Benjamin Erickson, MD, is Clinical Assistant Professor of Ophthalmology at Stanford's Byers Eye Institute. He specializes in Ophthalmic Plastic & Reconstructive Surgery as well as Orbital Oncology. His clinical interests include functional & cosmetic surgery of the eyelids, brow & mid-face, thyroid eye disease, orbital trauma & tumors, and Mohs reconstruction. His research interests include development of surgical instruments & medical devices.
Benjamin received his AB from Harvard University, magna cum laude, with highest departmental honors in History & Science. He received his medical degree from the Yale School of Medicine and a Masters of Health Science while completing a NIH sponsored research fellowship year in tissue engineering. He completed his residency in Ophthalmology at the number one ranked Bascom Palmer Eye Institute in Miami, Florida, where he remained for his ASOPRS fellowship in Ophthalmic Plastic & Reconstructive Surgery.
Outside of work, Benjamin is an avid cyclist and outdoor enthusiast.
- Ophthalmic Plastic & Reconstructive Surgery
Clinical Assistant Professor, Ophthalmology
Honors & Awards
Farr Scholar, Yale School of Medicine (2009)
Charles Ohse Research Award, Yale Department of Surgery (2009)
CTSA Research Fellowship, National Institute of Health (2008-2009)
Harvard Varsity Letter, Harvard Lightweight Crew (2004)
Fellowship: Bascom Palmer Eye Institute (2016) FL
Residency: Bascom Palmer Eye Institute (2014) FL
Board Certification: American Board of Ophthalmology, Ophthalmology (2018)
Fellow, Bascom Palmer Eye Institute, Ophthalmic Plastic & Reconstructive Surgery, Orbital Oncology (2016)
Internship: Lankenau Medical Center (2011) PA
Resident, Bascom Palmer Eye Institute, Ophthalmology (2014)
Medical Education: Yale School Of Medicine Office of Student Affairs (2010) CT
M.D./M.H.S., Yale School of Medicine, Medicine & Masters in Health Science (2010)
A.B., Harvard University, History & Science/ Mind, Brain & Behavior (2004)
Current Research and Scholarly Interests
Surgical instrument & medical device design
Reconstructive techniques & outcomes
Orbital tumors & trauma
Instruments in production:
- Erickson-Lee Pigtail Cannula (E2517, E2517), Bausch & Lomb/Storz
- Erickson-Lee Ptosis Clamp (E2515), Bausch & Lomb/Storz
Lateral Canthal Tendon Disinsertion: Clinical Characteristics and Anatomical Correlates.
Ophthalmic plastic and reconstructive surgery
2016; 32 (5): 378-385
To highlight features of lateral canthal tendon disinsertion (LCTD), provide an algorithm for systematic assessment, and describe the anatomic genesis of signs and symptoms.Retrospective case series of consecutive patients with lateral canthal tendon disinsertion, who underwent lateral canthal tendon fixation by a single surgeon (DTT) between 2004 and 2011.One hundred and seventeen eyes in 90 patients underwent lateral canthal tendon fixation. Average age was 69.3 ± 17.9 years. Twenty-three percentage of eyes had undergone lower eyelid blepharoplasty and 52% had undergone lateral canthal tightening; 35% had no previous periocular surgery. Patients with purely involutional lateral canthal tendon disinsertion were significantly older (76.1 ± 7.8 years of age; p < 0.03). Six key features associated with lateral canthal tendon disinsertion were identified. On static evaluation: 1) a blunted or vertically displaced lateral canthal angle; 2) a narrow horizontal fissure with reduced temporal scleral triangle; and 3) pseudo eyelid retraction. On dynamic evaluation with attempted closure: 4) medial and inferior movement of the lateral commissure; 5) incomplete apposition of the eyelid margins in the absence of anterior lamellar shortage; and 6) temporal eyelid imbrication. Improved blink dynamics with manual lateral canthal tendon complex repositioning ("the thumb test") predicted a favorable outcome with surgical tightening in 95.7% of cases.Lateral canthal tendon disinsertion results in altered eyelid fissure symmetry, blink dynamics, and lacrimal pump function. The authors recommend the mnemonic-A.B.C.: for Aperture configuration, Blink dynamics, and eyelid Closure-to structure the examination of all symptomatic patients. Manual restoration of the disinserted lateral canthal tendon with the "thumb test" predicts favorable outcomes with surgical fixation.
