Suspected orbital myositis associated with COVID-19.

A 44-year-old male patient developed proptosis, edema, and erythema progressing to complete ptosis and supraduction deficit 2 days after positive COVID-19 test. He failed to improve on systemic antibiotics. MRI showed thickening and T2 enhancement of the superior rectus/levator complex consistent with orbital myositis. He improved on intravenous corticosteroids and experienced continued gradual improvement on oral steroids.

Reversible Charles Bonnet Syndrome After Oculoplastic Procedures.

Individuals with Charles Bonnet syndrome (CBS) typically have severe visual loss and experience visual hallucinations yet have no psychiatric disease. Visual impairment often is due to end-stage glaucoma or macular degeneration. We report 3 cases of CBS in patients who underwent an oculoplastic surgical procedure. One patient experienced binocular visual distortion due to excessive topical ophthalmic ointment, and 2 patients experienced monocular visual impairment from patching. Visual hallucinations resolved once vision returned to baseline. We highlight the possibility of transient CBS in postoperative patients who have temporary iatrogenic vision impairment in one or both eyes.

Cosmetic Adolescent Filler: An Innovative Treatment of the "Selfie" Complex.

PURPOSE: "Selfie" photography is increasing among teenagers, accentuates congenital anomalies, and impacts self-confidence. Tear trough deformity is most commonly due to aging, but also occurs as a congenital anomaly and can be a major source of insecurity and embarrassment. OBJECTIVE: The purpose of this study is to show the efficacy and safety of hyaluronic acid gel filler in a teenage patient with congenital tear trough deformity. MATERIAL AND METHOD: We describe the case of a teenager who underwent hyaluronic acid gel filling to the tear trough deformity at age 14 years. Prospective follow up was assessed for 5 years. RESULTS: The patient improved clinical appearance and self confidence. Her satisfaction level was high, and no complication occurred during entire follow up. CONCLUSION: In this case, hyaluronic gel acid filler was safe and effective for augmentation of congenital tear trough. The patient was satisfied and experienced increased self-esteem.

Giant Ocular Horn Occurring in a 10-Year-Old Female.

Cutaneous horns uncommonly involve the periocular region. Involvement of the ocular surface is particularly rare. The authors present a patient who underwent a perinatal buccal mucosal graft for corneal perforation due to congenital corneal ectasia, most likely resulting from Peters anomaly. She developed a giant ocular horn 10 years later.

Partial Orbicularis Resection for the Augmentation of Traditional Internal Brow Pexy: The "Tuck and Rise".

PURPOSE: Brow ptosis commonly occurs with aging. Minimally invasive techniques are varied and include neurotoxin paralysis of eyebrow depressors and internal brow pexy. The authors present a modification of the traditional brow-pexy surgery which incorporates weakening of the lateral eyebrow depressor, the orbicularis oculi muscle, to synergistically influence brow position. METHODS: This retrospective review includes 44 brows in 22 patients treated over a 14-month period. All patients underwent surgery by a single surgeon (RM) at UT Southwestern Medical Center. The surgical technique includes partial orbicularis resection to augment the traditional internal brow pexy. Preoperative and postoperative photographs were analyzed using ImageJ software. RESULTS: This procedure has been successfully performed on 44 brows in 22 patients with no complications and a high satisfaction rate. ImageJ analysis demonstrates an average elevation of 2.42 mm of the lateral tail of the brow with improved brow contour, volume, and symmetry. CONCLUSIONS: The "Tuck and Rise" has proven a simple, minimally invasive, and effective technique to volumize and elevate the lateral tail of the eyebrow.

The evolution of untreated acute syphilitic posterior placoid chorioretinitis captured by multimodal retinal imaging.

Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a rare manifestation of syphilis. Most cases respond to systemic treatment of the underlying Treponema pallidum infection. The authors illustrate the natural progression of untreated ASPPC with multimodal retinal imaging.

Diplopia as the primary presentation of foodborne botulism.

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist.