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May 2004

Orbital Osteoma With Gaze-Evoked Amaurosis

Arch Ophthalmol. 2004;122(5):788. doi:10.1001/archopht.122.5.788

A 54-year-old woman complained of repeated episodes of painless, gaze-evokedamaurosis of the right eye of 3 months' duration. Within 20 seconds afterabduction of her right eye, her visual field would rapidly constrict fromthe periphery toward the center. On resuming primary eye position, her visionreturned to normal within 30 seconds. She had a medical history of "sinusproblems" but was otherwise healthy.

Acuity, color vision, pupils, eye movements, and visual fields werenormal. She had 3 mm of proptosis in her right eye. On abduction her visiondeteriorated to no light perception OD; the pupil slightly enlarged and becameunresponsive to light. Intraocular pressure was 20 mm Hg OU and it increasedto 50 mm Hg OD on abduction. A computed tomographic scan showed a 3-cm calcificmass in the ethmoid sinus and anterior medial orbit (Figure 1). The tumor was approached through a modified Lynch incisionand excised through an external ethmoidectomy and anterior orbitotomy. Itwas histopathologically shown to be an osteoma (Figure 2). The transient vision loss resolved after surgery.

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