View details for DOI 10.1097/IOP.0000000000000552
View details for PubMedID 26398240
The Locking Y Lateral Canthopexy With Osseous Integration: Clinical Experience and Surgical Technique.
Ophthalmic plastic and reconstructive surgery
2016; 32 (5): 386-392
To describe a surgical technique to correct lateral canthal tendon disinsertion with a strabismus surgery-inspired locking capture of the tendon complex and osseous integration via drill holes.Retrospective interventional case series including all patients with lateral canthal tendon disinsertion who underwent locking Y lateral canthopexy with drill hole reinforcement by 1 surgeon (D.T.T.) between 2006 and 2011. Outcome measures included resolution of presenting ocular symptoms, improved blink dynamics and lid closure, correction of lagophthalmos and exposure keratopathy, and need for further surgery.A total of 53 lateral canthopexies with osseous integration were performed in 42 patients who fulfilled clinical criteria for lateral canthal tendon disinsertion. The population was biased toward treatment failures; 81% of eyes (43/53) had a history of prior lateral canthal tightening, and of these 30.2% (16/53) had undergone 3 or more procedures. Postoperatively, all eyes demonstrated improved eyelid position and blink mechanics, and 83% (44/53) had subjective resolution of epiphora and ocular irritation. Lagophthalmos was fully corrected in 95% (19/20) of cases, and corneal staining resolved in 88% (14/16). With a mean follow-up period of 24 months, 3.7% of eyes (2/53) required additional lateral canthal tightening.The locking Y lateral canthopexy is an effective and durable method for repositioning the lateral canthal tendon complex to improve blink dynamics, eyelid closure, and cosmesis. Even in a population heavily biased toward treatment failure, clinical results are excellent and the reoperation rate is low.
View details for DOI 10.1097/IOP.0000000000000553
View details for PubMedID 26359700
Novel Pigtail Cannula for a Canalicular-Involving Eyelid Laceration
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
2016; 32 (2): E45-E47
An 89-year-old woman presented with a canalicular-involving laceration/avulsion of the right lower eyelid after a fall. The inferior canaliculus was severed deep within the wound, and the ends were difficult to identify. Novel pigtail cannulas, designed by the authors, were used for lacrimal system intubation and suture passage. Satisfactory cosmetic and functional results were achieved. These cannulas facilitate repair by integrating multiple functionalities in a single instrument. Once a cannula has been inserted and rotated, the location of fluid egress provides important clues. If injected saline appears in the nasopharynx but not in the wound, absence of a common canaliculus can be suspected. Injection of viscoelastic, air or fluorescein-impregnated saline also permits easier identification of the cut end of the canaliculus within the wound and facilitates appropriate rotation of the pigtail.
View details for DOI 10.1097/IOP.0000000000000226
View details for Web of Science ID 000372060900009
View details for PubMedID 25126768
Recurrent Dermatofibrosarcoma Protuberans Masquerading as a Lacrimal Sac Neoplasm: A Case Report and Review
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
2015; 31 (5): E135-E138
A 71-year-old African American man presented with an indolent growth above the left medial canthus. CT of the orbits revealed a circumscribed, homogeneously enhancing 2.1 × 2.2 × 2.5 cm mass that appeared to extend into the medial orbit and proximal nasolacrimal duct without obstructing it. Intraoperatively, the mass was readily dissected free and excised in toto. Histopathology demonstrated spindle cells in a storiform pattern. Immunohistochemical staining was consistent with dermatofibrosarcoma protuberans (DFSP) although the t(17;22) translocation was absent. The patient underwent two-thirds of the recommended intensity-modulated radiation therapy dose before refusing further treatment. He declined additional interventions in favor of serial imaging. He remained recurrence free at 11 months. To the best of the authors' knowledge, this is the first case of recurrent DFSP invading the orbit managed with conservative resection and adjuvant therapy. A comprehensive review of the literature pertaining to DFSP of the orbit is presented.
