Eye Socket Research Articles

Character evolution in the orbital region of the Afrotheria

AbstractThe orbit or eye socket is a highly plastic area of the mammalian skull. There is significant variation within and between the different mammalian orders in the size and position of the bones and foramina that contribute to this region. For this reason, orbital characters are often used in attempts to determine the relationships of the various mammalian groups. This study describes the orbital region of the Afrotheria, the proposed group of endemic African mammals that comprises the paenungulates (elephants, manatees and dugongs, and hyraxes), elephant‐shrews, aardvarks, golden moles and tenrecs. Evolution within the Afrotherian orbit is then explored by scoring 19 orbital characters in each Afrotherian genus, and plotting the character state changes on to previously existing phylogenies of the Afrotheria. These phylogenies were all produced from recent molecular work. It was found that there is a great deal of variation in the orbital region within the Afrotheria, most notably in the size of the lacrimal and its contacts with other bones, the appearance of the palatine in the orbit and the structure of the zygomatic arch. Overall, orbital characters strongly supported an elephant‐hyrax clade over the more traditional grouping of elephants and sirenians (Tethytheria) within the paenungulates. There was also support for a monophyletic Tenrecoidea (a clade of tenrecs plus golden moles). Additionally, it was shown that there is a great deal of variation in the orbital region among the genera of the Tenrecidae and the Macroscelididae.

Vision loss after spine surgery: a new hypothesis

To the Editor: As new reports concerning vision loss after spine surgery continue to be published,1,2 it is crucial to explore possible mechanisms. The incidence of vision loss after noncardiac surgery is 0.0008%,3 while it is 0.2% following spine surgery,4 with the causes usually taken to be anemia or hypotension.5 We hypothesize a possible additional mechanism: that the use of large amounts of crystalloids in such cases can lead to an accumulation of edema in the eye socket with the production of an “eye compartment syndrome”. Presumably, increased eye socket pressure in this setting can lead to ischemia of the optic nerve, especially in the posterior segment having a single blood supply derived from the ophthalmic artery.6,7 Our hypothesis is supported by the frequent observation of facial edema and chemosis in long spine cases carried out in the prone position, as well as by occasional cases of blindness after bilateral neck dissection where the internal jugular veins have been sacrificed.8 Here, the loss of vision is attributed to back pressure from the distended ophthalmic veins, leading to ischemic neuropathy. Experience suggests that prone positioning for spine surgery may play a particularly important role. We recommend that, where possible, prone patients should be positioned so that their heads are higher than the heart, and that any position that might impair venous drainage of the head be avoided. In addition, anything that might lead to direct pressure on the orbit must be carefully prevented. We believe that eye compartment syndrome as a cause of blindness should be considered in any prone spine case managed with extensive use of crystalloids and where anemia and hypotension have been excluded. We also speculate that the use of colloids for spine cases in the prone position may offer the potential to reduce eye socket edema and subsequent vision loss.

Elevated fluctuating asymmetry in eastern mosquitofish (Gambusia holbrooki) from a river receiving paper mill effluent

The present study investigated whether fluctuating asymmetry can serve as a useful biomarker of environmental stress in the eastern mosquitofish (Gambusia holbrooki). Fluctuating asymmetry was measured in sexually mature females sampled from two Florida, USA, coastal streams: The Fenholloway River, which is dominated by effluent from a paper mill, and Spring Creek, a tributary to the Fenholloway River (Taylor County, FL, USA) that does not receive paper mill effluent. Nine morphometric (lengths of the A and B scales, fifth pectoral fin ray, supraorbital canal, and preorbital canal and the sixth gill raker on the first brachial arch; orbit diameter; distance from the dorsal-ventral midpoint of the eye socket to the base of the pectoral fin; and distance from the postorbital canal to the operculum) and five meristic traits (numbers of scales in the lateral line, radii on the A and B scales, pectoral fin rays, and gill rakers on the first brachial arch) were included. For each of the three indexes of fluctuating asymmetry that were used, the majority of the traits showed a higher level of fluctuating asymmetry in fish from the Fenholloway River than in fish from Spring Creek. For two of the indexes, the difference was significant. Comparisons of mean values for fluctuating asymmetry (over all traits) for each fish and the means of a composite index of asymmetry both indicated that fish from the Fenholloway River had significantly greater overall fluctuating asymmetry than those from Spring Creek. Results of the present study are consistent with the hypothesis that environmental stress increased the level of fluctuating asymmetry in fish from the Fenholloway River. Thus, fluctuating asymmetry appears to be a useful biomarker for stress-induced developmental instability in the eastern mosquitofish.

