Patient Preferences for Physician Attire in Ophthalmology Practices.

Importance: Interest is growing in targeting physician attire to improve the patient experience. Few studies in ophthalmology have examined patient preferences for physician attire.

Objective: To understand patient preferences for physician attire in ophthalmology practices in the United States.

Refractive changes following corrective surgery for thyroid-related orbitopathy.

Thyroid-related orbitopathy (TRO) is a common and recognizable manifestation of Graves' disease, caused by an increase in orbital fat volume, increased extraocular muscle diameter, and fibrosis. Together, within the bony confines of the orbit, these changes might alter the shape and position of the globe, potentially inducing refractive shifts. These refractive changes may then be affected by corrective surgical interventions for TRO such as orbital decompression and strabismus surgery.

Glomuvenous Malformation: A Rare Periorbital Lesion of the Thermoregulatory Apparatus.

Glomuvenous malformations (GVMs), previously referred to as glomus tumors or glomangiomas, are benign, mesenchymal venous malformations arising from glomus bodies. Glomus bodies are modified smooth muscle neuromyoarterial structures involved in temperature regulation via blood shunting. These classically occur in the digits but can occur in other locations.

Outcomes of Orbital Blow-Out Fracture Repair Performed Beyond 6 Weeks After Injury.

Purpose: Blow-out fractures cause expansion of the bony orbital walls and prolapse of orbital contents in the sinuses. This can result in diplopia, enophthalmos, and hypoglobus. Early surgical repair has been previously recommended, however, recent reports show that delayed surgery can also be effective.

Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation.

Purpose: Dacryocystorhinostomy (DCR) is the standard procedure for the treatment of acquired nasolacrimal duct obstruction (NLDO) that can be performed through an external or endonasal approach. Both techniques create a fistula from the lacrimal sac into the nasal cavity via a bony osteotomy. Historically, external DCR has been considered the gold standard; however, recent reports suggest endonasal DCR is an effective alternative.

Bilateral squamous cell carcinoma of the lacrimal sac.

A 42-year-old man presented with right-sided epiphora, a fleshy lesion emanating from the right inferior punctum and a painless mass below the medial canthal tendon. Biopsy of the lacrimal sac mass disclosed papillary squamous cell carcinoma in situ. The patient underwent wide local excision with clear surgical margins and remained disease free until 28 months later when he returned with hemorrhagic epiphora of the OS and fullness overlying the left lacrimal sac.

Recognizing and managing complications in blepharoplasty.

The goal of this article is to enhance the surgical precision and accuracy of surgeons performing upper and lower eyelid blepharoplasty. The most common blepharoplasty complications are described and how to avoid them is discussed in detail. Complications range from mild to severe and for each, preoperative measures to prevent, perioperative measures to avoid, and postoperative measures to minimize complications are detailed.

Mastication induced retrobulbar hemorrhage.

Retrobulbar hemorrhage is a feared potentially sight threatening complication after orbital decompression surgery. We present a patient, 36 hours after surgery, while forcefully biting, suddenly developed a retrobulbar hemorrhage arising from the temporalis muscle causing an orbital compartment syndrome. Rapid intervention with canthotomy and cantholysis was associated with recovery of vision from absent light perception to 20/20.

A 55-mm object inside a 40-mm orbit.

A 43-year-old man was struck in the left orbit with his board while surfing and sustained a 3-cm laceration above his left eyebrow. The laceration was sutured closed primarily at a local emergency room. When he presented to UCSD oculoplastics for suture removal, he complained of diplopia with upgaze and was found to have hypoglobus on clinical exam.

Principles of Periocular Reconstruction following Excision of Cutaneous Malignancy.

Reconstruction of periocular defects following excision of cutaneous malignancy can present difficulties for oculofacial and reconstructive surgeons. The intricate anatomy of the eyelids and face requires precise restoration in order to avoid postoperative functional anesthetic concerns. Various reconstructive procedures based on common principles, location and size of the defect, can be applied to achieve restoration with the best possible functional and aesthetic outcomes.

Conjunctival-orbital fistula from extensive facial trauma.

A 31-year-old man with a history of severe facial trauma and multiple reconstructive operations presented with a conjunctival-orbital fistula in the OS. Successful treatment required a vascularized orbicularis oculi flap with a temporalis fascia overlay. Risk factors for fistula formation included extensive orbital trauma, devascularized tissue from previous operations and infection, and prior strabismus surgery using the fornix-based approach.

Blepharoplasty complications: prevention and management.

This article presents common and rare complications following blepharoplasty, with discussion of avoidance of these complications through presurgical planning and review. Management of the complications is provided, with surgical details supported by images and advice for the best approaches. The complications discussed include hemorrhage, infection, corneal abrasion, ptosis, lacrimal gland injury, and residual excess skin.

Use of antimetabolites in the reconstruction of severe anophthalmic socket contraction.

Purpose: The use of antimetabolites is well established in ophthalmology with expanded uses still being defined. We describe our experience of antimetabolite use in the reconstruction of severe anophthalmic socket contraction.

Methods: Nonrandomized, retrospective case series.

The delayed cost of treatment.

A 78-year-old woman presented with acute decreased vision in both eyes. She had been treated for a pituitary mass with a total of 4,500 centigray of external beam radiation 8 months prior to presentation. She was diagnosed with radiation optic neuropathy.

Modifying the upper eyelid crease in Asian patients with hyaluronic acid fillers.

Background: Preliminary experience with the use of hyaluronic acid fillers as a nonsurgical alternative in the management of upper eyelid crease asymmetry and superior sulcus hollowing in Asian patients has proven promising.

Methods: This retrospective, interventional case series included seven patients (11 eyes) of various Asian ancestries. All patients had eyelid crease asymmetry or undesirably elevated eyelid creases along with hollowing of the upper eyelids.

Three carcinomas in one eyelid.

A 90-year-old woman presented with 2 masses on the right lower eyelid. Excisional biopsy revealed 1 lesion to be Merkel cell carcinoma and the other to be invasive squamous cell carcinoma. The patient also had a prior history of basal cell carcinoma in the same eyelid.