Retinoblastoma in Upper Egypt [1981-1991]

We conducted a retrospective study on 78 children with retinoblastoma who were admitted, diagnosed and treated at the Ophthalmology Department of Assiut University Hospital [AUH] in the period between October 1981 and November 1991. Forty-seven children were male and 31 female, forming a male/female ratio of 3:2. The tumor was unilateral in 68 [87%] and bilateral in 10 children [13%]. Retinoblastoma was primary in 67 [86%] and recurrent in 11 cases [14%]. The mean age at diagnosis in males with unilateral and bilateral retinoblastoma was 36 months and 17 months respectively, while it was 33 months in females with unilateral tumors. Bilateral retinoblastoma was seen in only two females, aged 3 and 4 years. The first presenting symptoms were leukokoria [44.9%] and proptosis [39.7%]. Echography showed a solid mass, with moderate to high refractile echoes, an orbital shadowing, and normal axial length of the globe. Retinoblastoma was treated by primary enucleation [50.0%], exenteration [16.7%], irradiation [3.8%], and chemotherapy [2.6%]; in 25.6% of cases the parents refused treatment. The late presentation by the patients, and the deficiency in specialized centers for the management of retinoblastoma in our region of the world worsen the prognosis, both for life and for vision

Eyelid [and orbital] malignant fibrous histiocytoma

We report a case of an eyelid malignant fibrous histiocytoma in a 6 year old girl, because the eyelid is an unusual location for a fibrous histiocytoma [whereas it is common in the orbit], and the malignant variety of the tumor is the least frequent. The tumor presented as a painless, rapidly growing mass, causing complete ptosis of the right upper eyelid. Computerized tomography [CT-scan] showed a soft tissue mass in the right upper eyelid, in contact with the globe, and extending, superiorly to the globe, to the adjacent medial orbital wall, and posteriorly to the level of origin of the superior and medial recti muscles. The diagnosis of malignant fibrous histiocytoma was confirmed by histopathological examination. The tumor was treated by wide surgical excision

Lethal midline granuloma

We report a case of lethal midline granuloma in a 12-year-old girl. She presented with epistaxis, nasal obstruction, and bilateral progressive proptosis. The respiratory tract and kidneys were clinically free, as revealed by chest X-ray films and abdominal sonography. Examination of the bone marrow showed hypercellularity, with increased plasma cells and marrow eosinophils. The blood picture was within normal limits. The diagnosis was confirmed by a CT scan of the skull. A biopsy from the nasopharynx revealed lymphocytes, reticulum cells, and atypical cells considered representative of polymorphic reticulosis. The chosen treatment in our case was a combination of radiotherapy and a course of chemotherapy consisting of endoxan, adriamycin, oncovine and prednisone. The short-term result of treatment was favorable

Pattern of astigmatism between the ages of 6 and 12 years: a cross-sectional study

A cross-sectional study was performed on 1231 eyes of 645 astigmatic children aged 6 to 12 years. Eyes with irregular astigmatism were excluded. The magnitude of astigmatism most commonly seen was one diopter cylinder or less. In 90.9% of children, astigmatism was found to be bilateral. Myopic astigmatism was seen in 51.1% of the eyes overall, and astigmatism with-the-rule constituted 48.5% of all cases

Prevalence and clinical features of recurrent herpetic keratitis in upper Egypt

The prevalence and clinical features of herpes simplex keratitis in Upper Egypt were studied. Of 8447 patients presenting to the Eye Clinic in Assiut University Hospital, 456 [5.4%] patients had herpetic keratitis. The highest prevalence of herpetic keratitis was found in the age group of 30 - 39 years of both males and females [116 out of 456 patients]. The disease was unilateral among 427 [93.6%] and presented in the seasons of winter in 195 [42.8%] patients. Herpetic keratitis was detected during the first recurrence in 274 [60.1%] patients, and 182 [39.9%] patients had more than one recurrence [average 1 recurrence per year]. The commonst symptom was irritation, 233 [51.1%]. Herpetic lesions were ulcerative keratitis in all patients with one recurrence and keratouveitis in 47 [25.8%] out of 182 patients with more than one recurrence. Herpetic keratitis should be considered as one of the leading causes of corneal blindness in Upper Egypt. The factors affecting the course and seriousness of the disease are discussed

Ocular injuries in children

This is a study of 170 children admitted to the Ophthalmology Department of Assiut University Hospital [Egypt] for ocular trauma between January 1987 and December 1990. Results of this study showed that ocular injuries among children were a relatively common occurrence in this locality forming 2.5% of all admitted ophthalmic patients and 46.7% of all admitted ocular injuries. Boys were affected more than girls. The age group 5-12 years included the largest number of such cases. The most common objects involved were of botanic origin i. e. sticks, twigs, stems, etc

