Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000476
Cassie Cameron, Jessica Y Tong, Sandy Patel, Dinesh Selva
{"title":"Cystic Lesions of the Orbit.","authors":"Cassie Cameron, Jessica Y Tong, Sandy Patel, Dinesh Selva","doi":"10.1097/IIO.0000000000000476","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000476","url":null,"abstract":"","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"101-135"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000454
Jiawei Zhao, Bita Esmaeli
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma.1 cSCC accounts for 5% to 10% of all eyelid cancers with an incidence rate estimated to be 1.37 per 100,000 individuals per year.2–4 Majority of patients with periorbital cSCC are older (60 years of age or older) and fair-skinned with significant sun exposure.3,5–7 Locally advanced cSCC in the periorbital region, when treated with current standard of care which is surgery followed by adjuvant radiotherapy (with or without concurrent chemotherapy) can lead to significant morbidity with poor cosmetic and functional outcome. An attempt for R0 resection (microscopically margin-negative resection) in such patients can be extensive, causing loss of lacrimal drainage apparatus and a significant distortion of the eyelid and orbit despite best efforts in reconstruction. Orbital exenteration is often required in locally advanced periorbital cases of cSCC. Orbital exenteration causes major functional impairment and aesthetic deformity, and is associated with substantial negative emotional and psychosocial impact.8–10 Highdose radiation therapy in the periorbital region is also associated with significant ocular toxicity, including dry eye syndrome, keratopathy, cataract, optic neuropathy, and radiation-induced retinopathy.11 Despite aggressive local treatments, the recurrence rate for locally advanced resectable cSCC of the head and neck region is up to 30% and can progress to death from disease in some patients.12,13 The 2-year diseasefree survival in locally advanced, resectable cSCC treated by current standard of care (surgery and adjuvant radiation) has been reported to be 78%.14
{"title":"Systemic Neoadjuvant Therapies for Treatment of Cutaneous Squamous Cell Carcinoma of the Periorbital Region.","authors":"Jiawei Zhao, Bita Esmaeli","doi":"10.1097/IIO.0000000000000454","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000454","url":null,"abstract":"Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma.1 cSCC accounts for 5% to 10% of all eyelid cancers with an incidence rate estimated to be 1.37 per 100,000 individuals per year.2–4 Majority of patients with periorbital cSCC are older (60 years of age or older) and fair-skinned with significant sun exposure.3,5–7 Locally advanced cSCC in the periorbital region, when treated with current standard of care which is surgery followed by adjuvant radiotherapy (with or without concurrent chemotherapy) can lead to significant morbidity with poor cosmetic and functional outcome. An attempt for R0 resection (microscopically margin-negative resection) in such patients can be extensive, causing loss of lacrimal drainage apparatus and a significant distortion of the eyelid and orbit despite best efforts in reconstruction. Orbital exenteration is often required in locally advanced periorbital cases of cSCC. Orbital exenteration causes major functional impairment and aesthetic deformity, and is associated with substantial negative emotional and psychosocial impact.8–10 Highdose radiation therapy in the periorbital region is also associated with significant ocular toxicity, including dry eye syndrome, keratopathy, cataract, optic neuropathy, and radiation-induced retinopathy.11 Despite aggressive local treatments, the recurrence rate for locally advanced resectable cSCC of the head and neck region is up to 30% and can progress to death from disease in some patients.12,13 The 2-year diseasefree survival in locally advanced, resectable cSCC treated by current standard of care (surgery and adjuvant radiation) has been reported to be 78%.14","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"35-46"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000460
Naif Alsulaiman, Shahad F AlTayash, Danah Y Alkadi, Adel H Alsuhaibani
The upper eyelid usually sets 1 to 2 mm below the upper corneal limbus. Upper eyelid retraction (UER) is defined as an abnormally elevated eyelid exposing the upper sclera in the resting position. This definition requires statistical knowledge of the normal population’s upper lid position distribution.1 Multiple causes can lead to UER with thyroid eye disease (TED) especially Graves’ ophthalmopathy being the most common causative disorder.2 Other causes include myogenic etiologies such as congenital UER and poststrabismus/ptosis surgeries, neurogenic causes such as Parinaud syndrome and Collier’s sign, and mechanistic factors such as cutaneous or conjunctival scaring, proptosis, and axial myopia.3,4 Proper patient assessment including comprehensive medical history and physical examination is crucial to deliver the most appropriate management plan and exclude causes of pseudo eyelid retraction such as proptosis and contralateral upper eyelid ptosis. Hence, accurate preoperative understanding and controlling the causative factors are of great value before proceeding to the operating theater. In the clinical settings, patients should be assessed for syndromic features, signs of previous trauma, cranial palsies, TED, conjunctival scaring, or neurological insults. The upper eyelid assessment is typically done using various methods as marginal reflex distance 1 (MRD1) which is normally 4 to 5 mm, palpebral fissure height, levator function, and the mid-pupil to upper lid margin distance.2 Moreover, other assessment tools such as Hertel exophthalmometer, orbicularis oculi function, lagophthalmos, bells phenomenon, corneal sensation, and preoperative