Reconstruction of the anophthalmic orbit by orbital osteotomy and free flap transfer

It is challenging to perform an adequate reconstruction of the post enucleation irradiated orbit of patients with rentinoblastoma. Rebuilding of the orbital structure, reconstruction of the eye socket and restoration of periorbital volume are required. We reviewed 12 patients with hypoplastic orbital deformities, who have undergone orbital osteotomy and free flap transfer. Reconstruction of the orbital cavity was achieved using 'C' osteotomy of the lateral portion of the orbit in mild and moderate cases or transverse 'U' osteotomy of lateral wall, roof, and floor by intra-cranial approach in severe cases. Socket reconstruction and periorbital volume restoration was achieved using dorsalis pedis free flap transfer. From our experience the combination of orbital osteotomy and free flap transfer could meet the multi-requirements for the anophthalmic orbital reconstruction, including both orbital bony enlargement and soft tissue restoration.

Post-Traumatic Reconstruction of the Enucleated Contracted Eye Socket

Contracted eye socket is a constant cosmetic embarrassment to the patient. It does not only render patients unable to maintain eye prosthesis, but it becomes a source of chronic discharge and irritation. Traumatic injuries to the orbit and neighboring soft tissue lead to a contracted eye socket. To evaluate the use of full thickness and thick split thickness skin graft in the reconstruction of contracted eye socket with achieving satisfactory cosmetic results we used bilateral fish tail incision in continuity with the transverse incision on the back of the eye socket for rising of two unipedicle hinge flaps for creation of upper and lower fornices. Fixation of full-thickness and thick split-thickness skin graft to the created raw area by stitch and splint (non-adherent tulle and eye prosthesis).Twenty-six patients with contracted eye sockets treated with above method from February, 2004 to March, 2005. Eye sockets with adequate size were created in 22 patients and the results were satisfactory, four patients had unsatisfactory results due to partial loss of the full thickness skin graft. We believe that thick split thickness skin graft can be effectively used well than full thickness skin graft in the reconstruction of the contracted eye socket with uncomplicated problems.

Preliminary findings on the paleomicrobiological study of 400 naturally mummified human remains from Upper Nubia

We present 400 mummies excavated from two early Christian burial sites at Kulubnarti, between the 2nd and 3rd cataracts of the Nile in Northern Sudan, prior to the flooding caused by the Aswan Dam. One site was on an island in the Nile dated from 550-750 AD. The other was on the Nile western bank and was in use from c.750-1500 AD. Due to the exceptionally dry climate many of the remains were naturally mummified. Analysis of diet, via chemical examination of hair and of coprolites, had indicated possible deficiencies in vitamins B6, B12, folacin and vitamin C, suggesting iron deficiency. The presence of criba orbitalia, a pathological lesion of the roof of the eye socket (orbit), also suggests iron deficiency anaemia but may also be caused by inflammation. Anaemia is found in several infectious diseases, and severe iron deficiency increases susceptibility to disease. Tuberculosis was widespread in ancient and Roman Egypt, and there was historical contact with Upper Nubia via the Nile. The presence of Acacia pollen in coprolites suggested the possibility of leishmaniasis, as these trees are the habitat of the sand fly vector of the protozoan pathogen. The area is known today for the many infectious diseases afflicting its inhabitants, but were these present in antiquity? We have, therefore, undertaken a study of diseases in Kulubnarti. Initially we looked for evidence of tuberculosis and leishmaniasis. We anticipate shortly broadening the search to include brucellosis, malaria, hepatitis and West Nile fever viruses. Schistosomasis was considered but at this level the Nile flows swiftly and the intermediate host snail is not present so was at present not ocnsidered. Ribs were examined for Mycobacterium tuberculosis DNA, using nested PCR targeting a123 bp sequence on the repetitive element IS6110. Material from the heads of the long bones, possible bone marrow, was examined for Leishmania species using a PCR which amplifies a 119 bp-conserved region of the minicircle kinetoplast DNA. Initial results indicate that M. tuberculosis and Leishmania sp were present in both populations.

