Malignant apocrine sweat gland carcinoma of the caruncle.

A 34-year-old male presented with a mass in the medial aspect of the orbit. Histological examination demonstrated a malignant apocrine sweat gland carcinoma, which we consider to be most likely derived from the caruncle. We describe the clinical, radiological and histological features, with management options and a review of the relevant literature regarding sweat gland carcinomas.

Adenoid cystic carcinoma of the superonasal conjunctival fornix.

The case of a 32-year-old female with a mass in the superonasal conjunctival fornix is described. Histological examination revealed an adenoid cystic carcinoma, which we consider to be most likely derived from an accessory lacrimal gland. The clinical presentation, histological features, management and follow-up are described. A literature review of orbital adenoid cystic carcinoma arising outside the main lacrimal gland is presented.

Synthetic hydroxyapatite orbital implants: a clinical and MRI evaluation.

PURPOSE: Coralline hydroxypatite orbital implants have been used since the 1980s. More recently, synthetic hydroxyapatite orbital implants have been used, in both primary and secondary orbital implantation surgery. The implant may be drilled and pegged, if required, after adequate vascularisation of the implant has occurred. In this study we evaluated the clinical results and vascularisation of synthetic hydroxyapatite orbital implants. METHODS: Twelve consecutive patients who had synthetic hydroxyapaptite orbital implants were evaluated clinically and 8 of these patients had orbital magnetic resonance imaging (MRI) scans with intravenous gadolinium performed at least 9 months post-operatively to assess vascularisation of the implant. Six patients had primary orbital implants at the time of enucleation and 6 patients had secondary implants. RESULTS: No significant complications occurred following insertion of the synthetic hydroxyapatite orbital implants. All patients reported cosmetic satisfaction with the results of surgery. MRI scans revealed inhomogeneous enhancement in 3 of the 4 patients receiving primary implants. All patients with secondary implants and 1 patients who had a primary implant had moderate to large areas of poor enhancement in the implant. CONCLUSION: Synthetic hydroxyapatite implants gave good clinical results but variable vascularisation occurs, especially with secondary implants.

Antigen presentation of herpes simplex virus by corneal epithelium--an in vitro and in vivo study.

Ia antigen (class II antigen) is a histocompatibility antigen that foreign peptides associate with, before antigen presentation to T cells and subsequent triggering of the CD4 T cells. Although corneal epithelium is normally Ia negative it may become Ia positive under abnormal circumstances but the functional significance of this is uncertain. In this study the expression of Ia antigen on corneal epithelium of mice during in vivo primary and secondary herpes simplex keratitis and the in vitro accessory function of corneal epithelium in the presentation of herpes simplex virus (HSV) antigen to in vivo HSV primed T cells were evaluated. Whole mount preparations of corneal epithelium were found to express Ia antigen on days 3, 5, and 7 following corneal inoculation with live HSV. The intensity of the Ia expression was greater in non-immune mice on day 7 after corneal inoculation compared with immune mice. A cellular suspension of corneal epithelium induced HSV primed T cells to proliferate in the presence of HSV antigen. Induction of Ia antigen on corneal epithelium during herpes simplex keratitis may functionally expand the population of antigen presenting cells in the cornea and contribute to T cell activation.

Randomised double-masked trial of lodoxamide and sodium cromoglycate in allergic eye disease. A multicentre study.

135 patients were entered into a 28-day randomized double-masked multicentre study comparing the efficacy and short-term safety of lodoxamide 0.1% ophthalmic solution (Alomide--Alcon Laboratories), a mast cell stabilizer, with sodium cromoglycate 2% ophthalmic solution (Opticrom--Fisons Pharmaceuticals) in the treatment of allergic eye disease. Patients given lodoxamide 0.1% showed a significantly more rapid and greater improvement in their signs and symptoms of allergic eye disease than patients given sodium cromoglycate 2%. Both treatments were found to be safe, and side-effect profiles were comparable between the two treatment groups, although the overall incidence of side-effects in this study was found to be less frequent in the lodoxamide-treated group.