Oedipism: An unusual case of auto-enucleation including mechanism of avulsion.

Introduction: Self-inflicted enucleation, also known as auto-enucleation (AE) or Oedipism, is an uncommon and severe form of ocular injury which presents as an ophthalmic and psychiatric emergency. Usually known to occur with untreated psychosis, this case is a rare report which demonstrates AE as a result of a subsequently diagnosed drug induced psychosis. We report the clinical presentation, management and for the first time a detailed speculative account about the mechanism of AE, based on our clinicopathologic findings.

Periocular cutaneous sarcoid: case series and review of the literature.

Objectives: To illustrate the varying clinical presentations of cutaneous sarcoidosis affecting the periocular region, which may masquerade as other clinical entities such as basal cell carcinoma or seborrheic dermatitis. Furthermore, the authors present an unusual observation of lupus pernio involving the adnexal region with the rare presence of perineural granulomas on histology following incisional biopsy.

Methods: We report a consecutive series of four cases with lesions involving the eyelids with varying clinical appearances.

Squamous cell carcinoma in the anophthalmic socket: a series of four cases with HPV-16 profiling.

Purpose: To present the clinical and histological features of squamous cell carcinoma (SCC) in the anophthalmic socket in four adult patients, and to determine the presence of human papillomavirus infection (HPV).

Methods: Retrospective case series of four adult patients with SCC of the anophthalmic socket. P16 immunohistochemistry and HPV testing was carried out in all cases.

Pseudodacryocystitis: paediatric case series of infected atypical ethmoid air cells masquerading as recurrent dacryocystitis.

PurposeTo highlight the clinical and surgical considerations in treating patients with apparent recurrent acute dacryocystitis with a patent lacrimal system.MethodsThree children referred to a tertiary unit as recurrent acute dacryocystitis were reviewed retrospectively. Imaging and subsequent surgical intervention revealed the underlying diagnosis.

A case of non-lacrimal immunoglobulin G4 (IgG4)-related orbital disease with mastitis.

IgG4-related orbital disease is a recognised cause for orbital inflammation. As its awareness increases and diagnostic accuracy improves there will be an increased number of cases being identified. This unique case demonstrates for the first time, with histological evidence, a case of a non-lacrimal IgG4-related orbital disease with concurrent IgG4-related mastitis.

Spindle Cell Lipoma of the Conjunctiva.

A 67-year-old woman presented with progressive enlargement of a long-standing mass on the surface of her OS associated with ocular surface irritation. The mass was excised en bloc. Histopathological examination showed a well-defined encapsulated tumor composed of wiry collagen containing bland spindle cells that were strongly positive for CD34 with scattered mature adipocytes.

Orbital presentation of a nasal midline destructive lesion in a young boy.

Midline Destructive Lesions (MDL) are well known to cause nasal problems. There is a long differential diagnosis of such lesions. However, in the pediatric population, the 2 main diseases to be aware of are Non-Hodgkin's T-cell lymphoma and granulomatosis with polyangiitis (previously known as Wegener's granulomatosis).

Post-radioiodine De Novo Onset Graves' Ophthalmopathy: Case Reports and a Review of the Literature.

New-onset Graves' ophthalmopathy (GO) following radioiodine treatment (RAI) and worsening of existing GO are well-described in the endocrinology literature. These phenomena are recognized by ophthalmologists, yet poorly documented in the ophthalmology literature. Two male patients, aged 43 and 62 years, respectively, with Graves' disease without GO, received RAI.

A prospective, multicentre study of malignant and premalignant lesions at the base of periocular cutaneous horns.

Purpose: The primary objective of the study was to determine the incidence of the various pathological conditions present at the base of the periocular cutaneous horns. The secondary objective was to study the presentation of these cutaneous horns with a view to finding any clinical indicators for premalignant, malignant and benign lesions at the base.

Methods: Prospective multicentre study of patients presenting with cutaneous horns.

Auditory-olfactory synesthesia coexisting with auditory-visual synesthesia.

Synesthesia is an unusual condition in which stimulation of one sensory modality causes an experience in another sensory modality or when a sensation in one sensory modality causes another sensation within the same modality. We describe a previously unreported association of auditory-olfactory synesthesia coexisting with auditory-visual synesthesia. Given that many types of synesthesias involve vision, it is important that the clinician provide these patients with the necessary information and support that is available.

