Charles K. Beyer

The Marcus Gunn Phenomenon: A Review of 71 Cases

We have reviewed the clinical findings, natural course, pathologic observations, and management of 71 patients with the Marcus Gunn phenomenon. We found individuals with this syndrome to have a significant incidence of amblyopia (59%), double elevator palsy (25%), anisometropia (25%), and superior rectus muscle palsy (23%). Long-term follow-up did not reveal a case that improved with age. In most patients requiring surgery, we recommend a unilateral levator excision on the affected side plus a bilateral frontalis suspension.

The Use and Fate of Fascia Lata and Sclera in Ophthalmic Plastic and Reconstructive Surgery: The 1980 Wendell Hughes Lecture

The introduction and use of newer surgical materials, better surgical instruments, finer suture materials, and improved optical equipment have allowed us to advance certain techniques in ophthalmic surgery and ophthalmic plastic surgery. In oculoplastic surgery, fascia lata and sclera are but a few of these materials used with greater frequency. In this paper, a number of techniques are described depicting the use of fascia lata and sclera. A histologic study of these materials after variable periods of implantation is presented.

Conjunctival Cysts of the Orbit Following Enucleation

Four patients developed orbital conjunctival cysts following enucleation. The cysts were demonstrated by ultrasonography and computerized tomography and confirmed by histopathology. They were lined by a non-keratinizing stratified squamous epithelium without goblet cells and contained fluid with mucinous strands. They were excised at eight, seven, and seven, and 25 years post-enucleation, respectively, the latter being the longest interval yet recorded. A simple classification of conjunctival cysts of the orbit is proposed and the mechanisms of the development of cysts in anophthalmic sockets are discussed. The effects of secretory rate and cyst growth are reviewed and surgical management in prevention and treatment of these lesions is outlined.

Naso-orbital Fractures, Complications, and Treatment

Naso-orbital fractures designate a backward displacement of the bones of the nasoskeletal framework into the interorbital space. This anatomical disruption results in deformities, lacrimal dysfunction, medial canthal deformities, ptosis, blow-out fractures, ocular complication, and most severely, penetration of bony fragments into the anterior cranial fossa. Early and late treatment methods are considered. Restoration of the bony contour of the nose and medial canthoplasty procedures are discussed.