1/10. Orbital hemorrhage following face-mask barotrauma.A 41-yr-old female recreational diver suffered an orbital hemorrhage following face-mask barotrauma This case illustrates the potential for significant orbital injury to occur as a result of face-mask barotrauma Barotraumatic orbital hemorrhage is an unusual disorder, but recognition of this entity is important for diving physicians. The signs and symptoms should not be mistaken for decompression sickness or arterial gas embolism. patients with barotraumatic orbital hemorrhage require emergency referral to an ophthalmologist so that potentially vision-threatening ocular complications may be identified and treated. barotrauma may result in several different types of cranial neuropathies and should be recognized as another possible cause for neurologic deficits following a dive.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/10. Spontaneous globe luxation associated with contact lens placement.PURPOSE: Globe luxation, characterized as the anterior dislocation of the eyeball beyond retracted lids, presents a dramatic clinical picture. It is an uncommon event and can produce anxiety in both the patient and the physician. The purpose of this article is to present a case of spontaneous globe luxation which occurred with attempted contact lens placement. methods: A case report and literature review are presented. RESULTS: Manual reduction of the globe required conscious sedation in the emergency room. Diffuse superficial punctate keratitis resolved completely with no visual sequelae. DISCUSSION: The clinical features, epidemiology, risk factors, complications and treatments of globe luxation are presented. eye care specialists who fit and dispense contact lenses should be aware of risk factors associated with globe luxation. A step-wise plan for management is presented, in hope of limiting patient discomfort, recurrence, and perhaps long-term visual impairment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/10. Ocular complications of the Fernand-Widal triad and its therapy.BACKGROUND: The Fernand-Widal triad (FWT) is the association of non-allergic intrinsic asthma, nasal polyposis and sensitivity to aspirin. The aim of this paper is to describe the possibility of ocular complications, which we found in 3 cases: in 1 case due to the FWT itself and in the other 2 as a result of corticosteroid treatment. methods: Three cases of the FWT with ocular complications were studied, and the pertinent literature was reviewed. RESULTS: No previous description of ocular involvement in individuals with FWT was found in the literature. In the first case, episodes of orbital cellulitis due to superinfected nasal polyposis were found as a complication produced by the disease. In the other 2 cases, corticosteroid treatment created complications: ocular hypertension in both cases and bilateral subcapsular cataracts in 1 case. CONCLUSIONS: Although not rare, the diagnosis of the FWT is often missed. This perhaps explains why no report of ocular complications has yet been published in the literature. Because of the serious clinical consequences, physicians involved in the treatment of these patients should be aware of this diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/10. Refractory periorbital edema in a 29-year-old man.A 29-year-old man developed periorbital edema which was initially diagnosed as angioedema. Further clinical investigation by orbital CT and orbital biopsy showed this to be orbital pseudotumor. Immunofluorescence staining for major basic protein clearly demonstrated tissue eosinophilia and extracellular major basic protein deposition. orbital pseudotumor can mimic angioedema or allergic rhinoconjunctivitis and should be familiar to allergists and primary care physicians. The demonstration of striking extracellular major basic protein in biopsy specimen implicates a role for eosinophils in the pathogenesis of this disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/10. An unusual case of orbital cellulitis.Munchausen's syndrome, an unusual disorder related to malingering and hysteria, is occasionally seen by the ophthalmologist. Munchausen patients deliberately deceive and attempt to manipulate physicians 'through factitious signs and symptoms. They know they are acting, yet appear unable to control their actions. Unnecessary medical workups and inappropriate surgical interventions are common with this perplexing syndrome. An unusual case of orbital cellulitis that illustrates a number of these features is illustrated and the syndrome is reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/10. Acute orbital pseudotumor: ocular emergency on a general medical service.We have reported a case of acute orbital pseudotumor, an idiopathic inflammatory process that usually responds dramatically to corticosteroids. Untreated, severe proptosis and eventual optic neuropathy may result. Although its signs and symptoms may cause confusion with infectious, endocrinologic, traumatic, allergic, and neoplastic ophthalmopathies, the acute onset, rapid progression, and characteristic CT picture are nearly pathognomonic of orbital pseudotumor. When both the clinical and CT findings are compatible with this diagnosis, a therapeutic trial of oral corticosteroids can be undertaken. It is important for the primary physician to be aware of this disease to facilitate appropriate diagnosis and treatment, avoiding unnecessary surgical intervention and possible complications.