{"title":"Total meibomian gland loss in Parkinson's disease.","authors":"Prajakta Dandekar, Swati Singh","doi":"10.1080/01676830.2025.2475840","DOIUrl":"10.1080/01676830.2025.2475840","url":null,"abstract":"<p><p>Parkinson's disease is characterized by motor dysfunction, affecting blink frequency in the eyes. Reduced blinking and use of anticholinergic medications result in dry eye disease (DED) in these patients. This unique case had complete meibomian gland loss seen on meibography with reduced blinking and lacrimal gland function as well attributed to Parkinson's and its treatment. The autoimmune workup was negative, and the final diagnosis of drug-induced DED was made. The patient was managed with ocular lubricants and anti-inflammatory eye drops.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"625-627"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan E Lu, Lisa Y Lin, Elana Meer, Yilin Feng, Michele Bloomer, Nailyn Rasool, Mary E Cunnane, Michael K Yoon
{"title":"Orbital conditions and their Hounsfield unit characteristics.","authors":"Jonathan E Lu, Lisa Y Lin, Elana Meer, Yilin Feng, Michele Bloomer, Nailyn Rasool, Mary E Cunnane, Michael K Yoon","doi":"10.1080/01676830.2025.2492819","DOIUrl":"10.1080/01676830.2025.2492819","url":null,"abstract":"<p><strong>Purpose: </strong>Computed tomography (CT) uses Hounsfield units (HU) for density, which is a standardized unit of measure. This study created a HU reference guide and evaluates the use of HU for orbital lesions and normal structures.</p><p><strong>Methods: </strong>Retrospective chart review at two academic centers identified patients with biopsy proven orbital lesions and CT imaging. Patients with normal orbital structures were included as a normative database. HU was measured.</p><p><strong>Results: </strong>The study included 219 patients with orbital lesions and 50 control patients with a total of 341 images. Of these, 241 images were orbital lesions, with 137 non-contrast and 104 contrast. There were 50 non-contrast and 50 contrast normal scans. The orbital lesion group represented 29 distinct orbital diagnoses. Major orbital structures were distinguishable by HU, and extraocular muscles were found to be significantly different between muscles. A subset of orbital lesions had significantly different mean HU compared to normal orbital structures.</p><p><strong>Conclusions: </strong>Analysis of Hounsfield units provides additional depth to orbital imaging that may aid in diagnostic yield and therapeutic intervention for certain lesions. This study summarizes HU data for orbital lesions as well as a normative database of orbital structures.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"544-554"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timon Ax, Tomas L Bothe, Jennifer P Craig, Simon J Dean, Francesc March de Ribot, Fabian N Fries, Slade O Jensen, Thomas Millar, Berthold Seitz
{"title":"The effect of short-term microgravity and hypergravity on eyelid and brow position.","authors":"Timon Ax, Tomas L Bothe, Jennifer P Craig, Simon J Dean, Francesc March de Ribot, Fabian N Fries, Slade O Jensen, Thomas Millar, Berthold Seitz","doi":"10.1080/01676830.2025.2491375","DOIUrl":"10.1080/01676830.2025.2491375","url":null,"abstract":"<p><strong>Purpose: </strong>Spaceflights induce periocular facial changes which could contribute to ocular conditions which affect astronauts. This study is to validate parabolic flight as a suitable model for studying gravitational facial changes.</p><p><strong>Methods: </strong>Healthy participants (<i>n</i> = 13; 37 ± 10 years) underwent short-term exposure to microgravity and hypergravity during parabolic flight. Facial images were captured and differences in measurements from pupil center to upper and lower eyelid margins (MRD1 and MRD2), and to the inferior and superior eyebrow margin (PTB<sub>i</sub> and PTB<sub>s</sub>) under normogravity, microgravity, and hypergravity were compared. A repeated measures ANOVA with Bonferroni-Holm corrected post-hoc paired t-test was used for statistical analysis.</p><p><strong>Results: </strong>One hundred and twenty-seven images (44 normal gravity, 43 microgravity, 40 hypergravity) revealed that short-term microgravity induced a mean PTB<sub>i</sub> increase of 2.3 mm (<i>p</i> < 0.001) and mean PTB<sub>s</sub> increase of 2.4 mm (<i>p</i> < 0.001) while decreasing mean MRD2 by 0.9 mm (<i>p</i> < 0.001) but without change in MRD1 (<i>p</i> = 0.41). Short-term hypergravity did not change PTB<sub>s</sub>, PTB<sub>i</sub> or MRD2 but reduced mean MRD1 by 0.7 mm (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Short-term microgravity, similar to spaceflight, significantly elevates PTB but not MRD1. It was also shown that MRD2 was reduced. Short-term hypergravity induces significant reductions only in MRD1. Phenomena are likely explicable by co-activation of the muscles raising the eyelid and eyebrow. Comparison to space data suggests that parabolic flight offers a valid model to study periocular facial changes in microgravity.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"535-543"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Viana N Phan, Emma C McDonnell, Laura T Phan, Jessica R Chang, Thomas N Hwang, Michael K Yoon, Timothy J McCulley, Ying Chen
