RESUMO
To study the clinical features and bacteriology of canaliculitis in patients presenting to King Khaled Eye Specialist Hospital [KKESH], a major tertiary eye care center in the Middle East and compare the results to previous studies from other countries. In this retrospective study, a chart review was performed of 131 patients [135 eyes] diagnosed with lacrimal canaliculitis who underwent treatment between January 1983 and December 2012 at KKESH. Data were evaluated on demographics, presenting signs and symptoms, diagnostic studies, causative organisms, treatment rendered including medical or surgical interventions and rate of recurrence. There were 47 males and 84 females with a mean age of 64 years. The average duration of symptoms was 81.38 weeks. The most common presenting symptom was eye discharge [68.7%]. The lower canaliculus was most commonly involved [49.6%] and 27 [20.6%] patients had upper and lower canaliculi involved. The left eye was most commonly involved in 71 patients [54.2%]. Microbiological studies were available for 101 [77.1%] patients. Streptococcus species [48.2%] were the most commonly cultured organisms. Concretions were noted in 45 [34.4%] patients. Canaliculotomy was performed in 33 [25.2%] patients. Topical Penicillin G was the most commonly used antibiotic [65.7%]. Seventeen [13%] patients had a recurrence of canaliculitis. Canaliculitis is frequently overlooked and misdiagnosed as conjunctivitis. Persistence or recurrence may complicate the condition. New organisms are emerging as the most common causative agents. Canaliculotomy with removal of all concretions is still considered the gold standard of treatment to eliminate the infection and improve patient symptoms
RESUMO
To study the pattern of ocular adnexal lymphoproliferative disorders [OALD] in an ophthalmic referral center in Saudi Arabia and to review their, histopathological characteristics with clinical correlation. Retrospective chart review of 40 cases of patients who underwent incisional biopsy with the suspected diagnosis of per-iocular and/or adnexal lymphoid lesions over the period: 2000-2012 at the King Khaled Eye Specialist Hospital [KKESH], Riyadh, Saudi Arabia. The routine histopathologic slides are reviewed by a single pathologist to identify cases of Benign Reactive Lymphoid Hyperplasia [RLH], Atypical Lymphoid Hyperplasia and probable lymphoma. The identification of the specific types of lymphoma is performed at a tertiary general hospital: King Faisal Specialist Hospital and Research Centre [KFSH and RC]. Results: Forty patients are included with an age range of 11-91 years and a median of 36 years. The males constitute 70% and females 30% of the cases. The right eye and/or orbit are involved in 48%. The left eye is involved in 45% while a bilateral disease is found in 7.5%. The median duration of symptoms is 5 months. The site distribution is conjunctiva [42.5%], orbit [25%] lacrimal gland [12.5%], eyelid [10%], lacrimal sac [7.5%] and caruncle [2.5%]. One case is excluded after histopathologic diagnosis of malignant melanoma. Diagnosis in the remaining 39 cases includes: RLH in 14 cases [35%], atypical lymphoid hyperplasia in three cases [9%], and lymphoma in 22 cases [56%]. Classification of the lymphoma group is: extranodal marginal zone lymphoma [EMZL] in 9/22 cases [41 %], diffuse large B cell lymphoma [DLBCL] in 4/22 cases [18%], Castelman's disease in 3/22 cases [14%], Burkitt's lymphoma in 2/22 cases [9%], follicular lymphoma and T cell-rich B cell lymphoma: one case each [4.5%].Two cases remain unclassified. Conclusion: We have a wide age range which is comparable to other studies. Our results show male predominance and the commonest site of involvement is conjunctiva!, however if RLH cases are excluded, the commonest site for lymphoma is orbit/lacrimal gland in 45% followed by conjunctival in 23%. The commonest type of lymphoma is: EMZL in 41% followed by DLBCL in 18% then other types of lymphoma including follicular lymphoma
RESUMO
Idiopathic orbital inflammation, also known as orbital pseudotumor, describes a spectrum of idiopathic, non-neoplastic, non-infectious, space-occupying orbital lesions without identifiable local or systemic cause. The condition occurs mainly in young adults who may present with acute pain, proptosis, chemosis and limitations of extraocular movements. Decreased vision due to optic nerve infiltration and macular edema as a result of scleritis is less common sequel of orbital pseudotumor. Herein, we present a case of unilateral orbital pseudotumor in a young male who presented with chief complaints of painful decreased vision which was attributed to optic neuritis and macular edema as a result of scleritis. Imaging studies were helpful in the establishment of the correct diagnosis and patient's complaints improved with administration of systemic corticosteroids