About

Julie Ann Woodward is a Professor of Ophthalmology and serves as the Chief of Oculoplastics at Duke University. She holds a faculty position in the Department of Dermatology, where she contributes to the academic and clinical missions of the institution. Her roles involve leadership in ophthalmic plastic and reconstructive surgery, with a focus on patient care, research, and education within her specialty.

Research topics

• Medicine
• Surgery
• Anatomy
• Optics
• Ophthalmology

Selected publications

• Immunoglobulin G4-Related Disease Manifesting as Posterior Uveitis

  Journal of VitreoRetinal Diseases · 2026-03-31

  articleOpen access

  Purpose: To describe an atypical presentation of immunoglobulin G4 (IgG4)-related disease manifesting as posterior uveitis and masquerading as intraocular lymphoma. Methods: A single case was reviewed. Results: A 74-year-old man with a history of a left orbital lesion and prior nondiagnostic biopsies was referred for evaluation of bilateral choroidal lesions suspicious for intraocular lymphoma. Fundus examination revealed irregular hyperpigmentation of the retinal pigment epithelium with a leopard-spot pattern on fundus autofluorescence. Optical coherence tomography showed diffuse choroidal thickening with a “lumpy-bumpy” appearance and an exudative retinal detachment in the right eye. Diagnostic pars plana vitrectomy and subretinal fluid drainage showed negative flow cytometry, cytology, and MYD88 mutation testing. Subsequent enlargement of the left orbital lesion prompted repeat biopsy, which confirmed IgG4-related disease. The patient responded well to prednisone and rituximab. Conclusions: IgG4-related disease may present with atypical posterior uveitis findings and mimic intraocular lymphoma. This entity should be considered in the differential diagnosis of posterior uveitis masquerade syndromes.

  PublisherOA PDFDOI

• Aesthetic Oculofacial Abstracts

  Ophthalmic Plastic and Reconstructive Surgery · 2026-01-01

  articleSenior author
  PublisherDOI

• Reply Re: “Risk of Blindness from Temple Filler Injections: Investigating Vascular Anastomoses Between the Deep Temporal and Ophthalmic Arteries”

  Ophthalmic Plastic and Reconstructive Surgery · 2026-01-01

  article1st authorCorresponding
  PublisherDOI

• Risk of Blindness From Temple Filler Injections: Investigating Vascular Anastomoses Between the Deep Temporal and Ophthalmic Arteries

  Ophthalmic Plastic and Reconstructive Surgery · 2025-01-03 · 4 citations

  articleSenior author

  PURPOSE: Soft-tissue filler injections, particularly hyaluronic acid, are popular for temple volume restoration. Although uncommon, this area poses risk for vision loss from embolic occlusion. Guidelines recommend injecting into the supraperiosteal plane for safety; however, the deep temporal arteries (DTAs) in this plane pose a risk. This study investigates potential pathways from the DTA to the ophthalmic artery (OA) and mechanisms of filler travel. METHODS: Retrospective analysis of carotid angiograms from patients with marked carotid artery stenosis or vascular malformations, given that collaterals are more visible in the presence of vascular blockages. Select cases were identified by the neurosurgery team. RESULTS: Four anastomotic pathways between the DTA and OA were identified, displaying a combination of anterograde and retrograde flow. Case 1 shows direct DTA-lacrimal artery anastomosis. In cases 2 to 4, the DTA is shown originating from the internal maxillary artery (IMAX) following its anatomical course. Retrograde flow from the DTA into the IMAX can then lead to anterograde flow into branches connecting to the IMAX including the superficial temporal artery, infraorbital artery, and middle meningeal artery. These arteries then form collaterals with the OA. CONCLUSIONS: This study is the first to elucidate 4 potential routes for filler-induced OA occlusion originating from DTAs in the supraperiosteal plane. These pathways involve retrograde flow, a mechanism previously suggested for filler-induced occlusion. Notably, the likelihood of these pathways being traversed may be low due to their length and amount of filler volume required; however, it is not impossible.

