method for orbital apex syndrome caused by sinus diseases,which is the primary therapy for the disease.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Orbital Diseases ; diagnosis ; etiology ; therapy ; Paranasal Sinus Diseases ; complications ; diagnosis ; therapy ; Retrospective Studies ; Syndrome

Alloplastic implants are known to be inert for many years, though complications are infrequently reported many years after their insertion. We report the case of a patient who had undergone a blow-out fracture repair five years before the discovery of a hematic cyst. He had been free of symptoms for the first five years after his orbital floor repair but then developed pain on eyeball movement and persistent vertical diplopia, which finally led to surgical intervention. At surgery, a hematic cyst was found to have formed around the implanted silastic plate. When alloplastic material is used in orbital fracture repair, we should be alert for late complications which may occur many years after surgery.
Adult ; Biocompatible Materials ; *Blood ; Bone Cysts/diagnosis/*etiology ; Humans ; Male ; Orbital Diseases/diagnosis/*etiology ; Orbital Fractures/diagnosis/*surgery ; Postoperative Complications ; Prostheses and Implants/*adverse effects ; Reoperation ; Silicone Elastomers/*adverse effects ; Tomography, X-Ray Computed

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