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Biomedical subjects

D M Reifler

Publications and source records attributed to D M Reifler.

At least 19 recordsLinked to original sources
PubMed1989

Orbital hemorrhage and eyelid ecchymosis in acute orbital myositis.

We examined two patients with acute orbital myositis associated with orbital hemorrhage and eyelid ecchymosis. Both patients were young women (aged 22 and 30 years) who had painful proptosis, diplopia, and computed tomographic evidence of single extraocular muscle involvement with spillover of inflammatory edema into the adjacent orbital fat. Patient 1 showed contralateral preseptal eyelid inflammation and did not suffer an orbital hemorrhage until after an episode of vomiting. In Patient 2, the diagnosis of occult orbital varix was initially considered but an orbital exploration and a biopsy specimen showed no vascular anomaly. Both patients were treated successfully with high-dose systemic corticosteroids. Some cases of idiopathic orbital inflammation may be related to preexisting vascular anomalies or orbital phlebitis.

Acute Disease↗
PubMed1989

Eyelid crease approach for chalazion excision.

Chronic chalazia that predominantly involve the anterior eyelid lamellae are most easily approached through a transcutaneous incision. We describe the use of an eyelid crease incision for chalazia of the upper lid as an alternative to incision directly over the lesion. The technique has been used successfully in 16 patients with anteriorly situated upper eyelid chalazia. The advantages of this technique include excellent exposure with minimal patient discomfort. There is no need for eyelid eversion or compression with a chalazion clamp. The inflamed tissue can be directly inspected and the controlled excision will yield a superior specimen if biopsy is contemplated.

Adolescent↗
PubMed1987

Orbital lymphoid tumors located predominantly within extraocular muscles.

Lymphoid masses can be centered predominantly within an extraocular muscle (EOM), as exemplified by computed tomography (CT) scanning and biopsy confirmation in the seven cases reported in this study. In these patients, an insidious and painless onset of exophthalmos was overshadowed by ptosis or a motility disturbance (particularly limited upgaze) in the absence of chemosis and lid erythema. The lesions were located in the superior rectus-levator complex (6 cases) and in the medial rectus muscle (1 case). One patient, with an exclusive infiltration of the levator, had a complete ptosis, whereas four others had a partial ptosis. Important clinical clues included palpable masses (4 cases) and preserved downward gaze (all cases), the latter suggesting the absence of fibrotic restriction, as is often seen in Graves' myopathy and the idiopathic myositis of pseudotumor. The biopsy specimens showed spill-over of the hypercellular and stroma-free lymphoid tissue into the orbital fat (all cases) and into the lacrimal gland (3 cases). Full extraocular motility on upgaze was restored after local orbital radiotherapy, although a residual ptosis persisted in five cases. Five patients had well-differentiated lesions and nonocular disease did not develop, whereas a widespread disease developed in one of two patients with a cytologically malignant lymphoma; the patient eventually died.

Adult↗
PubMed1987

Tricholemmoma of the eyelid.

Tricholemmoma is a benign cutaneous tumor that shows differentiation characteristic of the outer hair sheath. The usual site of occurrence is the face, including the nose and eyelid. Four cases of tricholemmoma involving the eyelid margin to a variable extent are presented and the clinical and pathologic findings are reviewed. In three of the four cases, a histopathologic misdiagnosis of squamous cell carcinoma was initially made. In one case, this resulted in a greater sacrifice of normal lid tissue than was necessary, although the reconstruction yielded a good result. In the subsequent cases, the entity of tricholemmoma was well appreciated before definitive oculoplastic surgery and the referring diagnosis of squamous cell carcinoma was refuted.

Aged↗
PubMed1987

A review of chemical eye burns referred to the Blodgett Regional Poison Center.

We reviewed a random sampling of 500 cases of chemical eye exposures referred to the Blodgett Regional Poison Center from July 1, 1986 to December 31, 1986. While some injuries were encountered in laboratories and industrial plants, the great majority originated in the home (84.4%) and involved commonly used household products. Most exposures were acute and reported within minutes to 1 hr. Cases predominantly involved children suffering accidental exposure. The most common symptoms were eye discomfort (56.2%) and redness (26.4%), but many patients were completely asymptomatic (11.4%). The reported injuries included corneal burns or abrasions (23 cases), and conjunctivitis (7 cases). Only 8 cases (1.6%) were initially seen by an ophthalmologist. In virtually all cases, the recommended emergency treatment was immediate prolonged rinsing of the eye.

Accidents, Home↗
PubMed1986

Histochemical analysis of breast carcinoma metastatic to the orbit.

A 62-year-old woman was seen for evaluation of an orbital tumor. Recognition of a relatively rare syndrome of pain, ptosis, and a progressively immobilized globe with enophthalmos suggested the diagnosis of metastatic carcinoma to the left orbit. In this case, this was confirmed by open breast and orbital biopsies, revealing infiltrating lobular breast carcinoma. This is the first reported case where estrogen and progesterone receptors were identified in a metastatic orbital tumor using fluorescent histochemical techniques. This technique was of value in confirming the diagnosis and providing direction for subsequent endocrinologic palliative therapy.

Biopsy↗
PubMed1986

Surgical management of squamous cell carcinoma of the lid.

A series of 12 patients with eyelid squamous cell carcinoma was studied retrospectively with emphasis on the clinical presentation, management, and results. Of the five cases that constituted our personal experience, surgical excision with frozen-section control was an efficacious mode of treatment. In the overall series, there were no cases of regional lymph node metastasis and no tumor deaths. One patient required orbital exenteration. The methods of surgical extirpation of the tumor with frozen-section control, as advocated by the authors, are similar to those used in the management of basal cell carcinoma and other eyelid neoplasms. Because of the potential lethality of squamous cell carcinoma, a wider excision than that usually performed for basal cell carcinoma is recommended, as is close postoperative follow-up.

Aged↗