Clinical presentation and staging of newly diagnosed intraocular retinoblastoma according to international classification of retinoblastoma

To report the clinical presentation and stage of the disease in newly diagnosed retinoblastoma cases at Al-Shifa Trust Eye Hospital Rawalpindi according to International Classification of Retinoblastoma. A hospital based prospective descriptive study. Clinical data of presentation and staging of cases diagnosed with primary retinoblastoma from January 2009 to June 2011 was collected. All patients underwent an examination under anaesthesia including fundus examination by indirect ophthalmoscopy with 360 degrees indentation, ultrasound and RetCam photographs to document the location and size of the tumours, the presence and extent of vitreous and subretinal seedings and subretinal fluid. An oncologist performed the metastatic workup. All the eyes were then classified according to the Reese-Ellsworth classification and International classification of retinoblastoma [IIRC]. Treatment methods included chemoreduction, focal therapy [transpupillary thermotherapy and cryotherapy], enucleation and exenteration in rare cases with extra ocular extension. 72 eyes of 51 patients with primary retinoblastoma were diagnosed during this period. Thirty patients [58.8%] had unilateral retinoblastoma and 21 patients [41.2%] had bilateral retinoblastoma. Thirty four [66.6%] patients presented with leukocoria. The disease in 32 [62.74%] patients was classified in group E. Majority of the patients presented with advanced disease manifesting as leukocoria and were staged in group E

Cyclic oculomotor spasm and third nerve palsy

In the present report, cyclic oculomotor spasm occurring in a patient with third nerve paresis is described, which is a rare occurrence. An 11 year old female presented with decreased vision of the right eye and drooping of the right upper lid since early childhood. Third nerve paresis was seen with limited adduction and elevation. During examination the right exotropic eye became esotropic, over which the patient had no voluntary control. After orthoptic assessment, right superior oblique resection and transposition close to the medial rectus, with a large lateral rectus recession was done