Review of recent advances in managing periocular skin malignancies.

Management of cutaneous malignancies can be particularly challenging when they are located in the periocular region. The standard of care for localized disease is complete surgical excision, but this may not be possible without significant disruption to visual structures and facial appearance. Definitive radiation may be an option for some patients who cannot or do not wish to undergo surgery.

Ocular Emergencies During the Coronavirus Disease 'Safer at Home Order' in Wisconsin.

Introduction: The coronavirus pandemic created large shifts in utilization of hospital resources, patient presentations, and delivery of medical care.

Objectives: This retrospective study evaluated the ocular emergencies at a tertiary-care academic hospital in Wisconsin during the COVID-19-related "Safer at Home" order.

Methods: Ophthalmology consultations performed March 23 through May 26, 2020, were compared to the same time period in the 4 preceding years and the subsequent year.

fungal dacryocystitis with cutaneous fistula: a case report.

is a fungal genus that can cause opportunistic human infection in immunocompromised hosts. While the majority of clinical manifestations are cutaneous or subcutaneous infections, there are reports of oculomycosis, which is most commonly present as keratomycosis or endophthalmitis.Here, we present a rare case of Alternaria dacryocystitis with cutaneous fistula in a diabetic patient.

Transcutaneous retrobulbar amphotericin B for rhino-orbital-cerebral mucormycosis: a multi-center retrospective comparative study.

Purpose: To assess whether transcutaneous retrobulbar amphotericin B injections (TRAMB) reduce exenteration rate without increasing mortality in rhino-orbital-cerebral mucormycosis (ROCM).

Methods: In this retrospective case-control study, 46 patients (51 eyes) with biopsy-proven ROCM were evaluated at 9 tertiary care institutions from 1998 to 2021. Patients were stratified by radiographic evidence of local orbital versus extensive involvement at presentation.

Physical Activity in Functionally Monocular Persons in the United States, 2003-2006.

Purpose: Real-world physical activity patterns in monocular persons have not been previously characterized. This study uses a nationally representative sample to compare the physical activity levels of functionally monocular to binocularly sighted persons in the United States.

Methods: This cross-sectional study uses data from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey (NHANES) to compare differences in physical activity between functionally monocular and binocular participants.

Psychological distress and well-being among sensory impaired individuals during COVID-19 lockdown measures.

Purpose: Hearing and vision impairment are prevalent chronic conditions associated with poorer mental health. Limitations of in-person contacts during COVID-19-related lockdown measures may affect those with sensory impairments more severely exacerbating mental health problems. We aimed to determine whether hearing and/or visual impairment were associated with more psychological distress during a time of lockdown measures in Spring/Summer 2020 in Wisconsin.

Predictive Modeling of New-Onset Postoperative Diplopia Following Orbital Decompression for Thyroid Eye Disease.

Purpose: To identify risk factors for the development of new-onset, postoperative diplopia following orbital decompression surgery based on patient demographics, clinical exam characteristics, radiographic parameters, and surgical techniques.

Methods: We conducted a multi-center retrospective chart review of patients who underwent orbital decompression for thyroid eye disease (TED). Patient demographics, including age, gender, smoking history, preoperative exophthalmometry, clinical activity score (CAS), use of peribulbar and/or systemic steroids, and type of orbital decompression were reviewed.

Telemedicine Use by Oculoplastic Surgeons During the COVID-19 Pandemic.

Telemedicine use expanded dramatically during the COVID-19 pandemic, including to surgical fields that had limited prior adoption of telehealth such as oculoplastic surgery. To assess telemedicine usage patterns, barriers to implementation, and satisfaction with telemedicine, we conducted a survey among members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). We performed a Web-based, anonymous survey of ASOPRS members from November to December 2020.

The effect of visually significant dermatochalasis and blepharoptosis on driving safety.

Objective: To evaluate the impact of visually significant blepharoptosis and dermatochalasis on driving safety and performance. Patients with visually significant blepharoptosis often complain of difficulty with driving, but the impact of blepharoptosis on driving has not been evaluated in a real-world setting.

Methods: Retrospective cohort study of 610 consecutive adult patients undergoing bilateral functional blepharoplasty or ptosis repair surgery at a single, University-based practice between 2014 and 2017.

Simultaneous Orbital and Intracranial Abscesses in 17 Cases.

Purpose: To describe the demographics, clinical presentation, treatment, and outcomes of a rare cohort with simultaneous orbital and intracranial abscesses.

Methods: A historical cohort study of 17 patients with simultaneous orbital and intracranial abscesses between 2010 and 2018 was performed. The demographics, location of abscesses, treatment, and outcomes of these patients were analyzed.

Necrotizing myositis in a rectus muscle arising in the setting of long-standing Langerhans cell histiocystosis and recent dabrafenib treatment.

Purpose: to describe an unusual case of necrotizing myositis in a rectus muscle, possibly related to BRAF inhibitor therapy.

Observations: An 18-year old man with neurodegenerative Langerhans cell histiocytosis (LCH), recently started on the BRAF inhibitor dabrafenib, presented with right eye pain. Magnetic resonance imaging (MRI) orbits revealed a rectus muscle mass concerning for LCH recurrence or malignancy.

Two cases of epidemic keratoconjunctivitis-associated dacryocystitis.

