Orbital and para-orbital tumours--a 10 years retrospective study.

A total number of 631 cases of orbital and para-orbital tumours causing proptosis was analysed in a retrospective way in relation to age, anatomic location, histological and clinical profile. CT-scan was considered as the primary modality of investigation as it correctly delineates the extent of the tumour, integrity of bony structures and intracranial spread. Different modalities of surgery like lateral orbitotomy, medial orbitotomy, lateral rhinotomy and endoscopic excision, etc, had been performed depending upon the anatomical locations. Surgical approaches, histological types of various tumours are analysed in detail.

A study of sleeping disorders in blind patients.

An internal 24-hour biological clock working in tandem with external environmental cues like bright light regulates our daily rhythms specially sleep-wake cycle. In a blind individual, due to absence of external cue endogenous rhythm may take upper hand and free running of sleep-wake cycle starts without any synchronicity with day-night cycle, creating ground for sleep disorders. To evaluate the frequency of sleep disorders, 65 blind individuals without any comorbid medical or surgical problem were interviewed according to the criteria of Diagnostic and Statistical Manual of Mental Disorder-IV (DSM-IV). Simultaneously 70 persons with no visual impairment were assessed in the same manner as used for blind persons. Blind patients showed far higher presence (44.6%) of sleep problems compared to controls (15.7%), and this difference was highly significant statistically [odd's ratio (OR) = 4.32, CI 95 =1.8-10.54]. Blind patients showed far higher presence (43.1%) of DSM-IV based diagnosis compared to controls (8.6%), and this difference was highly significant statistically [OR = 8.072, CI 95 = 3.059-21.298]. Circadian sleep disorders, insomnia and hypersomnia were relatively higher in blind patients. High incidence of sleep disorders calls for development of short reliable screener for sleep disorders among blind persons and better liaison among ophthalmologists and psychiatrists for early detection of this problem.

Hurler's disease.

Hurler's disease, also known as mucopolysaccharidoses 1H, an autosomal recessive disease due to enzyme alpha-iduronidase deficiency has generally a spectrum of findings involving the eye, skeletal abnormality, organomegaly, joint stiffness, hernia, mental retardation and cardiovascular abnormalities. The two cases presented here are related to each other as brother of 9 years age and sister of 7 years of age with their parents had consanguineous marriage. On ocular examination in both the cases there was dense bilateral corneal opacities. Glycosaminoglycan's level was found to be 4 mg/mmol cr in the first case and 5 mg/mmol cr in the second case. In the first case no ocular treatment was planned and in the second case penetrating keratoplasty was the choice of management.

Nosocomial ocular infection--a prospective study.

Nosocomial infection of the eye is an uncommon complication, acquired during the course of hospital management. It may prolong the disease process or even destroy the eye. The overall incidence varies considerably by hospital services. To ascertain the various types of ocular infections and its responsible pathogens, a laboratory-based, nosocomial ocular infection control study was performed in a large referral hospital during a period of January 1997 to June 1999. The study revealed 29 cases (0.08%) of culture proven ocular infections, out of 35,758 total admission during the period of one calendar year. Fifty-one eyes of 29 cases (22 bilateral) had nosocomial infection. Staphylococcus aureus (9), Staphylococcus epidermidis (8) and Pseudomonas aeruginosa (5), were the most frequent bacteria. Laboratory investigations helped in initiation and modification of specific antimicrobial therapy and also prognosis. Proper surveillance with the help of laboratory investigations has effective role in the management of nosocomial ocular infection.