Late presentation of a unilateral sporadic retinoblastoma in a 16-year-old girl.

BACKGROUND: Retinoblastoma is the commonest intraocular tumour of childhood with the majority of cases being diagnosed before 5 years of age. Late presentation of retinoblastoma is rare. CASE HISTORY: A healthy 16-year-old Caucasian girl presented with a 1-day history of blurred vision in the left eye. Examination revealed an inferonasal mass in the left retina with an overlying haemorrhage and vitreous seeding. Imaging studies revealed a 5-mm densely calcified opacity. Other investigations, including cerebral spinal fluid examination, bone marrow aspirate trephine, toxocara serology and serum protein studies, were normal. After considering the differential diagnoses such as toxocariasis and Coat's disease, a diagnosis of late-presenting retinoblastoma was made. The patient subsequently underwent enucleation with a primary orbital implant. The diagnosis was confirmed histopathologically. CONCLUSION: Late presentation of retinoblastoma is uncommon but can be a cause of acute visual impairment in the non-paediatric age group. Retinoblastoma should be considered in the differential diagnosis of a fundal mass in any age group.

Laser in situ keratomileusis interface deposits.

BACKGROUND: A clinical investigation was undertaken to determine the origin of a brown interface deposit that developed in 15 eyes after laser in situ keratomileusis (LASIK). METHODS: The LASIK procedure was evaluated and agents that were thought to be related to these brown deposits in the interface were eliminated sequentially. Eyes were observed after LASIK for presence or absence of the deposit. RESULTS: Twenty-five consecutive LASIK eyes in which a methylcellulose sponge was eliminated as a protector of the hinge developed no similar interface deposits. CONCLUSION: The use of a dry methylcellulose sponge to protect the hinge may result in unexpected interface deposits after LASIK.

Orbital squamous cell carcinoma following retinal detachment surgery.

BACKGROUND: Orbital squamous cell carcinoma following retinal detachment surgery is a rare condition. A proposed pathogenesis involves implantation of conjunctival squamous epithelium at the time of surgery, with subsequent malignant transformation. METHODS/RESULTS: An 81-year-old Caucasian man presented with a six-month history of a discharging painful red right eye. Ten years earlier a right scleral buckling with an encircling sponge exoplant had been performed. Examination revealed exposure of the sponge, and a large mass in the superomedial conjunctival fornix. Computed tomography revealed a mass invading around the globe in the region of the exoplant. Biopsy revealed squamous cell carcinoma. Orbital exenteration was performed. CONCLUSION: Orbital squamous cell carcinoma may arise following retinal detachment surgery presumably due to iatrogenic conjunctival implantation deep in the orbit.

Infectious crystalline keratopathy.

Two cases of typically appearing crystalline keratopathy both grew an alpha haemolytic streptococcus and had many of the features common to other cases. In one case, the use of topical and systemic antibiotics alone resulted in resolution of the disease, while in the second case even after corneal transplantation, a recurrence occurred which required further long-term antibiotics plus a repeat transplant.

Crossed-quadrant homonymous hemianopsia.

This case report illustrates the clinicopathological correlation between the anatomic defect of bilateral occipital lobe infarction with crossed-quadrant homonymous hemianopsia that resulted from a cervical spine injury. Routine ophthalmological and neuroradiological investigations were undertaken, including magnetic resonance imaging scanning, that demonstrate some important characteristics of this rare field defect.