Extranodal Rosai-Dorfman Disease of the Orbit: Clinical Features of 8 Cases.

Purpose: To report on the presentation, radiography, histology, and treatment of 8 cases of extranodal Rosai-Dorfman disease involving the orbit.

Methods: Multicenter retrospective case series.

Results: Five males and 3 females had a median age of 10 years (range 2-78 years).

Management of postblepharoplasty chemosis.

Clinically significant chemosis occasionally complicates lower eyelid blepharoplasty. In this report, the etiologic components of postblepharoplasty chemosis are discussed. The time course and duration of chemosis vary according to the underlying cause.

Epstein-Barr virus associated smooth muscle tumors in post transplant pediatric patients two cases of rare locations, and review of the literature.

Epstein-Barr virus (EBV) may present few or no symptoms in immunocompetent individuals; however, in immunocompromised patients as in the case of AIDS and post-transplant patients, the virus occasionally stimulates neoplastic transformations. Epstein-Barr virus may play a role in the development of smooth muscle tumors (SMT). In the case of Epstein-Barr associated smooth muscle tumors (EBV+SMT), the virus is thought to be the leading factor to the tumorigenic pathway.

Concepts in eyelid biomechanics with clinical implications.

The inner canthal orbicularis drives spontaneous blinking of the eyelids and is richly innervated by a branching network of twigs based largely on the buccal branch of the facial nerve. This segment of the orbicularis is relatively resistant to denervation from subciliary incisional approaches. Combined with proper eyelid tension, contraction of this segment of orbicularis results in the normal physiologic blink mechanism.

The open brow lift.

The open brow lift procedure is discussed in terms of relevant surgical anatomy, preoperative evaluation, and detailed surgical technique for pretrichial coronal forehead lift with hair-bearing temporal lift, direct incisional brow lift, and coronal brow lift. Complications are discussed, and information is presented on patient evaluation and expectations, with a discussion of what patients can expect before and after brow lift surgery.

Diffuse symmetric meningioma en plaque mimicking metabolic disease of bone.

A 50-year-old African American woman with right proptosis and decreased vision demonstrated symmetric, bilateral thickening of the sphenoid wings, calvarium, and skull base on computed tomography. Histopathologic evaluation of the hyperostotic lesion was consistent with meningotheliomatous meningioma. The patient underwent uncomplicated right frontal orbital craniectomy with postoperative radiation.

Non-surgical treatments of primary, non-melanoma eyelid malignancies: a review.

The diagnosis and management of periocular cutaneous malignancies are essential components of an ophthalmologist's practice. Skin cancers comprise nearly one-third of newly diagnosed malignancies. Furthermore, the incidence of skin cancer appears to be increasing.

Bilateral circumferential macular folds in inflicted childhood neurotrauma.

Purpose: To report an infant with inflicted neurotrauma who exhibited bilateral circumferential macular folds.

Methods: Bedside ophthalmic examination and fundus photography using RetCam-II (Clarity Medical Systems, Pleasanton, CA).

Results: Both pupils were miotic and nonreactive.

Magnetic resonance imaging evidence of optic nerve glioma progression into and beyond the optic chiasm.

Optic nerve glioma has been a topic of great interest and controversy, particularly with respect to its tendency to invade the optic chiasm. This case report demonstrates histologically verified optic nerve glioma in an otherwise healthy 5-year-old girl. MRI revealed sequential prechiasmal, chiasmal, and postchiasmal disease during the untreated course of 18 months.

Metastatic endometrial carcinoma resulting in orbital apex compression.

A 63-year-old woman presented subacutely with signs of orbital apex and cavernous sinus disease in the setting of widespread, untreated metastatic carcinoma of the uterus. MRI revealed a destructive lesion of the left sphenoid wing with compression of the orbital apex and with possible extension in the cavernous sinus. The underlying diagnosis was confirmed with repeat endometrial biopsy, revealing well-differentiated endometrial adenocarcinoma.

Compressed helium injury to the orbit resulting in pneumocephalus.

A 33-year-old woman received a conjunctival laceration after accidental contact with the flexible outlet tip of a tank of compressed helium while filling balloons. The gas discharged during the contact, blowing compressed helium into her right orbit, with intracranial extension. The patient was asymptomatic, except for a transient headache.

Cysticercosis isolated to the orbit.

A 55-year-old woman who underwent orbital fat excision for cosmesis was incidentally found to have an isolated orbital cysticercus identified by histopathologic examination. The ensuing workup was negative for disseminated cysticercal infection and further treatment was deferred. Although uncommon, orbital cysticercosis should be considered in the differential diagnosis of an asymptomatic orbital mass.