{"title":"The Art of Upper Eyelid Retraction Repair.","authors":"Naif Alsulaiman, Shahad F AlTayash, Danah Y Alkadi, Adel H Alsuhaibani","doi":"10.1097/IIO.0000000000000460","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000460","url":null,"abstract":"The upper eyelid usually sets 1 to 2 mm below the upper corneal limbus. Upper eyelid retraction (UER) is defined as an abnormally elevated eyelid exposing the upper sclera in the resting position. This definition requires statistical knowledge of the normal population’s upper lid position distribution.1 Multiple causes can lead to UER with thyroid eye disease (TED) especially Graves’ ophthalmopathy being the most common causative disorder.2 Other causes include myogenic etiologies such as congenital UER and poststrabismus/ptosis surgeries, neurogenic causes such as Parinaud syndrome and Collier’s sign, and mechanistic factors such as cutaneous or conjunctival scaring, proptosis, and axial myopia.3,4 Proper patient assessment including comprehensive medical history and physical examination is crucial to deliver the most appropriate management plan and exclude causes of pseudo eyelid retraction such as proptosis and contralateral upper eyelid ptosis. Hence, accurate preoperative understanding and controlling the causative factors are of great value before proceeding to the operating theater. In the clinical settings, patients should be assessed for syndromic features, signs of previous trauma, cranial palsies, TED, conjunctival scaring, or neurological insults. The upper eyelid assessment is typically done using various methods as marginal reflex distance 1 (MRD1) which is normally 4 to 5 mm, palpebral fissure height, levator function, and the mid-pupil to upper lid margin distance.2 Moreover, other assessment tools such as Hertel exophthalmometer, orbicularis oculi function, lagophthalmos, bells phenomenon, corneal sensation, and preoperative","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"59-73"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000453
Kenneth K H Lai, Matthew C W Lam, Hunter K L Yuen
{"title":"Review of Surgical Techniques in Evisceration.","authors":"Kenneth K H Lai, Matthew C W Lam, Hunter K L Yuen","doi":"10.1097/IIO.0000000000000453","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000453","url":null,"abstract":"","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"195-208"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000461
Carolina A Chiou, Thad W Vickery, Edith R Reshef, Benjamin S Bleier, Suzanne K Freitag
{"title":"Endonasal Endoscopic Approach to Orbital Tumors.","authors":"Carolina A Chiou, Thad W Vickery, Edith R Reshef, Benjamin S Bleier, Suzanne K Freitag","doi":"10.1097/IIO.0000000000000461","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000461","url":null,"abstract":"","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"249-262"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000459
Daphna Landau Prat, Dana Zvi, Ofira Zloto, Morris Hartstein, Yoav Vardizer, Guy J Ben Simon
Congenital anophthalmia may be caused by an early pathology in the gestational development of the optic vesicle. It can be further divided into “true” anophthalmia and “clinical” anophthalmia.1 “True” anophthalmia is a rare condition, defined as the complete absence of ocular tissue within the orbit and is typically associated with other severe intracranial disorders. The term “clinical” anophthalmia is more accurate for describing most situations with no clinically apparent eye (Figure 1). Although there may be no visible globe, there is, however, almost always some rudimentary ocular structure that can be observed on orbital imaging.2 The smaller the eye remnant, the more severely retarded the growth of the eyelids and orbit.1
{"title":"Acquired Anophthalmic Socket: Clinical Course and Treatment Options.","authors":"Daphna Landau Prat, Dana Zvi, Ofira Zloto, Morris Hartstein, Yoav Vardizer, Guy J Ben Simon","doi":"10.1097/IIO.0000000000000459","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000459","url":null,"abstract":"Congenital anophthalmia may be caused by an early pathology in the gestational development of the optic vesicle. It can be further divided into “true” anophthalmia and “clinical” anophthalmia.1 “True” anophthalmia is a rare condition, defined as the complete absence of ocular tissue within the orbit and is typically associated with other severe intracranial disorders. The term “clinical” anophthalmia is more accurate for describing most situations with no clinically apparent eye (Figure 1). Although there may be no visible globe, there is, however, almost always some rudimentary ocular structure that can be observed on orbital imaging.2 The smaller the eye remnant, the more severely retarded the growth of the eyelids and orbit.1","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"163-185"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000474
Camille Yvon, Bhupendra Patel, Raman Malhotra
Conjunctivochalasis (CCh) is an underdiagnosed and common condition characterized by redundant and loose conjunctival folds usually found in the inferior bulbar conjunctiva.1 The term, which originates from the Greek “chalasis,” meaning to slacken, was first coined by Hughes in 1942.2 CCh can cause a vast array of symptoms, ranging from mild discomfort, photosensitivity, epiphora to exposure keratopathy with subsequent visual loss in severe cases.3 It typically affects elderly patients and is often missed due to the broad spectrum of symptoms that can mimic other disorders. Management comprises a stepwise approach, ranging from topical lubricants to surgical intervention. Due to the high prevalence, there has been an increasing interest in the condition. We highlight the importance of diagnosis and management of CCh to improve patient outcomes and compare the different surgical techniques.
