This report describes a case of pleomorphic adenoma of an ectopic lacrimal gland arising subconjunctivally in the lateral fornix in a 13-year-old girl. The tumor was removed surgically in toto with the capsule. This is probably the first reported case.
The next care to be taken, in respect of the Senses, is a supplying of their infirmities with instruments, and as it were, the adding of artificial organs to the natural...and as glasses have promoted our seeing, so 'tis not improbable, but that there may be found many mechanical inventions to improve our other senses of hearing, smelling, tasting and touching. " Robert Hooke English natural philosopher (1665) [1] Nothing could demonstrate more than this concept of Hooke with regards to replacement of all the senses by artificial means. Hooke was enthralled by spectacle correction itself and felt that the other senses could also be improved. No doubt the medical world has caught up with hearing aids and cochlear implants but in the real sense the restoration of sight to a blind is still in an experimental stage and the most daunting challenge in ophthalmic research.
Purpose: The aim of this study is to determine the success rate over time in patients undergoing External Dacryocystorhinostomy (DCR) with acquired naso-lacrimal duct obstruction (NLDO), when done by a trainee ophthalmologist. Methods:The study was Prospective Observational study and was conducted in Tertiary Eye Hospital, Uttar Pradesh, India. One hundred and fourteen consecutive adult patients underwent external DCR for acquired complete NLDO by a trainee with less than 3 years of experience in ophthalmology between November 2011 and March 2013. Postoperative anatomic success rate was determined at 6 months on the basis of the patency of lacrimal sac syringing and patients were asked to subjectively evaluate improvement of their epiphora using a questionnaire. Results: Anatomical success rate across the entire study period was 93.7% and this improved from 87% in the first tertile of 38 patients to 94% in the second tertile and 100% in the final tertile of cases (p<0.05). Overall complication rate was 16.67% and reduced from 29% in the first tertile to 8% in the final tertile (p<0.05). Loss of anterior nasal flap was the commonest complication (10 cases) during the training period. Conclusion: External DCR, as a primary procedure for acquired NLDO, even when operated by trainee ophthalmologists, has a relatively high success rate that improves over time. As the learning curve improves, complication rates reduce significantly. Financial Disclosure: No author has any financial or proprietary interest in the material or method mentioned.
Extramedullary plasmacytoma is a rare plasma cell malignancy, comprising 3% of the whole group. The involvement of orbit is even rarer since 80% of extramedullary plasmacytoma have been reported from upper respiratory tract, followed by gastrointestinal tract. The disease is thrice more common in males than females and is more common in 6th to 7th decade of life, but we are reporting a case of extramedullary plasmacytoma presenting as lacrimal gland tumor in a 59-year-old female. The correct diagnosis is essential since the disease is highly radiosensitive and responds well to radiotherapy unlike other malignancy in this region. A high index of suspicion with imaging and careful use of fine needle aspiration cytology helps in diagnosis and prompt treatment.
Introduction: Pseudoexfoliation (PEX) is a systemic disease characterised by the accumulation of dandruff like fluffy deposits of fibrillar granular material. It is the most common cause of secondary open angle glaucoma. Pseudoexfoliation Glaucoma (PXG) is typically associated with rapid visual field loss, greater severity of optic neuropathy and pressure spikes. Aim: To evaluate the clinical characteristic of Pseudoexfoliation Syndrome (PXS) and PXG in the eastern part of Uttar Pradesh. Materials and Methods: This retrospective cross-sectional study was done at Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India. The authors reviewed the medical records database to identify all patients aged 35 years or older with PXG or PXS who attended the outpatient clinic between January 1, 2020 and January 31, 2021. Ethical approval was obtained from the Institutional Review Board at Sitapur Eye Hospital, Sitapur. Continuous variables were calculated by Mann-whitney and student t-test and qualitative variables using the chi-square test. The p-value <0.05 was considered significant. Results: A total of 40 patients with 78 eyes were diagnosed as having PXG or PXS. The mean age of study patients was 66.12±11.63 years. The male to female ratio was 2.64:1. The average Intra Ocular Pressure (IOP), Cup:Disk ratio was more in the patients having PXG (p<0.001) as compared to PXS. The PEX at the pupillary margin and pupillary ruff atrophy was more in PXG. The bilateral involvement of disease was observed in most of the patients. Conclusions: The spectrum of PEX includes a detailed ocular and systemic examination. Dilated anterior segment examination should be emphasised in routine practice to prevent missed diagnosis of early PEX patients, thus resulting in decreased glaucomatous damage.
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