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1.
Indian J Ophthalmol ; 2023 Jul; 71(7): 2906-2910
Article | IMSEAR | ID: sea-225155

Résumé

Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Osteomyelitis is one of the rare sequelae of ROCM, frontal osteomyelitis being the rarest. We present four patients of coronavirus disease 2019 (COVID-19)-associated mucormycosis, who presented with frontal bone osteomyelitis after being treated for ROCM surgically and medically. This is the first case series highlighting this complication in post–COVID-19 mucormycosis patients and needs utmost attention as it can be life-threatening and can cause extreme facial disfiguration. All four patients are alive with salvage of the affected globe and vision being preserved in one patient. If identified early, disfiguration of face and intracranial extension can be avoided.

2.
Indian J Ophthalmol ; 2023 Jul; 71(7): 2812-2817
Article | IMSEAR | ID: sea-225135

Résumé

Purpose: The aim of this study was to report the outcomes of panophthalmitis and to identify factors significantly affecting globe survival in the disease. Methods: This was a retrospective study on patients with panophthalmitis in a tertiary hospital between January 1, 2017, and December 31, 2019. The demographics, treatment details, culture results, and final outcomes were recorded. Logistic regression and Cox proportional hazards (CPH) were calculated to identify variables associated with globe loss. A P < 0.05 was considered significant. Results: Eighty?five eyes of 85 patients (31 culture positive) were eligible for review. The mean age of the participants was 55.21 ± 20.17 years with a male?to?female ratio of 2.04:1. Corneal ulcer (38.82%; n = 33) and open globe injuries (OGIs) (38.82%; n = 33) were the most common etiologies. Pseudomonas aeruginosa (n = 10; 11.76%) was the most common isolate. The mean duration of hospital stay was 7.58 ± 2.32 days. Overall, 44 (51.76%) globes could be salvaged. The need for evisceration (P = 0.901) and hospital stays (P = 0.095) were similar for culture?positive and ?negative cohorts. The unadjusted logistic regression and CPH models showed that culture sterility did not affect globe survival [OR = 1.210 (0.501– 2.950), P = 0.668; HR = 1.176 (0.617–2.243), P = 0.623]. The adjusted logistic regression and the CPH models showed that corneal ulcers [OR = 10.900 (2.460–48.200), P = 0.002; HR = 5.393 (1.603–18.140), P = 0.006] and OGI [OR = 7.360 (1.650–32.700), P = 0.009; HR = 4.548 (1.321–15.660), P = 0.016] were significantly associated with globe loss. Conclusion: Corneal ulcer or OGI as the primary etiology is detrimental to globe survival in panophthalmitis.

3.
Indian J Ophthalmol ; 2022 Nov; 70(11): 3833-3836
Article | IMSEAR | ID: sea-224695

Résumé

Purpose: To determine the diagnostic accuracy of manual regurgitation on pressure over the lacrimal sac (ROPLAS) versus lacrimal irrigation for screening nasolacrimal duct obstruction (NLDO) in adults prior to intraocular surgeries. Methods: This cross-sectional study took place in a tertiary eye care hospital in South Tamil Nadu, India. From January to December 2017 and included consecutive patients who presented for routine cataract surgery. Prospective data collection occurred in 8369 eyes of patients who underwent cataract surgery. All patients underwent ROPLAS testing by an ophthalmologist followed by lacrimal irrigation by trained ophthalmic assistants, rechecked or confirmed in equivocal cases by ophthalmologists who were masked to the ROPLAS status. The primary outcome, the sensitivity, specificity, positive, and negative predictive values to detect lacrimal occlusion by ROPLAS compared with lacrimal irrigation with 95% confidence intervals was estimated. Results: A total of 8369 eyes underwent cataract surgery during the time periods of the study. ROPLAS and lacrimal irrigation were performed in all eyes. The sensitivity of ROPLAS to diagnose NLDO correctly was 54.5% (95% CI, 44.8%�.9%) and its specificity was 100% (95% CI, 100%�0%). The positive and negative predictive values were 75.3% (95% CI, 65.6%-83.0%) and 99.4% (95% CI, 99.2%�.5%), respectively. Conclusion: We found that ROPLAS when used alone had very low sensitivity and low positive predictive value in detecting NLDO prior to cataract surgery as compared with lacrimal irrigation. Hence, we recommend performing ROPLAS and lacrimal irrigation in every patient as part of the routine preoperative workup prior to cataract surgery