Bilateral primary localized amyloidosis of eyelids

Amyloid tumours localized to the conjunctiva and eyelids are not a common finding. This is a case of primary localized amyloidosis of both the upper eyelids of a middle-aged female patient. The diagnosis was confirmed by histo - pathological examination and Congo-red staining

orbital osteoma presenting as epiphora

A 14-year-old boy presented with a four-months history of epiphora in his left eye. Clinical examination revealed a hard palpable mass in the upper-inner quadrant of the left orbit, laterally displacing the medial palpebral ligament. Orbital radiography, computed tomographic scan, and dacryocystography confirmed the presence of an osteoma of the anterior ethmoidal cells causing impaired drainage of left lacrimal passages. Surgical excision of the osteoma restored the patency of the impaired lacrimal passages, as confirmed by postoperative dacryocystography

Prevalence and clinical features of recurrent herpetic keratitis in upper Egypt

The prevalence and clinical features of recurrent herpes simplex keratitis [RHSK] in Upper Egypt were studied. Of 8447 patients presenting with different eye diseases to Assiut University Hospital, 456 [3.4%] of patients had active recurrent herpetic lesions. The highest incidence of herpetic affection was found in the age group of 30-39 years of both males, 70[26.5%] and females, 46[24.0%] patients. The majority of cases were unilateral, 427[93.6%] patients and presented in the season of winter, 195 [42.8%] patients. RHSK was detected during the first recurrence in 274[60.1%] of patients, and 182.[*39.9%][of cases had more than one recurrence [average3 recurrences in 3 years]. The commonest symptom was pain in 233[51.1]%] - patients and the commonest herpetic lesions were ulcerative keratitis in 319[70%] patients with one recurrence and kerato-uveitis in 47[25.8%] patients with more than one recurrence. RHSK should be considered as one of the serious diseases affecting the cornea in Upper Egypt. The factors affecting the course and seriousness of the disease were discussed

Surgical management of rodent ulcer of the eyelids

A clinical study of 34 cases of rodent ulcer of the eyelids and adjacent skin was carried-our over a period of 4 years in the ophthalmic department of Assiut University Hospital. For the treatment of these cases, variable surgical techniques were performed and their results were compared with those of others

safe retrobulbar block; How?

In a retrospective study; the incidence and severity off retrobular haemorrhage [RBH] were estimated in 1378 patients subjected to various ocular operations under local anaesthesia. The retrobulbar block [RBB] was done by disposable needles of 38.9 mm and 20 gauge. RBH had occurred in 33 [2.4%] patients [4 mild, 5 moderate and 24 severe]. In a prospective study, the safety and efficacy off the trocars of two i.v. cannulae in doing the RBB were evaluated in two groups of patients, each formed off 100 patients. A mild RBH occurred in one patient off the group off "Angiocath" trocars, and no RBH had occurred in the group of "Supercath" trocars. Both trocars were proved to be cheap, safe and effective needles for doing the RBB for various ocular operations done under local anaesthesia

randomised double-controlled clinical study of trifluridine and adenine arabinoside in herpetic keratitis

This study included 213 patients with different herpetic lesions. They were randomly divided into two treatment-groups. Group 1 included 144 patients [88 men and 56 women] received 3% Ara-A [Vidarabine] ointment 5 times daily. Thereapy was continued for a period of 7-15 days. The results of therapy in different herpetic lesions by the two drugs were compared and discussed

Eye findings in some blood and reticuloendothelial diseases

Ophthalmic examination was performed over a period of one year on one-hundred patients in Assiut University Hospital diagnosed clinically and by laboratory investigations as cases of blood and reticulo-endothelial diseases. The ocular findings in these diseases were studied and their incidence was compared with that of other authors

study of infants defaulters in immunization against poliomyelitis, diphtheria, tetanus and whooping cough

The live births of infants born in El-Moski District whose birth dates were in August, September and October 1981 were followed up from the fourth month of age to know the number of vaccinated infants and the causes behind defaulting vaccination. Also to test the different methods of calling the defaulters. 325 infants were followed up, 73.75% have attended the three doses of vaccination. The vaccinated infants [230 infants] were studied as a control group to the defaulters [59 infants] as regards the different variable of the study. The results showed a statistical significant difference between the vaccinated groups and the defaulters regarding the father's occupation, the maternal education level and the first three order of birth of infant. While the sex of infant, age of parents, employment of mothers and paternal education proved to have no statistical significant difference. The results showed that the infants who attended the first dose of DPT and OPV were more liable to attend the second and the third doses than the defaulters of the first dose, the difference was statistically significant. Analysis of the cause of defaulting showed 58.95% were medical causes and 41.05% were socio-psychological causes. The main medical causes were gastroenteritis [30.36%], upper respiratory tract infection [28.57%] and acute bronchitis with gastroenteritis [21.42%] which was not different from the general pattern of infant morbidity in Egypt. For the socio-psychological causes, it was found that, change of residence comprises 35.90%. Half of this group changed their residence due to demotion of their hours which stresses the importance of housing problems as a course of defaulting in this area. The other important socio-psychologlcal causes were negligence [25.64%] and travel [20.51%]. Half the travelling groups of infants, traveled to Arab countries with their families. Testing the different methods of calling showed that, although calling by letters had 32.44% responses. Yet the best method of calling was the house visits [51.35% responses] and the difference was statistically significant. It showed also that association of the home visits with letters had no difference in response