Syringocystadenoma Papilliferum of Sweat Gland of Caruncle: A Unique Case Report.

Syringocystadenoma papilliferum (SP) is a rare benign hamartomatous malformation of skin which arises from apocrine or eccrine sweat glands. Skin of the head and neck is the usual site for this but rarely involves the eyelids. It is also called as a childhood tumor since it usually appears at birth or during puberty. The diagnosis is confirmed on histopathological examination after surgical excision. We are first to report a case of SP involving the caruncle in an elderly female.

Congenital Double Elevator Palsy with Sensory Exotropia: A Unique Surgical Management.

PURPOSE: To report a unique surgical approach for congenital double elevator palsy with sensory exotropia. CASE REPORT: A 7-year-old boy with congenital double elevator palsy and sensory exotropia was managed surgically by Callahan's procedure with recession and resection of the horizontal recti for exotropia without inferior rectus recession, followed by frontalis sling surgery for congenital ptosis. CONCLUSIONS: Favourable surgical outcome was achieved without any complication.

Monitoring the appositions of posterior graft-host junctions with anterior segment optical coherence tomogram after penetrating keratoplasty.

This study aimed to monitor the graft-host junction's (GHJ's) apposition with anterior segment optical coherence tomogram after penetrating keratoplasty (PK) and correlate the analysis with the preoperative diagnosis. Fifty-one eyes of 50 patients with various preoperative diagnosis of adherent leucoma, pseudophakic bullous keratopathy, corneal opacity or scarring, graft failure, corneal dystrophy and anterior staphyloma, who underwent PK for optical purposes were reviewed retrospectively. Based on the age, the patients were divided into groups 1 and II: those aged ≤40 and >40 years, respectively. Anterior segment optical coherence tomography was done for all these eyes to evaluate the posterior graft-host junction. All graft-host junction patterns were classified as well apposed, and malapposed with various components like hill, gap, step and tag. The comparisons of various clinical parameters were done for the various malapposed junction groups (hill, gap, step and tag). A total of 408 graft-host junction cross sections of 51 eyes were analysed. Amongst them 70 (17.15 %) sections were well apposed, and 338 (82.84 %) were malapposed. Most frequent type of malapposition was hill: 164 sections (40.19 %) followed by step: 139 sections (34.06 %). The distribution of graft-host junction alignment patterns varied amongst all the indications. Patients with preoperative diagnosis of adherent leucoma and corneal dystrophy had predominantly steps pattern in 65 (40.62 %) and 12 (75 %) sections, respectively. Hill pattern was seen predominantly in PBK, corneal opacity, graft failure and anterior staphyloma in 55 (42.96 %), 16 (40 %), 22 (45.83 %) and 8 (50 %) sections, respectively. Comparisons of various clinical characteristics like intraocular pressure, central corneal thickness, best-corrected visual acuity, astigmatism and size of graft with the various malapposed patterns showed significant differences in best-corrected visual acuity and keratometric astigmatism in the hill pattern of malapposition group with p values of .004 and .053, respectively, using independent T test. Posterior graft-host junction analysis with anterior segment optical coherence tomography is very important for post penetrating keratoplasty management. The posterior wound profile differed according to the indications of penetrating keratoplasty. Best-corrected visual acuity and keratometric astigmatism showed significant difference with the malapposition hill (pattern).

Correlation of Retinal Nerve Fiber Layer Thickness and Axial Length on Fourier Domain Optical Coherence Tomography.

INTRODUCTION: The assessment of the peripapillary Retinal Nerve Fiber Layer (RNFL) thickness has been an important tool for evaluating and diagnosing glaucoma and its progression. Literature suggests that myopic eyes are at an increased risk for developing glaucoma. This study gives an insight into the relationship of RNFL thickness to the axial length in normal population. AIM: To correlate the RNFL thickness and the axial length in normal individuals with Fourier domain Optical Coherence Tomography (OCT). MATERIALS AND METHODS: In the current study, 298 eyes of 149 normal individuals (10 years or older) with or without refractive error were recruited. The RNFL thickness was measured using Optovue (RTVue) three-dimensional Fourier domain OCT. RESULTS: We observed an inverse relationship between average RNFL thickness and increasing axial length(p=0.003). Maximum RNFL thickness was seen in the Infero-Temporal (IT) quadrant and minimum in the Supero-Nasal (SN) quadrant. RNFL thickness did not show any tendency to decline with age using the Pearsons correlation (r=0.07). Females had an increased RNFL thickness in the Supero-Temporal (ST) and Infero-Nasal (IN) quadrant (p-value 0.046 and 0.02) in comparison to males. There was a statistically significant thinning in Ganglion Cell Complex (GCC) with increasing axial length (p-value 0.000). CONCLUSION: The current study suggests that the average RNFL thickness does not decrease with age. The RNFL and GCC thickness shows an inverse correlation with axial length of the eyeball hence observations have to be carefully interpreted in myopic eyes. Clinicians need to keep the anatomical variations in RNFL for better patient management.

Correlation between CT scan and automated perimetry in supratentorial tumors.

An attempt was made to correlate various types of visual field defects on automated perimetry with the findings of computed tomography in 44 patients of supratentorial tumors. All the patients above the age of 10 years were subjected to complete neurological examination including investigations like plain X-rays and CT scan, however, MRI and angiography were performed wherever indicated. Ocular examination particularly pertaining to neuro-ophthalmological profile was carried out with special emphasis on automated perimetry on Humphrey field analyser. The results indicated that automated perimetry was capable of reliably detecting and quantitating the visual field defects and thus established the location of the tumor in 72% patients when compared to CT scan. Hence, any patient with neuro-ophthalmic features should be subjected to automated perimetry for early diagnosis and probable location of intracranial space occupying lesion affecting visual pathways.

Comparative evaluation of antimicrobial activity of polyvinylpyrrolidone (PVP)-iodine versus topical antibiotics in cataract surgery.

Comparative evaluation of polyvinylpyrrolidone (PVP)-iodine versus topical broad-spectrum antibiotics for disinfecting the eye and surrounding area to prevent postoperative complications was carried out on 100 patients. PVP-iodine proved superior antiseptic for pre-operative preparation of eyes before cataract surgery. It was cheaper, caused minimal side-effects, reduced bacterial counts to a great extent and eliminated fungi completely.

Total lactate dehydrogenase and its isoenzyme pattern in lens, aqueous humour, and serum in cases of senile cataract.

Lens, aqueous humour and serum LDH and its isoenzyme pattern were estimated in 50 patients with senile cataract; 10 each with immature senile cortical cataract, mature senile cortical cataract, hypermature senile cortical cataract, immature senile nuclear cataract and mature senile nuclear cataract. The gradual decrease in total LDH and activity in the lens with advancement of cataract was maximum in hypermature senile cortical cataract. Aqueous LDH and its isoenzyme pattern remained unaltered with the maturity of cataract, and serum LDH and its isoenzyme pattern were found to be within normal limits. The lens LDH activity was found to be not related to the serum and aqueous humour LDH activity, but LDH3 isoenzyme showed declining trend, whereas LDH5 isoenzyme increased with the maturity of cataract. The present study concluded that significant decrease in lens LDH did not bear any relationship to LDH in serum and aqueous humour in cases of senile cataract.