Ophthalmic Plastic and Reconstructive Surgery

Active thyroid eye disease with pretibial myxedema A patient with a 10-year history of hyperthyroidism treated with levothyroxine and liothyronine developed one month of intermittent double vision, redness, and foreign body sensation. His exam was notable for vision 20/20 in the right eye and 20/30…

Sebaceous Cell Carcinoma A patient presents to the Bascom Palmer emergency room with complaints of bloody tearing. Exam demonstrates a large, erythematous epithelial mass on the left upper eyelid palpebral surface. Biopsy of the lesion demonstrates a poorly differentiated carcinoma demonstrating po…

[Diagnosis] An infant with history of preterm birth presented to the Bascom Palmer emergency room with a rapidly progressive left upper lid mass. Evaluation showed non-axial proptosis and a large superonasal, vascular mass deep in the left orbital rim. MRI brain and orbits with and without contrast…

Kabuki Syndrome Associated Euryblepharon and Ptosis Repair with Post Operative Hematoma A teenager with a history of Kabuki Syndrome presents to the ophthalmology clinic for evaluation of bilateral ptosis and eye rubbing, and epiphora. Best corrected visual acuity is 20/40 bilaterally, intraocular …

Presumed Rhino-Orbital Mucormycosis A patient with a past medical history of PCOS and type 2 diabetes mellitus presented to an outside hospital six weeks pregnant with right sided facial pain and periorbital swelling. Ophthalmology was consulted for sudden, progressive vision loss in the right eye.…

Sub-Periosteal Abscess A pediatric patient presented as a transfer from OSH with orbital cellulitis secondary to a superior located sub-periosteal abscess (SPA). The patient has a history of acute on chronic sinusitis and had FESS with sinus debridement and abscess drainage 5 days prior to arrival.…

Intraorbital Foreign Body A patient presented with right eye redness, swelling, and diplopia for 6 weeks after a dirt bike accident, where his right eye hit a tree branch. He underwent imaging and evaluation at an outside institution which revealed orbital fractures, but no evidence of an orbital f…

Intraosseous Hemangioma An otherwise healthy patient presented to the Emergency Room for evaluation of a left orbital rim lesion, found incidentally by an eyebrow technician. On exam, there was a firm bony mass along the superior orbital rim. Eye exam was otherwise unremarkable. CT scan of the orbi…

Closed-Globe Ocular Trauma An 18-year-old female presents to BPEI ER after sustaining injuries to the eye from a motor vehicle accident. The patient was diagnosed with a closed-globe injury and had subsequent traumatic angle-recession glaucoma, vitreous prolapse, and traumatic cataract. She also ha…

Conjunctival SCC A patient presented to the emergency department with a right eye conjunctival mass. Examination showed a large mass, emanating from the conjunctiva. CT scan showed inferior orbital involvement. Surgical treatment via exenteration was carried out, using a lid sparing technique, prov…

Cutaneous Melanoma Metastatic to the Orbit A patient with a past medical history of Stage IIA cutaneous melanoma, treated with wide local excision and radiation therapy, presented after 12 years of remission with proptosis, pain, diplopia, and decreased vision, unresponsive to antibiotic therapy. S…

A unique way to provide cosmesis.

External Ophthalmomyiasis due to Dermatobia Hominis A child presented with right eye swelling for five days refractory to systemic antibiotics. On examination, he had significant periorbital edema, erythema, injection, a chemosis. At the lateral canthus, a small scab with skin defect was visualized…

Extranodal Rosai-Dorfman Disease A 28-year-old male without past medical history presented with a 1 year history of painless bilateral upper lid swelling. After multimodal imaging studies, the patient underwent diagnostic orbital biopsy. The pathologic analysis of the biopsy showed a plasmacytic in…

Hydrolyzed MIRAgel Scleral Buckle A patient presented with one year of gradually worsening left eye pain and binocular diplopia. He had a history of remote retinal detachment repair in 1988 and prostate cancer in 2019 s/p radiation therapy in remission. In the left eye, he had limitations to gaze i…

Idiopathic Orbital Inflammation A 47-year-old woman with a past medical history of Grave’s disease complicated by thyroid associated ophthalmopathy presents with left eye pain, swelling, and diplopia worsening for 3 months. Exam reveals left-sided periorbital edema, proptosis, and extraocular mot…

Infantile Hemangioma A 17-month-old girl presented with her mother for evaluation of birthmarks that appeared shortly after birth. The patient was born at 38 weeks gestation weighing 7.2 lb. via C-section. Examination disclosed multiple confluent hemangiomas involving the right cheek, upper and low…

Intraorbital Foreign Body Intraorbital foreign bodies most commonly present with an ocular or penetrating injury. However, when the globe is not involved, the presentation of an intraorbital foreign body can be subtle. Here, we present a case of a 21-year-old female with right upper and lower lid s…

Intraorbital Wooden Foreign Body A 63-year-old male with a history of decreased extraocular motility, binocular diplopia and proptosis presenting to the ED after trauma with a palm tree branch a few days before presentation. The patient presents 6 days after trauma with a tree branch. He had a 360-…

Slit lamp photo post trauma with bungee cord. There was 5 clock hours of iridodialysis superior nasally with inferior crystalline lens subluxation seen on retroillumination. Post-surgical iris repair and lensectomy the anatomy is restored.