改良外侧开眶术摘除球后肿瘤

球后肿瘤位于眼眶深部，肌圆锥内甚至达眶尖。且肿瘤较大，与周围组织均不同程度粘连。无论何种人路，因眶腔狭小难以彻底完成，组织的损伤重。笔者对外侧开眶进行改良，在直视下顺利摘除球后肿瘤5例c报告如下。1资料和方法1．l一般资料本组5例，男2例，女3例。年龄最／J’31a，最大59a，病程2～sa。眼球呈轴性突出或略偏内侧。眼球运动大多正常。其中2例于眶外侧向深部可触及肿物，外转受限。术前均作CT及B超检查。诊断为眼眶球后肿瘤。1．2手术方法（）麻醉：静脉注射安定10mg，209·I－－’利多卡因加7．sg·I。－－’布比卡因10ml作…     

网脱术后迟发性脉络膜下出血1例

脉络膜下迟发性出血国内很少报道 ,据Ｃｏｎｔｏｒ (1985年 )报告为 0 73% ,可以发生在任何内眼手术后 ,但以抗青光眼滤过手术多见〔1〕。本文报道的是视网膜脱离环扎术后第 9天发生脉络膜下出血 ,尤为罕见 ,现报告如下。患者方××　男　 42岁　供销社下岗职工　住院号1895 2 6　患者因左眼前有幕状物遮挡伴视力下降 1周 ,以左眼孔源性视网膜脱离 ,高度近视眼住院 ,拟行手术治疗。入院体检 :血压 12 0 /75ｍｍＨｇ ,心律齐 ,心率 90次 /分。腹软 ,肝脾未及。ＥＫＧ正常 ,胸片示 :右侧胸膜稍肥厚。血常规 :Ｗｂｃ 6 6× 10 9/Ｌ ,Ｒｂｃ 3 …     

眼眶骨折术后继发对侧眼球后视神经炎1例

正0引言球后视神经炎是球后视神经受到脱髓鞘改变,被压迫、肿瘤浸润、炎症、外伤及缺血是可能病因,其临床表现包括视力下降、视觉减退、视野缺损、视盘苍白、相对性瞳孔传入阻滞(RAPD)或称Marcus-Gunn征等。我们报道1例眼眶骨折术后对侧眼发生球后视神经炎的罕见例子以及回顾相关文献。1病例报告一名藏族五岁女性患儿15d前从12m高处坠至地面     

彩色多普勒图像检测非环扎巩膜扣带术对球后血流动力学的影响

目的：采用彩色超声多普勒成像研究非环扎的节段性巩膜扣带术对球后血流动力学的影响。 方法：对单侧孔源性视网膜脱离而行巩膜扣带术的65例65只限。我们采用彩色超声多普勒成像技术。分别于术前、术后2周、12周、24周时对眼动脉、视网膜中央动脉和睫状后短动脉的血流速度进行测量。应用彩色超声多普勒测量收缩期峰值血流速度（PSV）和舒张末期血流速度（EDV）（以厘米／秒计）。 结果：随访过程中眼动脉的PSV和EDV无显著变化。术后2周时视网膜中央动脉的PSV和EDV短暂性地降低，但是在术后12周时恢复到术前水平。两侧睫状后短动脉的PSV和EDV在术后持续降低。到术后24周时其血流速度降低的程度有统计学意义（扣带侧PSVP=0．001；EDVP=0．002；非扣带侧PSVP〈0．001；EDVP=0．004）。扣带侧睫状后短动脉的PSV和EDV降低与患者的年龄呈正相关（PSVR=0．40。P=0．001；EDVR=0．32P=0．008）。 结论：即使未采取环扎术，巩膜扣带术仍可以引起脉络膜血液循环的亚临床紊乱。年龄是其危险因素。     

Mastication Induced Retrobulbar Hemorrhage

Abstract

Retrobulbar hemorrhage is a feared potentially sight threatening complication after orbital decompression surgery. We present a patient, 36 hours after surgery, while forcefully biting, suddenly developed a retrobulbar hemorrhage arising from the temporalis muscle causing an orbital compartment syndrome. Rapid intervention with canthotomy and cantholysis was associated with recovery of vision from absent light perception to 20/20. A mastication induced retrobulbar hemorrhage has not been previously described.     

