Bulbar conjunctival plexiform schwannoma in a 5-year-old patient; expect the unexpected!

Rare, atypical ophthalmological conditions in adults include bulbar conjunctival plexiform schwannomas, which are usually asymptomatic. Few case reports in the literature indicate the presence of orbital/conjunctival schwannomas in adult patients and, rarely, among children under the age of 12. We report a case of a 5-year-old girl who presented in an outpatient clinic with inferior temporal conjunctival nonpigmented cystic lesion of a 10 × 10 mm size. Upon examination, we could not identify a feeding vessel. The mass was mobile and not fixed to the sclera. The history indicated a 1-year duration but the mass in the left eye had progressively increased in size during the last 2 months prior to presentation. There was no traumatic injury or past history of ophthalmic surgery. Surgical excision of the cyst was sucessfully performed, and histopathological examination confirmed bulbar conjunctival plexiform schwannoma diagnosis. Upon regular follow-up evaluation, there was no evidence of recurrence or malignant transformation. Although it is extremely rare to encounter conjunctival schwannomas in children, it should be considered in ovoidal well-circumscribed orbital swellings, particularly those that appear with no history of trauma or surgery to the eye. Surgical excision is effective and safe therapeutic intervention.

A 5-year-old girl consulted our ophthalmology clinic for an unusually large swelling in her left eye. It had been increasing in size over the last 2 months before the consultation. She reported no injury or surgery at the swelling site. Apart from the mass, no other abnormality was noted. The family agreed to the surgical removal of the mass, which was performed. Pathological examination revealed a rare tumor called a bulbar conjunctival plexiform schwannoma. This case report is of interest as this type of tumor is rare in children. This case report confirms that surgical removal of these tumors is safe, feasible, and effective as a treatment for this rare condition.

Effects of Early Treatment of Retinopathy of Prematurity at a Tertiary Care Hospital in Saudi Arabia: A Retrospective Study.

PURPOSE: To estimate the prevalence of retinopathy of prematurity (ROP) among high-risk neonates and to illuminate the benefits of early treatment in type 2 ROP (zone II, stage 3 without plus) and ROP milder than type 1 with pre-plus disease (zone III, stage 3). METHODS: This retrospective cross-sectional study was conducted among 307 high-risk neonates (614 eyes) with a gestational age of 32 weeks or younger at birth and a birth weight of 1,500 g or less, from 2011 to 2016. Treatment was initiated for neonates with low-risk type 2 ROP and ROP milder than type 1 with pre-plus disease, whenever retinopathy was evident for 3 clock hours with or without vitreous hemorrhage. Post-treatment progression was recorded. RESULTS: The prevalence of ROP in the current study was 33.71%. Two hundred seven eyes had ROP; 47.34% had mild retinopathy that did not require treatment, and 52.66% received laser treatment, including the early treated group. Of the 207 eyes with ROP, 46.86% had low-risk type 2 ROP disease and ROP milder than type 1 with pre-plus disease, and underwent photocoagulation therapy. After treatment, 15.38% and 10.71% eyes were stable, 84.62% and 88.10% eyes had regressed retinopathy, and 0% and 1.19% progressed in both groups, respectively. CONCLUSIONS: Early treatment of type 2 ROP and ROP milder than type 1 with pre-plus disease in certain cases significantly decreased the rate of progression to more advanced stages and resulted in good clinical outcomes. [J Pediatr Ophthalmol Strabismus. 2021;58(4):240-245.].

A Subcutaneous Juvenile Xanthogranuloma in a 4-Year-Old Girl Who Presented with a Lower Eyelid Mass.

Juvenile xanthogranuloma (JXG) is a relatively uncommon, benign, histiocytic proliferative cutaneous disorder that typically affects children, with the head and neck being the most common sites. The present case report describes an isolated subcutaneous JXG in a 4-year-old girl who presented with a circumscribed oval mass located in the lower eyelid of the right eye. This lesion was histologically diagnosed as JXG after a surgical resection of the mass.