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Squamous Cell Carcinoma of the Lacrimal Sac A patient presented to the emergency department for a history of tearing on the right eye and medial canthal mass. He had a history of chronic sinus pain for months, initial examination was notable for increased tear lake on the right eye, along with an i…

Conjunctival melanoma treated with I-125 brachytherapy.

This patient presented with 1 month of left eyelid swelling. MRI showed infiltration in the periorbital soft tissues. Absolute CD4 count was 27 and the diagnosis was made with immunohistochemistry positive for HHV8. The patient was started on HAART therapy, the local lesions were treated with nitro…

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…

Conjunctival Melanoma Two darkly pigmented patients with a diagnosis of conjunctival melanoma by an outside provider are presented here. Case 1 presented with a large jet black conjunctival lesion that was present for nearly 12 years. This lesion was biopsied by an outside provider and interpreted …

Metastatic Melanoma; Side Effect of Immune Checkpoint Inhibitor A patient with a history of recurrent metastatic conjunctival melanoma presented with a left upper lid orbital lesion and pigmented lesion in the medial fornix. The original conjunctival melanoma was originally excised in an outside ce…

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…

PAM and OSSN This case presents a 67-year-old gentleman who was referred for a pigmented lesion. The HR-OCT suggested that this was not simply a small area of PAM, but rather demonstrated an epithelial hyper-reflectivity and thickening with an abrupt change from normal to mildly thickened epitheliu…

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…

Adenoid Cystic Carcinoma A patient with past medical history of a previously resected lacrimal gland mass presented to the emergency room with worsening unilateral proptosis and eye pain with persistent new eversion of the upper eyelid for several days. Examination was significant for severe propto…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

Alveolar Rhabdomyosarcoma A patient presented to BPEI for evaluation of a left upper lid lesion present since birth with no improvement with conservative treatment. Examination revealed a firm, blue, red lesion involving the upper left eyelid and lower eyelid. MRI orbit imaging revealed extensive s…

Histopathology and radiographic images of rhabdomyosarcoma in a young infant.

Carcinoma Ex Pleomorphic Adenoma A 76-year-old female referred by primary care physician for right eye proptosis. The patient complained of diplopia for the last six months without associated pain or irritation. External exam was significant for proptosis of the right eye and hypoglobus. Visual acu…

Choroidal Metastasis Consistent with Renal Cell Primary A 57-year-old male presented to clinic with a one-week history of red line in his vision OS. The patient was noted to have a history of left nephrectomy for renal cell carcinoma that was diagnosed after a metastatic lesion was detected in the …

Chroroidal Osteoma is a rare benign tumor characterized by the presence of cancellous bone within the peripapillary choroid

Enophthalmos Due to Metastatic Orbital Breast Carcinoma A patient presented to the ER with subconjunctival hemorrhage but incidentally noted to have enophthalmos with mild extraocular movement restriction in the contralateral eye. Further history revealed breast cancer history that was treated 18 y…

Extranodal Marginal Zone Lymphoma 52-year-old male with Stage IV extranodal MALT lymphoma who initially presented with paranasal and perioribtal disease. He failed treatment with multiple chemotherapeutic agents and represented with decreased VA 20/40 and 20/80 thought to be due to diffuse choroida…

Granular Cell Tumor The patient presented to BPEI for evaluation of a two-week history of worsening diplopia. Examination revealed left unilateral proptosis. MRI orbit imaging revealed an intraorbital well-defined, well-circumscribed lesion arising at the level of the medial rectus. The patient und…

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 …