This report presents two cases of epidemic keratoconjunctivitis (EKC)-associated dacryocystitis. Both patients presented with preseptal edema. Orbital computed tomography (CT) scans were performed out of concern for orbital cellulitis and revealed soft tissue edema involving the preseptal aspect of the eyelids and also the lacrimal sac.

Recurrent natural killer/T-cell lymphoma of the lacrimal sac and nasolacrimal duct in a 59-year-old Caucasian woman.

A 59-year-old Caucasian woman with past medical history significant for Natural Killer (NK)/T-cell lymphoma of the right nasal septum in remission for nine months presented after surveillance PET-CT imaging revealed increased metabolic activity in the right nasolacrimal duct. She also reported ipsilateral epiphora starting around this time. The lacrimal sac and nasolacrimal ductal mucosa were biopsied via an external approach.

Physical therapy for facial nerve palsy: applications for the physician.

Purpose Of Review: The aim of this study was to describe the current state of physical therapy for facial nerve palsy, the evidence basis for these interventions and how therapy can be integrated with other medical and surgical interventions for facial nerve palsy, as it applies to ophthalmologists, oculoplastic surgeons and other specialists.

Recent Findings: Many studies indicate that physical therapy is effective for the rehabilitation of patients with facial nerve palsy and can be used synergistically with interventions administered by physicians, such as targeted botulinum toxin injections. The field is limited by a relative paucity of high-quality randomized controlled trials.

Carbon footprint and cost-effectiveness of cataract surgery.

Purpose Of Review: This article raises awareness about the cost-effectiveness and carbon footprint of various cataract surgery techniques, comparing their relative carbon emissions and expenses: manual small-incision cataract surgery (MSICS), phacoemulsification, and femtosecond laser-assisted cataract surgery.

Recent Findings: As the most commonly performed surgical procedure worldwide, cataract surgery contributes significantly to global climate change. The carbon footprint of a single phacoemulsification cataract surgery is estimated to be comparable to that of a typical person's life for 1 week.

A Case Report: Consecutive Cranial Neuropathies Following the Use of Phosphodiesterase-5 Inhibitors.

We report a patient who suffered consecutive cranial neuropathies where each event was immediately preceded by the use of oral PDE-5 inhibitors. A discussion of the etiology of the events including possible interaction with other medications is included.

Comparing the Impact of Refractive and Nonrefractive Vision Loss on Functioning and Disability: The Salisbury Eye Evaluation.

Purpose: To compare the effects of uncorrected refractive error (URE) and nonrefractive visual impairment (VI) on performance and disability measures.

Design: Cross-sectional, population-based study.

Participants: A total of 2469 individuals with binocular presenting visual acuity (PVA) of ≥ 20/80 who participated in the first round of the Salisbury Eye Evaluation study.

Evaluation of real-world mobility in age-related macular degeneration.

Background: Previous research has suggested an association between poor vision and decreased mobility, including restricted levels of physical activity and travel away from home. We sought to determine the impact of age-related macular degeneration (AMD) on these measures of mobility.

Methods: Fifty-seven AMD patients with bilateral, or severe unilateral, visual impairment were compared to 59 controls with normal vision.

Reading ability and reading engagement in older adults with glaucoma.

Purpose: We evaluated the impact of glaucoma-related vision loss on reading ability and reading engagement in 10 reading activities.

Methods: A total of 63 glaucoma patients and 59 glaucoma suspect controls self-rated their level of reading difficulty for 10 reading items, and responses were analyzed using Rasch analysis to determine reading ability. Reading engagement was assessed by asking subjects to report the number of days per week they engaged in each reading activity.

Fear of falling in age-related macular degeneration.

Background: Prior studies have shown age-related macular degeneration (AMD) to be associated with falls. The purpose of this study is to determine if (AMD) and AMD-related vision loss are associated with fear of falling, an important and distinct outcome.

Methods: Sixty-five persons with AMD with evidence of vision loss in one or both eyes and 60 glaucoma suspects with normal vision completed the University of Illinois at Chicago Fear of Falling questionnaire.

Driving habits in older patients with central vision loss.

Objective: To determine if central visual loss is associated with driving cessation, driving restriction, or other-driver preference.

Design: Cross-sectional study.

Participants: Sixty-four subjects with bilateral visual loss (<20/32 in better eye) or severe unilateral visual loss (<20/200) from age-related macular degeneration (AMD) and 58 normally sighted controls between 60 and 80 years of age.

Impact of dry eye on reading in a population-based sample of the elderly: the Salisbury Eye Evaluation.

Background/aims: People with dry eye often complain of difficulty reading, but this perceived deficit has not been appropriately quantified. The purpose of this study is to determine if dry eye is associated with measurable reading deficits.

Methods: A cross-sectional study of 1981 participants in the Salisbury Eye Evaluation, a population-based study of the elderly.

Alteration of travel patterns with vision loss from glaucoma and macular degeneration.

Importance: The distance patients can travel outside the home influences how much of the world they can sample and to what extent they can live independently. Recent technological advances have allowed travel outside the home to be directly measured in patients' real-world routines.

Objective: To determine whether decreased visual acuity (VA) from age-related macular degeneration (AMD) and visual field (VF) loss from glaucoma are associated with restricted travel patterns in older adults.

Driving patterns in older adults with glaucoma.

Background: The ability to drive is important for ensuring quality of life for many older adults. Glaucoma is prevalent in this age group and may affect driving. The purpose of this study is to determine if glaucoma and glaucomatous visual field (VF) loss are associated with driving cessation, limitations, and deference to another driver in older adults.