Multifocal infantile hemangioma of the eyelid causing amblyopia requiring surgical resection.

Cutaneous vascular lesions in the pediatric population are rare and may represent a variety of localized and systemic diagnoses with diverse treatment protocols. We present a unique case of an infant with multiple cutaneous vascular lesions, initially diagnosed as congenital disseminated pyogenic granuloma based on histopathologic findings and later diagnosed as multifocal infantile hemangioma with extracutaneous hepatic involvement. The largest vascular lesion in our patient was on the left upper eyelid, which failed medical treatment and ultimately required surgical excision to prevent amblyopia progression.

Isolated globe rupture without concomitant eyelid laceration or orbital trauma following facial dog bite injury in a child.

Purpose: Facial dog bites often cause periorbital trauma; however, the globe is rarely damaged. Most globe injury following dog bites results from unusual circumstances and typically presents with concomitant periorbital and ocular adnexal injuries.

Observations: The case presented is a rare presentation of isolated globe rupture without orbital trauma following facial dog bite in a child without history or evidence of decreased blink reflex, mental deficiency, or substance use.

Traumatic intrachoroidal nail implantation.

Penetrating globe injury can lead to serious vision loss and even loss of the eye. Intraocular foreign bodies (IOFBs) are a major cause of traumatic globe injury commonly seen in work-related accidents. We present a unique case of a large IOFB that was fully embedded within the choroid, where enucleation was pursued due to inability to safely remove the IOFB.

Acute Chagas Disease Manifesting as Orbital Cellulitis, Texas, USA.

We report a case of acute, vectorborne Chagas disease, acquired locally in central Texas, USA, manifesting as Romaña's sign, which was initially mistaken for orbital cellulitis. After the infection failed to respond to antibiotics, DNA-based next generation sequencing on plasma yielded high levels of Trypanasoma cruzi; results were confirmed by PCR.

Rifle Blast Exacerbating Hearing Loss in a Patient Treated With Teprotumumab for Thyroid Eye Disease.

Teprotumumab is a promising new immunomodulatory therapy for thyroid eye disease. One unique adverse effect observed in clinical trials was hearing impairment; however, all adverse auditory effects in prior clinical trials resolved spontaneously after completion of teprotumumab therapy. The authors present a case of a patient on teprotumumab for thyroid eye disease who experienced sustained hearing loss secondary to shooting a rifle without ear protection.

panophthalmitis with delayed dermis fat graft.

panophthalmitis secondary to intravenous drug use typically leads to an explosive ocular and/or orbital infection. Though several cases of panophthalmitis secondary to intravenous drug use have been reported, no clear consensus exists regarding preferred surgical technique and orbital reconstruction. Additionally, no cases describe delayed dermis fat graft placement following enucleation for such cases.

Autologous Fat Transfer Harvest-site Complications: Incidence, Risk Factors, and Management.

Purpose: Autologous fat transfer is an effective tool for volume restoration to the aging face. Although numerous reports exist regarding injection site complications, there is limited data on donor-site morbidity in the cosmetic surgery literature.

Methods: This study is a large-scale retrospective review to determine incidence of fat harvest-site complications, identify risk factors, and describe management strategies.

Disseminated Coccidioidomycosis With Orbital Osteomyelitis and Periorbital Abscess.

Coccidioidomycosis osteomyelitis involving the orbital bones is exceedingly rare and is often misdiagnosed initially as other inflammatory or infectious conditions. No clear guidelines currently exist regarding appropriate management. The authors present an atypical presentation of disseminated coccidioidomycosis in an immunocompetent child with frontal bone superotemporal orbital rim osteomyelitis and associated periorbital abscess, successfully managed with surgical debridement through an upper eyelid crease incision.

Simultaneous presentation of orbital mantle cell lymphoma and endocrine mucin-producing sweat gland carcinoma.

Mantle cell lymphoma is a rare malignancy to present in the orbit, comprising only 1-5% adnexal lymphomas. Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is an equally uncommon adnexal tumor of sweat gland origin that may present on the eyelid. Herein we present a case of a 77-year old man with no previous cancer history who presented with painless progressive left globe proptosis and an enlarging left upper lid margin lesion, ultimately determined upon biopsy to be simultaneous orbital mantle cell lymphoma with systemic involvement and isolated eyelid EMPSGC.