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/10. Allergic sino-orbital mycosis. A clinical and immunologic study.We present a case of pansinusitis with orbital involvement associated with an allergic response to the fungus Curvularia (Cochliobolus) lunata. Key elements to the diagnosis included a predominant eosinophilic response of the sinus mucosa, the presence of a characteristic mucoid exudate containing fungal hyphae, peripheral blood eosinophilia, serum precipitins against C lunata, elevated serum total and Curvularia-specific IgE and IgG concentrations, and immediate cutaneous reactivity to C lunata antigen. This report suggests that an exaggerated allergic response should be considered in the pathogenesis of pansinusitis. The presence of fungal hyphae in sinus mucosal specimens should alert the physician to the possibility of this disease. Sinus fungal cultures, as well as thorough immunologic evaluation, of such patients is recommended.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/10. Periorbital necrotizing fasciitis: trivial facial injury resulting in cardiac arrest.facial injuries in the context of alcohol abuse are a common presentation to casualty departments. While the majority are self limiting, the presence of periorbital or facial oedema should alert physicians to the development of periorbital necrotizing fasciitis. Here, a case illustrates this unusual manifestation of streptococcal infection, and emphasises the rapid onset and devastating systemic and local cosmetic consequences of this condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/10. Atypical mycobacterial infection of the orbit.PURPOSE: To describe the clinical presentation and successful management of an orbital infection caused by mycobacterium abscessus, a formerly unrecognized cause of orbital disease after penetrating trauma. methods: An orbital infection due to M. abscessus is described, and previously reported ocular and extraophthalmic infections caused by M. abscessus are reviewed. RESULTS: A 5-year-old boy had acute, painless visual loss shortly after being struck in his left lower eyelid with a fishing rod. Radiologic evaluation established a mass in the orbital apex. Initial biopsy and cultures of the apex mass were negative; however, additional orbital exploration and cultures demonstrated M. abscessus to be the causative organism. The orbital infection was treated successfully with long-term oral clarithromycin. review of the literature on ocular/adnexal and soft tissue infections caused by atypical mycobacteria shows characteristic clinical and histopathologic features. CONCLUSIONS: To the authors' knowledge, only seven patients with atypical mycobacterial infections of the ocular adnexa have been reported. The patient reported in the current study illustrates the difficulty in establishing the preoperative diagnosis of atypical mycobacterial infections of the orbit. A chronic draining wound or a localized orbital abscess, after penetrating trauma, should alert the physician to the possibility of an M. abscessus infection. clarithromycin, an oral macrolide antibiotic, appears to be the most effective medical therapy for these patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/10. Percutaneous treatment of an orbital hydatid cyst: a new therapeutic approach.PURPOSE: To describe the percutaneous treatment of an orbital hydatid cyst as an alternative approach to conventional surgery. methods: In a 21-year-old man with diplopia and right proptosis, radiologic studies disclosed a 25 x 25 x 20-mm purely cystic mass in the right retrobulbar area. Based on the presumptive diagnosis of hydatid cyst, the cyst was treated percutaneously under ultrasonographic guidance with aspiration, 15% hypertonic saline injection, and reaspiration without any complication. RESULTS: A substantial decrease in the size of the cyst was observed in the 3 months after treatment. Nine months after treatment, the shrunken cyst had a volume of only 0.5 ml, and the patient was asymptomatic. Twenty-one months after the procedure, the findings were consistent with those at 9 months of follow-up. CONCLUSION: Percutaneous treatment of orbital hydatid cysts, which is more satisfactory to both the patient and the physician, may be a safe and effective alternative to surgical extirpation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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