Blue Rubber Bleb Nevus Syndrome Manifesting as an Isolated Congenital Orbital Mass in a Neonate.

A male neonate presented with an isolated congenital right orbital vascular malformation without other mucocutaneous lesions or signs/symptoms of systemic disease. The orbital mass was progressive, causing amblyogenic ptosis by 6 months of age. Over 11 years, the patient underwent 4 orbital mass resections, 3 embolizations, and even a craniotomy with mass resection for an intraorbital meningoencephalocele secondary to orbital bony erosion.

The Ophthalmology Surgical Competency Assessment Rubric for External Dacryocystorhinostomy Surgery.

Purpose: The International Council of Ophthalmology (ICO) is currently developing a series of standardized, internationally validated, teaching tool for key ophthalmic surgical procedures called the Ophthalmology Surgical Competency Assessment Rubrics (OSCARs). This study aims to develop an OSCAR for external dacryocystorhinostomy (ExDCR).

Methods: An international panel of content experts, representing Argentina, India, U.

Perioperative Prophylactic Antibiotics in 1,250 Orbital Surgeries.

Purpose: Intravenous antibiotic prophylaxis is used for many clean-contaminated surgeries or clean surgeries with an implant, but its value for clean orbital surgery has not been determined. This study investigated infection risks and adverse effects related to antibiotics in patients undergoing orbital surgery.

Methods: A prospective, nonrandomized comparative case series of all patients undergoing orbital surgery with participating surgeons between October 1, 2013, and March 1, 2015.

Primary ductal adenocarcinoma of the lacrimal gland: A review and report of five cases.

Primary ductal adenocarcinoma (PDA) is a rare epithelial tumor of the lacrimal gland. Herein we report 5 cases and review 29 published cases of PDA of the lacrimal gland. Among these 5 cases, the most common clinical presentation was painless swelling and/or proptosis of their eye.

Upper Eyelid Splitting to Facilitate the Insertion of Glaucoma Drainage Devices.

Purpose: To describe a new application for vertical splitting of the upper eyelid, a technique traditionally used for orbital access, to facilitate glaucoma drainage device (GDD) implantation in patients with poor surgical exposure.

Methods: Case series.

Cases: We present a case of Möbius syndrome with complete restriction of the extraocular muscles, followed by a case of cicatricial narrowing of the palpebral fissures due to chronic allergic dermatitis.

Donor-Derived Conjunctival-Limbal Melanoma After a Keratolimbal Allograft.

Purpose: To report a single case of donor-derived conjunctival-limbal melanoma that occurred after a keratolimbal allograft (KLAL).

Methods: Case report and literature review.

Results: A 56-year-old white woman with a history of bilateral limbal stem cell deficiency developed a donor-related melanoma after a KLAL.

Hering's Law in Congenital Ptosis: Evaluation of the Contralateral Response to Unilateral Congenital Ptosis Repair.

Purpose: To determine the applicability and clinical relevance of Hering's law for the eyelids in cases of congenital ptosis.

Methods: A retrospective chart review and digital photograph analysis of patients who underwent unilateral congenital ptosis repair at a tertiary, university-based, Oculoplastics clinic was conducted. Pre- and postoperative eyelid height (marginal reflex distance), upper eyelid symmetry, and brow position were determined using ImageJ analysis software.

Scleral Contact Lenses in an Academic Oculoplastics Clinic: Epidemiology and Emerging Considerations.

Purpose: To describe the role and efficacy of scleral contact lenses (SCLs) in the treatment of progressive keratopathy in patients who have undergone periocular surgical procedures, to investigate the financial impact of these surgical interventions, and to demonstrate the role of oculoplastic surgery in improving scleral contact lens fit.

Methods: A retrospective medical record review was performed to identify patients who both received SCLs and were examined by the oculoplastics service at the University of Iowa between January 1990 and December 2015. Inclusion criteria also required a minimum of 12 months of patient follow up after being fit with a SCL.

Rethinking Our Definition of Postoperative Success: A Comparative Analysis of Three Upper Eyelid Retraction Repair Techniques Using Novel Metrics to Capture Functional and Aesthetic Outcomes.

Purpose: To compare 3 upper eyelid retraction repair techniques and introduce novel metrics, which enhance the analysis of postoperative aesthetic outcomes.

Methods: Retrospective review with Image J 1.48 digital analysis of patients who underwent repair of thyroid-related upper eyelid retraction at the University of Iowa from 1996 to 2014 via 1 of 3 surgical techniques, septum-opening levator recession with Muellerectomy, modified septum-preserving levator recession with Muellerectomy, and modified septum-preserving full-thickness blepharotomy, was conducted.

The Revised Direct Transconjunctival Approach to the Orbital Floor.

Purpose: To review common surgical approaches to the orbital floor and to evaluate the utility of canthal-sparing, single incision transconjunctival method.

Methods: A retrospective chart review of a consecutive series of patients who underwent transconjunctival, direct incision surgery without eyelid dissection or lateral canthotomy and inferior cantholysis and review of the literature were conducted.

Results: Twenty-three consecutive patients (33 orbits) were operated using a canthal-sparing direct single cut approach, including 10 unilateral pediatric orbital floor fractures, 1 orbital floor implant removal, 2 unilateral post-traumatic enophthalmos repairs, and 10 bilateral orbital floor decompressions.

