Squamous cell tumors and ocular prostheses.

Conjunctival squamous cell carcinoma is an infrequent tumor. It has been reported to occur in association with actinic damage and chronic irritation. To the authors' knowledge, however, this tumor has not been reported secondary to poorly fitting ocular prostheses. Two patients were studied in whom conjunctival squamous cell carcinoma had developed. In both instances, the patient had been enucleated and fitted with an ocular prosthesis more than 40 years before tumor development. Histopathologic evaluation of each tumor revealed its squamous cell origin. In one of the patients, the tumor was found to be metastatic to the ipsilateral parotid gland, an uncommon finding. The authors attempted to identify risk factors that may have contributed to the development of these tumors. Aside from the poor fit of the prostheses, neither patient had significant risk factors for the development of conjunctival squamous cell carcinoma. It is concluded that a new, sanguineous conjunctival discharge or focal eyelid swelling after years of prosthetic wear may not be due to mechanical irritation alone. The onset of these symptoms, especially years after the initial fitting of an ocular prosthesis, should prompt a thorough investigation of its cause.

Herpes simplex blepharoconjunctivitis presenting as complete acquired ankyloblepharon.

PURPOSE: A 90-year-old woman was referred to us with a 1-month history of progressively worsening blepharoconjunctivitis. She had a complete acquired ankyloblepharon of the right lids, which resulted in the appearance of a right upper lid abscess on computed tomography. METHODS: Blepharotomy with separation and debridement of the lid margins was performed. RESULTS: Cultures were positive only for herpes simplex virus, type II. CONCLUSIONS: Herpes simplex blepharoconjunctivitis may take many clinical forms. Our patient's severe manifestations led to the clinical and radiologic appearance of preseptal cellulitis with a right upper lid abscess.

Traumatic cataract and Wieger's ligament.

The objective of this study was to determine the relationship between posterior subcapsular contusion cataract and Wieger's ligament. Two clinical cases of traumatic cataract, occurring in young patients, were analyzed. In neither case was there evidence of penetrating or perforating injuries to the globe. During cataract extraction a smooth oval defect in the posterior capsule was observed; however, there was no evidence of intraoperative capsular damage. The outline of the defect was consistent with the border of Wieger's ligament. It appears that blunt trauma avulsed this region of lens capsule, resulting in these findings.

Plasmacytoma of the eye and orbit.

BACKGROUND: Plasmacytomas of the ocular and adnexal tissue are rare. The variation in their clinical manifestations and potential association with multiple myeloma are not well appreciated. METHODS: We reviewed the clinical features and laboratory data of five cases of plasmacytoma involving the eye and orbit. RESULTS: Plasmacytomas involved the conjunctiva in one case, the orbit in three cases, and the iris in one case. Plasmacytoma was the solitary plasma cell neoplasm in a patient with a conjunctival lesion and another patient with an orbital lesion. Two other patients who developed plasmacytomas of the orbit and iris, respectively, had a known history of multiple myeloma. An orbital plasmacytoma preceded the onset of systemic plasma cell neoplasia in the final patient. CONCLUSION: Plasmacytomas of the eye and orbit are rare. They may or may not be associated with multiple myeloma.