{"title":"The swinging sclera technique for evisceration.","authors":"Viana N Phan, Emma C McDonnell, Laura T Phan, Jessica R Chang, Thomas N Hwang, Michael K Yoon, Timothy J McCulley, Ying Chen","doi":"10.1080/01676830.2025.2456496","DOIUrl":"10.1080/01676830.2025.2456496","url":null,"abstract":"<p><strong>Purpose: </strong>To present a modified evisceration technique with a full-thickness horizontal sclerotomy and assess post-operative motility and long-term outcomes.</p><p><strong>Methods: </strong>This is a retrospective chart review of patients who underwent evisceration with a single surgeon (TJM). The standard initial steps of evisceration were performed. Before implant placement, a complete radial sclerotomy was extended posteriorly at the 3 and 9 o'clock positions, 2 mm above the optic nerve, longitudinally dividing the medial and lateral rectus insertions. The scleral halves were mobilized, allowing them to \"swing\" forward and overlap over the spherical implant. In a subgroup of five patients, postoperative motility was assessed by marking the conjunctiva overlying the implant and taking photos in extreme gazes. Operative and non-operative eye measurements were compared in SiliconCoach Digitizer Software.</p><p><strong>Results: </strong>Thirty patients were identified (16 male, 14 female; mean age 56.9, range 4.6-90.1 years). Eleven patients were noted to have phthisis bulbi. Implant sizes were 18 mm (<i>n</i> = 13), 20 mm (<i>n</i> = 14), and 22 mm (<i>n</i> = 2) with a mean of 19.24 mm. Mean horizontal and vertical motility ratios of operated to non-operated eye were 0.61 ± 0.18 and 0.76 ± 0.28, respectively, with no statistically significant differences (<i>p</i> = 0.38).</p><p><strong>Conclusions: </strong>Evisceration with complete horizontal full thickness sclerotomy is an effective technique that prevents the sclera from limiting implant size, even in patients with phthisis bulbi. Longitudinal division of the recti insertions also did not affect function or implant stability.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"572-577"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khizar Rana, Mark Beecher, Jessica Y Tong, Tejaswi Bommireddy, Katja Ullrich, Richard Hart, Jwu Jin Khong, Geoffrey Wilcsek, Thomas Hardy, Phung Vu, Dinesh Selva
{"title":"Immunotherapy for orbital squamous cell carcinoma.","authors":"Khizar Rana, Mark Beecher, Jessica Y Tong, Tejaswi Bommireddy, Katja Ullrich, Richard Hart, Jwu Jin Khong, Geoffrey Wilcsek, Thomas Hardy, Phung Vu, Dinesh Selva","doi":"10.1080/01676830.2025.2469305","DOIUrl":"10.1080/01676830.2025.2469305","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the demographics, clinical features and response of orbital squamous cell carcinoma treated with immunotherapy in an Australian and New Zealand cohort.</p><p><strong>Methods: </strong>This is a multi-institutional, retrospective case series. Data was collected on patient demographics, clinical presentation, imaging findings, treatment course and outcomes. Details of post-immunotherapy surgical interventions were documented along with their histological findings.</p><p><strong>Results: </strong>Ten patients were included. All patients had invasive orbital squamous cell carcinoma. Perineural spread was present in six patients. Seven patients received Cemiplimab, while three patients received Pembrolizumab. No patients experienced side effects requiring cessation of immunotherapy. One patient died during follow up due to an unrelated cause. Eight (80%) patients had measurable radiological response, whereas one (10%) patient had progressive disease. Two patients had orbital exenteration: one due to progressive disease and one due to residual disease on MRI. One patient had orbital mapping biopsies. Two (66%) patients that had tissue analysis following immunotherapy showed complete pathologic response.</p><p><strong>Conclusion: </strong>Our findings support the emerging role of immunotherapy in the management of invasive orbital squamous cell carcinoma.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"504-510"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pratheeba Devi Nivean, Rohit Shetty, Swaminathan Sethu, Arkasubhra Ghosh, Govindasamy Kumaramanikavel, Keerti Koka, Carroll A B Webers, Tos Tjm Berendschot, Dion Paridaens
