Skorin, Leonid

ABSTRACT Supplemental digital content is available in the text. Purpose To present and discuss a case representing both a new sign and symptom of prostaglandin‐associated periorbitopathy. Case Report An 83‐year‐old female patient presented for a 6‐month glaucoma follow‐up in July 2013 with no specific visual or comfort complaints. The patient had a 14‐year history of bilateral primary open angle glaucoma and a 13‐year history of once daily bimatoprost use in both eyes. Evaluation at previous examinations revealed long eyelashes, tight eyelids, small palpebral fissures, and deepening of the upper eyelid sulcus. During slit‐lamp examination of the anterior segment, it was noted that the patient’s eyelids clicked intermittently when she blinked. The patient had not previously noticed the clicking and it was determined to be present in each eye individually. The eyelid clicking has been noted to be present in every follow‐up examination since it was discovered in July 2013. Conclusions Prostaglandin‐associated periorbitopathy and the resulting cosmetic effects noticed visually by patients are well documented. Our case represents a new audible sign and symptom that may be found with prostaglandin‐associated periorbitopathy but has not to our knowledge been reported in the literature.

ABSTRACT Purpose To present a case of neovascular age‐related macular degeneration treated with aflibercept intravitreal injections after bilateral bevacizumab injections, administered on separate dates, resulted in bilateral iritis. Case Report A 73‐year‐old woman with a previous history of two episodes of nongranulomatous iritis in her right eye that was believed to be associated with her systemic diagnosis of rheumatoid arthritis was treated with intravitreal bevacizumab injections for bilaterally occurring neovascular age‐related macular degeneration. Initial bevacizumab injections in each eye administered sequentially over a week's time resulted in immediate‐onset nongranulomatous iritis in each eye. Subsequent intravitreal injections of aflibercept were administered, and therapeutic benefit was achieved without occurrence of iritis. Conclusions In cases where intravitreal bevacizumab results in anterior uveitis, aflibercept may be a safe alternative therapeutic choice for the treatment of neovascular age‐related macular degeneration.

ABSTRACT Purpose To present and discuss a case of herniation of subconjunctival orbital fat, a very rare but benign condition. Case Report An 84‐year‐old man presented to the eye clinic for a cataract surgery consultation but also had a secondary complaint about yellow lesions on the bulbar conjunctiva of both eyes. Examination with biomicroscopy revealed protruding orbital masses superotemporally in both eyes, with the right lesion being larger than the left. After thorough testing, these lesions were diagnosed as being subconjuntival herniated orbital fat (HOF), and the patient underwent surgical excision of the lesions. Conclusions In cases of HOF, appropriate and accurate testing is essential, as this condition can mimic several other neoplasms, all of which require specialized treatment strategies. If cosmesis is unacceptable to the patient or the lesion impedes normal ocular function, a subconjunctival excision of the excess fat may be performed with little concern of recurrence. This article discusses a case of HOF, with an explanation of testing and treatment options.