Annals of ophthalmology
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Annals of ophthalmology · Feb 1988
Case ReportsIntraocular malignant melanoma simulating uveal prolapse.
An 87-year-old woman, who had undergone cataract surgery and vitrectomy OD two years previously, had a blind, painful right eye secondary to intraocular hemorrhage and glaucoma. At the initial examination, a flat area of darkly pigmented tissue was noted at the wound site of the previous cataract surgery, and uveal prolapse was diagnosed. ⋯ Histologic study revealed areas of hemorrhage and epithelioid malignant melanoma. It is important to recognize that prolapse of tissue at a surgical wound site may represent an extension of an intraocular malignancy.
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A 56-year-old woman developed episodes of throbbing pain in the right orbit accompanied by ipsilateral nasal stuffiness and the feeling of ear swelling six months after orbital exenteration and ethmoidectomy for invasive, sclerosing basal-cell carcinoma. Extensive evaluation and treatment of her sinusitis failed to provide relief for her disabling symptoms. ⋯ To the best of our knowledge, this is the second patient with cluster headaches after orbital exenteration. Though no known causal relationship exists, these two patients document that orbital or ocular pain with cluster headaches is a referred or "phantom" pain and confirm the etiology of cluster headaches to lie outside the orbit.
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Ocular findings of three patients with Terson's syndrome are presented. Two patients had a ruptured intracranial aneurysm, and one had a subdural hematoma. Ocular findings included retinal, preretinal, and vitreous hemorrhages. ⋯ The eye findings are characteristic but not pathognomonic of this syndrome. The authors emphasize the diagnostic and prognostic importance of ocular findings in patients with spontaneous intracranial hemorrhages. Some of the primary theories of the syndrome are reviewed.
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Acute acquired comitant esotropia is characterized by a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive error. Two children, aged 41/2 and 61/2, who suddenly developed a nonaccommodative comitant esotropia are presented. There was no preceding trauma or febrile illness, and neurologic evaluation (including CT scans and Tensilon testing) was normal. Bimedial recession provided satisfactory alignment.
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