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Ophthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy

DeMaria, Lauren; Tran, Ann Q; Tooley, Andrea A; Abdelhakim, Aliaa; Belinsky, Irina; Kim, Eleanore
A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Neuroimaging revealed extensive vascular congestion along the extraocular muscles at the orbital apex. Retinal imaging demonstrated an ophthalmic artery occlusion. OCS following a frontal or frontotemporal craniotomy relates to increased orbital venous congestion from direct compression of the myocutaneous flap and subsequent intraorbital pressure elevation, vascular compromise, and ocular ischemia.
PMCID:8312523
PMID: 34318304
ISSN: 2772-3089
CID: 4949682

Placement of a PROPEL sinus implant during endoscopic dacryocystorhinostomy

Iyengar, Nishanth S; Tran, Ann Q; North, Victoria S; Voigt, Erich P; Kim, Eleanore T
PMID: 33491533
ISSN: 1744-5108
CID: 4766912

Ossifying Pilomatrixoma of the Eyelid

Charles, Norman C; Kim, Eleanore T
Pilomatrixoma, an uncommon, usually benign cutaneous appendageal tumor, shows differentiation toward the hair follicle matrix cell. It undergoes various histopathologic stages, early on displaying epithelial and shadow cells along with granulomatous inflammation. In later stages, illustrated by this unusual case, epithelial cells disappear and are replaced by calcification and ossification. Immunohistochemistry in the current case showed transitional cell reactivity for β-catenin, probably linking the tumor to a mutation in the β-catenin gene CTNNB1. There was also transitional cell positivity for cyclin D1, a marker found in matrical cells of the human hair follicle. While pilomatrixoma occurs occasionally in the eyelid, the ossified eyelid variant in the current case is very rare, with only one preceding description in the literature.
PMID: 32304502
ISSN: 1537-2677
CID: 4401872

Living with COVID-19: A Perspective from New York Area Ophthalmology Residency Program Directors at the Epicenter of the Pandemic [Editorial]

Chen, Royce W S; Abazari, Azin; Dhar, Sonya; Fredrick, Douglas R; Friedman, Ilana B; Dagi Glass, Lora R; Khouri, Albert S; Kim, Eleanore T; Laudi, John; Park, Sunju; Reddy, Harsha S; Rosenberg, Jamie B; Sandler, Shlomit F; Shrivastava, Anurag; Sun, Grace; Winokur, Jules
PMCID:7204687
PMID: 32387482
ISSN: 1549-4713
CID: 4437912

Oculoplastics Education in the Coronavirus 2019 Pandemic With Virtual Suturing Curriculum

DeMaria, Lauren N; Tran, Ann Q; Tooley, Andrea A; Lisman, Richard D; Belinsky, Irina; Kim, Eleanore T
PMID: 32675725
ISSN: 1537-2677
CID: 4528512

Complications of Orbital Emphysema in a COVID-19 Patient

Stevens, Dylan V; Tran, Ann Q; Kim, Eleanore
PMCID:7211670
PMID: 32434673
ISSN: 1549-4713
CID: 4446922

Fibrous Dysplasia-like Lacrimal Sac Tumor Associated With Dacryocystitis

Charles, Norman C; Hoda, Syed T; Patel, Payal; Kim, Eleanore T; Belinsky, Irina
A 72-year-old woman who presented with right-sided epiphora and conjunctivitis underwent a probing and irrigation procedure with normal results. She improved with antibiotic-steroid drops. A swelling in the medial canthal region completely resolved. One year later, she returned with symptoms of dacryocystitis. An external dacryocystorhinostomy was performed. Characteristic dacryoliths were removed from the sac lumen, and biopsy of the sac wall showed spicules of lamellar bone within a fibrous stroma. Diagnosed as fibrous dysplasia of the lacrimal sac, this rare entity represents the second such case in the literature.
PMID: 31895726
ISSN: 1537-2677
CID: 4251682

Ophthalmic manifestations of superior orbital blow-in fractures with and without bone fragment globe compression [Meeting Abstract]

