American Journal of Ophthalmology Case Reports, Mar 1, 2022
Purpose To report a case of orbital coccidiomycosis in an otherwise healthy 11-month-old male. Ob... more Purpose To report a case of orbital coccidiomycosis in an otherwise healthy 11-month-old male. Observations An 11-month-old male presented to his pediatrician with parental complaints of swelling, erythema, and pain of the right orbit that increased over ten days in the absence of constitutional symptoms. The child's parents reported an earlier fall onto a carpeted floor. After four weeks of conservative treatment and a course of oral cephalexin, he developed a fever, increased erythema, and palpable enlargement of a mass posterior to the lower eyelid. Ultrasound revealed an encysted mass in the inferior orbit, suggestive of an abscess. Urgent ophthalmic referral led to incision and drainage via orbitotomy. Culture, histopathology, and serological testing were positive for Coccidioides spp.. Blood studies revealed mild anemia and thrombocytosis. There was complete resolution of symptoms after surgical drainage and several weeks of oral fluconazole. Conclusion and importance We describe a patient with orbital coccidiomycosis without apparent systemic involvement, following what was most likely an unrelated minor trauma. Despite being rare, orbital coccidiomycosis should be considered as a primary manifestation of infection when ocular inflammation is encountered, especially in endemic regions.
Investigative Ophthalmology & Visual Science, May 14, 2008
by Internal Approach) for Coexisting Cataract and Open-Angle Glaucoma Brian A. Francis, MD, MS1, ... more by Internal Approach) for Coexisting Cataract and Open-Angle Glaucoma Brian A. Francis, MD, MS1, Don Minckler, MD, MS2, Laurie Dustin3, Shahem Kawji, MD1, Jason Yeh, MD1, Arthur Sit,MD4, Sameh Mosaed,MD2, Murray Johnstone, MD5, and the Trabectome Study Group* 1-Doheny Eye Institute, Keck School of Medicine, USC, Los Angeles CA, 2-UC Irvine Ophthalmology, Irvine CA, 3-USC Preventive Medicine and Biostatistics, 4-Mayo Clinic Ophthalmology, Rochester MN, 5-Private Practice, Seattle, Washington, * See appendix for Trabectome Study Group
Ophthalmic Plastic and Reconstructive Surgery, Mar 1, 2020
The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland ... more The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland tumor characterized histopathologically by nests of atypical poromatous cells and the presence of duct-like lumina. Histopathologic analysis of this case also exhibited numerous loose tumor cells in the adjacent tear film, a finding that has not been previously described.
Radioautographic and cytochemical studies were performed at the ultrastructural level on the opti... more Radioautographic and cytochemical studies were performed at the ultrastructural level on the optic nerve heads of 21 Macaca fascicularis eyes with normal, elevated, or decreased intraocular pressures (IOP). Orthograde axoplasmic transport was labeled in all eyes by intravitreal ...
The primary injury in glaucoma probably involves axonal transport block in the lamina cribrosa. T... more The primary injury in glaucoma probably involves axonal transport block in the lamina cribrosa. Topographic correlations between visual field damage and axon injury in the lamina are dependent on anatomical dispersion of ascending axons. Lateral and vertical dispersion of axons is partially due to intermixing of axon bundles in the peripapillary retina and is accentuated by further intermixing in the nerve head. Morphometric studies of nerve fiber layer axons demonstrate mirror image symmetry in fiber populations in arcuate bundles between paired normal eyes, but with a preponderance of large axons in the inferior relative to the superior bundles. In glaucomatous monkey eyes, large axons in arcuate bundles are especially vulnerable to injury. Dispersion of axons and selective vulnerability of subpopulations of axons are potentially important factors in the pathogenesis of glaucomatous visual field defects.
American Journal of Ophthalmology Case Reports, Mar 1, 2022
Purpose To report a case of orbital coccidiomycosis in an otherwise healthy 11-month-old male. Ob... more Purpose To report a case of orbital coccidiomycosis in an otherwise healthy 11-month-old male. Observations An 11-month-old male presented to his pediatrician with parental complaints of swelling, erythema, and pain of the right orbit that increased over ten days in the absence of constitutional symptoms. The child's parents reported an earlier fall onto a carpeted floor. After four weeks of conservative treatment and a course of oral cephalexin, he developed a fever, increased erythema, and palpable enlargement of a mass posterior to the lower eyelid. Ultrasound revealed an encysted mass in the inferior orbit, suggestive of an abscess. Urgent ophthalmic referral led to incision and drainage via orbitotomy. Culture, histopathology, and serological testing were positive for Coccidioides spp.. Blood studies revealed mild anemia and thrombocytosis. There was complete resolution of symptoms after surgical drainage and several weeks of oral fluconazole. Conclusion and importance We describe a patient with orbital coccidiomycosis without apparent systemic involvement, following what was most likely an unrelated minor trauma. Despite being rare, orbital coccidiomycosis should be considered as a primary manifestation of infection when ocular inflammation is encountered, especially in endemic regions.
Investigative Ophthalmology & Visual Science, May 14, 2008
by Internal Approach) for Coexisting Cataract and Open-Angle Glaucoma Brian A. Francis, MD, MS1, ... more by Internal Approach) for Coexisting Cataract and Open-Angle Glaucoma Brian A. Francis, MD, MS1, Don Minckler, MD, MS2, Laurie Dustin3, Shahem Kawji, MD1, Jason Yeh, MD1, Arthur Sit,MD4, Sameh Mosaed,MD2, Murray Johnstone, MD5, and the Trabectome Study Group* 1-Doheny Eye Institute, Keck School of Medicine, USC, Los Angeles CA, 2-UC Irvine Ophthalmology, Irvine CA, 3-USC Preventive Medicine and Biostatistics, 4-Mayo Clinic Ophthalmology, Rochester MN, 5-Private Practice, Seattle, Washington, * See appendix for Trabectome Study Group
Ophthalmic Plastic and Reconstructive Surgery, Mar 1, 2020
The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland ... more The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland tumor characterized histopathologically by nests of atypical poromatous cells and the presence of duct-like lumina. Histopathologic analysis of this case also exhibited numerous loose tumor cells in the adjacent tear film, a finding that has not been previously described.
Radioautographic and cytochemical studies were performed at the ultrastructural level on the opti... more Radioautographic and cytochemical studies were performed at the ultrastructural level on the optic nerve heads of 21 Macaca fascicularis eyes with normal, elevated, or decreased intraocular pressures (IOP). Orthograde axoplasmic transport was labeled in all eyes by intravitreal ...
The primary injury in glaucoma probably involves axonal transport block in the lamina cribrosa. T... more The primary injury in glaucoma probably involves axonal transport block in the lamina cribrosa. Topographic correlations between visual field damage and axon injury in the lamina are dependent on anatomical dispersion of ascending axons. Lateral and vertical dispersion of axons is partially due to intermixing of axon bundles in the peripapillary retina and is accentuated by further intermixing in the nerve head. Morphometric studies of nerve fiber layer axons demonstrate mirror image symmetry in fiber populations in arcuate bundles between paired normal eyes, but with a preponderance of large axons in the inferior relative to the superior bundles. In glaucomatous monkey eyes, large axons in arcuate bundles are especially vulnerable to injury. Dispersion of axons and selective vulnerability of subpopulations of axons are potentially important factors in the pathogenesis of glaucomatous visual field defects.
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