Recurrent metastatic breast carcinoma presenting with pansinusitis and choroidal metastases and subsequent bilateral simultaneous orbital cellulitis.

A case report and literature review of a unique presentation of metastatic breast cancer is provided. A 46-year-old patient with a history of breast carcinoma presented with a choroidal mass. Three days later she went on to develop bilateral simultaneous orbital cellulitis, investigation of which revealed underlying bony metastases from a breast primary.

Endoscopic dacryocystorhinostomy in functional lacrimal obstruction.

Introduction: We performed endoscopic dacryocystorhinostomy in cases diagnosed with both anatomical and functional lacrimal obstruction, and here report results for the latter cases.

Methods: Sixty-eight endoscopic dacryocystorhinostomies were performed for functional obstruction on 44 patients. The indication for surgery was epiphora in 66 patients and recurrent dacryocystitis in two.

Ipswich lacrimal tube: pedicle nasal septal tube for the reconstruction of lacrimal drainage passage.

Canalicular blockage of the lacrimal system still remains a major challenge for oculoplastic surgeons. The conventional treatment of conjunctival dacryocystorhinostomy using the Lester Jones bypass tube is often associated with tube migration and foreign body reaction. The authors report a new technique to reconstruct the lacrimal passage on a single patient with severe canalicular obstruction following repeated failures from previous Lester Jones tube operations.

Analysis of the results of surgical endoscopic dacryocystorhinostomy: effect of the level of obstruction.

Aim: One of the main factors in determining success rate of lacrimal surgery is the level of obstruction in the lacrimal drainage system. There are only few reports which quantify this, and none on endoscopic dacryocystorhinostomy (DCR).

Methods: A case series of patients who had endoscopic DCR for anatomical obstruction of the lacrimal drainage system was performed.

Lacrimal fossa block: an audit of a minimally invasive regional anaesthetic technique for endoscopic dacryocystorhinostomy (DCR).

The lacrimal fossa block (LFB), a new development to provide regional anaesthesia for endoscopic dacryocystorhinostomy, is reported. Cadaveric study showed that the block needle, inserted as described, made direct contact with the periosteum of the frontal process of the maxilla within the lacrimal fossa. This technique enables both relevant divisions of the trigeminal nerve to be anaesthetized through a single entry site and, as this injection is confined to the anterior part of the orbit, ocular complications are minimized.

Non-bullous congenital ichthyosiform erythroderma, with ocular albinism and Noonan syndrome.

A 21-year-old woman presented with non-bullous congenital ichthyosiform erythroderma; she was born a collodion baby. Associated features were ocular albinism, anterior segment dysgenesis of both eyes and Noonan syndrome. X-linked ichthyosis (steroid sulphatase deficiency) and X-linked ocular albinism have been mapped to the Xp22.

Endoscopic inferior dacryocystorhinostomy.

Conventional dacryocystorhinostomy (DCR) usually involves extensive removal of bone at the lacrimal fossa and hence risks disruption of the lacrimal pump mechanism. A physiological operation for nasal lacrimal blockage is described whereby only the inferior portion of the lacrimal sac and the adjacent duct are marsupialized into the nose. The operation is safe, quick and does not involve sophisticated instruments.

Mucosal-associated lymphoid tissue lymphoma of the conjunctiva.

The recognition of mucosal-associated lymphoid tissue as a distinct entity has lead to the separate classification of tumors arising in this tissue, ie, the mucosal-associated lymphoid tissue lymphoma. Five patients with mucosal-associated lymphoid tissue lymphoma of the conjunctiva are described herein; four of the five patients had bilateral tumors. Laboratory analysis was done using microscopy, immunophenotyping, gene rearrangement analysis using both Southern blot and polymerase chain reaction techniques, and oncogene (bcl-1, bcl-2, and c-myc) rearrangement studies.

Mucosa-associated lymphoid tissue (MALT) in the human conjunctiva.

The recent description of conjunctival lymphomas with features of lymphomas that arise in mucosa-associated lymphoid tissue (MALT) infers the presence of MALT in the human conjunctiva. Some authors suggest that organized MALT is found in the normal human conjunctiva, but others disagree. In order to resolve this problem, we have examined the conjunctival fornix from unselected autopsies with no prior history of conjunctival or ocular disease for the presence of organized MALT.

The use of the same size host and donor trephine in penetrating keratoplasty for keratoconus.

The results of a retrospective analysis of 49 eyes (40 patients) that underwent penetrating keratoplasty for keratoconus are presented. All grafts had the same size trephine for both host and donor corneas. Ninety-eight per cent of eyes achieved a post-operative visual acuity of 6/12 or better; 43% of eyes attained this level of acuity unaided, although more than half of these required spectacles or contact lenses to reach their best corrected acuity.

Determination of the nodal point position in the pseudophakic eye.

The optics of the schematic eye have been described by Gullstrand and Listing (System of Ophthalmology (ed. H. Kimpton), Vol.

Microtropia versus bifoveal fixation in anisometropic amblyopia.

Microtropia with identity is a unique condition in which amblyopes have parafoveal eccentric fixation in the amblyopic eye in either monocular or binocular viewing, plus a macular scotoma. The condition has previously been described in anisometropic amblyopia. The records of 55 consecutively presenting anisometropic amblyopes were scrutinised and the cases divided into microtropes or non-microtropes (bifoveal fixators).

Visual performance in idiopathic macular holes.

Previously published reports on the clinical features of idiopathic macular holes highlight the predilection for post-menopausal women and implicate vitreomacular traction in the aetiology of these lesions. Relatively little attention, however, has been paid to the quality of visual loss in eyes with macular holes. Histological studies of full-thickness macular holes have shown loss of all retinal layers in the area of the hole, and this would be expected to produce a central absolute scotoma of the same diameter.

Pseudophakic accommodation? A study of the stability of capsular bag supported, one piece, rigid tripod, or soft flexible implants.

A group of pseudophakic patients was investigated to determine whether their implants shift along an anteroposterior axis under different conditions of ciliary muscle stimulation. There was no statistically significant change in refraction after either pilocarpine or cyclopentolate administration. A change in anterior chamber depth between the position after pilocarpine and that after cyclopentolate was found.

White light interferometry in amblyopic children--a pilot study.

Interferometric acuity using the IRAS white light interferometer was compared with Snellen acuity in nine amblyopic children between the ages of five and nine years, and nine aged matched controls. All of the amblyopic eyes achieved better grating acuities than Snellen acuities. Fifty-seven per cent of the amblyopes with a best corrected Snellen acuity of 6/18 or less in their amblyopic eye, achieved grating acuities indistinguishable from normal.

The interaction between hydrogel lenses and sodium fluorescein. Theoretical and practical considerations.

The interaction between sodium fluorescein dye and hydrophilic contact lenses was assessed quantitatively by spectrophotometry. Absorption of dye into he lens matrix was found to be proportional to the exposure time and also depends on the optical power and water content of the lens. 0.

The sensitive period for anisometropic amblyopia.

Fifty-five children with pure anisometropic amblyopia presented consecutively between 1983 and 1986. Analysis of their records was undertaken with respect to the age at presentation, the initial visual acuity after spectacle correction, and the final acuity attained after treatment. The results show that the final vision achieved does not depend on the age at presentation.

Cryptophthalmos: surgical treatment of the congenital symblepharon variant.

A case of the congenital symblepharon variant of cryptophthalmos is reported. Surgical treatment is described. The ophthalmic features of cryptophthalmos and its systemic associations are reviewed.