Ophthalmic plastic and reconstructive surgery
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Ophthal Plast Reconstr Surg · Sep 2006
Case ReportsThyroid eye disease presenting after cosmetic botulinum toxin injections.
A 53-year-old woman with left periorbital swelling 4 days after botulinum toxin injection in the lateral canthal area presented after noticing left eye prominence. Physical examination demonstrated proptosis and eyelid retraction. ⋯ In this case, the patient had development of proptosis after receiving botulinum toxin injections. Although the proptosis may represent progression of the patients' thyroid eye disease, it is worthwhile to consider incitation by botulinum toxin as a possible cause given its widespread use.
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Ophthal Plast Reconstr Surg · Jul 2006
Case ReportsDelayed presentation of orbito-cerebral abscess caused by pencil-tip injury.
This report describes the clinical and radiologic findings of a child who was stabbed with a pencil tip in his right upper eyelid, in what initially appeared to be an innocuous injury. The child presented again 3 weeks later with a combined orbital and frontal lobe brain abscess. The mechanism of injury is discussed, the orbital and neuro-surgical interventions are detailed, and the medical treatment is presented. Ophthalmologists should have a high index of suspicion for orbital foreign bodies and possible intracranial injury in cases of penetrating eyelid trauma.
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Ophthal Plast Reconstr Surg · May 2006
Myobloc for the treatment of benign essential blepharospasm in patients refractory to botox.
A small percentage of cases with essential blepharospasm or hemifacial spasm will become resistant to botulinum toxin A (Botox). We present our experience treating these patients with botulinum toxin B (Myobloc). ⋯ Botulinum toxin B is a useful treatment for cases that have become refractory to botulinum toxin A. The duration of beneficial effect is shorter than for type A. The side effect profile is similar to that for toxin type A except for pain on injection and the occurrence of dry mouth. Side effects occurred at a higher frequency than with botulinum toxin A, and the pattern suggests that botulinum toxin B spreads more diffusely. Side effects appear to be dosage-related.
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Ophthal Plast Reconstr Surg · Jan 2006
Case ReportsLower eyelid entropion in Langer-Giedion syndrome.
Langer-Giedion syndrome results from a genetic deletion on chromosome 8. Although redundant skin is part of Langer-Giedion syndrome, lower eyelid entropion and eyelid laxity have not been previously reported in the medical literature. We report a case of bilateral lower eyelid entropion in a patient with Langer-Giedion syndrome who successfully underwent entropion repair with anterior lamellar resection, lower eyelid retractor advancement, and lateral canthopexy. Although she has done well 6 months after surgery, we anticipate that laxity and eyelid instability will continue to develop with age, and additional reconstructive surgery may be required.
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Ophthal Plast Reconstr Surg · Nov 2005
Case ReportsSevere subcutaneous emphysema following orbital blowout fracture.
A 19-year-old man sustained a blowout fracture to the left orbital floor. Subcutaneous emphysema developed after a protracted sneezing episode. Some signs of respiratory distress ensued, and the patient was emergently intubated. ⋯ The left nasal cavity was packed and the emphysema slowly resolved. Clinically significant subcutaneous emphysema is an uncommon complication of orbital blowout fracture. Informing the patient to avoid excessive nose-blowing and to avoid occluding the nose while sneezing may prevent this complication.