View details for DOI 10.1097/IOP.0000000000000184
View details for Web of Science ID 000361383500007
View details for PubMedID 24988500
- An Unexpected Intraorbital Foreign Body OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY 2015; 31 (5): E140-E140
Delayed sclerotomy wound dehiscence after lensectomy and vitrectomy in Marfan syndrome.
Oman journal of ophthalmology
2015; 8 (3): 198-199
Marfan syndrome (MFS) is associated with abnormal fibrillin development that can cause morbidity and mortality. A case of acute onset hypotony due to sclerotomy wound dehiscence 13 years after 20-gauge pars plana vitrectomy and lensectomy is reported in a patient with MFS. Slit lamp examination revealed a leaking sclerotomy wound and intraoperatively the source was noted to be the prior sclerotomy site. On postoperative follow-up, the patient's vision returned to baseline, and intraocular pressure normalized. Twenty-gauge sclerotomy wound dehiscence may occur years after surgery, especially in patients with abnormal collagen as in MFS.
View details for DOI 10.4103/0974-620X.169893
View details for PubMedID 26903732
Orbital Cellulitis and Subperiosteal Abscess: A 5-year Outcomes Analysis.
Orbit (Amsterdam, Netherlands)
2015; 34 (3): 115-120
Orbital cellulitis and subperiosteal abscess (SPA) are historically associated with poor outcomes. We seek to characterize current associations with abscess formation, surgical failure and vision loss.All cases of orbital cellulitis presenting to an affiliated hospital between April 2008 and 2013 were critically reviewed.Thirty patients met inclusion criteria. Average age was 28.7 ± 24.4. The male to female ratio was 2:1. Abscesses were identified in 56.7% of patients. Adults were less likely than children to present with abscesses (28.6% vs. 81.3%, p = 0.008). Of the other factors analyzed, only antibiotic use before admission (70.5% vs. 23.1%, p = 0.03) and maximum restriction (-2.5 ± 1.2 vs. -0.9 ± 0.7, p = 0.008) were associated with SPA. Temperature at presentation (37.9 ± 0.9 vs. 37.1 ± 0.4, p = 0.04), relative proptosis (5.8 ± 3.3 mm vs. 2.1 ± 1.1, p = 0.002) and abscess volume (4.3 ± 1.3 mm(3) vs. 0.7 ± 0.5 mm(3), p = 0.0004) were associated with progression to surgery. Reoperation was required in 26.7% of patients. Of these, two-thirds had combined superior/medial abscesses that re-accumulated after isolated endonasal surgery. Two of the 3 patients with profound vision loss had a dental etiology.Only young age, prior antibiotics and degree of restriction predicted the presence of an abscess. Re-accumulation was more common than anticipated, and drainage of superior/medial abscesses by endoscopic surgery alone had the strongest association with surgical failure. Patients with odontogenic abscesses must be treated with particular caution.
View details for DOI 10.3109/01676830.2014.950286
View details for PubMedID 25867948
The Role of Neurotoxins in the Periorbital and Midfacial Areas
FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA
2015; 23 (2): 243-?
Initially popularized for the treatment of strabismus and blepharospasm, injection of botulinum neurotoxin has become the most commonly performed cosmetic treatment in the United States. Injection techniques have been particularly well-studied in the midface and periocular region, and patient satisfaction tends to be very high. We review the salient differences among available neurotoxins, how to optimally reconstitute them, how to inject the forehead, glabella, lateral canthal lines ("crow's feet"), infralid region, and transverse nasal lines ("bunny lines"), how to sculpt the brow, and how to manage potential complications.