An Unusual Case of Retrobulbar Arachnoid Cyst and its Management

Arachnoid cysts are collection of cerebrospinal fluid contained inside a cavity lined by leptomeninges. It constitutes 1% of all intracranial tumours mostly present in the middle cranial fossa. Retrobulbar arachnoid cyst in elderly persons are a rare occurrence. We report a rare case of retrobulbar arachnoid cyst with ophthalmic manifestations and its effective management. CT-guided aspiration of the cyst and subsequent cytological and biochemical test revealed an arachnoid cyst. Patient is on a 5-year follow up without recurrence and improvement of the vision in the affected eye.     

Minimally Invasive Bone-Saving Orbitotomy for Removal of Optic Nerve Cysticercosis

A 32-year-old man previously being managed for multiple neurocysticercosis presented with a reduction in vision and pain on eye movement. Fundus examination revealed disc edema with venous dilatation. MRI showed a localized hypointensity on T1 weighted images and hyperintensity on T2 weighted images suggestive of a cyst in the optic nerve sheath. Medical therapy with albendazole and steroids did not improve vision. Surgical removal of the cyst was achieved by a modified lateral orbital exploration using a lateral canthal incision without bone removal, with full recovery of vision. Histopathological examination confirmed cysticercosis.     

Retrobulbar botulinum toxin for treatment of oscillopsia

Two cases are presented in which multiple episodic retrobulbar botulinum toxin injections have diminished incapacitating acquired oscillopsia and nystagmus and improved visual acuity. One transient ptosis occurred in six procedures. Improvement duration averaged approximately three months. This is a simple, safe and effective therapy where alternative treatments are typically unsatisfactory.     

Acute Retrobulbar Optic Neuropathy as the Sole Manifestation of Subarachnoid Haemorrhage from a Ruptured Anterior Communicating Artery Aneurysm

Abstract

Anterior communicating artery aneurysm is the most common form of intracranial aneurysm and subarachnoid haemorrhage (SAH) is the common presenting feature of anterior communicating artery aneurysms. In general, patients with SAH from anterior communicating artery aneurysm present with neurological deficit. We report an interesting case of a 60-year-old man who presented with acute monocular vision loss accompanied by periorbital pain without any neurological deficit, finally diagnosed with SAH from ruptured anterior communicating artery aneurysm. Five months after immediate craniotomy with aneurysm neck clipping, his visual acuity was improved to 20/63 with a pale optic disc appearance. Acute retrobulbar optic neuropathy may be the sole manifestation of SAH from ruptured anterior communicating artery aneurysm. Unilateral decrease of visual acuity with periorbital pain, in the absence of other neurological change, may be the initial and isolated sign.     

Retrobulbar irradiation for Graves' ophthalmopathy -- long-term results

BACKGROUND: Significance of retrobulbar irradiation in patients suffering form Graves' ophthalmopathy, though established since almost one century, is subject of scientific debate. The present study investigated the effect of retrobulbar irradiation using a standardized protocol focussing on long term results. PATIENTS AND METHODS: Between 1981 and 1997, 104 patients treated by retrobulbar irradiation (10 to 20 Gray) due to Graves' disease. Twenty-nine of these underwent irradiation as sole treatment (mean follow-up 57 months), while in the remaining 75, it was combined with a systemic steroid treatment (mean follow-up 40 months). Patients were evaluated regarding proptosis, intraocular pressure, lid signs, motility as well as subjective assessment of double vision and retrobulbar pain. RESULTS: While proptosis remained unchanged, lid signs, chemosis and intraocular pressure showed slight and statistically significant improvement. However, these findings were considered to be clinically insignificant. Retrobulbar pain was improved in 75 % of patients. 25 % of patients showed improved motility, 75 % remained stable, and in none of them was there a deterioration of ductions. Results proved stable even in long-term follow-up. 25 % per cent of patients underwent a surgical procedure one year after radiotherapy. CONCLUSIONS: In our series, we could not demonstrate an additional benefit of systemic steroids when combined with retrobulbar irradiation. Up to sixteen years after treatment, no treatment-related adverse reaction was seen. We found a remarkable improvement in ocular motility. This holds even more true in comparison to the natural course of the condition. Retrobulbar irradiation seems to shorten the duration of the disease, thus allowing earlier performance of eventual rehabilitative surgery.