Rebhun, C; Dempsey, K; Tran, A; Tooley, A; Belinsky, I; Kim, E; Godfrey, K J
Purpose : To describe clinical features requiring urgent surgical intervention for superior orbital blow-in fractures with and without globe compression. Methods : Retrospective, consecutive case series between 6/1/2018 and 12/1/2019. Results : Six patients (6 eyes) with superior orbital blow-in fractures were identified, 50% with bone fragments compressing the globe. The mean age of presentation was 31.8 +/- 10.5 years. The majority of patients were male (83%), involved the left eye (83%), and were assault victims with a swinging object (50%). All patients had periorbital edema and a brow laceration. No patients had clinical evidence of a ruptured globe. The visual acuity of the affected eye ranged from 20/20 to 20/30. Post-operative visual acuity worsened in one case (16%) due to vitreous hemorrhage. Surgical approaches included lateral orbitotomy through the brow laceration (66%), through an eyelid crease incision (17%) and a craniotomy (17%). The most common fracture types on computed tomography included communicated fractures of the frontal sinus to the superior orbital rim (83%), involvement of the zygomatic bone (33%) and an inferiorly displaced superior orbital rim (17%). Additional orbital injuries included left rectus hematoma (16%), bone fragment abutting the lacrimal gland (50%) and intraconal hematoma (33%). An intracranial injury was seen in 33% of patients, including a parieto-occipital hematoma and frontal white matter contusion. Fifty percent of patients had bone fragments directly compressing the globe with deformation of the globe contour, which was visible on fundoscopic examination and bedside ocular ultrasound. Distinguishing features of orbital blow-in fractures with globe compression compared to those without included supra-and abduction motility deficits, proptosis, globe dystopia and abnormal posterior segment exam, which were seen in all cases. Posterior segment findings included choroidal folds (100%), choroidal rupture (33%), commotio (33%) and vitreous hemorrhage (33%), however there were no retinal tears or detachments. Conclusions : In cases of periocular trauma, the presence of exophthalmos, globe dystopia, ocular motility deficits, and choroidal folds may suggest an orbital blow in fracture with globe compression. These findings should prompt expedited imaging and surgical intervention when appropriate
EMBASE:632695656
ISSN: 1552-5783
CID: 4586142

Staged embolization and excision of an arteriovenous malformation involving the eyelid and orbit

Tsui, Edmund; Dunbar, Kristen E; Kim, Eleanore T; Patel, Payal
PMID: 30732507
ISSN: 1744-5108
CID: 3632362

Assessment of mentorship needs during ophthalmology residency [Meeting Abstract]

Tsui, E; Lo, C; Kim, E; Haberman, I; Sperber, L T; Madu, A; Lazzaro, D; Schuman, J
Purpose: Mentorship during various stages of medical training has been demonstrated to improve satisfaction in training and also to shape career goals. There are few studies evaluating formal mentorship programs within ophthalmology residency. We aim to evaluate the mentorship needs of ophthalmology residents, which may provide the framework to establish a formal mentorship program.
Method(s): An online cross-sectional survey was distributed in May 2017 to all residents (n=20) in the New York University School of Medicine ophthalmology residency program to evaluate their perspectives on mentorship. The questionnaire consisted of multiple choice and Likert-type questions.
Result(s): The response rate was 100% (20/20 of surveyed residents), of which 7 were PGY- 2, 6 were PGY-3, and 7 were PGY-4. Seventy-five percent (15/20) of residents reported that mentorship was "very important" during residency. Approximately two-thirds of residents (13/20) had participated in a formal mentorship program prior to residency. Eighty percent (16/20) of residents reported that two mentors were an ideal number, while 20% preferred three mentors. Sixty percent (12/20) of residents had already identified an informal mentor during residency. Respondents replied that "accessibility" was the most important quality in a mentor followed by "willingness to write a letter of recommendation". Gender, age, and academic ranking were the least frequently selected as important qualities in a mentor. The most common reason for pursuing a mentor was "seeking career guidance", followed by "obtaining a letter of recommendation" and "seeking someone as an advocate or confidant". The least commonly selected reason for seeking a mentor was "improvement of clinical skills".
Conclusion(s): Ophthalmology residents view mentorship as an important part of their training. Residents prioritize accessibility and career guidance as important aspects of mentorship and many are seeking a faculty member who may contribute a reference letter in the future. The results of this survey have contributed to the development of a formalized residency mentorship program, and help guide mentorship objectives and practice
EMBASE:628582956
ISSN: 1552-5783
CID: 4001372