{"title":"Role of biomarkers in South Indian Thyroid Eye Disease study (SITED).","authors":"Pratheeba Devi Nivean, Rohit Shetty, Swaminathan Sethu, Arkasubhra Ghosh, Govindasamy Kumaramanikavel, Keerti Koka, Carroll A B Webers, Tos Tjm Berendschot, Dion Paridaens","doi":"10.1080/01676830.2025.2453536","DOIUrl":"10.1080/01676830.2025.2453536","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid eye disease (TED) is a complex autoimmune disease. Early detection with routine disease monitoring using biomarker assessment would help in mitigating TED-associated vision loss. Hence, we performed a non-invasive tear fluid (TF) based screening in patients with TED as part of the South Indian Thyroid Eye Disease Study (SITED).</p><p><strong>Materials and methods: </strong>We used TF from healthy controls (HC;13 eyes;13 subjects), patients with thyroid dysfunction but without TED (No TED;11 eyes;11 subjects) and patients with TED (18 eyes;18 subjects). TED subjects were further sub-divided into those with and without an active form of the disease. Patients with dysthyroid optic neuropathy (DON) were analyzed separately. The diagnosis of TED was based on Gorman and Bartley's criteria. Activity was defined as scoring more than 4 in the Vision, Inflammation, Strabismus and Appearance (VISA). Schirmer's strip was used to collect TF and the levels of IL-2, IL-4, IL-5, IL-6, IL-7, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-22, IFNγ, TNFα, PDGF-AA and PDGF-BB were determined by multiplex ELISA using flow cytometry.</p><p><strong>Results: </strong>Significantly (<i>p</i> < 0.05) higher levels of IL-6 and IL-10 were observed in TED patients compared to HC and No TED subjects. TF levels of IL-6 and IL-10 were significantly higher in active TED patients compared to No TED subjects. Interestingly, TF levels of PDGF-AA were observed to be negatively associated with IL-4 and IL-13.</p><p><strong>Conclusion: </strong>Elevated TF levels of IL-6 and IL-10 can be explored for their role as a non-invasive risk stratification biomarker or as targets to modulate management of TED.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"489-497"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyed Mohammad Malakooti Shijani, Mohsen Bahmani Kashkouli, Mercia J Bezerra Gondim, Peter J Timoney, Adrianna H Masters, Guneet Sarai, Christopher J Compton, Jeremy D Clark
{"title":"Orbital and ocular adnexal histiocytic tumors; a multidisciplinary literature review.","authors":"Seyed Mohammad Malakooti Shijani, Mohsen Bahmani Kashkouli, Mercia J Bezerra Gondim, Peter J Timoney, Adrianna H Masters, Guneet Sarai, Christopher J Compton, Jeremy D Clark","doi":"10.1080/01676830.2025.2483975","DOIUrl":"10.1080/01676830.2025.2483975","url":null,"abstract":"<p><strong>Purpose: </strong>To review and update the clinical presentation, pathology, treatment strategies, and follow-up of the orbital and ocular adnexal histiocytic tumors.</p><p><strong>Methods: </strong>The review included the publications in English literature up to January 2024.</p><p><strong>Results: </strong>Out of 263 screened publications, 73 studies on Langerhans cell histiocytosis (LCH), juvenile and adult onset xanthogranuloma (JXG, AOXG), Erdheim-Chester disease (ECD), Rosai-Dorfman disease (RDD), and histiocytic sarcoma (HS) were included. Diagnosis is based on histological characteristics and markers on immunohistochemical staining. Treatment options vary depending on the type of histiocytic tumors, number of lesions, number of involved organs, and presence of vital organ involvement such as central nervous system. Surgery is the first diagnostic step for all and serves as the primary treatment for LCH and XG. Systemic chemotherapy is the primary treatment for EDC, RDD, and HS and the treatment of choice for the patients with multifocal or multi-organ involvement as well as recurrent or refractory lesions, regardless of the type of histiocytic tumor. Radiotherapy is an adjunctive primary treatment for the patients with HS. It is reserved for recurrent or refractory lesions in the other types. Targeted therapy is currently in progress and may replace the systemic chemotherapy in patients with LCH, XG, and EDC.</p><p><strong>Conclusion: </strong>Surgical debulking is diagnostic in all and therapeutic in LCH, JXG, and AOXG. All recurrent, refractory, multifocal, and multi-organ tumors require additional systemic chemotherapy with or without radiotherapy. Follow-up imaging every 3 to 6 months for the first 2 years and then annually is recommended.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"657-669"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Technical notes for a method of eyebrow reconstruction by retroauricular scalp graft: problems and countermeasures.","authors":"Hidetaka Miyazaki, Jonnah Kristina Teope, Yasuhiro Takahashi, Hirohiko Kakizaki","doi":"10.1080/01676830.2024.2444515","DOIUrl":"10.1080/01676830.2024.2444515","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a technique using retroauricular scalp graft for eyebrow reconstruction, along with problems encountered and countermeasures in treatment.