Some Orbital Confusion

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Identifier walsh_2013_s1_c3-2
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
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 Image/MovingImage
Format video/mp4
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/s6dr5s1p
Setname ehsl_novel_fbw
Date Created 2015-02-21
Date Modified 2021-05-06
ID 179233
Reference URL