  PublisherDOI

• Aesthetic Oculofacial Abstracts

  Ophthalmic Plastic and Reconstructive Surgery · 2025-01-01

  article1st authorCorresponding
  PublisherDOI

• Aesthetic Oculofacial Abstracts

  Ophthalmic Plastic and Reconstructive Surgery · 2025-07-01

  articleSenior author
  PublisherDOI

• Hybrid neurofibroma-schwannoma of the orbit: a case report and review of the literature

  Orbit · 2025-03-17

  article

  Hybrid peripheral nerve sheath tumor is a rare tumor subtype that infrequently occurs within the orbit. A 50-year-old male presented with a 6-year history of worsening left-sided proptosis and hypoglobus. Magnetic resonance imaging of the orbits revealed a left superior extraconal, muti-lobulated orbital lesion with extension into the left orbital apex originating from the left frontal nerve. The patient underwent surgical resection of the mass via a left orbito-cranial approach. Histopathologic examination was positive for orbital hybrid neurofibroma-schwannoma. Postoperatively, the patient had improvement in proptosis, resolution of symptoms, and improved cosmesis. This case represents the eleventh reported occurrence of orbital hybrid neurofibroma-schwannoma.

  PublisherDOI

• Aesthetic Oculofacial Abstracts

  Ophthalmic Plastic and Reconstructive Surgery · 2025-05-01

  articleSenior author
  PublisherDOI

• Relative exophthalmos in facial nerve palsy

  Canadian Journal of Ophthalmology · 2025-04-14

  article
  PublisherDOI

• Comparison of the Degradability of Hyaluronic Acid by Ovine and Recombinant Human Hyaluronidase

  Aesthetic Surgery Journal · 2025-06-27 · 3 citations

  articleOpen access

  BACKGROUND: The mainstay of treatment for adverse events to hyaluronic acid filler is the use of hyaluronidase (HYAL); however, the dose and dilution are not standardized. OBJECTIVES: The objective of this study was to examine differential dilutions and concentrations of HYAL, and to compare the effectiveness of ovine and human HYAL. METHODS: Fillers were selected for study based on a variety of rheologic factors. A 0.2-mL dose of product was selected for use based on previous studies. Degradation was assessed by comparing both ovine and recombinant HYAL over a range of concentrations and dilutions. RESULTS: In the 2:1 dilution group, Restylane Lidocaine (Galderma, Lausanne, Switzerland) was degraded by 100 U of ovine HYAL after 50 minutes. No other filler was completely degraded; Restylane Lyft (Galderma) was partially degraded after 1 hour of treatment with 100 U of HYAL. In both the 3:1 and 4:1 dilution groups, Restylane Shaype (Galderma) and Restylane Lyft fillers were most susceptible to degradation, dissolving within 30 minutes with 100 U of recombinant HYAL and within 40 minutes with 100 U of ovine HYAL. Juvéderm and RHA4 fillers were the most resistant, requiring 300 U of HYAL for degradation within 1 hour. Beyond a 3:1 dilution ratio, no further improvement was observed. CONCLUSIONS: This study demonstrates that 300 U of hyaluronidase is sufficient to degrade 0.2 mL of the most resistant hyaluronic acid fillers within 1 hour. Importantly, a minimum dilution of 3:1 should be used to provide adequate fluid for dissolving filler. Ovine HYAL appears to be just as effective as recombinant HYAL in terms of dissolving product.

  PublisherDOI

Frequent coauthors

• Catherine J. Hwang

  Cleveland Clinic

  152 shared

• Tanuj Nakra

  82 shared

• Allan E. Wulc

  Temple University

  80 shared

• Daniel B. Rootman

  Doheny Eye Institute

  74 shared

• John Burroughs

  University of Colorado Colorado Springs

  39 shared

• Nicole Langelier

  Duke Medical Center

  29 shared

• Roshni Ranjit-Reeves

  Duke Medical Center

  28 shared

• John R. Burroughs

  University of Colorado Colorado Springs

  26 shared