Acute esotropia in heroin withdrawal: a case series.

BACKGROUND: Esotropia during opiate withdrawal is a new clinical syndrome that has only recently been reported in the literature. METHODS: Clinical case series. RESULTS: Five patients with acute esotropia during opiate withdrawal are presented. In four there was evidence of underlying hyperopia and/or other strabismogenic features. CONCLUSIONS: The precise cause of esotropia with heroin withdrawal is uncertain. Most (and possibly all) of these patients have one or more objective strabismogenic features, and these are probably a large factor in the causation.

Congenital retraction of the lower eyelid: two case reports.

PURPOSE: Idiopathic congenital retraction of the lower eyelid is rare. To further define the clinical features of this condition, we describe two new cases. METHODS: Retrospective chart review. RESULTS: In both cases, eye movements were restricted ipsilaterally and the condition was nonprogressive. CT scans showed mildly enlarged inferior and medial rectus muscles in one patient and normal muscles in the other. All other orbital structures were normal. CONCLUSIONS: No definite cause for the lower eyelid retraction could be found, but it appeared to be related to a tight inferior rectus muscle. These patients may represent a variant of ocular fibrosis syndrome.

Respiratory epithelial orbital cysts.

Congenital or post-traumatic respiratory epithelial lined cysts of the orbit are very rare, and such cysts more commonly occur as mucocoeles secondary to chronic paranasal sinus disease. Four new cases of such cysts are described herein, three presumed choristomas and one occurring after trauma. Two of three presumed choristomatous (congenital) cysts occurred in sites that were atypical for the commoner dermoid cyst. One occurred in the superior orbit between the superior rectus and levator palpebrae superioris muscle and one in the temporal fossa and lateral orbit. The third choristomatous lesion occurred in the superotemporal orbit with a well-defined bony defect, a typical pattern of the commoner dermoid cyst. The fourth case, a presumed traumatic respiratory epithelial cyst, probably arose from ethmoidal sinus mucosa. Respiratory epithelial orbital cysts are very rare and may occur in sites that are atypical for the commoner orbital dermoid cyst.

Orbital teratoma: late presentation with normal vision.

Orbital teratoma is a rare, rapidly growing tumour that usually presents with congenital proptosis. Visual outcome is usually poor. A case is described of orbital teratoma presenting in an 18-month-old child as an inferior orbital mass with normal vision and intermittent hypertropia. Computed tomography demonstrated a cystic mass containing a tooth adjacent to the inferior orbital fissure. Histology revealed tissues derived from all three germ cell layers. The tumour was removed with preservation of vision and resolution of the strabismus. Late presentation of an orbital teratoma with a good visual outcome is exceptional.