Lymphomas are the most common primary orbital tumour in adults 60 years of age and older. We present a case of a 79-year-old woman complaining of redness in the right eye, tearing and diplopia. She had a history of a thyroid nodule with normal thyroid function, uncontrolled hypertension, and impaired fasting glucose. The Weiss coordimeter showed right eye lateral rectus palsy. Right 6th nerve palsy due to microvascular disease was assumed. At the follow-up visit performed six weeks later, there was a constant esodeviation of the right eye with proptosis and a temporal mass on the right ocular globe. The biopsy was diagnostic of non-Hodgkin’s lymphoma. Differential diagnosis of orbital masses is complex. Initial manifestations are non-specific and clinical suspicion of an orbital mass may not arise until the considerable growth of the lesion. The relevance of this case is its initial presentation with rapid evolution and the fact that the patient had thyroid disease. RESUMO Os linfomas são o tumor orbitário primário mais comum em adultos com mais de 60 anos. Os autores apresentam o caso clínico de uma doente de 79 anos de idade, que recorre ao Serviço de Urgência com hiperemia conjuntival do olho direito, lacrimejo e diplopia. Salientava-se, na história pregressa, a existência de nódulo tiroideu com função eutiroideia, hipertensão não controlada e anomalia da glicemia em jejum. O coordímetro de Weiss apontava para hipoação do músculo reto externo do olho direito. Assumiuse o diagnóstico de paralisia do sexto par craniano direito em contexto de provável doença microvascular. Na consulta de seguimento, seis semanas depois, apresentava uma esotropia com proptose, e uma massa temporal no olho direito A biopsia foi diagnóstica de linfoma não-Hodgkin. O diagnóstico diferencial de massas orbitárias é complexo. As manifestações iniciais não são específicas e a suspeita de presença da lesão pode não surgir até que haja um crescimento considerável da mesma. Este caso clínico assume especial relevância pela sua apresentação inicial com evolução rápida e pelo facto de a doente ter concomitantemente patologia da tiroide.

Pituitary apoplexy (PA) is a rare endocrine emergency, which can occur due to acute hemorrhage or infarction of pituitary gland, usually in the context of a pituitary macroadenoma. The most frequent ophthalmologic symptoms/sings are impaired visual acuity, visual field defects, and diplopia. A dense bitemporal hemianopic scotoma can cause a rare non-paretic diplopia, so-called hemifield slide phenomenon. This brief report describes a patient with this phenomenon caused by a PA from a pituitary macroadenoma.

The purpose of this study was to report the ocular findings in an unusual case of ectrodactylyectodermal dysplasia-clefting (EEC) syndrome and review the etiology and clinical presentation of similar situations in the literature. This study is an observational case report of a 13-year-old woman with complaints of epiphora and red eye. On examination, she presented with lachrymal punctal agenesis and neo-vascularization in both eyes. She was treated medically and without any surgical intervention. Corneal changes in EEC can have a variable presentation. The etiology of such keratopathy seems to be due to several factors and limbal stem cell deficiency (LSCD) being the newest factor involved. Recurrent infection from lachrymal drainage obstruction and tear film instability are other risk factors for disease severity and progression. Since these patients present several anomalies, it is important, to follow an interdisciplinary approach to reduce complications and provide the best possible medical care.

Purpose: To describe the visual and topographical changes after accelerated corneal collagen cross-linking (ACXL) in keratoconus-affected eyes. Methods: Clinical records of patients with keratoconus-affected eyes that underwent ACXL treatment and had 24 months of follow-up were reviewed. Data regarding demographics, visual acuity (VA), refraction and Sheimpflug values before and post ACXL were analyzed. We included patients with keratoconus older than 12 years old, with corneal thickness greater than 400 microns and steepest keratometry <60 diopters by Sheimpflug (Pentacam), with reported uncorrected distant visual acuity (UDVA), manifest refraction and best-corrected visual acuity (BCVA) evaluation pre ACXL and 24 months after surgery. The exclusion criteria were: history of ocular trauma, anterior segment surgery, retinal detachment or any type of maculopathy. Results: 21 eyes were included. Mean age was 27 years. Mean uncorrected distant VA (UDVA) before the procedure was 1.01 logMAR (20/200 Snellen) and after 24 months improved significantly to 0.62 logMAR (20/83 Snellen) with a p value of 0.005. No statistical significant difference was found between preoperative and postoperative refractive, keratometric and pachymetric data. Induced astigmatism value was -1.11 D (range 0.13 D – 2.28 D). Conclusions: ACXL is a technique to prevent the progression of keratoconus, however refractive and VA changes could be expected after procedure. The observed changes must be considered when performing the procedure together with refractive surgery.