Reconstruction of the Anophthalmic Orbit by Orbital Osteotomy and Free Flap Transfer

It is a challenging problem for the plastic surgeon to perform adequate reconstruction of the postenucleation and radiated orbit of patient with retinoblastoma. Rebuilding of the orbital structure, reconstruction of the eye socket, and restoration of periorbital volume are required in this kind of orbital reconstruction. In this study, we reviewed 12 patients with hypoplastic orbital deformities who underwent orbital osteotomy and free flap transfer. Reconstruction of the orbital cavity was achieved using "C" osteotomy of the lateral portion of the orbit in mild and moderate cases or transverse "U" osteotomy of the lateral wall, roof, and floor by an intracranial approach in a portion of severe cases. Socket reconstruction and periorbital volume restoration was achieved using dorsalis pedis free flap transfer by microsurgery. What we concluded from our experience was that the combination of orbital osteotomy and free flap transfer could meet the multirequirements for anophthalmic orbital reconstruction, including both orbital bony enlargement and soft tissue restoration.

Reconstruction of Contracted Eye Socket With Amniotic Membrane Graft

To investigate the use of amniotic membrane graft for socket reconstruction in cases in which forniceal shortening by scar or symblepharon formation has made it difficult to successfully wear an ocular prosthesis. A retrospective analysis of 20 contracted eye sockets that underwent forniceal reconstruction with amniotic membrane graft from 1997 to 2001. There were 8 male and 12 female patients, with an age range between 2 and 66 years. Duration of forniceal shortening varied from 2 months to 48 years. The operation was performed in the lower fornix in 13 eyes, upper fornix in 1 eye, and both fornices in 6 eyes. The mean follow-up period was 13.6 months. Eighty percent of cases achieved successful prosthetic fitting after surgery. Four eyes had recurrent forniceal shortening after surgery in which a prosthesis could not be properly fitted. There were no serious complications, such as infection or graft rejection. The use of amniotic membrane grafts can be a useful option in forniceal reconstruction with a high success rate, a low rate of complications, and without discomfort of donor sites.

Teratogenic effects in rabbits of simultaneous exposure to ochratoxin A and aflatoxin B 1 with special reference to microscopic effects

