Clinical features and bacteriology of lacrimal canaliculitis in patients presenting to a tertiary eye care center in the Middle East

To study the clinical features and bacteriology of canaliculitis in patients presenting to King Khaled Eye Specialist Hospital [KKESH], a major tertiary eye care center in the Middle East and compare the results to previous studies from other countries. In this retrospective study, a chart review was performed of 131 patients [135 eyes] diagnosed with lacrimal canaliculitis who underwent treatment between January 1983 and December 2012 at KKESH. Data were evaluated on demographics, presenting signs and symptoms, diagnostic studies, causative organisms, treatment rendered including medical or surgical interventions and rate of recurrence. There were 47 males and 84 females with a mean age of 64 years. The average duration of symptoms was 81.38 weeks. The most common presenting symptom was eye discharge [68.7%]. The lower canaliculus was most commonly involved [49.6%] and 27 [20.6%] patients had upper and lower canaliculi involved. The left eye was most commonly involved in 71 patients [54.2%]. Microbiological studies were available for 101 [77.1%] patients. Streptococcus species [48.2%] were the most commonly cultured organisms. Concretions were noted in 45 [34.4%] patients. Canaliculotomy was performed in 33 [25.2%] patients. Topical Penicillin G was the most commonly used antibiotic [65.7%]. Seventeen [13%] patients had a recurrence of canaliculitis. Canaliculitis is frequently overlooked and misdiagnosed as conjunctivitis. Persistence or recurrence may complicate the condition. New organisms are emerging as the most common causative agents. Canaliculotomy with removal of all concretions is still considered the gold standard of treatment to eliminate the infection and improve patient symptoms

Aortic aneurysm: a rare cause of Ortner's syndrome

A young man presented with hoarseness of voice and was found to have left vocal cord paralysis and a large opacity on chest X-ray in the left upper zone. CT angiography showed a giant aneurysm of the aortic arch involving the left subclavian artery. Using a dual perfusion system, with the femoral bypass circuit taking care of the spinal protection and the aortic bypass circuit providing the cerebral protection, the aneurysm was excised and a 16 mm Dacron [registered] graft was anastomosed to the aortic arch and the left subclavian artery was anastomosed to the interposition graft. He had a smooth postoperative course and his hoarseness subsided in next 6 months.

Primary orbital liposarcoma: histopathologic report of two cases

Liposarcoma is a malignant tumor of adipose tissue. Considered the most common soft tissue sarcoma in adults, orbital liposarcoma is extremely rare. Most cases of orbital liposarcoma are primary and rarely metastatic. We report two cases of primary orbital liposarcoma with clinical presentation, radiologic studies [available for one case], and detailed histopathologic features. A brief review of primary orbital liposarcoma is also presented

Epithelioid sarcoma of the orbit

Epithelioid sarcoma is an aggressive and rare malignancy first recognized by Enzinger in 1970. It is known most commonly to affect the distal upper extremities in young adults. The classical "distal" form has a male predominance and can also involve other less frequent sites including lower extremities, proximal upper extremities, and the trunk. The "proximal" variant of this tumor is deep seated, tends to occur in older patients and predominantly develops in the pelvis, perineum, and genital tract. In the orbit, only a single report of two cases, which had a typical histopathologic appearance, has been previously published. We present the third case of orbital primary epithelioid sarcoma