A case of Goldenhar-Gorlin syndrome with unusual association of hypoplastic thumb.

A case of Goldenhar-Gorlin syndrome in a seven-month-old male infant presented with the features of epibulbar dermoid, microtia and hemifacial microsomia associated with thumb defect. The dermoid was bilateral and microtia was unilateral. Preauricular appendages and pits were double and single respectively on both the sides. Hemifacial microsomia was unilateral and was associated with cleft lip, macrostomia, dental misalignment, large tongue and high arched palate. The association of hypoplastic thumb with Goldenhar-Gorlin syndrome has not been documented in the past.

Conjunctival intra-epithelial neoplasia in a young Indian male with human immunodeficiency virus (HIV) infection.

Conjunctival intra-epithelial neoplasia is a disease of the elderly but recently this ocular surface tumour has been observed in younger age group specially who are serologically human immunodeficiency virus (HIV)-positive. Here a case of conjunctival intra-epithelial neoplasia of a 38-year-old male who was HIV-positive from Kolkata is reported. The patient presented with a growth at limbus in his left eye. Excision of the mass under local anaesthesia was done. Biopsy report confirmed conjunctival intra-epithelial neoplasia. The serological tests for HIV were found positive.

Klippel-Feil syndrome: a case report and current understanding of molecular genetic background.

A case of Klippel-Feil syndrome in a 12-year-old boy presentingwith the features of low set posterior hairline, short webbed neck, scoliosis and Sprengel's deformity associated with upper eyelid coloboma and pre-auricular appendages is described. Radiologically there was evidence of maldeveloped cervical and upper thoracic vertebrae associated with elevated scapula. The association of the eyelid defect and pre-auricular appendages has not been documented in the past. The current literatures based on the recent advances in understanding of molecular genetic control over embryonic development of the cervical spines were reviewed.

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.

Evaluation of visual outcome following cataract surgery in a tertiary eye care hospital.

A retrospective study was conducted at the Regional Institute of Ophthalmology (RIO), Kolkata to assess the visual outcome in senile cataract after surgery in the age group of 45-65 years. A total number of 1837 operated eyes (1826 patients) were included in the study during the period of January, 2000 to December, 2000. Patients with low vision unrelated to cataract surgery were excluded. The mean age at cataract extraction was 56 +/- 9 years. Patients were followed for 6 months. Of 1837 operated eyes, 26 (1.4%) were blind (visual acuity < 3/60), 122 (6.6%) had low visual acuity (3/60-6/18) and 1689 eyes (92.2%) gained good vision (visual acuity > 6/18). Of 148 visually compromised eyes posterior capsular opacity (41.2%) was the commonest complication followed by corneal oedema (36.5%) and glaucoma (12.8%). Other posterior segment causes accounted for the remaining cases. The study emphasises the need for proper selection, good pre-operative check-up, skilled surgery and regular follow-up to improve the qualitative aspect of cataract surgery.

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.

Late spontaneous extrusion of a wooden intraorbital foreign body.

Wooden intraorbital foreign body is characteristic for delayed manifestation, silent progression and unpredictable outcome. A silent wooden intraorbital foreign body is difficult to diagnose clinically. Spontaneous expulsion of entire foreign body is rare.