To elucidate the teratogenic effects, ochratoxin A (OTA) and aflatoxin B 1 (AFB 1) were dissolved in corn oil and administered in combination to New Zealand White rabbits during 6–18 days of gestation orally with the dose levels of OTA + AFB 1, 0.05 + 0.05 and 0.1 + 0.1 mg/kg body weight. To assess pathomorphological features of the anomalies, the fetal serial sections were histologically examined. There was no mortality in any of the treated groups. Body weights and body weight gains of dams in the combined treatment groups were comparable with those of controls and individual treatments. The mean crown to rump lengths in both the combination dose groups and mean fetal weights in high dose combination group were significantly decreased. In the high dose combination, there was increase in the percent of implants resorbed and significant increase in the incidence of visceral anomalies. The combination treatment resulted in various gross, skeletal and visceral anomalies such as wrist drop, scoliosis, bent metacarpals, rudimentary ribs, cardiac defects and microphthalmia. There was a dose-related increase in the percent of litters showing the histopathological changes in the fetal tissues. The incidence of histopathological changes in the tissue sections prepared from fetal liver, kidneys, brain, heart and eyes was found increased in the high dose combination group. The comparative evaluation of the results of combination versus individual treatments revealed that certain anomalies observed in the individual treatment of OTA such as knuckling of fetlock, rudimentary tail or agenesis of tail, wavy ribs, hydrocephalus and agenesis of kidney and AFB 1 as enlarged eye sockets and enlarged liver were absent in the combination treatment. However, some new manifestations such as cardiac defects and scoliosis were seen. The results of the present study indicated that in combination, OTA and AFB 1 have antagonistic interaction. The presence of subtle lesions histologically due to an interference with normal development suggested that microscopic examination of the fetal tissues could provide additional, useful information to a developmental toxicity study.

Conjunctival fornix small incision to remove the lipid in lower eye pouch

目的 探讨穹隆部结膜小切口下睑眼袋整形术的优缺点.方法:局麻下,于下穹隆部结膜2mm切口入路,去除眶隔脂肪,切口毋需缝合.结果:本组28例术后随访,除2例效果不甚明显(未要求二次手术),余效果均良好.结论:穹隆部结膜小切口行下睑眼袋整形术效果确切.适用于眼袋为单纯局部组织膨出不伴皮肤松弛者。

Bilateral orbital cellulitis due to Neisseria gonorrhoeae and Staphylococcus aureus: a previously unreported case

Cellulitis of the orbit is a common cause of proptosis in children, and also frequently arises in the elderly and the immunocompromised. The condition is characterized by infection and swelling of the soft tissues lining the eye socket, pushing the eye ball outwards and causing severe pain, redness, discharge of pus and some degree of blurred vision. There is a small risk of infection spreading to the meninges of the brain and causing meningitis. This paper reports the case of an adult in whom polymicrobial bilateral orbital cellulitis had developed due to Staphylococcus aureus and Neisseria gonorrhoeae infection. N. gonorrhoeae infections are acquired by sexual contact. Although the infection may disseminate to a variety of tissues, it usually affects the mucous membranes of the urethra in males and the endocervix and urethra in females. To the authors' knowledge this is the first report of polymicrobial bilateral orbital cellulitis due to S. aureus and N. gonorrhoeae in medical literature.

Effects of aflatoxin B 1 on embryo fetal development in rabbits

Aflatoxin B 1 (AFB 1), is a food borne mycotoxin produced by fungal species of the genera Aspergillus. To elucidate the teratogenic effects, AFB 1 was dissolved in corn oil and given orally to New Zealand White rabbits during 6–18 days of gestation with the dose levels of 0.025, 0.05 and 0.1 mg/kg body weight. To assess pathomorphological features of the anomalies induced by AFB 1, the fetal serial sections were histologically examined. There was no maternal mortality in any group. There was non-significant decrease in percent of live fetuses and increase in the percent resorptions and post-implantation losses at 0.1 mg/kg dose group as compared with those of controls. The mean crown to rump lengths of 0.05 and 0.1 mg/kg dose groups were significantly reduced than that of the control. The mean fetal weights were significantly reduced in 0.1 mg/kg dose group than that of other treated groups. The gross anomalies observed included wrist drop and enlarged eye socket whereas, skeletal anomalies were agenesis of caudal vertebrae, incomplete ossification of skull bones and bent metacarpals. The visceral anomalies of microphthalmia and cardiac defects were seen at 0.1 mg/kg dose group. The characteristic histological findings of fetal tissues were distortion of normal hepatic cord pattern and reduced megakaryocytes in liver, fusion of auriculo-ventricular valves, mild degenerative changes in myocardial fibers, microphthalmic eyes and lenticular degeneration. The results of this study indicated that AFB 1 was found to be teratogenic in rabbits when given by oral route during gestation days 6–18 and the dose of 0.1 mg/kg could be considered as the minimum oral teratogenic dose. The histological examination of the fetal tissues indicated its importance in identifying the visceral anomalies which were otherwise not visible.

