Background: The Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic has limited patient access to outpatient care, prompting many clinicians to incorporate telemedicine in their practice. This study aims to explore the impact of the pandemic on the use of tele-ophthalmology in the Philippines. Methodology: A 30-item online survey on practices and attitudes related to teleophthalmology was sent to ophthalmologists and ophthalmologists-in-training all over the Philippines. Results: A total of 327 local ophthalmologists responded to the anonymous survey. Reported use of tele-ophthalmology increased from 53% to 90% (P < 0.001) at the time of the COVID-19 pandemic. Social media messaging was the most employed modality, utilized by 8 out of 10 tele-ophthalmology users. Respondents reported confidence in diagnosing gross conditions of the eye, and lack of confidence in diagnosing posterior pole conditions and orbital fractures. The majority (84%) believe that it can be adopted on a wider scale in the upcoming years. Conclusion: The pandemic catalyzed a nationwide increase in the utilization of teleophthalmology. The majority of respondents expressed willingness to continue incorporating tele-ophthalmology in their practice after the pandemic.
Rhabdomyosarcoma is the most common soft-tissue sarcoma in paediatric patients and may arise as a primary orbital neoplasm. Imaging studies show a unilateral solitary orbital lesion. With larger tumours, erosion of the adjacent orbital walls is a common accompanying bony change. We present an unusual case of rhabdomyosarcoma in a preschool girl with proptosis and temporal bossing. Imaging studies showed a homogeneous, well-delineated, extraconal mass of the right orbit with hyperostosis of the adjacent sphenoid bone. After excision of the mass and debulking of the sphenoid bone, histopathology showed embryonal rhabdomyosarcoma with no malignant infiltration of the adjacent bone. This is the first reported case of hyperostosis associated with rhabdomyosarcoma. Periosteal reaction is the proposed underlying mechanism.
Objectives The study aimed to determine the effect of oxymetazoline nasal spray on the patency of the fistula created after dacryocystorhinostomy, specifically: to compare the success of fistula formation with oxymetazoline versus placebo, and to compare the incidence of post-operative congestion, pain and bleeding with oxymetazoline versus placebo. Results The study was a single-center, randomized controlled, triple-masked study involving the patients of the Plastic-Lacrimal service of a national university hospital. Block randomization was done. Dacryocystorhinostomy was performed by a single-masked surgeon. The intervention group used oxymetazoline. The placebo group used sodium chloride. The data were collected by another masked investigator. The study showed no significant difference in terms of congestion, pain and epistaxis between the two groups at day 2 post-operation. The patency, presence of silicone tube, granuloma formation, and presence of bleeding on both day 2 and day 16 post-operation had no difference between the two groups. This study doesn’t support the use of oxymetazoline nasal spray after DCR, since it does not decrease the symptoms of congestion, pain and epistaxis after DCR. Aside from being an additional expense for patients, it also does not affect fistula formation and success rate of the surgery. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12619001394134, Date registered 10/11/2019, Retrospectively Registered.
As solitary fibrous tumors (SFT) are rare orbital neoplasms, the role of radiotherapy in their management remains unclear. We report three SFT cases who underwent radiotherapy for different clinical scenarios. Case 1 was a 20‐year‐old woman who presented with a 2‐year history of worsening left eye proptosis, eventually leading to its enucleation. A histopathological diagnosis of SFT was established. Recurrence was noted after 3 months and was partially resected, as limited by its location and extent. The residual tumor was given 60 Gy through three‐dimensional conformal radiotherapy. Case 2 was a 23‐year‐old man who had been experiencing painless right eye proptosis for 8 months before undergoing excision, which revealed a diagnosis of SFT. With no residual mass detected on imaging, 54 Gy was delivered to the postoperative bed through intensity‐modulated radiotherapy. Case 3 was a 49‐year‐old man with a 3‐year history of blurred vision and left eye proptosis who underwent subtotal resection, which revealed a diagnosis of malignant SFT. A dose of 64 Gy was delivered to the residual tumor through intensity‐modulated radiotherapy. Grade 2 dermatitis was noted. No worsening in vision was observed. The patients remained recurrence‐free after 18, 12, and 5 months, respectively. Radiotherapy might provide a high tumor control probability in orbital SFT.
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