Zachary Joos

Review: The Lacrimal Gland and Its Role in Dry Eye.

The human tear film is a 3-layered coating of the surface of the eye and a loss, or reduction, in any layer of this film may result in a syndrome of blurry vision and burning pain of the eyes known as dry eye. The lacrimal gland and accessory glands provide multiple components to the tear film, most notably the aqueous. Dysfunction of these glands results in the loss of aqueous and other products required in ocular surface maintenance and health resulting in dry eye and the potential for significant surface pathology. In this paper, we have reviewed products of the lacrimal gland, diseases known to affect the gland, and historical and emerging dry eye therapies targeting lacrimal gland dysfunction.

Intraorbital Irrigation of Amphotericin B in the Treatment of Rhino-Orbital Mucormycosis.

The aim of this study was to describe a modified technique of intraorbital irrigation of amphotericin B in the treatment of rhino-orbital mucormycosis. A 38-year-old man was diagnosed with rhino-orbital mucormycosis and subsequently underwent orbital and sinus debridement with postoperative intraorbital irrigation of amphotericin B. Daily irrigation of amphotericin B was infused in the orbit with measures taken to avoid iatrogenic toxicity to the ocular surface and gastrointestinal tract. The use of local amphotericin B irrigation directly in the orbit allowed for local control of infection without orbital exenteration, a good cosmetic outcome and excellent postoperative visual acuity. The published reports on the use of intraorbital irrigation with amphotericin B in mucormycosis infections were reviewed and the technique used at the institution was outlined.

Posterior ischemic optic neuropathy in the setting of posterior reversible encephalopathy syndrome and hypertensive emergency.

We present the magnetic resonance imaging findings of posterior ischemic optic neuropathy in a patient with posterior reversible encephalopathy syndrome secondary to hypertensive emergency.

Reversible Blindness Following Orbital Fracture Repair.

The authors report a case of a 72-year-old woman with unilateral, complete, reversible blindness (no light perception) immediately after uncomplicated repair of an orbital floor fracture. In this case, vision loss was reversed with prompt surgical intervention with removal of the orbital floor implant. The authors review the etiology of vision loss after orbital fracture repair and hypothesize as to the cause of blindness in this case. Given the frequency with which orbital fracture repair is performed by a variety of surgical subspecialists, it is imperative for surgeons to be familiar with the ophthalmic complications and be aware of the multiple causes of postoperative vision loss. The authors propose that immediate postoperative assessment of visual function be performed on all patients undergoing orbital fracture repair.

Orbital foreign body masquerading as orbital air.

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