Dissecting the Gash

Dissecting the Gash

Eye socket reconstruction with free radial forearm flap in anophthalmic orbital syndrome and contracted eye socket

To assess the effect of eye socket reconstruction with free radial forearm flap. Reconstructive procedures were performed in 7 patients underwent orbital exenteration for malignant tumors and in 9 patients underwent enucleation and postoperative irradiation of the orbit for the treatment of retinoblastoma. These patients were suffered from anophthalmic orbital syndrome and contractive eye socket. A microvascular surgical technique with a free radial forearm flap was adopted. Hydroxyapatite implant was inserted as an intraorbital implantation. All patients were followed up for 6 months to 5 years and good cosmetic results were obtained. A large eye socket was achieved permanently. Artificial eye could be fitted with satisfactory results. Free radial forearm flap transplantation offers a useful option for the treatment of anophthalmic orbital syndrome.

A hybrid approach to the skull stripping problem in MRI

We present a novel skull-stripping algorithm based on a hybrid approach that combines watershed algorithms and deformable surface models. Our method takes advantage of the robustness of the former as well as the surface information available to the latter. The algorithm first localizes a single white matter voxel in a T1-weighted MRI image, and uses it to create a global minimum in the white matter before applying a watershed algorithm with a preflooding height. The watershed algorithm builds an initial estimate of the brain volume based on the three-dimensional connectivity of the white matter. This first step is robust, and performs well in the presence of intensity nonuniformities and noise, but may erode parts of the cortex that abut bright nonbrain structures such as the eye sockets, or may remove parts of the cerebellum. To correct these inaccuracies, a surface deformation process fits a smooth surface to the masked volume, allowing the incorporation of geometric constraints into the skull-stripping procedure. A statistical atlas, generated from a set of accurately segmented brains, is used to validate and potentially correct the segmentation, and the MRI intensity values are locally re-estimated at the boundary of the brain. Finally, a high-resolution surface deformation is performed that accurately matches the outer boundary of the brain, resulting in a robust and automated procedure. Studies by our group and others outperform other publicly available skull-stripping tools.

A hybrid approach to the skull stripping problem in MRI

We present a novel skull-stripping algorithm based on a hybrid approach that combines watershed algorithms and deformable surface models. Our method takes advantage of the robustness of the former as well as the surface information available to the latter. The algorithm first localizes a single white matter voxel in a T1-weighted MRI image, and uses it to create a global minimum in the white matter before applying a watershed algorithm with a preflooding height. The watershed algorithm builds an initial estimate of the brain volume based on the three-dimensional connectivity of the white matter. This first step is robust, and performs well in the presence of intensity nonuniformities and noise, but may erode parts of the cortex that abut bright nonbrain structures such as the eye sockets, or may remove parts of the cerebellum. To correct these inaccuracies, a surface deformation process fits a smooth surface to the masked volume, allowing the incorporation of geometric constraints into the skull-stripping procedure. A statistical atlas, generated from a set of accurately segmented brains, is used to validate and potentially correct the segmentation, and the MRI intensity values are locally re-estimated at the boundary of the brain. Finally, a high-resolution surface deformation is performed that accurately matches the outer boundary of the brain, resulting in a robust and automated procedure. Studies by our group and others outperform other publicly available skull-stripping tools.

