Pericardial-Pleural Effusion, Ocular Protrusion, Confusion

Blurred vision OU; Unsteady gaitA 68-year old male with bilateral proptosis, dim, blurred vision and transient obscuration of vision with diplopia OS. Previous history significant for diabetes insipidus and problems with postural balance.VA: 20/25 OD, 20/800 OS; Color plates: 9 missed OD; All OS; RAPD > OS to OD; Exophthalmometry: 22 OD, 25 OSMRIXanthoma cells mixed with mononuclear inflammatory infiltrateSurgery1. Miller, RL, Sheeler, LR, Bauer, TW, Bukowski, RN: Erdheim-Chester disease. Case report and review of literature. Amer J of Md. 80:1230-1236, 1986. 2. Shields, JA, Karcioglu, ZA, Shields, CL, Eagle, RC, Wong, S: Orbital and eyelid involvement with Erheim-Chester disease. A report of two cases. Arch of Ophthal. 109:850-854, 1991. 3. Alper, MG: Orbital manifestations of Erdheim-chester disease. Trans Amer Ophthal Soc. LXXXI: 64-85, 1983. 4. Lantz, B, Lange, TA, Heiner, J, Herring, GF. Erdheim-chester disease, a report of three cases. Jour of Bone Joint Surg. 71a:456-464, 1989. 5. Rozenberg, I, Wehsler, J, Koenig, S, Brun, B, Larde, D, Raulo, Y, Hazard, J, Pinudeau, Y, Coscas, G. Erdheim-Chester disease presenting as malignant exophthalmos. Brit J of Rad. 59:173-177, 1986. 6. Fink, MG, Levinson, DJ, Brown, NL, Sreekanth, S, Sobel, GW. Erdheim-Chester disease. Case report with autopsty findings. Arch Path and Lab Med. 115:619-623, 1991