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  • 1Department of Ophthalmology (PM, MTB, MED), Duke University Eye Center, Durham, North Carolina; Department of Neurology (MTB), Duke University School of Medicine, Durham, North Carolina; Department of Ophthalmology (EBP), Loyola University Chicago, Maywood, Illinois; Department of Ophthalmology & Visual Sciences (AYL, PS, HEM), University of Illinois at Chicago, Chicago, Illinois; Department of Pathology (AYL), University of Illinois at Chicago, Chicago, Illinois; Department of Neurosurgery (AA), University of Illinois at Chicago, Chicago, Illinois; Department of Neurology & Rehabilitation (HEM), University of Illinois at Chicago, Chicago, Illinois.

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Summary
This summary is machine-generated.

Two patients experienced visual disturbances, including double vision and eye movement issues, specifically during chewing. These symptoms were linked to defects in the lateral orbital wall, affecting eye position and vision.

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Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Radiology

Background:

  • Lateral orbital wall defects can arise from trauma or surgery.
  • Invasive pituitary adenomas may necessitate complex craniofacial resections.
  • Orbital and temporal fossa anatomy are closely interconnected.

Observation:

  • Two patients presented with unique visual symptoms during mastication.
  • Symptoms included intermittent double vision (diplopia), oscillopsia, and visual field defects (scotoma).
  • Proptosis (globe protrusion) was observed during chewing in one case.

Findings:

  • Computed tomography (CT) and magnetic resonance imaging (MRI) revealed bony defects in the lateral orbital wall.
  • One patient had a defect post-craniotomy for a pituitary adenoma.
  • The other patient had a lesion connecting the temporal fossa to the orbit via the defect.

Implications:

  • Mastication-induced visual symptoms can indicate underlying lateral orbital wall defects.
  • Understanding the neuroanatomy is crucial for diagnosing and managing these rare conditions.
  • Further research into the pathophysiology of these specific visual disturbances is warranted.