4.
Indian J Ophthalmol ; 2022 Apr; 70(4): 1327-1330
Article | IMSEAR | ID: sea-224254

Résumé

Purpose: To study the clinical presentations and outcomes of phthiriasis palpebrarum (PP) managed with combined treatment modality comprising of 20% fluorescein dye, mechanical removal of the ectoparasites, and topical application of antibiotic eye ointment with paraffin base. Methods: This is a prospective interventional noncomparative hospital?based series of 13 patients of PP. All the patients underwent local application of 20% fluorescein dye over the eyelashes and eyebrows of both the eyes followed by the mechanical removal of all the ectoparasites and trimming of the eyelashes from the base followed by application of ophthalmic ointment. Results: Mean age of the patients was 28 � 22 years (range 3� Years). Out of the total of 13 patients, 11 patients (85%) were having bilateral involvement. The mean duration of symptoms in 11 patients (rest 2 were accidental findings) was 4 � 3 weeks (range 1� weeks). Three patients (23%) had a history of sexual contact with possible parasite?infested partners. Four patients (31%) had additional parasites in the pubic area or torso. All the patients were completely parasite free at the end of 1 month. There was no infestation of the treating medical personnel from the patient. The average follow?up was 8 � 5 months (range 3� months). Conclusion: Itching and irritation of the eyes were the most common presentations of PP. Combined treatment modality comprising of 20% fluorescein dye, mechanical removal of ectoparasites, and topical application of antibiotic eye ointment with paraffin base is effective in the management of PP

5.
Indian J Pathol Microbiol ; 2016 Apr-June 59(2): 227-228
Article Dans Anglais | IMSEAR | ID: sea-179485

Résumé

We present the case of a 46 years old gentleman with longstanding ulcerative lesion of the right upper eyelid. Biopsy of the lesion revealed intracellular periodic acid–Schiff positive round to oval organisms with a surrounding clear halo suggestive of histoplasmosis. Histoplasma capsulatum specific polymerase chain reaction was positive. The patient was treated with oral antifungals and showed a prompt response to treatment. We report this rare case of primary cutaneous histoplasmosis of the eyelid in an otherwise healthy adult patient.

6.
Indian J Ophthalmol ; 2014 Oct ; 62 (10): 1032-1034
Article Dans Anglais | IMSEAR | ID: sea-155786

Résumé

Dermoid cysts are choristomas resulting from the inclusion of ectodermal tissue during closure of the neural tube and occur along the epithelial lines of fusion. Frontotemporal dermoids are the most common type and generally present as an asymptomatic mass. We present an unusual case of frontotemporal dermoid presenting as sudden onset oculomotor nerve palsy in young male patient and describe the neurosurgical approach in its management.

7.
Indian J Ophthalmol ; 2013 Feb; 61(2): 76-77
Article Dans Anglais | IMSEAR | ID: sea-147864

Résumé

Diving into lakes and ponds is a common activity of rural children. We present two cases of penetrating orbital injuries from plant matter sustained in this manner. Such injuries pose a particular challenge because wooden foreign bodies are often missed during orbital exploration, and current imaging modalities cannot reliably identify retained organic material. When a patient presents with orbital penetration after a high-risk mechanism of injury, such as freshwater diving, the clinician must maintain a very high index of suspicion for retained wooden foreign body.

8.
Indian J Ophthalmol ; 2011 Jan; 59(1): 55-58
Article Dans Anglais | IMSEAR | ID: sea-136141

Résumé

Traumatic subperiosteal hematoma (SpH) usually presents late, after the initial trauma. It is generally seen in young males. Computed tomography is the best mode of imaging and helps to rule out orbital fracture or associated subdural hematoma. We present the clinical features and management of four patients seen at the orbit clinic with SpH. Management is based on time of presentation, visual acuity and any communicating bleed. The prognosis of traumatic SpH is excellent if treated with an individualized patient approach.

9.
Indian J Ophthalmol ; 2010 Jul; 58(4): 338-339
Article Dans Anglais | IMSEAR | ID: sea-136087

Résumé

A 14-year-old boy presented with intractable diplopia for 10 days following an assault. A thorough history revealed that he was unaware of any penetrating injury. However, imaging demonstrated a radiolucent foreign body between the globe and the orbital floor. On surgical exploration, it was found to be the proximal part of a ball point pen. Its removal resulted in complete resolution of diplopia. Thorough clinical and radiological examination is recommended when a foreign body is suspected in pediatric patients. Prompt diagnosis will aid in early intervention and prevention of long-term complications.


