Bilateral Globe Research Articles

Traumatic Bilateral Globe and Optic Nerve Avulsion: Rare Case Report

Avulsion of optic nerve is a rare condition and vere serious injury We report a rare case report of bilateral optic nerve avulsion from severe trauma of orbit and face...

Visual acuity recovery due to anterior segment reconstruction after severe bilateral open globe injury – case report

Visual acuity recovery due to anterior segment reconstruction after severe bilateral open globe injury – case report

Fulminant Idiopathic Intracranial Hypertension and Venous Stasis Retinopathy Resulting in Severe Bilateral Visual Impairment

To report a complicated case of fulminant idiopathic intracranial hypertension and concomitant venous stasis retinopathy leading to postpapilledema optic atrophy. Case report. A 34-year-old morbidly obese woman with a history of idiopathic intracranial hypertension (IIH) presented with a 1-month history of bilateral vision loss, diplopia, and left eye pain after being lost to follow-up for 6 years. Fundus examination revealed florid papilledema with venous tortuosity bilaterally. Brain and orbit magnetic resonance imaging showed bilateral globe flattening, intraocular optic nerve swelling in both eyes, and no abnormality on magnetic resonance venography. After additional workup including lumbar puncture with an opening pressure of 55 cm H2O, a diagnosis of IIH was confirmed. Medical treatment with oral carbonic anhydrase inhibitors was initiated, followed by same-day bilateral optic nerve sheath decompression and ventriculoperitoneal shunt placement the following week. Fundus examination 2 months later revealed a persistent blood and thunder fundus suggestive of bilateral central retinal vein occlusions. Over the course of 6 months, both eyes displayed postpapilledema optic atrophy with light perception and hand motion vision in the right and left eyes, respectively. On Goldmann perimetry, the patient had vague limited isolated responses in both eyes to the largest target. Fulminant IIH can present with profoundly blinding complications recalcitrant to aggressive medical and surgical intervention. Central retinal vein occlusion is an uncommon blinding complication of IIH.

Histopathological analysis of retinopathy of prematurity after intravitreal bevacizumab

We report the case of a premature infant with end-organ failure who developed high-risk retinopathy of prematurity (ROP) bilaterally and was treated with intravitreal bevacizumab (IVB) injection therapy with regression noted on follow-up clinical examination. The infant died 3weeks after IVB injection therapy. Histopathological analysis was conducted on bilateral globes and revealed persistent preretinal vessels.

Parálisis del nervio abducens secundario a meningioma del canal de Dorello: Consideraciones anatómicas por resonancia magnética

La parálisis de los músculos oculomotores comprende una patología muy variada, producida por lesiones en varios niveles (desde la corteza cerebral hasta la placa neuromuscular) que debe ser estudiada de manera exhaustiva para poder encontrar la causa etiológica exacta y definir un manejo adecuado. La inervación motora del ojo humano es producida por los pares craneales III, IV y VI, que coordinan movimientos específicos del globo ocular hacia el objeto de atención del campo visual, permitiendo que las imágenes percibidas en la retina y transmitidas a través del nervio óptico se fusionen en una sola en la corteza visual cerebral. En este artículo, nos enfocaremos en la parálisis del nervio abducens, apoyándonos en un caso de una paciente de 50 años de edad, quien consultó por diplopía izquierda como único síntoma, y a quien se le diagnosticó un meningioma del canal de Dorello. Además haremos una correlación anatómica del VI par craneal, desde su origen hasta alcanzar el músculo recto lateral, su fisiología y el tipo de lesiones que lo pueden afectar, en especial los meningiomas, su comportamiento y las características en imágenes diagnósticas.

Verification of Embolic Channel Causing Blindness Following Filler Injection.

Ocular complications following cosmetic filler injections are serious situations. This study provided scientific evidence that filler in the facial and the superficial temporal arteries could enter into the orbits and the globes on both sides. We demonstrated the existence of an embolic channel connecting the arterial system of the face to the ophthalmic artery. After the removal of the ocular contents from both eyes, liquid dye was injected into the cannulated channel of the superficial temporal artery in six soft embalmed cadavers and different color dye was injected into the facial artery on both sides successively. The interior sclera was monitored for dye oozing from retrograde ophthalmic perfusion. Among all 12 globes, dye injections from the 12 superficial temporal arteries entered ipsilateral globes in three and the contralateral globe in two arteries. Dye from the facial artery was infused into five ipsilateral globes and in three contralateral globes. Dye injections of two facial arteries in the same cadaver resulted in bilateral globe staining but those of the superficial temporal arteries did not. Direct communications between the same and different arteries of the four cannulated arteries were evidenced by dye dripping from the cannulating needle hubs in 14 of 24 injected arteries. Compression of the orbital rim at the superior nasal corner retarded ocular infusion in 11 of 14 arterial injections. Under some specific conditions favoring embolism, persistent interarterial anastomoses between the face and the eye allowed filler emboli to flow into the globe causing ocular complications.

