Primary orbital manifestation of Hodgkin lymphoma in a 3-year-old child.

Hodgkin lymphoma is exceedingly rare in children, as is primary orbital manifestation of systemic Hodgkin lymphoma in any age category. The authors describe the clinicopathologic manifestations of a rare case of systemic Hodgkin lymphoma with primary orbital manifestation in a 3-year-old boy with histologically proven Hodgkin lymphoma with mixed cellularity. After an incisional biopsy and tumor debulking, followed by systemic workup, the diagnosis of stage IVA Hodgkin lymphoma was made. He underwent treatment with 4 cycles of adriamycin, bleomycin, vincristine, etopiside, prednisone, and cyclophosphamide, followed by involved field radiation. He has been followed at regular intervals for 6 years. Scans have shown resolution at all sites, and blood counts have remained normal. To the best of the authors' knowledge, this is the youngest patient with primary orbital manifestation of Hodgkin lymphoma reported in the English literature.

The use of osseointegration and rare earth magnetic coupling for oculofacial prosthesis retention in the exenterated orbit.

PURPOSE OF REVIEW: The goal of the present review is to update ophthalmologists and oculoplastic surgeons with the role of osseointegration for oculofacial prosthesis retention in patients requiring orbital exenteration surgery. RECENT FINDINGS: The biophysiology of osseointegration has been well established by our dentistry colleagues and is reviewed here. Using this technology, orbital surgeons can offer their patients an adhesive-free method of prosthesis retention. Recent literature discusses the difficulties of implant success in the irradiated orbit. SUMMARY: Osseointegration with rare earth magnetic coupling provides patients with proper oculofacial prosthesis alignment and retention assisting in the rehabilitation of the exenterated orbit.

Use of cobalt blue light in grading cataract and estimating vision loss.

PURPOSE: To test an anecdotally reported cataract grading system predictive of a 20/50 visual threshold in cataract-induced vision loss using cobalt blue light. SETTING: Hennepin County Medical Center, Minneapolis, Minneapolis VA Medical Center, Minneapolis, and Regions Hospital, St. Paul, Minnesota, USA. METHODS: Four observers evaluated pure nuclear cataracts using a standardized cobalt-blue-light protocol. Observers graded a nuclear cataract as positive if the posterior capsule was visualized with cobalt blue light and negative if the posterior capsule was not visualized. Results of the grading were compared with cataract-induced vision loss in an attempt to establish a threshold for lost visual acuity in grading cataracts with cobalt blue light. The study design was prospective observation of a cohort with a visually significant cataract. RESULTS: This study did not show a clear visual acuity threshold for cataract-induced vision loss using a standardized cobalt-blue-light protocol. Overall, 26.3% (95% confidence interval, 13.4-40.2) of all 20/40 or less dense nuclear cataracts had visible posterior capsules using cobalt blue light, with good estimated interobserver agreement. CONCLUSIONS: Although cobalt blue light is selectively absorbed by yellow pigment in an aging nuclear cataract, its ability to predict visual acuity loss due to lens opacity was limited.