OphthoPods: An Analysis of the Educational Content and Changes of Ophthalmology Podcasts.

Objective Podcasts are a novel modality for digitally disseminating ophthalmic knowledge, yet minimal information exists on their offerings. This study sought to describe the growth of ophthalmology podcasts, characterize their features, and analyze clinically pertinent content trends. Materials and Methods Apple Podcasts, Spotify, Google Podcasts, and Google Search were queried for English- language shows relating primarily to ophthalmology. Ninety-six podcasts and 3,594 episodes were analyzed. Results Of the 48 currently active shows, most cover general ophthalmology topics ( n = 25, 52.1%) and are run by multiple hosts ( n = 29, 60.4%) in both academics and private practice. The majority of podcasts released episodes monthly ( n = 21, 21.9%) or less frequently than monthly ( n = 36, 37.5%). Among all episodes, procedural topics ( n = 951 episodes, 26.4%) and clinical education ( n = 1385, 38.5%) were the most prevalent categories. Retina was the most represented subspecialty in podcast production, while oculoplastics and neuro-ophthalmology had the fewest podcasts. Episodes on disease pathophysiology ( p = 0.04) and published research ( p < 0.001) each declined over time. The proportion of episodes released from 2020 to 2022 that discussed digital technologies was 33.3% greater versus 2005 to 2019 ( p = 0.005). Personal retrospective episodes doubled, career guidance and patient perspectives tripled, and wellness and social justice topics increased fivefold (all p < 0.001). Conclusion In summary, the coronavirus disease 2019 pandemic coincided with a rise in ophthalmology podcasts and shifts in content. Podcasts have trended toward practical advice and technologies, reflecting their value in sharing modern, peer-to-peer pearls. Emphases on storytelling and social justice offer unique, clinically relevant perspectives compared with traditional modalities.

Current Guidelines and Opinions in the Management of Orbital Floor Fractures.

Orbital floor fractures are a common manifestation of facial trauma that is encountered by ophthalmology, otolaryngology, and oral maxillofacial specialists. Surgical intervention is required emergently in cases of tissue entrapment and less urgently in cases of presenting with persistent diplopia, enophthalmos greater than 2 mm, and/or fractures involving greater than 50% of the orbital floor. Surgical management is a debated topic with differing opinions among surgeons regarding timing of repair, type of implant, and surgical approach.

Intravascular Large B-cell Lymphoma Diagnosed by Nasal Biopsy in a Patient Presenting with Bilateral Ptosis and Ophthalmoplegia.

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of lymphoma, involving the lumen of predominantly small blood vessels, especially capillaries. The orbit is an uncommon site of involvement for IVLBCL, and diagnosis before autopsy is even more rare as most cases are established post-mortem. Herein, the authors describe a 73-year-old male who presented with 3 weeks of progressive bilateral ptosis and ophthalmoplegia. Computed tomography (CT) and subsequent magnetic resonance imaging (MRI) revealed diffuse abnormal thickening and enhancement of bilateral orbital apices, superior orbital fissures, and cavernous sinus, along with persistent focal opacification of the left frontal and ethmoid sinuses. Infectious and inflammatory workup of serum and cerebrospinal fluid was negative. Ethmoidal sinus and middle turbinate biopsy confirmed intravascular large B-cell lymphoma and the patient was started on R-CHOP chemotherapy regimen.

Blue nevi of the palpebral conjunctiva: report of 2 cases and review of literature.

PURPOSE: To describe two patients with blue nevi of the palpebral conjunctiva and to review the existing literature on common and cellular blue nevi of the conjunctiva. METHODS: Report of two cases and literature review. RESULTS: We present two cases of blue nevi in the palpebral conjunctiva: an atypical cellular blue nevus of the left upper eyelid and a common blue nevus around the lacrimal punctum of the left lower eyelid. Both patients underwent full thickness eyelid excision with wide margins. There was no tumor recurrence at 11 and 4 months postoperatively. CONCLUSIONS: Blue nevi are a group of melanocytic tumors that rarely involve the ocular adnexa. They may arise in the palpebral conjunctiva and should be considered in the differential diagnosis of pigmented lesions in this location as they can mimic melanoma.