View details for DOI 10.1016/j.fsc.2015.01.010
View details for Web of Science ID 000355054800013
View details for PubMedID 25921574
- Penetrating Ocular Fishhook Injury JAMA OPHTHALMOLOGY 2015; 133 (3): 347-348
Zone 3 ruptured globe from a dog bite
JOURNAL OF AAPOS
2015; 19 (1): 89-90
Periocular injuries from dog bites are relatively common in school-age children, but intraocular trauma is exceedingly rare. We present a 7-year-old boy who sustained a zone 3 ruptured globe injury after attack by a Perro de Presa Canario. At presentation, visual acuity in the injured eye was counting fingers. Surgical exploration revealed an inferotemporal corneoscleral laceration extending 15 mm posterior to the limbus, with protrusion of uveal tissue, which was repaired. Visual acuity improved to 20/40 by the first postoperative month.
View details for DOI 10.1016/j.jaapos.2014.09.011
View details for Web of Science ID 000351477500025
View details for PubMedID 25727600
- Imaging in Orbital Differential Diagnosis Orbital Tumors: Diagnosis & Treatment Springer. 2015; 2nd
Epiblepharon-Induced Head Tilt Masquerading as Torticollis
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
2015; 31 (1): E8-E9
A 10-month-old girl presented for ocular evaluation carrying a provisional diagnosis of torticollis. Her family reported that for the past 5 months, she consistently tilted her head to the left while twisting her chin toward the right shoulder. Her adnexal examination was notable for epiblepharon, with greater ciliary-corneal contact in the OS. It was therefore hypothesized that this posture was adopted to minimize ocular irritation. Her symptoms resolved immediately following a Hotz-Celsus procedure. To the best of the authors' knowledge, this is the first report of asymmetric ciliary-corneal contact from epiblepharon, resulting in preference for a head position mimicking a musculoskeletal abnormality such as torticollis.
View details for Web of Science ID 000347772000004
View details for PubMedID 25569166
Recurrent Orbital Adult-Type Fibrosarcoma in a 3-Year-Old Girl
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
2015; 31 (1): E16-E18
A 3-year-old Filipino girl presented with progressive left-sided ptosis and proptosis after resection of a superomedial orbital tumor 2.5 years ago. She had been followed with serial MRI, which demonstrated interval growth of a recurrent lesion. Repeat resection was undertaken via an eyelid-splitting anterior orbitotomy. The patient's pediatric oncologist and sarcoma specialist did not recommend adjuvant chemotherapy, and the family declined proton radiotherapy. The patient will continue to be monitored with serial imaging. Histopathology, immunohistochemistry, and reverse transcriptase polymerase chain reaction were most consistent with a diagnosis of adult-type fibrosarcoma. This is the first reported case of adult-type fibrosarcoma presenting in the orbit of a child. Fibrosarcoma is a fibroblast-derived tumor that commonly presents in the extremities, usually in patients in their fourth to sixth decades. It is rarely seen in the orbit, with the largest case series to date only including 5 patients.
View details for Web of Science ID 000347772000008
View details for PubMedID 24833462
The BLICK Mnemonic for Clinical-Anatomical Assessment of Patients With Epiphora
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
2014; 30 (6): 450-458
Evaluation of the tearing patient is often distilled to a search for ocular surface problems causing reflex hypersecretion versus lacrimal drainage problems. The literature does not typically emphasize conditions affecting the function of the tear distribution system, but neglect of these important factors can lead to suboptimal treatment outcomes. The intent of this review is to provide a systemic evaluation of frequently overlooked conditions that can influence the distribution system and to offer a mnemonic to ensure an orderly sequence of inspection during clinical examination.Review of clinical literature and experience from 1957 to 2014.Tearing complaints attributable to problems with the distribution system can be evaluated, classified, and managed according to the mnemonic BLICK, which stands for Blink dynamics, Lid malposition, Imbrication, Conjunctivochalasis, and Kissing puncta.The BLICK mnemonic is a useful adjunct to the workup of epiphora.
View details for DOI 10.1097/IOP.0000000000000281
View details for Web of Science ID 000345129600016
View details for PubMedID 25216202
Transitional cell-type papillary carcinoma of the lacrimal sac manifesting as a medial canthal skin lesion.
