Extra-medullary hematopoiesis causing bilateral optic atrophy in beta thalassemia/Hb E disease.

OBJECTIVE: To report a rare presentation of bilateral optic nerve compression from extra-medullary hematopoiesis in beta thalassemia/Hb E disease. DESIGN: Interventional case report. CLINICAL PRESENTATION: A 13-year-old Thai girl was reported with slowly progressive bilateral visual loss due to optic neuropathy as a result of compression from extra-medullary hematopoiesis. Computed tomography of orbit and brain revealed a homogeneous enhancing midline soft tissue mass originating from the ethmoid and sphenoid sinuses along with extensive involvement of the skull. INTERVENTION: Blood transfusion once every month and low-dose radiotherapy to sphenoid and ethmoid bones with some visual improvement. CONCLUSION: Extra-medullary hematopoiesis in beta thalassemia can involve paranasal sinuses and cause compressive neuropathy. In patients with beta thalassemia that required multiple blood transfusions with progressive visual loss, ectopic marrow compression of optic nerve should be ruled out.

Spontaneous resorption of an insect hair in the corneal stroma: a case report.

A case of keratitis, due to an insect hair penetrating into the deep cornea, was reported. The patient felt right ocular pain while riding a motorcycle, as an insect struck into his eye. On examination, an insect hair was seen embedded into the corneal stroma with severe corneal edema, which caused a visual acuity of the right eye decreased to hand motion. The patient was treated by a topical antibiotics, cycloplegics, and anti-inflammatory drugs, without removing the hair. After a 6-week follow-up period, there was a spontaneous resorption of the hair. There was no apparent toxic sign during 6-months of follow up, and the visual acuity improved to 6/6. The insect hair could be left in the deep cornea with careful observation, and spontaneous resorption can occur.

Squamous cell carcinoma of the lacrimal sac: a case report.

Lacrimal sac tumors are rare tumors of the periorbital region. The authors report a case of squamous cell carcinoma of the lacrimal sac in a 47-year-old Thai man. The patient presented with epiphora and a palpable mass in the medial canthal area. The diagnosis was confirmed by the pathological studies. Radical surgery and radiation therapy were given. Early detection and long-term follow-up are necessary.