Recurrent inverted papilloma of paranasal sinus presenting as acute proptosis.

Objective. To describe the course of events that followed from the time of the diagnosis to the management of a rare case of recurrent inverted papilloma presenting as an acute proptosis. Methods. A seventy-year-old diabetic female patient presented with a painful left eye proptosis for 15 days. She had a history of resection of inverted papilloma of paranasal sinus followed by radiotherapy for eight years before. The examination revealed a 23 mm proptosis, with restricted ocular movements, corneal oedema, funnel shaped anterior chamber, and total retinal detachment with a complete visual loss. The lobulated fixed hard mass was palpable circumferentially but more in the inferior orbital compartment. The transconjunctival incisional biopsy showed features of highly undifferentiated cytology. The lid sparing exenteration was done under general anesthesia with cosmetic reconstruction. Results. Immunohistochemistry of exenterated mass was doubtfully suggestive of a small cell tumor. However, histopathology confirmed features of rhabdomyosarcoma. Conclusion. The present case study revealed rhabdomyosarcoma cytology presenting as an association-inverted papilloma. Abbreviations : IP = Inverted papilloma, PNS = Paranasal sinus, SCC = Squamous cell carcinoma, IOP = Intraocular pressure, CT = Computed tomography.

Cycloplegic influence on the accuracy of autorefractometer in myopic and hyperopic children.

OBJECTIVE: To investigate the cycloplegic effect on the accuracy of TOPCON AR RM-8000B autorefractometer in children. MATERIALS AND METHODS: This study included 219 children of age 3 to 16 years. Topical 1% cyclopentolate hydrochloride was instilled for attaining cycloplegia. The children with the refractive error of -0.75 Diopter or more were grouped as myopic and more than +1.00 Diopter as hyperopic. Autorefraction was performed in addition to manual refraction. We used the XLSTAT and Medcalc statistics software. RESULTS: Out of 219 children, 149 (68%) were emmetropic, 48 (22%) hyperopic and 22 (10%) myopic (n=70). Males and females constituted 29 (60.42%) and 19 (39.58%) respectively in hyperopic group where as 11 (54.55%) and 9 (45.45%) children were myopic. The means of ages of the children were 10.29 (+/- 2.96) and 13.14 (+/- 2.36) years in hyperopic and myopic groups respectively. Cycloplegic hyperopic and myopic autorefraction revealed mean sphere of +1.45 and -4.06 diopter with correlation coefficient of 0.95 and 0.99 respectively. Non-cycloplegic hyperopic autorefraction showed 74.2% sensitivity and 8.3% specificity at >-1 diopter with area under curve of 0.517 (p LESS THAN 0.0001). Cycloplegic hyperopic autorefraction showed 100% sensitivity and 97.1% specificity at >+1.85 diopter with accuracy of 0.616. Non-cycloplegic myopic autorefraction showed 100% sensitivity and 0.91% specificity at >-0.75 diopter with accuracy of 0.889. Cycloplegic myopic autorefraction showed 100% sensitivity and specificity at >-1.25 diopter with perfect accuracy. CONCLUSION: Non-cycloplegic hyperopic autorefraction failed to identify true negative cases. Cycloplegic autorefraction identified true positive cases and myopic autorefraction was relatively unaffected by cycloplegia.