Necrotizing Granulomatous Papular Reaction Following Multiple Pulsed Dye Laser and Hybrid Fractional Laser Treatments for Rosacea.

This is a case report of a single patient who had pulsed dye laser and hybrid fractional laser treatments for facial rosacea and subsequently developed a prolonged papular reaction in and adjacent to the area of treatment, which was unresponsive to topical therapy. Biopsies of these lesions revealed necrotizing granulomas. This is a previously unreported side effect of these laser treatments and clinicians should be aware of this potential sequela.

Dacryoadenitis Caused by Blastomycosis: A Case Report.

This is the first case of histopathologically proven blastomycosis involving the lacrimal gland. A 51-year-old woman with a history of disseminated blastomycosis involving her lungs and skin, on oral itraconazole, presented with 3 days of right upper eyelid swelling, erythema, and pain concerning for recurrent dacryoadenitis. MRI showed enlargement of the right lacrimal gland with a cystic lesion at the anterior aspect of the gland with a radiographic differential diagnosis of abscess versus cyst.

Primary Neuroendocrine Tumor of the Orbit Presenting With Acute Proptosis.

Primary neuroendocrine tumors of the orbit are exceedingly rare and typically present with gradual, progressive exophthalmos. In this report, an otherwise healthy 64-year-old woman undergoes resection of a well-differentiated neuroendocrine tumor after presenting with acute proptosis. An extensive clinical and radiographic evaluation reveals no other evidence of disease, establishing the diagnosis of a primary neuroendocrine tumor.

Late-Onset Development of Eyelid Ptosis in Chronic Progressive External Ophthalmoplegia: A 30-Year Follow-up.

Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial myopathy with slowly progressive, often symmetric blepharoptosis and limitation of ocular motility in all directions of gaze. The authors present an unusual case of CPEO that initially presented with the unique features of markedly asymmetric facial weakness and the lack of blepharoptosis. However, over the subsequent three decades, the patient developed progressive facial and eyelid dysfunction more consistent with a classical description of CPEO.

Localized Immunoglobulin Light Chain Amyloid of the Conjunctiva Confirmed by Mass Spectrometry Without Evidence of Systemic Disease.

Current guidelines recommend a thorough systemic workup in patients with newly diagnosed immunoglobulin amyloid light chain (AL) amyloidosis because of a close association with an underlying plasma cell proliferative disorder. Rarely, however, AL amyloidosis may present as a localized, benign disease without systemic involvement. Few previous reports have documented localized AL amyloid of the conjunctiva, and all these used immunohistochemistry for amyloid typing, which can be inaccurate.

Immunosuppressant-Related Lower Eyelid Edema in Transplant Patients.

Solid organ transplantation is the preferred method of treatment for a number of advanced medical conditions, but it requires systemic immunosuppression to prevent transplant rejection. The authors report 2 unique cases of persistent eyelid edema following solid organ transplantation believed to be related to their systemic immunosuppression. The eyelid findings developed after initiation of the immunosuppressant sirolimus.

Changes in Intraocular Pressure During Orbital Floor Fracture Repair.

Purpose: To evaluate changes in intraocular pressure (IOP) during orbital floor fracture repair.

Methods: Retrospective chart review of patients undergoing isolated orbital floor fracture repair with implant placement at a level 1 trauma center and tertiary care center. Patients with combined zygomaticomaxillary or medial wall fracture repair, or other significant ocular injuries were excluded.

Accuracy and speed of electronic health record versus paper-based ophthalmic documentation strategies.

Purpose: To compare accuracy and speed of keyboard and mouse electronic health record (EHR) documentation strategies with those of a paper documentation strategy.

Design: Prospective cohort study.

Methods: Three documentation strategies were developed: (1) keyboard EHR, (2) mouse EHR, and (3) paper.

Interexpert agreement in the identification of macular location in infants at risk for retinopathy of prematurity.

Objective: To characterize variability in the identification of the macular center among retinopathy of prematurity (ROP) experts.

Methods: A printed set of 25 wide-angle retinal images was compiled from infants at risk for ROP using a commercially available camera. Ten recognized ROP experts were asked to mark the macular center on each image.

Plus disease in retinopathy of prematurity: quantitative analysis of vascular change.

Purpose: To examine the relationship between rate of vascular change and plus disease diagnosis.

Design: Retrospective observational case-control study.

Methods: Wide-angle images were taken bilaterally from 37 infants at 31 to 33 weeks and 35 to 37 weeks postmenstrual age (PMA).