Bilateral Concurrent Endocrine Mucin-Producing Sweat Gland Carcinoma and Mucinous Carcinoma of the Eyelids.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is thought to be a precursor to mucinous carcinoma, both of which are rare. In this case report, the authors present a 55-year-old woman with concurrent EMPSGC and mucinous carcinoma manifesting with 2 distinct lesions on her left upper and lower eyelid and 1 lesion on her right lower eyelid. Biopsy and immunohistochemical staining supported primary cutaneous origin of the tumors. Systemic metastatic workup was initiated and thus far negative. The patient underwent staged slow Mohs micrographic surgery to remove one tumor at a time, with delayed reconstruction. This is the first reported case of EMPSGC and mucinous carcinoma presenting as distinct lesions both bilaterally and synchronously.

Orbital inflammation in the setting of a nylon foil implant.

A 61-year-old man underwent left medial wall and floor fracture repair with a Suprafoil® implant. He had postoperative orbital congestion and lower eyelid swelling that persisted for over seven weeks. Examination demonstrated hyperglobus with supraduction, infraduction, and adduction deficits. Imaging revealed a 3.7 × 3.6 × 2.6 cm isodensity along the implant, thought to be hematoma. The patient elected to pursue exploration and possible drainage. Intraoperatively, there was no hematoma; rather, we found a fibroinflammatory rind along the periorbita surrounding the implant. This was biopsied, and the implant was removed, as the fractures had sufficiently healed. Pathology showed dense fibroconnective tissue with associated inflammation. The patient completed a steroid taper with improvement in all symptoms and resolution of diplopia. To our knowledge, this is the first reported case of such a prominent orbital inflammatory reaction to nylon foil, a departure from the delayed hematic cysts typically associated with these implants.

Thyroid Eye Disease-Related Epiblepharon: A Comparative Case Study.

PURPOSE: This study describes the clinical features and management of epiblepharon as a manifestation of thyroid eye disease (TED). In addition, we compare the frequency and age in Asian and non-Asian patients, and discuss pathophysiologic implications. DESIGN: Retrospective case-control study. METHODS: This is a single-center retrospective review that identified 172 adult patients (age 19 to 83) with TED that were consecutively evaluated by 1 author (T.J.M.) between December 2015 and July 2018. Diagnosis of TED and epiblepharon was based upon clinical assessment as documented in the medical record. RESULTS: In a cohort of 172 patients (mean age 52; 138 female), 3 patients with acquired epiblepharon were identified, all of whom were Asian. The proportion of affected Asian patients (3/of 17, 17.6%) was significantly higher than that of non-Asian patients (0/155, P < 0.001). Patients with epiblepharon were also significantly younger than those without epiblepharon, 29.7 ±â€Š2.1 versus 48.7 ±â€Š13 years of age (P = 0.026). All 3 patients underwent surgical correction with lateral canthoplasty and anterior lamellar pretarsal fixation with successful outcomes. CONCLUSIONS: Lower eyelid epiblepharon may occur in TED. In our clinic-based population, this finding was significantly more frequent in Asian patients and in younger patients. Relieving horizontal tension in conjunction with anterior lamella pretarsal fixation is an effective method of correcting TED-associated epiblepharon.

Current Understanding of the Progression and Management of Thyroid Associated Orbitopathy: A Systematic Review.

Thyroid associated orbitopathy (TAO) is a common diagnosis encountered by ophthalmologists and oculoplastic surgeons. TAO has a varying clinical presentation that can include upper eyelid retraction, restrictive strabismus, proptosis, exposure keratopathy, and optic neuropathy. In this review, we discuss the most recent literature on and the current understanding of the pathophysiology of TAO. We also review available and potential future treatment options for the management of TAO.

Pituitary Adenoma Apoplexy of the Orbit, Diagnosis, and Management With Presurgical Embolization.

Orbital invasion of pituitary adenomas has been previously reported. In this report, the authors describe a 71-year-old female with a prolactinoma that presented with invasion of and apoplexy within the orbit. The patient underwent exenteration, followed by rapid tumor recurrence and growth. Given the hemorrhagic nature of the tumor, she subsequently underwent preoperative embolization and surgical resection. This case is notable in that it illustrates both apoplexy of a pituitary tumor within the orbit and the benefit of presurgical embolization.