Orbital Volume Augmentation for Enophthalmos Following Ventriculoperitoneal Shunting: A Case Study in "Silent Brain Syndrome".

A 21-year-old female with a history of infantile hydrocephalus and ventriculoperitoneal shunting presented with bilateral persistent tearing. Examination revealed marked bilateral enophthalmos, poor lower eyelid apposition to the ocular surface, and patent nasolacrimal systems. Radiographic imaging demonstrated expanded orbital volumes with high arching orbital roofs, sequestered air under the eyelids, short, straight optic nerves, and expanded paranasal sinuses.

Disaster in Cosmetic Surgery: Inadvertent Formalin Injection During Blepharoplasty.

The authors report a case where formalin was accidentally injected into the eyelids of a 71-year-old woman undergoing blepharoplasty, causing full thickness necrosis of both upper eyelids and ocular complications that required multiple reconstructive surgical procedures.

Physical and chemical injuries to eyes and eyelids.

Ocular and periocular injuries are common reasons for emergency department visits. In fact, an estimated 2 million Americans suffer ocular injuries each year. Evaluation and treatment of physical and chemical injuries to the eyes and eyelids begin with a systematic examination.

Factors affecting eyelid crease formation before and after silicone frontalis suspension for adult-onset myogenic ptosis.

Purpose: To evaluate factors that affect eyelid crease formation before and after frontalis suspension.

Design: Nonrandomized, comparative, interventional case series.

Methods: Sixty-three patients (125 eyes) with myogenic ptosis were included.

The clinical characterization and surgical correction of blepharoptosis associated with congenital aniridia.

Purpose: To document the clinical characteristics and describe our management of patients with blepharoptosis associated with congenital aniridia.

Methods: Consecutive retrospective case series of patients with congenital aniridia seen at a single institution (Cincinnati Eye Institute) from 1963 to 2010. Surgical correction was performed by 2 surgeons (J.

Intimate partner violence: an underappreciated etiology of orbital floor fractures.

Purpose: To evaluate the prevalence of intimate partner violence (IPV) in a large population of female orbital floor fracture patients and provide recommendations on effectively identifying and referring IPV survivors.

Methods: Retrospective review of facial fracture patients examined at the University of Iowa Hospitals and Clinics between January 1995 and April 2013. International Classification of Diseases, Ninth Revision, codes and medical record review were used to determine the prevalence of IPV victimization and clinical outcomes.

Optic nerve cyst-like formation presenting as a delayed complication of optic nerve sheath fenestration.

Two patients with idiopathic intracranial hypertension underwent optic nerve sheath fenestration. One patient developed decreased vision and choroidal folds 1 month postoperatively. The other patient developed proptosis and pain 9 months postoperatively.

The ophthalmology surgical competency assessment rubric for lateral tarsal strip surgery.

Purpose: To produce an internationally valid tool to assess skill in performing lateral tarsal strip surgery.

Methods: A panel of 7 content experts adapted a previously published tool for assessing lateral tarsal strip surgery by using a modified Dreyfus scale of skill acquisition and providing behavioral descriptors for each level of skill in each category. The tools were then reviewed by 11 international content experts for their constructive comments.

Different patterns of orbital roof involvement by cholesterol granuloma.

Two patients presented with cholesterol granuloma (CG), with completely different patterns of orbital roof involvement. One patient had a large intraorbital cystic CG, whereas the other had a very large intraosseous CG of the frontal bone. The presentation of CG with variable orbital roof involvement highlights the importance of being aware of the clinical characteristics and the imaging features of CG.

Ocular adnexal lymphoma of the extraocular muscles: case series from the University of Iowa and review of the literature.

Purpose: To review and statistically analyze the data of patients with discrete involvement of the extraocular muscles with ocular adnexal lymphoma from the tumor registry at the University of Iowa and to compile with current cases in the literature.

Methods: The records of patients with biopsy-proven orbital lymphoma at the University of Iowa Hospitals and Clinics Department of Ophthalmology and the Tumor Registry of the University of Iowa were reviewed. A review of the literature and meta-analysis were conducted.

The current state of ptosis repair: a comparison of internal and external approaches.

Purpose Of Review: Posterior approach ptosis repair has made a resurgence over the last decade. The purpose of this review is to examine the history of posterior approach ptosis repair and the events that have led to its current favorable status.

Recent Findings: The evolution of the posterior and anterior approach ptosis surgeries has resulted in two favored techniques for involutional ptosis repair: the Müller muscle-conjunctiva resection (MMCR) and the external levator advancement.

Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trial.

Background: Human immunodeficiency virus (HIV) infection is associated with dyslipidemia and increased risk for cardiovascular events; however, the use ofstatins in HIV-infected people is complicated by pharmacokinetic interactions and overlapping toxicities with antiretroviral medications. Policosanol is a dietary supplement derived from sugar cane that is widely used as a statin alternative in Latin America.

Primary Study Objective: To collect feasibility data on sugar cane-derived policosanol to normalize dyslipidemic profiles in a sample of medically underserved HIV-infected people.