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A 73-year-old man with congestion and mild proptosis of the left eye
Digital Journal of Ophthalmology 2016
Volume 22, Number 2
April 25, 2016
DOI: 10.5693/djo.03.2014.05.001
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Amanda Mohanan Earatt, MS | Department of Ophthalmology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
Lathika Vasu Kamaladevi, MS, DO, FRCS Glasgow | Department of Ophthalmology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
Charles K. Skariah, MS, DO | Department of Ophthalmology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
Treatment
The patient was referred to an oncologist for treatment. He underwent metastatic evaluation with bone scintigraphy and contrast enhanced CT of the thorax, abdomen, and pelvis. No other foci of metastasis were identified, and he subsequently underwent palliative conformal radiotherapy to left orbit (total dose, 30Gy/10#). Two weeks after radiotherapy, the left eye showed madarosis with partial ptosis (Figure 4A). The lid edema and proptosis were significantly reduced compared to the previous visit. The conjunctival chemosis and congestion had resolved completely (Figure 4B). Extraocular movements had improved, but moderate restriction of elevation persisted (Figure 4C).
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Figure 4
Clinical photographs 2 weeks after radiotherapy. A, Reduced lid edema and partial ptosis of left eye. B, Reduced proptosis and resolved conjunctival chemotic congestion of left eye. C, Moderate restriction of elevation in left eye.