Ophthalmic plastic and reconstructive surgery
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Ophthal Plast Reconstr Surg · Nov 2009
Case ReportsOculocardiac reflex associated with a large orbital floor fracture.
A 40-year-old man presented with bradycardia, left eye pain, and intermittent nausea 1 day after blunt trauma to the left orbit. Imaging revealed a large orbital floor fracture with significant herniation of orbital contents but no obvious extraocualar muscle entrapment. ⋯ His bradycardia resolved immediately postoperatively. This case is a unique presentation of the oculocardiac reflex in a large orbital floor fracture with significant herniation of orbital contents but without extraocualar muscle entrapment.
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Trapdoor fractures occur almost exclusively in the pediatric population. The authors describe an adult with an entrapped inferior rectus muscle sheath in a trapdoor fracture. A 37-year-old man presented with persistent diplopia 3 weeks after blunt right orbital trauma. ⋯ One month postoperatively, extraocular motility had improved with no diplopia in primary or reading positions. This case demonstrates that trapdoor fractures can occur in adults and should be considered when suggestive findings are encountered. Clinicians should be aware of this because timely diagnosis and treatment might achieve more favorable outcomes.
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Ophthal Plast Reconstr Surg · Sep 2009
Case ReportsHorner syndrome as a presenting sign of nasopharyngeal carcinoma.
Nasopharyngeal carcinoma is generally diagnosed prior to ophthalmic complaints. The authors present a case of a 57-year-old healthy man with sudden-onset unilateral ptosis. MRI showed an ulcerating soft-tissue mass in the nasopharynx with skull base invasion. Biopsy confirmed nasopharyngeal carcinoma.
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Ophthal Plast Reconstr Surg · Jul 2009
Case ReportsPercutaneous ultrasound-guided intraorbital foreign body removal.
Percutaneous ultrasound-guided intraorbital foreign body removal was successfully performed for removal of an intraorbital wooden foreign body. A 13-month-old boy presented with left periorbital cellulitis, which developed 3 days after a fall from an all-terrain vehicle. Orbital CT showed preseptal and postseptal orbital cellulitis, and an 11 x 2 mm linear foreign body in the medial compartment of the left eye. ⋯ The percutaneous procedure was performed with intravenous deep sedation. With sonographic guidance, a Hartmann forceps was advanced in the medial soft tissues of the orbit, and the foreign body was removed intact. Ophthalmologic follow-up over 6 months revealed no evidence of visual loss, nerve injury, or impairment of extraocular muscle function.
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Ophthal Plast Reconstr Surg · Jul 2009
Comparative StudyIncidence of ocular injury in visually asymptomatic orbital fractures.
To determine the incidence of severe ocular injury in visually asymptomatic patients with orbital fractures. ⋯ Visually asymptomatic patients with orbital fractures do not have ocular injury requiring emergent evaluation.