Survey of ophthalmology
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A 67-year-old woman with a history of chronic headache and recent removal of two squamous cell lesions from her forehead presented with left facial pain and diplopia. A diagnosis of Tolosa-Hunt syndrome was made based on clinical presentation and imaging studies. When the patient did not respond to steroids, further studies were done, including biopsy, which revealed perineural spread of squamous cell carcinoma.
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A 44-year-old woman presented with a painful abducens nerve palsy in the left eye. Examination revealed a white, quiet eye and an orbital bruit without proptosis. ⋯ Symptoms resolved spontaneously in approximately 8 months. The classification and treatment options for carotid-cavernous fistula are discussed.