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A 60-year-old woman presents with diplopia on extreme upgaze and a complaint that her left eye seems to be a bit smaller than the right. She recently had cosmetic plastic surgery and mentioned this to the surgeon who injected some “filler” in the left upper lid and this is shown by the arrow above. He also obtained the MRI shown above and referred the patient to the ophthalmologist for further evaluation of the eyes.

1.	What is the most significant feature of this MRI?
	a. The turbinates are larger on the left. b. The globes are rotated outward. c. The right maxillary sinus is clear. d. The left orbital floor is displaced downward. e. The optic canals cannot be seen.
2.	The most likely diagnosis in this case is:
	a. sinusitis b. adverse response to “filler” injection c. silent sinus syndrome d. Parry-Romberg syndrome e. none of the above
3.	Treatment for this would be:
	a. none b. decongestants c. surgery d. antibiotics e. steroids

For answers to the above, click here on or after March 27, 2012.