A unique case of IgG4 sclerosing dacryocystitis.

IgG4-related ocular adnexal disease, a relatively recently described clinical entity, is important to diagnose because during the acute phase, it responds favorably to corticosteroid treatment. The diagnosis can be confirmed by simple blood tests and histology. IgG4-related dacryoadenitis and generalized orbital disease have been reported; however, this is the first report of IgG4-related disease of the lacrimal sac.

Topical diclofenac gel for the management of periocular actinic keratosis.

Purpose: We sought to evaluate the efficacy of topical 3% diclofenac gel in the management of periocular actinic keratosis.

Methods: Four consecutive patients with periocular actinic keratosis who were treated with topical 3% diclofenac gel twice daily for up to 4 months were included in the study. Patients were reviewed at 1 and 2 months and then as clinically required up to 13 months after treatment.

Xanthogranulomatous variant of immunoglobulin G4 sclerosing disease presenting as ptosis, proptosis and eyelid skin plaques.

A 70-year-old male was referred to the oculoplastic clinic with left-sided ptosis and floppy eyelids. During follow-up, bilateral upper lid xanthelasma developed with worsening ptosis and proptosis, which was worse on the left side. A left orbital biopsy showed xanthogranulomatous inflammation of the orbit.

A Rare Presentation of Occult Sinusitis: Upper Eyelid Fistula.

Sinus disease can present in a variety of ways and may occur in individuals who are not otherwise aware that they have problems (occult sinusitis). An unusual presentation of occult frontal sinus disease in a 64-year-old patient was reported. A fistulous communication with the upper lid, causing a persistent abscess.

A rare case of bilateral eyelid ulceration with mycosis fungoides.

Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is a low-grade lymphoma usually occurring after the age of 50 years. We present a case of a 60-year-old man with cutaneous manifestations of MF, who later developed bilateral eyelid ulceration. MF is a highly recalcitrant disease with a relentless course.

Ocular findings in sleep apnoea patients using continuous positive airway pressure.

Purpose: To describe ocular findings in patients with established obstructive sleep apnoea hypopnoea syndrome (OSAHS) using continuous positive airway pressure (CPAP).

Methods: hundred and fifteen referrals investigated for OSAHS were included. Patients with OSAHS were compared with those with normal sleep study controls.

Molluscum Contagiosum-Induced Periocular Toxic Dermatitis.

This report describes an unusual case of a 9-year-old boy with a 6-month history of right lower eyelid lesion and excoriation of the adjoining skin that had not responded to topical treatment. The umbilicated lesion was electively excised and the base of the lesion was cauterized under general anesthesia, which resulted in complete resolution of the periocular dermatitis without additional treatment. It is important to consider molluscum contagiosum in the differential diagnosis in patients with periocular dermatitis, especially in the presence of an umbilicated vesicle, although it is classically taught that these lesions present with toxic conjunctivitis.

Successful treatment of nasolacrimal duct obstruction secondary to fibrous dysplasia by external dacryocystorhinostomy with mitomycin C.

A 60-year-old woman developed polyostotic fibrous dysplasia involving the right zygomatic and maxillary bones, which led to swelling along the right side of her nose that was associated with constant epiphora. A sac washout revealed a blocked right nasolacrimal duct, which was confirmed by CT dacryocystography. CT also showed signs of fibrous dysplasia in the maxillary and zygomatic bones in the form of bony expansion and ground-glass bone density.

A histopathologic study of orbital implant vascularization.

Purpose: To histopathologically assess the extent and pattern of vascularization of explanted porous polyethylene (PP) and hyrdoxyapatite (HA) orbital implants. To compare the vascularization in PP implants harvested after enucleation versus after evisceration.

Methods: This is a comparative case series of six orbital implants explanted between 11 months and 5 years and 4 months post implantation.

A case of lower lid ulcer secondary to reverse migration of silicone punctal plug.

Silicone punctal plugs are effective and relatively safe method of managing keratoconjunctivitis sicca. We present a case where a silicone punctal plug migrated to cause aseptic necrosis of the surrounding tissue leading to a lid ulcer.