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Biomedical subjects

J R Boynton

Publications and source records attributed to J R Boynton.

30 records · Page 2Linked to original sources
PubMed1984

Malignant Merkel cell neoplasm of the eyelid.

Malignant Merkel cell neoplasms of the eyelid are most commonly found in elderly patients. They occur most frequently on the upper eyelid and are seen as large, nontender , red or violaceous masses with intact overlying skin. Differential diagnosis includes lymphoma and oat cell carcinoma. Conventional light microscopic features are usually distinctive, but tissue should be saved for electron microscopy and immunocytochemical studies, since the presence of dense-core neurosecretory granules and perinuclear microfilaments on electron microscopic examination and positive staining for neuron-specific enolase, are strongly suggestive of malignant Merkel cell neoplasm. Because of the diffuse infiltrative growth pattern and early lymphatic spread of this tumor, treatment requires careful examination of regional lymph nodes and wide surgical excision of the tumor with frozen-section control of margins.

Adenocarcinoma↗
PubMed1979

Ocular findings in Kenny's syndrome.

In 1966, Kenny described two patients with an unusual congenital syndrome including dwarfism, thickened long bone cortex, transient hypocalcemia, and normal intelligence. These and other patients previously were incorrectly described as "myopic". Ocular findings in four subjects ranged from uncomplicated nanophthalmos with hyperopia to extreme pseudopapilledema, vascular tortuosity, and mucular crowding. Postmortem findings from one patient showed calcium deposits demonstrable only by special histochemical stains that were distributed uniquely in the cornea. This distribution differed greatly from the pattern seen in band keratopathy. Retinal calcification was also an unusual feature. Because one patient exhibited a pseudodoubling of the optic papilla, the literature was reviewed. We conclude that no convincing case of true doubling of the optic nerve has been described. Ophthalmologists should be alert for undiagnosed electrolyte abnormalities, especially hypocalcemia, in patients with Kenney's syndrome.

Adolescent↗
PubMed1978

Treatment of intermittent exotropia.

To study the long-range results of surgically treated intermittent exotropia, 100 consecutive patients have been followed up for an average of 6.1 years. In all cases, the initial procedure was bilateral recession of the lateral rectus muscles. The overall functional cure rate was 78%. To accomplish this result, 27 patients were operated on a second time, 21 for undercorrection and six for overcorrection. A number of patients cooperated very poorly or were lost to follow-up while still under treatment. Had these patients been eliminated from the series, the cure rate would have been greater than 90%. In this study, bilateral recession of the lateral rectus muscles corrected the distant measurement more than the near measurement only with the divergence excess type of deviation. Also, this procedure was not notably more effective with divergence excess than with basic-type intermittent exotropia.

Adolescent↗
PubMed1978

Chalazion management by tarsus trephination.

The use of a small trephine for chalazion surgery or tarsal biopsy is described. Over 1,000 cases have been treated in this manner with minimal recurrences and complications.

Cysts↗
PubMed1977

Surgical treatment of eyelid neurofibromas.

The classical surgical treatment of eyelid neurofibromas has been careful dissection of the tumor with preservation of much of the surrounding abnormal lid tissues. The reported outcome has been uniformly unfavorable. These tumors infiltrate extensively and are impossible to dissect out completely. However, the lateral location of lid neurofibromas allows "en bloc" resection of most of the tumor including the adjacent involved lid tissues. Levator function in these cases is potentially good and the lid will elevate well if the levator aponeurosis is joined to the tarsus laterally at the time of surgery. The four cases presented here indicate that this procedure is technically easier and may produce more acceptable results than other forms of treatment.

Adolescent↗
PubMed1977

Sebaceous adenocarcinoma of the eyelid. Definition of surgical margins.

Carcinoma of the sebaceous glands of the eyelid carries a serious prognosis. Although uncommon, the diagnosis must be frequently considered owing to the similarity of the early signs of adenocarcinoma to those of chalazion. Three cases with proved sebaceous adenocarcinoma of the eyelid are reviewed to relate subtle evidence of clinical and histopathological malignancy to surgical management.

Adenocarcinoma↗
PubMed1976

Acute dacryocystic retention.

Acute dacryocystic retention is a disease of adults under 50 years old due to a noninfective foreign body blocking the nasolacrimal duct. It is characterized by the sudden onset of severe unilateral facial pain without significant localized swelling or erythema. Palpation of the involved lacrimal sac reveals slight induration and marked tenderness. Percutaneous aspiration of lacrimal sac contents, followed by probing of the nasolacrimal duct, is usually curative.

Acute Disease↗
PubMed1976

Technique of combined lid and medial canthus reconstruction.

Standard lid reconstruction techniques (sliding flaps or tarsoconjunctival grafts) may be combined with the Laissez-Faire treatment of large medial canthal defects. Using this methods, satisfactory results were achieved in three cases in which it was necessary to excise both a large portion of an eyelid and the adjacent medial canthus.

Aged↗
PubMed1975

Bilateral microphthalmos without microcornea associated with unusual papillomacular retinal folds and high hyperopia.

A 23-year-old man had bilateral microphthalmos without microcornea. The eyes measured about 15 mm in length by ultrasound while the corneas were 11 mm in diameter. A distinctive, elevated, funnel-shaped retinal fold stretching between the disk and the macula was present bilaterally. Other unusual aspects were the deep anterior chambers and uncompromised chamber angles. This combination of anomalies is believed to be the result of a failure of growth of the posterior outer coats of the eye. These were of insufficient size to accommodate the excess sensory retina which folded to conform to its outer structural shell. Other cases of high hyperopia may in some instances be cases of microphthalmos, unrecognized because of normal-sized corneas.

Adult↗
PubMed1975

Hypoplastic optic nerves studied with B-scan ultrasonography and axial tomography of the optic canals.

Radiologic studies of the optic foramina in cases of optic nerve hypoplasia have been inconsistent, some authors reporting normal foramina, others finding small foramina. The technique of axial tomography of the optic canals has been found more useful in this regard than plain foramen views, and has demonstrated small canals in cases of optic nerve hypoplasia. A case of bilateral hypoplasia is presented in which the discs were one half normal size, the optic nerves measured 2 mm in diameter on B-scan ultrasonography, and the optic canals were about 4 mm in diameter radiographically on the axial tomograms. These measurements are compared with normals of 4 to 4.5 mm for scans of the optic nerve, and a reported average optic canal width of 5.5 mm. A second case of less severe hypoplasia also presented a small ultrasonic nerve pattern of 3.5 mm. With the techniques of ultrasonography and axial tomography, the course of hypoplasic nerves can be followed from the level of the retina to the optic chiasm posteriorly. It is suggested that the optic canal dimensions correspond closely to the size of the optic nerve in cases of hypoplasia. When the nerve is only slightly hypoplastic the radiographic change in foramen or canal dimensions may not be detectable. Reasonably accurate measurements of the nerve may be more easily obtained with ultrasound.

Adolescent↗