Some Orbital Confusion

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Identifier walsh_2013_s1_c3
Title Some Orbital Confusion
Creator Steven A. Newman, M.D., University of Virginia School of Medicine; Bourne, David T
Subject Orbit; Marginal Zone Lymphoma; IGH-PCR; Immunohistochemistry
Presenting Symptom A 64 year old gentleman was referred for progressive horizontal diplopia.
History In September 2006 he had been referred for a second opinion regarding a 5 year history of intermittent swelling around the right orbit, worsening over 7 months associated with double vision, and proptosis (C,D).
Clinical Acuity was 20/25. 24-2 demonstrated moderate diffuse depression OD > OS, and some arcuate VF changes OS. Palpebral fissures were 13 and 10 with an upper lid range of 15 and 12. Hertels 28/19 with some resistance to retropulsion. There was no APD, but definite limitation in elevation > abduction, adduction, and depression OD with 100 seconds stereopsis. Applanation tensions were 16 and 12. OCT demonstrated minimal thinning of NFL superiorly and nasally, but symmetric OU. CT scan (A,B) demonstrated R orbital pathology.
Neuroimaging Flow Cytometry
Pathology Review of the original orbital pathology failed to confirm malignancy and a repeat orbital biopsy was planned.
Disease/Diagnosis Persistent and recurrent low grade B cell lymphoma (marginal zone) demonstrated by gene rearrangement studies.
Treatment Chlorambucil
References Attached
Relation is Part of Case presented at the NANOS 2013 Walsh Session, February 10
Contributor Primary Bruce, Beau B
Contributor Secondary Phillips, Paul H
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2013-02-10
Type Text
Format application/pdf
Source 45th Annual Frank Walsh Society Meeting
Holding Institution North American Neuro-Ophthalmology Association (NANOS), Copyright 2013. For further information regarding the rights to this collection, please visit
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6jt2n0c
Setname ehsl_novel_fbw
Date Created 2013-12-12
Date Modified 2021-05-06
ID 179170
Reference URL
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