Ocular chemical injuries and their management

Chemical burns represent potentially blinding ocular injuries and constitute a true ocular emergency requiring immediate assessment and initiation of treatment. The majority of victims are young and exposure occurs at home, work place and in association with criminal assaults. Alkali injuries occur more frequently than acid injuries. Chemical injuries of the eye produce extensive damage to the ocular surface epithelium, cornea, anterior segment and limbal stem cells resulting in permanent unilateral or bilateral visual impairment. Emergency management if appropriate may be single most important factor in determining visual outcome. This article reviews the emergency management and newer techniques to improve the prognosis of patients with chemical injuries.

Choroidal melanoma

Choroidal melanoma is the most common primary intra-ocular malignant tumor and second most common site of ten malignant melanoma sites in the body. Current diagnosis of choroidal melanoma is based on both the clinical experience of the specialist and modern diagnostic techniques such as indirect ophthalmoscopy, A-and B-ultrasonography scans, fundus fluorescein angiography, and transillumination. Invasive studies such as fine needle aspiration cytology can have significant morbidity and should only be considered if therapeutic intervention is indicated and diagnosis cannot be established by any other means. Several modes of treatment are available for choroidal melanoma. Multiple factors are taken into account when deciding one approach over other approaches, such as visual acuity of the affected eye, visual acuity of the contralateral eye, tumor size, location, ocular structures involved and presence of metastases. A comprehensive review of literature available in books and indexed journals was done. This article discusses in detail epidemiology, diagnosis, current available treatment options, and prognosis and survival of choroidal melanoma

Primary sebaceous gland carcinoma of the bulbar conjunctiva without involvement of eyelid: a clinical dilemma

Sebaceous gland carcinoma usually arises from the meibomain or Zeis glands within the eyelid, but tumor arising primarily from the conjunctiva, especially bulbar conjunctiva, is a rarity. We hereby report a case of a50-year-old female who presented with a painless mass in the inferior limbus, encroaching the cornea and hanging over the lower eyelid without involving it. Imprint cytology was suggestive of adenosquamous carcinoma. management consisted of wide local excision, cryotherapy to tumor bed, and topical 5-fluorouracil [5-FU] 1% preoperatively and postoperatively. Histopathologic analysis was in favor of sebaceous gland carcinoma. This case suggests that although sebaceous gland carcinoma commonly originates as a lid tumor, it can present as a bulbar conjunctival mass. Topical 5-FU is a viable and efficient cost-effective alternative for neo-adjuvant and adjuvant treatment of sebaceous gland carcinoma