Modulating neuromuscular junction density changes in botulinum toxin-treated orbicularis oculi muscle.

Purpose: Botulinum toxin A is the most commonly used treatment for blepharospasm, hemifacial spasm, and other focal dystonias. Its main drawback is its relatively short duration of effect. The goal of this study was to examine the ability of corticotropin releasing factor (CRF) or antibody to insulin growth factor I-receptor (anti-IGFIR) to reduce the up-regulation of neuromuscular junctions that are associated with return of muscle function after botulinum toxin treatment.

A rabbit model of lower eyelid fibrosis.

Purpose: To create and validate a new model of lower eyelid fibrosis in Dutch-belted rabbits.

Methods: Five Dutch-belted rabbits were injected with a transcutaneous 1-ml injection of standard 95% ethanol alcohol just inferior to the eyelid margin of one lower eyelid. A control injection of 1 ml of balanced saline solution was given to the opposite eyelid.

Use of DermaMatrix graft in oculoplastic surgery.

Purpose: The use of acellular human dermal allografts has become widely accepted in oculoplastic surgery. However, the literature only describes the use of AlloDerm as the only source of acellular human dermis. The authors describe our experience using DermaMatrix in oculoplastic surgery.

Intravascular lymphoma presenting as an orbital mass lesion: a case report.

We describe a case of intravascular lymphoma that presented as an orbital mass lesion. A 77-year-old female presented with longstanding fatigue and one-month of diplopia. Magnetic resonance imaging (MRI) revealed a frontal lobe brain lesion and a right orbital mass.

Rhino-orbital-cerebral mucormycosis: a lethal complication of body dysmorphic disorder.

Young diabetics can sometimes have difficulty with insulin compliance for various reasons. This can be exacerbated if associated with body dysmorphic disorder or other eating disorders. The manipulation of insulin to lose weight can have devastating consequences.

Primary canaliculitis.

Purpose: To review the clinical findings, treatment outcomes, and microbiology of primary canaliculitis.

Methods: A medical record database was queried to identify cases of primary canaliculitis. The 23 cases identified were reviewed for clinical presentation, treatment, microbiology, pathology, and patient outcome at the time of most recent follow-up.

Amaurosis and optic disc blanching during upgaze in graves ophthalmopathy.

A 60-year-old man with worsening Graves ophthalmopathy complained of complete loss of vision in the left eye on upgaze ("gaze-evoked amaurosis" [GEA]). Examination disclosed congestive orbital signs bilaterally. Upon upgaze, intraocular rose from 18 to 35 mm Hg in the left eye and visual acuity fell in that eye from 20/25 to no light perception.

Asymptomatic renal cell carcinoma as a finding of Bardet Biedl syndrome.

Retinitis pigmentosa represents a class of disorders that exhibit dystrophy of the photoreceptors, pigment epithelium, and often systemic abnormalities, Bardet-Biedl syndrome is a form of retinitis pigmentosa that has characteristic non-ocular findings including polydactyly, obesity, learning difficulties, male hypogonadism, and renal anomalies. Though none of these renal anomalies are neoplastic, there is a 17 fold increased risk for renal cell carcinoma in obligate carriers of Bardet-Biedl syndrome. Herein, we describe a case of metastatic renal cell carcinoma discovered in a patient with Bardet-Biedl syndrome.

Subconjunctival herniated orbital fat: A benign adipocytic lesion that may mimic pleomorphic lipoma and atypical lipomatous tumor.

Prolapse of subconjunctival intraconal orbital fat is a rare cause of an intraorbital mass lesion. Over the past several years, we have seen a number of cases in which this prolapsed fat was confused pathologically with a neoplasm of adipocytic lineage, specifically pleomorphic lipoma and atypical lipomatous neoplasm (well-differentiated liposarcoma). We report the clinical, histopathologic, and immunohistochemical findings in 21 specimens from 17 patients, all of whom presented with prolapsed intraconal orbital fat.

Office evaluation of lacrimal and orbital disease.

This article describes a stepwise system for evaluating the function of the lacrimal system. It discusses evaluation of the orbit with particular attention to thyroid eye disease and orbital fractures.

Acute intermittent porphyria presenting as a diffuse encephalopathy.

Although acute intermittent porphyria presents with dramatic neurological findings, the diagnosis is difficult. An 18-year-old woman had a clinical picture of porphyric encephalopathy. Magnetic resonance (MR) imaging demonstrated multiple large contrast-enhancing subcortical white matter lesions, which regressed with glucose and hematin infusions.

Primary intraocular lymphoma: clinical, cytologic, and flow cytometric analysis.

Purpose: To compare cytologic with flow cytometric results of vitreous biopsy specimens obtained to rule out primary intraocular lymphoma (PIOL).

Study Design: Prospective noncomparative case series.

Participants: Patients suspected of having PIOL who underwent vitreous biopsy were evaluated.

Metastatic breast carcinoma to the vitreous.

Purpose: To evaluate the clinical and pathologic findings in two patients with prior breast carcinoma who underwent diagnostic vitrectomy for vitreous opacities and preretinal membrane.

Methods: The clinical histories and ophthalmic findings in two patients were reviewed. Vitrectomy specimens from the patients were processed by cytospin and standard tissue techniques, stained with hematoxylin and eosin, and examined immunohistochemically for cytokeratins.

Clinicopathologic findings in choroidal melanomas after failed transpupillary thermotherapy.

Purpose: To review the clinicopathologic features of eyes enucleated after failed transpupillary thermotherapy.

Design: Retrospective review.

Methods: Pathology reports in the L.