Enucleation in a patient with neurofibromatosis type 1 with buphthalmos and ocular deformity

In infants with neurofibromatosis type 1, plexiform neurofibroma with altering anterior segment outflow system may result in raised intraocular pressure. Here we report a case of buphthalmos with neurofibromatosis [NF-1] who suffered with blindness suffered enucleation. Physical examination and histopathology were performed. Physical examination revealed Buphthalmos and vascularized cornea with lower lid ectropion and orbital deformity. Histopathologic findings showed plexiform neurofibroma in orbital tissue with scleral wall involvement. And hamartomatous proliferation in choroid and cilliary bodies with melanocytic elements. Few NF-1 cases with buphthalmos have been reported. But cases with complicationg buphthalmos [retinal detachment and optic nerve atrophy] suffering enucleation are very rare

[Normal conjunctival flora in newborns and infants]

To determine the normal conjunctival flora in neonates and infants. Conjunctival specimens were obtained from both eyes of 43 newborns delivered by cesarean section [C/S] and 53 newborns delivered by normal vaginal delivery [NVD] as well as 54 healthy infants in two maternity and pediatric hospitals. The specimens were cultured aerobically, anaerobically and for fungi. Among C/S delivered newborns 51% were culture positive for Staphylococcus epidermidis as the most common isolate [72.4%] followed by corynebacterium species. [10.3%]. Among NVD newborns 73.5% were culture positive. The most common isolates were S. epidermidis [26.5%] and Streptococcus viridans [17%]. Significantly greater isolates of anaerobic bacteria were observed in NVD newborns compared to C/S delivered newborns as follows: Lactobacillus [9.5%], Propionibacterium acnes [7.8%] and Fusobacterium [1.5%]. Among healthy infants 48% were culture positive. The most common isolates were S. epidermidis [55%] and P. acnes [10.5%]. There were no significant differences in normal conjunctival flora between healthy infants and C/S newborns, but significant differences were observed between infants and C/S newborns versus NVD newborns in certain vaginal tract related isolates such as Lactobacillus and Streptococcus species. Due to the higher incidence of anaerobic bacteria in NVD newborns, these organisms may be considered as presumptive causes in ophthalmia neonatarum