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4 year old boy with proptosis of the left eye and an afferent pupillary defect
Digital Journal of Ophthalmology 1999
Volume 5, Number 9
February 8, 1999
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Peter A.D. Rubin, M.D.,F.A.C.S. | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Ramin Tayani, M.D., M.P.H. | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Examination
On admission, the patient was found to be in significant distress and pain.

Vision: 20/20 OD, 20/200 OS
Pupils: 2+ afferent pupillary defect OS
Motility: 3 in all fields OD, 1-2 in all fields OS
External: No lymphadenopathy, no sinus tenderness. A soft cystic lesion was palpated in the preauricular region on the left side 2 mm of lagophthalmos
Slit lamp examination: OD: WNL; OS: chemosis, corneal exposure. Otherwise normal
Fundus examination: OD: WNL; OS: opitc nerve head edema, Retinal striae
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Figure 1
OS : Severe proptosis, nasal conjunctival chemosis