Oculoplastic fellow education during the COVID-19 crisis.

Purpose: In March 2020, the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) advised the suspension of all non-emergent oculofacial patient care, imparting unprecedented interruptions in fellowship training.

Methods: ASOPRS fellows and program directors were asked to complete an anonymous survey regarding their perceived impact of the COVID-19 crisis.

Results: Forty ASOPRS fellows (70.

Atypical acute presentation of an optic nerve sheath meningioma.

Purpose: Primary optic nerve sheath meningiomas (ONSM) are benign lesions that typically present with findings of painless proptosis (59%), optic nerve pallor (55%), and decreased peripheral vision (35%). Herein we share an atypical case of a patient who presented acutely with periorbital pain and optic nerve head edema, and was ultimately determined to have a low-grade optic nerve meningioma.

Observations: A 36-year-old healthy woman presented with acute onset of left periorbital discomfort.

Acute post-partum vision loss due to pilocytic astrocytoma.

Purpose: We report an unusual case of a thirty-three-year-old woman who presented with acute unilateral vision loss following pregnancy and was ultimately discovered to have a pilocytic astrocytoma of the optic nerve.

Observations: A thirty-three-year-old previously healthy female presented one month following Caesarean section with unilateral vision loss. She was found to have significantly decreased visual acuity, an afferent pupil deficit, proptosis, optic nerve edema and choroidal folds.

Homonymous Horizontal Sectoranopia Caused by an Occipital Lobe Infarct.

Homonymous horizontal sectoranopia is a rare visual field defect that characteristically occurs after damage to the lateral geniculate nucleus (LGN). While there are many reports of homonymous horizontal sectoranopia resulting from LGN damage, there are very few reports of homonymous horizontal sectoranopia resulting from damage to other areas of the brain. We present a unique case of a patient with a homonymous horizontal sectoranopia with an occipital lobe infarct.

Pneumatic retinopexy for retinal detachment occurring after prior scleral buckle or pars plana vitrectomy.

Background And Objective: To report outcomes of pneumatic retinopexy (PR) for retinal detachment (RD) occurring after prior scleral buckling surgery (SB) or pars plana vitrectomy (PPV).

Patients And Methods: Single-center study evaluating all patients treated between January 2000 and March 2013.

Results: Ten eyes underwent PR after prior SB.

Outcomes and complications of pneumatic retinopexy over a 12-year period.

Background And Objective: To evaluate anatomic and clinical outcomes of pneumatic retinopexy for treatment of primary retinal detachment.

Patients And Methods: Noncomparative, single-center, consecutive, interventional case series evaluating all patients treated between 2000 and 2012. Patients with less than 1 month of follow-up or coexisting neovascular age-related macular degeneration, uveitis, endophthalmitis, or prior posterior segment surgery were excluded.

Multimodal imaging of sarcoid choroidal granulomas.

Background: Enhanced-depth imaging optical coherence tomography (EDI-OCT) provides high-resolution imaging of the choroid. Herein, we report multimodal imaging, including EDI-OCT, of a case of sarcoid choroidal granulomas.

Findings: A 63-year-old female with biopsy-supported sarcoidosis presented with unilateral multifocal choroidal granulomas.

Retained lens fragments after cataract surgery: outcomes of same-day versus later pars plana vitrectomy.

Purpose: To compare visual acuity outcomes and adverse events in patients with retained lens fragments who underwent same-day versus later pars plana vitrectomy (PPV).

Design: Retrospective, interventional case series.

Methods: Single-center study evaluating all patients with retained lens fragments that underwent PPV over a 22-year period (1990 through 2011).

A noninvasive bladder sensory test supports a role for dysmenorrhea increasing bladder noxious mechanosensitivity.

Objective: Catheterization to measure bladder sensitivity is aversive and hinders human participation in visceral sensory research. Therefore, we sought to characterize the reliability of sonographically estimated female bladder sensory thresholds. To demonstrate this technique's usefulness, we examined the effects of self-reported dysmenorrhea on bladder pain thresholds.