Orbit (Amsterdam, Netherlands)
2014; 33 (5): 378-381
A 61-year-old man presented with a 2.5 cm fungating skin lesion above the right medial canthus, accompanied by fluctuance and subtle inferotemporal globe displacement. The tumor had erupted 2 months previously and grown rapidly. Computed tomography (CT) revealed a 4.2 × 2.8 × 2.1 cm exophytic mass of the right orbit, superimposed on chronic dacryocystitis. Incisional biopsy disclosed faulty epithelial maturation sequence with possible basement membrane invasion. The patient underwent wide excision with medial maxillectomy, inferior turbinectomy, ethmoidectomy, and partial rhinectomy. The orbital floor was then reconstructed; a paramedian forehead flap and myocutaneous cheek advancement flap were used to fill cutaneous defects. All surgical margins were negative on both frozen and permanent sections. Definitive histopathology was consistent with transitional cell type papillary carcinoma of the lacrimal sac. Adjuvant radiotherapy was recommended, but the patient has declined further treatment. He remains recurrence-free at one year.
View details for DOI 10.3109/01676830.2014.894541
View details for PubMedID 24911210
Advanced Single-Stage Eyelid Reconstruction: Anatomy and Techniques
2014; 40 (9): S103-S112
Skin cancers of the periocular tissue present formidable reconstructive challenges because of anatomic complexity, vital function, and cosmetic significance.To review eyelid anatomy and reconstructive techniques from an oculoplastic surgery perspective.Eyelid structure and function are intimately linked, and good working knowledge is a prerequisite for successful reconstructive efforts. We discuss periocular anatomy, patient evaluation, and single-stage repair of both anterior lamellar and full-thickness defects.Despite the challenges of periocular skin cancer reconstruction, excellent cosmetic and functional results can be achieved with appropriate technique.
View details for DOI 10.1097/DSS.0000000000000117
View details for Web of Science ID 000351057400011
View details for PubMedID 25158870
Management of neonatal proptosis: A systematic review
SURVEY OF OPHTHALMOLOGY
2014; 59 (4): 378-392
Gross proptosis presenting at birth is an uncommon manifestation of a variety of lesions that can compromise vision and result in disfigurement or even loss of life. Notably, many disease entities have different presentations and prognoses in neonates compared to older children. A structured mental framework is essential to an efficient and coordinated response. We present three challenging cases of neonatal proptosis and discuss the clinical presentation and biological behavior of the lesions that are most often implicated.
View details for DOI 10.1016/j.survophthal.2013.11.002
View details for Web of Science ID 000337715400002
View details for PubMedID 24929905
A 32-YEAR-OLD MAN WITH DELAYED ONSET POST-TRAUMATIC PROPTOSIS AND DIPLOPIA
JOURNAL OF EMERGENCY MEDICINE
2014; 46 (4): 475-478
Proptosis and motility deficits are common findings in the setting of craniofacial trauma, but can indicate the presence of vision and even life-threatening pathology.Our aim was to identify presentations consistent with traumatic carotid cavernous fistula (CCF) and to review the appropriate initial work-up and management.A 32-year-old man came to our emergency department with proptosis, ocular motility deficits, and decreased vision 1 month after a restrained motor vehicle accident. An orbital bruit was auscultated and four-vessel angiography revealed a CCF. Covered stents and an embolic agent were used to abolish the arteriovenous communication and the patient rapidly returned to his premorbid baseline.CCF is a relatively rare but important consequence of craniofacial trauma that must be recognized promptly in order to minimize the likelihood of serious sequelae. It should be suspected in patients with antecedent trauma presenting with exophthalmos, arterialized conjunctival vessels, and orbital bruit.