Implantation of hydroxyapatite pedestal in correction of eye socket deformity

目的 观察羟基磷灰石义眼座植入术矫治眼窝畸形的临床效果.方法剪除角膜、彻底清除眼内容物,环状剪除视盘和剪断视神经.剪开巩膜腔,植入羟基磷灰石义眼座,间断缝合巩膜.结果采用此手术方法矫治眼窝畸形23例(23眼),均获良好效果.结论羟基磷灰石义眼座是理想的眼窝充填材料,此手术方法简单,符合眼球运转功能,达到了眼窝整形与美容的效果。

Experimental infections of Atlantic salmon Salmo salar with Spironucleus barkhanus

Atlantic salmon Salmo salar L. (Salmonidae) were experimentally infected with Spironucleus barkhanus (Diplomonadida: Hexamitidae). Parasites were found in the blood 1 to 8 wk after infection, after which they disappeared from the blood and were found mainly in the internal organs (e.g. spleen and liver), eye socket or muscles. Mortality (38 out of 40 infected fish) occurred when fish had lesions in internal organs and/or on the body surface. Uninfected fish cohabiting with infected fish became infected after 4 wk, indicating direct transmission. There was no difference in susceptibility to spironucleosis between 3 different families of Atlantic salmon. All families developed the disease with a similar pattern of parasitaemia in the blood, similar clinical signs and gross pathology, and with very high mortality (29 out of 30). Clinical signs of systemic spironucleosis may include anemia, skin blisters, muscle ulcerations or unilateral exophthalmia. Gross pathologies include hemorrhaging of internal organs, splenomegaly or deformed (globulated) spleen, or granulomatous lesions in the spleen and liver.

顎関節鏡を用いて弾丸を摘出した顔面の盲管銃創の１例

Difficulty in extracting a foreign object embedded in tissue of the oromaxillofacial region is not uncommon. Arthroscopic surgery is often used to treat conditions of the temporomandibular joints. We successfully extracted foreign objects embedded in a cul-de-sac facial gunshot wound adjacent to the temporomandibular joint, using a rigid endoscope originally designed for temporomandibular arthroscopic surgery. The procedures used are described in this report.The patient was a 46-year-old man who had been shot in the left side of the face. The bullet lodged in tissue medial to the left temporomandibular joint and sphenoidal sinus. Without any additional incision, a temporomandibular arthroscope was introduced from the point of entry of the bullet beneath the eye socket with the patient under general anesthesia. A total of 34 objects, including the bullet, its fragments and glass fragments from the patient's eyeglasses, were endoscopically extracted with the use of a grasping forceps. Arthroscopic monitoring permitted visual confirmation of the foreign bodies and enabled their successful extraction with minimal invasion.

Meningioma probable reason for trephination

AbstractThe incomplete human skull with a trephined hole in the right frontal bone region was identified in 1997 among the collections of the Municipal Museum in Sedlčany. The calvaria of Sedlčany dated back to the period AD 1298–1550 years (14C calibrated age is 528±126 yr BP). The smooth edges of the entire hole indicate a healing process has occured. We can distinguish the application of three surgical techniques in the described trephined hole on the right side of the frontal bone region of the calvaria. The skull is that of a man over 50 years old. ‘Grooving’ remained visible mainly in the lower half of the trephined hole above the eye socket. Four tiny semicircular incisions in the upper edge of the hole probably represent traces of the ‘drilling’ technique. Thinning of the wall in the upper part of the hole was evidently caused by a ‘scraping’ technique. It is hypothesized that the medical reason for the trephination was to relieve the symptoms brought about by increased intracranial pressure caused by a dextral parasagittal meningioma. It is explained by an imprint of middle meningeal arteries. The groove produced by the right middle meningeal artery is deeper and wider than the one on the left side. The bone symptoms for meningioma consist of: a complex of the widened groove at the middle meningeal artery, relating to the cavity for a big Pacchionian (arachnoid) granulation situated along the superior sagittal venous sinus, completed by vascularization of diploe with three 1 mm foramina of vessels, and with a region of bone sclerosis visible in the X‐ray picture. Copyright © 2003 John Wiley & Sons, Ltd.