Lenz Micropthalmia Syndrome With Associated Orbital Cysts

An 8-year-old boy presented for oculoplastic evaluation of bilateral microphthalmia. He had multiple other congenital anomalies, including microcephaly, wide-spaced teeth, sloping shoulders, protruding ears, syndactyly, a posterior urethral valve, cystic dysplasia of the kidneys, and a bicuspid aortic valve. Taken together, these findings supported the diagnosis of Lenz microphthalmia syndrome. CT of the orbits revealed bilateral microphthalmic globes with associated colobomatous cysts. To the authors' knowledge, this is the first reported case of Lenz microphthalmia syndrome with associated orbital cysts.

Magnetic resonance imaging in pseudotumor cerebri: A case report

Idiopathic intracranial hypertension (IIH) is characterized by symptoms of raised intracranial tension (ICT) as headache and visual disturbances due to raised cerebrospinal fluid pressure, however without any ventricular enlargement or space occupying lesion. The characteristic findings include papilledema which is usually bilateral, however which may be unilateral or asymmetrical. We report a case of 35-year-old female patient who came with complaints of headache and diplopia. She underwent magnetic resonance imaging of the brain which showed changes in bilateral globes, optic nerves and sella, which were suggestive of increased ICT. The ventricles and basal cisterns were normal. No other abnormality was seen. The magnetic resonance venogram was also normal. Thus, we concluded the diagnosis of IIH. The patient underwent therapeutic lumbar puncture after which she showed significant improvement in symptoms.

Traumatic avulsion and bilateral eye loss: report of two cases

The optic nerve and the globes are resistant to mild to moderate trauma and bilateral avulsion of the eyes is rare with only a few cases reported in the literature. We report two cases of traumatic bilateral eye avulsion. The first case was secondary to a bear bite and was managed successfully, although the eyes were not salvageable whereas the second case which was due to physical assault expired due to associated severe head injury. Traumatic bilateral globe avulsion/loss is a rare complication of trauma. In developing countries like Nepal, poverty, forest encroachment activities, extensive deforestation, frequent domestic disturbances and lack of education are some of the circumstances that increase the probability of such visual injuries.

Bilateral Orbital Compartment Syndrome and Blindness After Cerebral Aneurysm Repair Surgery

A 56-year-old man who underwent surgical clipping of a cerebral aneurysm via a bifrontal craniotomy in a Jack-knife position complained of bilateral blindness immediately after surgery. Examinations 14 hours later revealed marked bilateral proptosis with eyelid edema and conjunctival chemosis. MRI demonstrated severe bilateral globe tenting with marked orbital tissue edema. Despite emergent lateral canthotomy and cantholysis, there was no visual recovery. This is a rare case of bilateral irreversible blindness after cerebrovascular surgery caused by orbital compartment syndrome and resulting in severe globe tenting and ocular ischemia. Attention to factors such as direct ocular pressure from skin flaps, congestion from head positioning, and adequate intraoperative eye protection and monitoring may reduce the risk of this complication or allow faster management when diagnosed.

The Novel Concurrence of Noonan Syndrome and Bilateral Duane-Like Synkinesis

A 9-year-old boy with Noonan syndrome was referred for evaluation of abnormal eye movements. Ocular motility examination revealed bilateral globe retraction with narrowing of the palpebral fissure in adduction and mild restriction of abduction consistent with a bilateral Duane-like synkinesis. This novel association expands the ocular phenotype of Noonan syndrome and may suggest a commonality in the pathogenesis of these two congenital malformation complexes.

Airbag injury and bilateral globe rupture

Airbag injury and bilateral globe rupture

Plasminogen activators in endometrial adenocarcinoma

We report a case with limited Wegener9s granulomatosis in which the eye findings were the initial and only evidence of the disease when the patient was first seen. The patient was unusual in that he developed bilateral combined choroidal and retinal detachments and severe necrotising scleritis, which led to bilateral globe perforations and loss of sight. We recommend a trial of cytotoxic agents in progressive ocular inflammatory diseases unresponsive to other medications before there is irreversible loss of vision.

Synthetic cataract teaching system for phacoemulsification

This paper describes a surgical training system for teaching and practicing the necessary skills to perform phacoemulsification, endocapsular phacoemulsification, and small incision intraocular lens insertion techniques. The surgical system includes head, bilateral globes, removable corneas, and replaceable synthetic cataracts of varying density. This synthetic system simulates ocular surgery more closely than previously used animal eyes and allows the surgeon to practice new techniques in laboratory courses and in the operating facility.