{"title":"Conjunctivochalasis.","authors":"Camille Yvon, Bhupendra Patel, Raman Malhotra","doi":"10.1097/IIO.0000000000000474","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000474","url":null,"abstract":"Conjunctivochalasis (CCh) is an underdiagnosed and common condition characterized by redundant and loose conjunctival folds usually found in the inferior bulbar conjunctiva.1 The term, which originates from the Greek “chalasis,” meaning to slacken, was first coined by Hughes in 1942.2 CCh can cause a vast array of symptoms, ranging from mild discomfort, photosensitivity, epiphora to exposure keratopathy with subsequent visual loss in severe cases.3 It typically affects elderly patients and is often missed due to the broad spectrum of symptoms that can mimic other disorders. Management comprises a stepwise approach, ranging from topical lubricants to surgical intervention. Due to the high prevalence, there has been an increasing interest in the condition. We highlight the importance of diagnosis and management of CCh to improve patient outcomes and compare the different surgical techniques.","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"209-223"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000456
Bolajoko A Adewara, Swati Singh
Glaucoma is one of the leading causes of irreversible blindness worldwide, and the control of elevated intraocular pressure (IOP) requires medical treatment utilizing antiglaucomamedications (AGMs) that are the first line of treatment.1,2 However, there are some unwanted or adverse side effects of these AGMs on the ocular adnexa. Such effects include the development of periocular dermatitis, prostaglandin-associated orbitopathy, and eyelid malpositions.3 The etiology of eyelid changes and the inciting or underlying predisposing factors are unknown. Most AGMs that are applied to the ocular surface contain preservatives; however, preservative-free formulations are also available, and progressive ocular surface cicatricial changes have been observed after the use of preservative-free AGMs as well.4–6 In a few cases, extensive changes such as drug-induced cicatrizing conjunctivitis can simulate mucous membrane pemphigoid, which is visually debilitating and can be associated with trichiasis and cicatricial entropion.4 Clinicians need to be aware of these side effects because studies have shown that such side effects could negatively impact drug adherence and/or compliance.7 However, these side effects can be reversed by discontinuing the offending drug and changing to another class of drug, using preservative-free formulations, or switching to laser or surgical treatments, if detected early.8–10 This review summarizes the current knowledge about eyelid changes that develop secondary to chronic AGM use, excluding the effects on the ocular surface.
{"title":"Ocular Adnexal Changes After Antiglaucoma Medication Use.","authors":"Bolajoko A Adewara, Swati Singh","doi":"10.1097/IIO.0000000000000456","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000456","url":null,"abstract":"Glaucoma is one of the leading causes of irreversible blindness worldwide, and the control of elevated intraocular pressure (IOP) requires medical treatment utilizing antiglaucomamedications (AGMs) that are the first line of treatment.1,2 However, there are some unwanted or adverse side effects of these AGMs on the ocular adnexa. Such effects include the development of periocular dermatitis, prostaglandin-associated orbitopathy, and eyelid malpositions.3 The etiology of eyelid changes and the inciting or underlying predisposing factors are unknown. Most AGMs that are applied to the ocular surface contain preservatives; however, preservative-free formulations are also available, and progressive ocular surface cicatricial changes have been observed after the use of preservative-free AGMs as well.4–6 In a few cases, extensive changes such as drug-induced cicatrizing conjunctivitis can simulate mucous membrane pemphigoid, which is visually debilitating and can be associated with trichiasis and cicatricial entropion.4 Clinicians need to be aware of these side effects because studies have shown that such side effects could negatively impact drug adherence and/or compliance.7 However, these side effects can be reversed by discontinuing the offending drug and changing to another class of drug, using preservative-free formulations, or switching to laser or surgical treatments, if detected early.8–10 This review summarizes the current knowledge about eyelid changes that develop secondary to chronic AGM use, excluding the effects on the ocular surface.","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"47-58"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/IIO.0000000000000457
Hatem A Tawfik, Jonathan J Dutton
{"title":"Facial Nerve Palsy and the Eye: Etiology, Diagnosis, and Management.","authors":"Hatem A Tawfik, Jonathan J Dutton","doi":"10.1097/IIO.0000000000000457","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000457","url":null,"abstract":"","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"63 3","pages":"75-94"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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