Purpose: To evaluate visual and refractive outcomes after intracorneal circular ring implantation with femtosecond laser for keratoconus treatment. Design: Prospective, cohort Methods: Were included 22 eyes of 16 adults patients with central keratoconus who had been implanted with continuous intracorneal circular ring (ICCR) MyoRing (Dioptex GmbH, Linz, Austria) in a pocket created by femtosecond laser (Ziemer Z6 LDV, Port, Switzerland). Visual and refractive outcomes, keratometry, pachymetry and asphericity were evaluated at one, three, six month and one year postoperative. Results: Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) improved from 1,33 (Standard deviation [SD]: 0,37) to 0,38 logMAR (SD 0,16) (p<.001) and from 0,25 (SD: 0,15) to 0,21 logMAR (SD: 0,23) (p=0,43) respectively at one year postoperative. Central keratometry, sphere, cylinder and corneal asphericity presented reduction of 8,13 Diopters (D) (p<.001), 5,42D (p<.001), 2,03D (p=0.01), 1,46 e2 (p=0,00) respectively. Visual, refractive and keratometric results did not reveal significant changes after the third month of follow up. Conclusion: Intracorneal circular ring implantation using femtosecond laser is an effective and safe procedure for central keratoconus treatment. Keratometric and refractive values can be effectively improved and good visual outcomes achieved. RESUMEN Objetivo: Evaluar los resultados visuales y refractivos tras el implante de anillo intracorneal circular continuo, usando láser de femtosegundo en el tratamiento de pacientes adultos con queratocono. Diseño: Prospectivo de cohorte. Materiales y Métodos: Se incluyeron 22 ojos de 16 pacientes, con diagnóstico de queratocono tipo central a los cuales se les implanto un anillo intracorneal circular continuo (ICCR), MyoRing (Dioptex GmbH, Linz, Austria) en un bolsillo creado con láser de femtosegundo (Ziemer Z6 LDV, Port, Switzerland). Se evaluó resultado visual, refractivo, queratometrías, paquimetría y asfericidad corneal al mes , tres meses, seis meses y a un año posoperatorio. Resultados: La agudeza visual sin corrección (AVSC) y la agudeza visual con corrección (AVCC) mejoraron de 1,33 (Desviación estándar [DE]: 0,37) a 0,38 logMAR ([DE]:0,16, p=0.001) y de 0,25 ([DE]:0,15) a 0,21 logMAR ([DE]:0,23, p= 0,43) respectivamente al año postoperatorio. La queratometría central, la esfera, el cilindro y la asfericidad corneal presentaron disminución de 8,13 Dioptrías (D) (p <.001), 5,42 D (p<.001), 2,03D (p=0.01) y 1,46 e2 (p<0,000) respectivamente. Los resultados visuales, refractivos y queratométricos no presentaron cambios significativos a partir del tercer mes posoperatorio. Conclusiones: El implante del anillo intracorneal circular continuo con láser femtosegundo, demostró ser un procedimiento eficiente y seguro para el tratamiento de queratocono tipo central, mejorando significativamente los valores queratométricos y refractivos, logrando buenos resultados visuales.

This systematic review of biopsy proven cases of non specific orbital inflammation and sclerosing variant from 2010-2016 attempts to elucidate new findings regarding the demographic profile of the diseases. Discussion of histopathology is emphasized, as to describe the most common presenting features of non-specific orbital inflammation as well as to discuss its molecular profile. This review also discusses the therapeutic approach and discusses the “steroids vs. biopsy first” controversy regarding non-specific orbital inflammation. The incidence of IgG4 and its relationship to non-specific orbital inflammation is also discussed.