A simple saccadic reading test to assess ocular motor function in cerebellar ataxia.

Cerebellar ataxia is a neurological disorder due to dysfunction of the cerebellum that affects coordination of fine movement, gait, and balance. Although ataxic patients commonly exhibit abnormal eye movement and have difficulties with saccadic reading, quantification of ocular motor abilities during reading in the clinical setting is rarely done. In this study, we assess visual performance with simple reading tests that can be used in the clinical setting and performed video infrared oculography in 11 patients with hereditary or acquired cerebellar ataxia and 11 age-matched controls.

Long-term management of orbital and systemic reactive lymphoid hyperplasia with rituximab.

Rituximab, a monoclonal antibody to the B cell marker CD20, is becoming increasingly popular in the treatment of various orbital disorders. In this university-based interventional case series, we describe two patients with bilateral orbital and extra-orbital reactive lymphoid hyperplasia (RLH) treated with rituximab. Initially both had favorable responses; but roughly a year later recurrent disease necessitated maintenance therapy in both cases.

Comparison of Humphrey Matrix frequency doubling technology to standard automated perimetry in neuro-ophthalmic disease.

Purpose: We compared Humphrey Matrix FDT 30-2 (FDT) and Humphrey Visual Field Analyzer 30-2 SITA standard (SAP) in the assessment of anterior (optic nerve or chiasm) and posterior (retro-chiasmal) afferent visual pathway defects.

Materials And Methods: In this retrospective comparative study, the charts of 37 patients (16 males, range 13-84 years, mean 72.1), with neuro-ophthalmic visual field defects who were tested with both FDT and SAP, were reviewed.

Evisceration in the modern age.

Evisceration is an ophthalmic surgery that removes the internal contents of the eye followed usually by placement of an orbital implant to replace the lost ocular volume. Unlike enucleation, which involves removal of the entire eye, evisceration potentially causes exposure of uveal antigens; therefore, historically there has been a concern about sympathetic ophthalmic (SO) associated with evisceration. However, critical review of the literature shows that SO occurs very rarely, if ever, as a consequence of evisceration.

Sunken eyes, sagging brain syndrome: bilateral enophthalmos from chronic intracranial hypotension.

Purpose: To explain the mechanism for acquired enophthalmos after ventriculoperitoneal shunting (VPS).

Design: Case series and a case-control study.

Participants And Controls: Four study patients with bilateral enophthalmos after VPS and 10 control subjects.

Giant cell arteritis in Asians: a comparative study.

Background: Giant cell arteritis (GCA) is a common systemic vasculitis, with a presumed Caucasian predominance. The occurrence of GCA in Asians has rarely been addressed. This study aims to assess the incidence of giant cell arteritis in Asians.

Acquired enophthalmos in lupus erythematosus profundus.

Lupus erythematosus profundus (LEP) is an uncommon subtype of lupus erythematosus. A 76-year old man presented with inflammation of the eyelids and underlying orbital soft tissue. A biopsy disclosed inflammation and atrophy of the orbital fat consistent with LEP.

Acquired pediatric blepharoptosis related to linear scleroderma.

Periocular linear scleroderma coup de sabre has been seen in association with blepharoptosis. The authors describe a 4-year-old girl who developed left blepharoptosis simultaneously with a remote scalp lesion consistent with linear scleroderma coup de sabre. This case is unique in that the scalp lesion was distant from the affected eye.

Adult orbital trapdoor fracture.

Trapdoor fractures occur almost exclusively in the pediatric population. The authors describe an adult with an entrapped inferior rectus muscle sheath in a trapdoor fracture. A 37-year-old man presented with persistent diplopia 3 weeks after blunt right orbital trauma.

Blindness from orbital varices: case report.

A 41-year-old woman presented with a 21-year history of a left orbital mass. She reported 3 distinct episodes of sudden proptosis, periorbital bruising, pain, nausea and vomiting with resulting stepwise deterioration in her vision. Her symptoms resolved spontaneously over several days, with the exception of loss in vision, which persisted.

Marsupialization of orbital conjunctival inclusion cysts related to strabismus surgery.

A 52-year-old woman presented with a giant conjunctival cyst related to strabismus surgery that was adjacent to the medial rectus muscle. Management consisted of excision of the anterior cyst wall with suturing of the remaining cyst lining to overlying conjunctiva. Following marsupialization, the cyst did not recur with persistence of the conjunctival drainage site.

Amyloidosis-associated neurotrophic keratopathy precipitated by overcorrected blepharoptosis.

Purpose: To describe amyloidosis-associated neurotrophic keratopathy.

Methods: In this interventional case report, we describe the clinical findings of a patient with amyloidosis-associated neurotrophic keratopathy, precipitated by exposure from overcorrected blepharoptosis.

Results: A 70-year-old woman with a history of amyloidosis was referred with bilateral eyelid retraction 1 month after levator aponeurosis advancement surgery.

Hypotony maculopathy after eyelid massage for overcorrected blepharoptosis.

A 57-year-old woman with a history of left eye trabeculectomy was evaluated for gradual ipsilateral visual loss. Several months prior, she had undergone levator advancement of the left upper eyelid. For management of resulting retraction, she was instructed to "massage" her eyelid.

Posterior retinal breaks as a cause of vitreous hemorrhage in diabetes.

Purpose: To describe posterior retinal breaks as a cause of vitreous hemorrhage in diabetic patients.

Methods: In two institutional practices, six posterior retinal breaks were identified in five eyes of five diabetic patients with vitreous hemorrhage. All eyes underwent fundus photography and fluorescein angiography.

Interactive image-guided endoscopic dacryocystorhinostomy.

The authors describe dacryocystorhinostomy performed with CT guidance. A 53-year-old man with a history of cocaine abuse was referred for bilateral nasolacrimal duct obstruction. Nasal speculum examination revealed an oronasal fistula and obliteration of the inferior nasal septum.

Delusions of parasitosis of the eyelids.

The authors describe preseptal cellulitis and corneal ulceration due to secondary infection of self- inflicted wounds in a patient with delusions of parasitosis. A 42-year-old man presented with a 3-day history of progressive painful, purulent, periocular erythema. He reported that "little black bugs and whitish eggs" had infiltrated his body including the left eye and eyelids.

Levator superioris muscle function in involutional blepharoptosis.

Purpose: To assess the role of muscular degeneration, we evaluated the correlation between ptosis severity and levator muscle function.

Design: Retrospective cohort study.

Methods: The medical records of 136 patients (53 men and 83 women; mean age, 67 years) with acquired blepharoptosis were reviewed for levator function (LF), margin reflex distance (MRD), age, and gender.