Sujets)
Adolescent , Diplopie/étiologie , Diplopie/anatomopathologie , Diplopie/chirurgie , Corps étrangers/anatomopathologie , Humains , Mâle , Résultat thérapeutique , Acuité visuelle , Plaies pénétrantes/anatomopathologie
10.
Indian J Ophthalmol ; 2009 Sept; 57(5): 395-398
Article Dans Anglais | IMSEAR | ID: sea-135987

Résumé

Primitive neuroectodermal tumor is a small round cell malignancy which rarely involves the orbit. We report a case of a two-year old male child presenting as unilateral eccentric proptosis with extraconal and intraconal mass, diagnosed as primary peripheral primitive neuroectodermal tumor (pPPNET) on histopathology and immunohistochemistry. There is no defined consensus in the management of these tumors due to its rare presentation. We describe its distinguishing features with emphasis on multimodal and aggressive treatment approach which ensures appropriate management of these cases.


Sujets)
Antinéoplasiques/usage thérapeutique , Biopsie , Enfant d'âge préscolaire , Études de suivi , Humains , Imagerie par résonance magnétique , Mâle , Tumeurs neuroectodermiques primitives périphériques/diagnostic , Tumeurs neuroectodermiques primitives périphériques/traitement médicamenteux , Tumeurs neuroectodermiques primitives périphériques/radiothérapie , Tumeurs de l'orbite/diagnostic , Tumeurs de l'orbite/traitement médicamenteux , Tumeurs de l'orbite/radiothérapie , Radiothérapie adjuvante , Tomodensitométrie
11.
Indian J Ophthalmol ; 2009 Sept; 57(5): 387-389
Article Dans Anglais | IMSEAR | ID: sea-135983

Résumé

Delleman Oorthuys syndrome (oculocerebrocutaneous syndrome) is a rare, congenital sporadic disorder affecting the skin and central nervous system. We present the case of a one-month-old male who presented with an orbital cyst in the left eye since birth along with other manifestations of this syndrome. The manifestations of this syndrome resemble other developmental disorders like Goldenhar and Goltz syndrome. Conservative management of the orbital cyst in these cases have been described. The need to diagnose this rare congenital anomaly with cerebral malformations as a separate entity is crucial in the management of these children.


Sujets)
Malformations multiples/diagnostic , Diagnostic différentiel , Malformations oculaires/diagnostic , Études de suivi , Humains , Nouveau-né , Mâle , Malformations du système nerveux/diagnostic , Malformations cutanées/diagnostic , Syndrome , Tomodensitométrie
12.
Indian J Ophthalmol ; 2009 Sept; 57(5): 385-386
Article Dans Anglais | IMSEAR | ID: sea-135982

Résumé

Hyperimmunoglobulinemia E (Job's) syndrome is characterized by markedly increased levels of immunoglobulin E, recurrent cutaneous and systemic pyogenic infections, atopic dermatitis, and peripheral eosinophilia. Although ocular involvement in Job's syndrome is rare, there are reports of keratoconus, staphylococcal chalazia with blepharitis, and Candida endophthalmitis by various authors. We present the first case report of retinal detachment with complicated cataract in Job's syndrome.


Sujets)
Adolescent , Diagnostic différentiel , Humains , Immunoglobuline E/sang , Syndrome de Job/sang , Syndrome de Job/complications , Syndrome de Job/diagnostic , Mâle , Rétine/anatomopathologie , Rétine/imagerie diagnostique , Décollement de la rétine/diagnostic , Décollement de la rétine/étiologie
13.
Indian J Ophthalmol ; 2006 Jun; 54(2): 123-5
Article Dans Anglais | IMSEAR | ID: sea-69702

Résumé

Congenital unilateral fibrosis, blepharoptosis and enophthalmos syndrome is one of the rare forms of congenital fibrosis of extraocular muscles. The nature and cause of such unilateral inflammation leading to fibrosis is unknown. Prenatal orbital penetration has been proposed as a cause of this syndrome. We report a case of this rare syndrome associated with an adjacent sinus tumor.


Sujets)
Diagnostic différentiel , Femelle , Fibrose/congénital , Humains , Nourrisson , Imagerie par résonance magnétique , Muscles oculomoteurs/anatomopathologie , Tumeurs de l'orbite/complications
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