Immune checkpoint inhibitors and the orbit; two cases of reactive dacryoadenitis.

Immune checkpoints refer to mechanisms entrusted with the modulation of immune responses in peripheral tissues and are required for minimising collateral damage. Immune checkpoint inhibitors (ICPi) work through numerous pathways, including the anti-CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), anti-PD-1 (programmed cell death protein 1) and the PD-L1 (protein cell death protein-ligand-1) pathways. They are proving to be an exciting therapeutic avenue in the attempt to activate anti-tumour activity.

Determining the Degree of Perceptible Static Eyelid Asymmetry and Effect of Face Inversion: A Cross-sectional Pilot Study.

Purpose: To determine the degree of static eyelid asymmetry required to be perceptible and whether this is affected by image inversion.

Methods: Images of 3 volunteers were digitally manipulated to have eyelid asymmetry of 0.5 mm, 1 mm, or 1.

Informed Consent In Facial Photograph Publishing: A Cross-sectional Pilot Study To Determine The Effectiveness Of Deidentification Methods.

This study determined the effectiveness of three deidentification methods: use of a) a black box to obscure facial landmarks, b) a letterbox view to display restricted facial landmarks and c) a half letterbox view. Facial images of well-known celebrities were used to create a series of decreasingly deidentified images and displayed to participants in a structured interview session. 55.

Diagnostic uncertainty following orbital injury from a grease gun.

Orbital trauma involving high-pressure grease guns is rare and can cause significant morbidity due to retained intraorbital grease. Grease can appear similar to intraorbital air on cross-sectional imaging, and clinicians should have a high index of suspicion for retained intraorbital grease and know how to recognise this. In this case, we will share the clinical and radiological findings as well as management of retained intraorbital grease.

Material Characterisation and Stratification of Conjunctival Epithelial Cells on Electrospun Poly(ε-Caprolactone) Fibres Loaded with Decellularised Tissue Matrices.

The conjunctiva, an under-researched yet incredibly important tissue, plays key roles in providing protection to the eye and maintaining homeostasis of its ocular surface. Multiple diseases can impair conjunctival function leading to severe consequences that require surgical intervention. Small conjunctival defects can be repaired relatively easily, but larger defects rely on tissue grafts which generally do not provide adequate healing.

Vertical Lid Split to Aid Excision and Reconstruction of Conjunctival Tumors Involving the Fornices.

Purpose: To describe how a vertical lid split helps excision and reconstruction of conjunctival tumors.

Methods: All patients with a limited view of conjunctival tumors involving the fornices underwent a vertical lid split procedure to improve access during resection and reconstruction.

Results: There were 11 cases where vertical lid splits were performed to assist excision and reconstruction of conjunctival tumors on patients between 2015 and 2019.

Globe preservation surgery for a paranasal tumor with orbital extension.

Orbital exenteration is a rare radical procedure used for the treatment of locally invasive or potentially life threatening orbital tumors. The procedure results in significant visual and psychosocial disability. Recently there has been a shift toward a subtotal extenteration with maximum preservation of orbital tissue and globe in appropriate cases.

Bilateral infiltrative disease of the extraocular muscles: a rare clinical presentation of early stage chronic lymphocytic leukemia.

Orbital involvement in chronic lymphocytic leukemia (CLL) is highly unusual and most commonly involves hemorrhage or soft tissue infiltration in advanced disease. We report a case of rapid onset bilateral orbital muscle infiltration as the presenting feature of early stage CLL. In addition, we demonstrate clinico-pathological correlation with an identical chronic B-cell lymphocytic infiltrate in both orbit and bone marrow, with good response of the orbital disease to local radiotherapy.

Lacrimal sac mucus-secreting adenocarcinoma.

A forty year old female presented with a swelling above the medial canthal tendon, later diagnosed as a mucus secreting adenocarcinoma. This rare carcinoma arose within an inverted papilloma lined by ciliated respiratory type columnar epithelium incorporating numerous goblet cells. We were only able to find two such cases reported in the literature.

Endoscopic-Assisted Removal of Orbital Roof Lesions via a Skin Crease Approach.

Objective: To describe the technique and indications for an endoscopic-assisted approach to orbital roof lesions.

Materials And Methods: The technique was used for six cases of orbital roof lesions. An anterior orbitotomy was performed via an upper eyelid skin crease incision.

Idiopathic sclerosing orbital inflammation.

Objective: To perform a multicenter review of the clinical features and treatment of 31 patients with idiopathic sclerosing orbital inflammation.

Methods: We included all patients with histologically confirmed idiopathic sclerosing orbital inflammation from 5 regional orbital centers. We reviewed the case notes to determine the clinical presentation, diagnostic features, and response to treatment.

Ophthalmic manifestations of multiple myeloma.

Purpose: To describe ophthalmic manifestations in a series of patients with multiple myeloma (MM) and review the literature.

Design: Retrospective case series.

Methods: Review of all cases with ophthalmic manifestations of MM seen at the Department of Ophthalmology, Royal Adelaide Hospital, between 1987 and 2002.

Orbital decompression for gross proptosis associated with orbital lymphangioma.

A 14-year-old boy with 11 mm of proptosis and exposure keratopathy secondary to an orbital lymphangioma underwent surgical debulking with a carbon dioxide laser through a lateral orbitotomy combined with a 3-wall orbital decompression. The proptosis was reduced by approximately 2 mm as a result of the debulking procedure, but a further 5 mm reduction was achieved with the orbital decompression. No serious adverse effects were encountered.

The use of a polyglactin suture in the lateral tarsal strip procedure.

Purpose: To evaluate the rate of recurrence of horizontal laxity or lid malposition and suture-related complications associated with the use of an absorbable suture in the lateral tarsal strip procedure.

Design: Prospective, interventional, consecutive case series.

Methods: A prospective study.

Correction of pseudophakic anisometropia with the Staar Collamer implantable contact lens.

Purpose: To assess the role of the Staar Surgical implantable contact lens (ICL) for the correction of pseudophakic anisometropia.

Setting: Oxford Eye Hospital, Oxford, and Rosen Eye Center, Alexandra Hospital, Manchester, United Kingdom.

Methods: Six patients with pseudophakic anisometropia ranging from 2.