</p><p><strong>Methods: </strong>We present a patient with eyebrow loss following resection of a malignant schwannoma. We initially covered the defect from the upper eyelid to the eyebrow area with artificial dermis for hemostasis and to increase the granulation of the graft bed. Considering hair texture, aesthetic unit and color match, the eyebrow area was grafted with a scalp harvested from the retroauricular region. The skin from the subclavian area was used for the upper eyelid defect. Tie-over fixation was performed.</p><p><strong>Results: </strong>After a slightly longer immobilization period of 8.5 days, the tie-over fixation was removed. All grafted scalp and skin were fully engrafted. The reconstructed eyebrows had natural hair flow and softness. The texture of retroauricular hair closely resembled that of natural eyebrow hairs. The color and texture the upper eyelid grafts were also matched well. Surgical scar at the retroauricular hairline was effectively concealed by surrounding hair.</p><p><strong>Conclusion: </strong>Eyebrow reconstruction could be successfully achieved using from the retroauricular scalp with some ingenuity in order to be successful. These include improving the hemodynamic status of the grafted bed, considering aesthetic units, and extending the fixation period.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"567-571"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juliana A Guimaraes, Denny M Garcia, Antonio Augusto V Cruz
{"title":"The von Gräfe sign measurement.","authors":"Juliana A Guimaraes, Denny M Garcia, Antonio Augusto V Cruz","doi":"10.1080/01676830.2025.2475823","DOIUrl":"10.1080/01676830.2025.2475823","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the amplitude of upper eyelid saccadic movements in patients with Graves' retraction.</p><p><strong>Methods: </strong>The amplitude and velocity of lid saccades were quantified using customized software in 36 patients with Graves' upper eyelid retraction (GO) and in 32 subjects of a control group (CG). All patients were in the chronic phase of the disease and had a controlled thyroid status. Eyelid retraction was measured using the software ImageJ. Levator palpebrae superioris muscle (LPSM) dimensions were measured through orbital computed tomography (CT).</p><p><strong>Results: </strong>The mean MRD1 was 6.5 mm and 3.9 mm in the GO and CG groups, respectively. The LPSM was radiologically enlarged in patients. The absolute values of both amplitude and velocity of lid movement did not differ between the two groups. However, considering the final position of the lid margin in relation to the pupil in downgaze, the margin-reflex distance of the patients was significantly higher than that of the controls.</p><p><strong>Conclusion: </strong>In patients with upper eyelid retraction in inactive GO the relaxation of the LPSM are not affected, despite the muscle enlargement. However, the amplitude of the downward lid movement of the patients does not compensate for the lid retraction. The final position of the lid margin of the patients in downgaze is significantly higher than in controls, indicating the inability of the LPMS relaxation to overcome lid retraction. The von Gräfe sign is thus a relative phenomenon and not an absolute indication of loss of the lid elastic properties.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"516-521"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corneal perforation secondary to medial canthal fistula in cocaine-induced midline destructive lesions.","authors":"Simerdip Kaur, Meydan Ben Ishai, Saul Rajak, Huw Oliphant, Mayank Nanavaty","doi":"10.1080/01676830.2025.2477637","DOIUrl":"10.1080/01676830.2025.2477637","url":null,"abstract":"<p><p>To report a rare case of corneal perforation precipitated by an abnormally positioned globe, lagophthalmos and exposure keratopathy secondary to medial canthal fistula in cocaine induced midline destructive lesions (CIMDL). We describe the clinical presentation of a middle-aged man who developed a corneal perforation secondary to medial canthal fistula and enophthalmos and adduction caused by CIMDL. He underwent combined strabismus surgery, cornea patch grafting and tarsorrhaphy, but ultimately required evisceration. Thereafter, his medial canthal fistula was closed with a double layered skin flap. Destructive medial canthal and orbital vasculitis can compromise the protection of the ocular surface and result in corneal perforation. Subsequent management of residual medial canthal fistulas can be challenging and risks failure in the future, especially if there is ongoing aggressive tissue destruction.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"628-632"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}