Ocular malignant tumors. Review of the tumor registry at a tertiary eye hospital in central Saudi Arabia

To present the epidemiologic profile and magnitude of ocular malignant tumors [MT] representative of the Saudi population from the Tumor Registry [TR] at King Khaled Eye Specialist Hospital [KKESH]. This study evaluated the demographic information, clinical features including tumor laterality, ocular tissue of origin, and diagnosis of patients from the TR registry between 1983 and 2012 at KKESH, Riyadh, Kingdom of Saudi Arabia. The incidence of MT among Saudi adults [>/= 15 years old], and children [<15 years old] was estimated. The TR recorded 4,146 neoplasms [2,509 [60.5%] benign tumors, and 1,637 [39.5%] MT]. The incidence of MT in children was 3.6 per million/year [M/Y], and 2.4/M/Y for adults. Retinoblastoma [Rb] [n=763, 91%] was the most common ocular malignancy in children. In adults, the most common MT was squamous cell carcinoma [SCC] [n=363, 45.8%], basal cell carcinoma [BCC] [n=186, 23%], uvealmelanoma [n=94, 11.9%], sebaceous gland carcinoma [n=54, 6.8%], lymphomas [orbital, adnexal] [n=46, 5.8%], and others [n=53, 6.8%]. The Rb [7.7/M/Y in <5 years old Saudi children] was less frequent than that reported in some Gulf countries, but higher than that reported from the West. The SCC was less frequent in countries with comparable sun exposure than in other continents, but the incidence remained unchanged over 3 decades. There was a significant increase in BCC between 1983-1992 and 2003-2012. The rates of all cancers remained stable over 3 decades except BCC, which showed a significant rise

Unilateral optic neuritis, scleritis and exudative retinal detachment due to recurrent orbital pseudotumor

Idiopathic orbital inflammation, also known as orbital pseudotumor, describes a spectrum of idiopathic, non-neoplastic, non-infectious, space-occupying orbital lesions without identifiable local or systemic cause. The condition occurs mainly in young adults who may present with acute pain, proptosis, chemosis and limitations of extraocular movements. Decreased vision due to optic nerve infiltration and macular edema as a result of scleritis is less common sequel of orbital pseudotumor. Herein, we present a case of unilateral orbital pseudotumor in a young male who presented with chief complaints of painful decreased vision which was attributed to optic neuritis and macular edema as a result of scleritis. Imaging studies were helpful in the establishment of the correct diagnosis and patient's complaints improved with administration of systemic corticosteroids

hot orbit: orbital cellulitis

Orbital cellulitis is an uncommon condition previously associated with severe complications. If untreated, orbital cellulitis can be potentially sight and life threatening. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. The infection most commonly originates from sinuses, eyelids or face, retained foreign bodies, or distant soources by hematogenous spread. It is characterized by eyelid edema, erythema, chemosis, proptosis, blurred vision, fever, headache, and double vision. A history of upper respiratory tract infection prior to the onset is very common especially in children. In the era prior to antibiotics, vision loss from orbital cellulitis was a dreaded complication. Currently, imaging studies for detection of orbital abcess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention

Eradicating blinding trachoma: what is working?

Trachoma remains the leading cause of preventable corneal blindness in developing countries. The disease is contracted in early childhood by repeated infection of the ocular surface by C. traehomatis. Initial clinical manifestation is a follicular conjunctivitis which if not treated on timely basis, may lead to conjunctival and eyelid scarring that may eventually result in corneal scarring and loss of vision. Over the past two decades, a remarkable reduction in the prevalence of active trachoma has occurred due to the World Health Organization's [WHOs] program GET 2020 for the elimination of trachoma with adoption of the SAFE strategy incorporating Surgery, Antibiotic treatment, Facial cleanliness and Environmental hygiene. However, patients who already had infection at young age may present with adnexal-related complications of trachomatous scarring that may cause corneal scarring and visual loss. These patients may present with evidence of trichiasis/entropion as well as eyelid retraction. Lacrimal complications may include nasolacrimal-duct obstruction, dacryocystitis and canaliculitis requiring intervention. In addition to the increased risk for corneal scarring, trichiasis/entropion may further increase the risks for microbial keratitis in patients who may have unrecognized dacryocystitis and canaliculitis. Female patients may have more trachomtous-related complications and may present at an early age. Available evidence indicates that SAFE strategy may be effective and on the right track towards achieving GET 2020 goal for the eradication of trachoma

Orbital alveolar soft part sarcoma: histopathologic report of two cases

Alveolar soft part sarcoma is considered as a distinct histopathological entity with rare cases reported from the orbit area. Two cases of alveolar soft part sarcomas occurring in the orbit of two patients along with their histopathologic findings are reported herewith. In both cases, the patients presented with eyelid swelling and proptosis. The diagnosis was made by incisional biopsies and histopathology. The literature is reviewed regarding occurrence of this tumor, its diagnosis and management

Modified fasanella-servat for acquired ptosis: case report and review of the literature

A 28-year-old man who had acquired ptosis of his left upper eyelid after a traffic accident did not benefit from standard levator advancement surgery. Patient had significant ptosis with moderate levator function. A modified Fasanella-Servat procedure under local anesthesia resulted in the desired correction of his left upper eyelid ptosis. A review of the Fasanella-Servat procedure for ptosis surgery is presented, as well as its modifications, along with its limitations

Evaluation and management of periocular capillary hemangioma: a Review

To review the salient features of periocular capillary hemangioma, provide the ophthalmologist with clinical, diagnostic and histological features characteristic of the tumor and discuss various methods of management. Literature review of periocular capillary hemangioma, diagnostic evaluation with emphasis on treatment through the presentation of illustrative clinical cases. Capillary hemangioma is the most common benign vascular tumour found on the head and neck area including eyelids and orbit. The lesion typically manifests within the first few weeks of life, grows rapidly in the first year during the proliferative phase, then invariably and slowly regresses over the next 4 to 5 years during the patients, however, the functional defects in the form of amblyopia, squint, facial disfigurement and rarely optic atrophy may persist long after complete resolution of the tumor. the diagnosis of capillary hemangioma requires a combination of clinical and imaging studies such as ultrasonography, computerized tomography, magnetic resonance imaging, and angiography in selected cases. With the advent of less invasive diagnostic techniques, the need for biopsy in capillary hemangiomas has decreased. Nevertheless, it should be differentiated from other periocular tumour such as rhabdomyosarcoma, lymphangioma, chloroma, neuroblastoma, orbital cyst, and orbital cellulitis. Treatment is indicated to prevent amblyopia or cosmetic disfigurement. If indicated, intra-lesional corticosteroids may be used to enhance resolution of the tumor. Other forms of treatment tried with variable success include systemic and topical corticosteroids, radiation, surgical excision and intravenous embolization of the tumor. In recent years, laser ablation of the tumor has been found to be effective in some cases. Interferon-u' has been utilized effectively in cases of capillary hemangiomas that are refractory to other forms of therapy. Early treatment of amblyopia is essential to restore good vision in the affected eye. Eyelid and orbital capillary hemangiomas are treatable vascular lesions. Ophthalmologists should be aware of the ocular complicationns of this tumor. Early recognition and timely diagnosis and treatment may prevent amblyopia and cosmetic disfigurement