View details for DOI 10.1016/j.jemermed.2013.09.015
View details for Web of Science ID 000333459200013
View details for PubMedID 24495940
- A 48-year-old woman with redness, photophobia, and eye discomfort. Digital journal of ophthalmology : DJO / sponsored by Massachusetts Eye and Ear Infirmary 2013; 19 (2): 42-45
- Yale Guide to Ophthalmic Surgery edited by Bernardino, C. Lippincott Williams & Wilkins. 2011
Cell-Seeding Techniques in Vascular Tissue Engineering
TISSUE ENGINEERING PART B-REVIEWS
2010; 16 (3): 341-350
Previous studies have demonstrated the benefits of cell seeding in the construction of tissue-engineered vascular grafts (TEVG). However, seeding methods are diverse and no method is clearly superior in either promoting seeding efficiency or improving long-term graft function. As we head into an era during which a variety of different TEVG are under investigation in clinical trials around the world, it is important to consider the regulatory issues surrounding the translation of these technologies. In this review, we summarize important advances in the field of vascular tissue engineering, with particular attention on cell-seeding techniques for TEVG development and special emphasis placed on regulatory issues concerning the clinical translation of these various methods.
View details for DOI 10.1089/ten.teb.2009.0527
View details for Web of Science ID 000278640000006
View details for PubMedID 20085439
- The Immuno-inflammatory Cascade Ocular Inflammatory Disease & Uveitis Manual 2010; 1st
Effects of recombinant human bone morphogenetic protein 2 on surgical infections in a rabbit posterolateral lumbar fusion model.
American journal of orthopedics (Belle Mead, N.J.)
2009; 38 (11): 578-584
Recombinant human bone morphogenetic proteins (rhBMPs) are often used during spine surgery, but their effects on postoperative infections have not been well elucidated. Long-bone studies suggest that BMPs may limit local infection and facilitate bone formation. Until now, rhBMP-2 had not been evaluated in the setting of infected spinal arthrodesis. In the study reported here, we evaluated the safety and efficacy of rhBMP-2 and autograft in inducing fusion in the setting of surgically acquired infection. Sixty rabbits underwent fusion with autograft or rhBMP-2 with coadministration of Staphylococcus aureus or sterile saline. In the noninoculated groups, 4/15 autograft and 13/13 rhBMP-2 rabbits fused (P<.001). In the inoculated groups, 0/14 autograft and 3/12 rhBMP-2 rabbits fused (P = .085). There were 4/14 early deaths caused by infection in the autograft group and 0/12 in the rhBMP-2 group (P = .1). Although the difference in fusion rates and early deaths from infection for rhBMP-2 and autograft did not reach our predetermined alpha error threshold, the data were trending toward significance. Our results demonstrated no increase in morbidity or mortality associated with use of rhBMP-2 in the setting of local infection. Although BMP use with infections remains controversial, these results indicate that rhBMP- 2 could be used in a contaminated environment.
View details for PubMedID 20049353
I-125-labeled OP-1 is locally retained in a rabbit lumbar fusion model
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
2008; 466 (1): 210-215
Osteogenic protein-1 is evolving as a potential bone graft alternative. Surgical site retention is important to maximize local osteoinduction and to limit peripheral effects. An established rabbit lumbar posterolateral fusion model was used to evaluate the systemic distribution and pharmacokinetics of locally applied osteogenic protein-1 delivered on a collagen carrier. L5-L6 intertransverse process fusions were performed on 27 New Zealand White rabbits. Radiolabeled (125)I-osteogenic protein-1 collagen putty was implanted. At intervals, whole blood, plasma, and excreta were analyzed for radioactivity with liquid scintillation counting. Surgical site and tissue radioactivity also were assessed by quantitative whole-body autoradioluminography of animals euthanized at times ranging from 6 hours to 35 days. Animals remaining at the final time were assessed for fusion with manual palpation, radiography, and histology. Limited distribution of radioactivity was observed in the blood, plasma, and tissues apart from at the surgical site and in the urinary bladder and thyroid. The mean residence time for osteogenic protein-1 collagen putty was 10.4 +/- 2.7 days. These excretion profiles and kinetic properties are similar to those described for recombinant human bone morphogenetic protein-2 in the rabbit model (mean residence times of 7.6 days and 10.2 days with different carriers).
View details for DOI 10.1007/s11999-007-0017-2
View details for Web of Science ID 000253164000044
View details for PubMedID 18196395