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Orthokeratology Lens Related Keratitis A myopic patient with daily orthokeratology lens use presented for eye pain and decrease in vision of both eyes for one week. Patient had no changes in his normal use of lenses. On examination, patient demonstrated findings concerning for an infectious keratit…

Orbital Venous Lymphatic Malformation A 2-year-old previously healthy female presented with 2 days of sudden onset left lid swelling immediately following an episode of vomiting. She was found on exam to have ptosis, mild proptosis, and left upper lid edema, induration, and fullness. MRI of the orb…

Orbital Venous Lymphatic Malformation A patient presented to the ER complaining of 2 days of increasing pain and swelling behind the left eye. Of note the patient reported that as a teenager he was previously treated for an orbital tumor. On exam he was found to have massive proptosis, hyperglobus …

Orbital Sarcoidosis A patient presented with three months of left eye swelling and pain. He was found to have periorbital firmness and fullness, proptosis, and conjunctival chemosis. He underwent computed tomography imaging of the orbits with contrast, which demonstrated an ill-defined, irregular a…

Orbital Rhabdomyosarcoma - Recurrence A young patient with notable past ocular history of orbital rhabdomyosarcoma, s/p chemotherapy with vincristine, dactinomycin, and cyclophosphamide, and proton beam radiation presented to Bascom Palmer ED with 2 days of blurry vision and “seeing everything gr…

Orbital Necrotizing Fasciitis A patient found down by EMS with left orbital swelling for 2 days after he was unable to take his medications due to a recent illness. He was admitted to a hospital and treated for diabetic ketoacidosis, Group A Streptococcus sepsis and left orbital infection before pr…

Orbital Metastatic Breast Cancer A patient presented to the ER with redness of the right eye for months. Initial exam revealed VA 20/50 and was noted to have right sided ptosis and ophthalmoplegia. MRI of the orbits was performed which showed an ill-defined right orbital mass. The patient underwent…

Orbital Lympathic Dominant Lymphatic Venous Malformation A patient with a past ocular history of orbital lymphatic-venous malformation with left upper eyelid swelling and proptosis at childhood who underwent sclerosing therapy presents 7 years later with newly developed left upper eyelid swelling, …

Orbital Cysts An elderly patient presented with two years of chronic pain in an otherwise healthy-appearing anophthalmic socket after enucleation. CT orbits was obtained which showed two hyperdense cystic lesions superior and posterior to the orbital implant. Orbital exploration was performed, the …

An elderly patient with anophthalmic socket pain underwent orbital exploration. Intra-operative photo shows a large cystic lesion superior to her orbital implant. Close up photograph of the cyst shows a 1-mm intact cystic lesion filled with gray opaque fluid.

Orbital Cellulitis, Cavernous Sinus Thrombosis, Pyomyositis of Extraocular Muscle, Bacteremia A 17-year-old female with no significant PMH presented to the BPEI Emergency Room with a red, swollen left eye for two days in the setting of recent lower lid lesion that the patient believed was a chalazi…

Optic Nerve Pit Optic nerve anomalies are rare entities with a variety of clinical presentations. They can be classified according to anomalies of disc size, disc conformation, or by the presence of abnormal tissue on the optic nerve head, or pseudoswelling. Here, we present a child with an inciden…

Optic nerve cyst (first image) that over time revealed an optic nerve coloboma (second image).

Increased cup to disc ratio at > 0.9 with some peripapillary atrophy.

Optic Disc Drusen with Structural and Functional Changes A young child presented with crossing of the eyes without headaches or associated neurologic symptoms. Visual acuity was OD 20/30 and OS 20/40. Motility examination demonstrated moderate angle esotropia with full versions. Intraocular pressur…

A presumed moth setae was identified in the anterior vitreous cavity of a patient with uveitis following ocular trauma by a flying insect. The multifocal keratitis and vitreous opacities improved following two weeks of high-dose oral prednisone.

Ophthalmia Nodosa A patient presented to the Bascom Palmer Eye Institute retina/uveitis clinic with 2 months of right eye irritation and floaters. He reported being hit in the right eye by a large flying insect while working on a cruise ship in the Bahamas immediately prior to the onset of symptoms…

In this module, we will look at:


Eyelids

Tear Drainage System

Orbit