| Identifier |
walsh_2015_s3_c3-2 |
| Title |
The Man with No Face (About Face) |
| Creator |
Michael S. Vaphiades, MD, University of Alabama |
| Subject |
Basal Cell; Visual Loss; Destructive Process; Head and Neck; Carcinoma |
| History |
A 61-year-old man presented with one week history of decreased vision OS. Past medical historyincludes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes nomedications. He is retired but worked for 21 years in social science research. The remarkable thingupon meeting this articulate intelligent individual is he had no face. On exam his visual acuity was NLPOD and HM OS. There was no view of the pupil OD and a poor view OS but there is minimal reactivity.Color vision was non-recordable. Confrontational visual field showed marked constrictionOS. Extraocular muscle exam showed complete restriction OD and a small amount of movement in allcardinal directions OS. External exam OD revealed absence of eyelids, exposed globe, and densecorneal scar with no view into the anterior chamber. External exam OS showed thick, keratinized upperand lower lids temporally and absence of lids medially, and 360 degrees of conjunctival chemosis,diffuse corneal edema with white lesion inferonasally, and a formed AC with poor view. Intraocularpressure was non-measurable OD and 40 mm Hg OS. No view of the fundus OU. Cranial and orbital CTand MRI revealed extensive destruction of soft tissue of the face that abuts and likely invades the dura.The right globe was involved, the left globe appeared intact. The intracranial and prechiasmatic portionof the optic nerves appeared normal. There was no definite evidence of involvement of the cavernoussinuses. However, there was disease surrounding several intracranial nerve roots, which likely representsperineural invasion of these structures. A biopsy was obtained. |
| Date |
2015-02-22 |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
2015 North American Neuro-Ophthalmology Society Annual Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| Collection |
Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416 |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6419tpd |
| Contributor Primary |
Courtney E. Francis |
| Contributor Secondary |
Alfredo A. Sadun |
| Setname |
ehsl_novel_fbw |
| ID |
179305 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6419tpd |
