Mitesh K. Kapadia, MD, PhD

A 52-year-old Latin-American man was referred to the Oculoplastics service at the New England Eye Center for evaluation of presumed pyogenic granuloma. The patient reported a history of a rapidly growing “stye” in his left lower eyelid for the prior 2 weeks. He denied any associated pain, erythema or discharge. Medical history was positive only for diet-controlled diabetes. He denied any history of malignancy or sexually transmitted infections such as HIV. Ocular history was unremarkable, including any history of trauma or surgery to the eyelid. He was not taking any medications. The patient also denied any history of smoking, intravenous drug use or high-risk sexual activity. He worked as a driver.

A 34-year-old male landscaper presented to the eye clinic for evaluation of increasing proptosis of the left eye over a period of 8 months. He recalled that he was hit by a small rock in the area of the left lateral orbit at the time he first noticed swelling. Since then, he had intermittent episodes of redness and noted a decline in vision in the left eye. He denied constant or severe pain but noticed that he had a painful soreness that worsened when lying down. He denied having any soreness or pain when sitting upright or any fluctuations in the proptosis. He had no significant medical, surgical or ocular history and did not take any medications. Of note, his mother had thyroid disease from which she developed ocular complications.

A 71-year-old woman presented to the New England Eye Center Oculoplastics Department for a right upper lid lesion that was present for approximately 1 year. She said that it did not change in appearance or size and was tender to touch. The lesion did not reduce in size despite weeks of warm compresses. Her medical history included diabetes type 2, gout, cardiac murmur, hypertension, hyperlipidemia and hypothyroidism, all of which were being treated with medications.

A 39-year-old man presented to his ophthalmologist with a complaint of his right eye looking “different” from his left eye for the past 6 months. He denied any pain, foreign body sensation, double vision or other ocular complaints. He also denied any history of trauma or recent facial surgery; he had a history of a broken nose as a teenager and nasal surgery to correct it at that time.

A 94-year-old woman presented to the New England Eye Center complaining of irritation in her left eye. She noted that this irritation was accompanied by a foreign body sensation when blinking, which she described as feeling like “double eyelids.” She also noted the appearance of a left upper lid lump within the past month. She denied any pain or decrease in vision in the left eye.

A 54-year-old Caucasian man was referred to the New England Eye Center for progressive right lower eyelid swelling. He reported that his symptoms started 10 days before presentation with eyelid swelling and redness, and he subsequently developed discharge and eye pain, exacerbated with extraocular movements and palpation. He also developed blurred vision and constitutional symptoms including decreased appetite and lethargy. He denied any light sensitivity, flashes, floaters, recent illness, fever or recent trauma.

A 52-year-old man presented to the oculoplastics service at the New England Eye Center for evaluation of bulging of his left eye, which had occurred gradually over the past 3 to 4 years. He denied any associated ocular pain, headache, double vision or change in vision.

A 48-year-old woman with a history of developmental delay and chronic hearing loss was referred by a general ophthalmologist for progressive periorbital erythema and edema with concurrent sinusitis.

A 47-year-old man presented to our oculoplastics clinic complaining that his right eye “looked smaller” than his left eye. He had noticed this asymmetry for at least 1 to 2 years and believed it had recently been getting worse. He also noted a slowly progressive decline in vision in the right eye for the past 2 years.

A 32-year-old woman presented to the New England Eye Center at Tufts Medical Center with a 2-week history of left eye pain accompanied by periorbital swelling and progressive central vision loss. Review of systems was positive for periorbital tenderness, left eye pain with movement, tearing and irritation of the left eye. She denied fever, and there was no history of trauma.