Introduction: Dry eye is a common disorder affecting a significant percentage of the population. Materials and methods: This study is a prospective, hospital-based, case-controlled study conducted between January 2009 and May 2010. Seventy-six pterygium cases and 152 age-and-sex matched controls presenting to the OPD of Manipal Teaching Hospital were included. The TBUT Schirmer's test and basal tear secretion were estimated in all patients. A TBUT of less than 10 seconds and a Schirmer's test of less than 10 mm were considered abnormal. Results: Pterygium was bilateral in 15 (19.7 % ) and unilateral in 61 (80.3 %) patients. Ninety-two (92.1 %) pterygium patients reported either one or more of the six dry eye symptoms. Redness was the most common (67 %) symptom reported. The mean Schirmer's test I, mean basal secretion and mean TBUT values were 16.19 mm, 10.01 mm and 10.56 seconds in pterygium cases and 20.22 mm,13.25 mm and 26.25 seconds in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium cases and the control group (p value < 0.05). The odds ratio between pterygium and dry eye was 3.28. Dry eye was present in 26 % of the normal patients and in 54 % of the pterygium cases. Conclusion: There is a strong relationship between dry eye and pterygium.
Primary pituitary tubercular abscess is a very rare and the majority are reported as case reports. It may present clinically with visual loss, headache, seizure, hormonal abnormalities or with cranial nerve palsies. MRI is the diagnostic modality and shows a cystic-solid mass in the sellar and suprasellar region, isointense on T1 and T2W images with heterogeneous areas and ring enhancement on contrast. Surgery remains the initial treatment and it is approached through the trans-sphenoidal/ trans-nasal or transcranial route followed by anti-Tubercular therapy. We report a case of PTA managed successfully with a brief review of its pathology.
The Himalayan black bear (Ursus thibetanus or Selenarctos thibetanus), although an omnivore, is more carnivorous than its American counterpart. It is also more aggressive towards humans and is a threatened species because of the deforestation in the Himalayas. Furthermore, poverty, encroachment of the forest, extensive deforestation, lack of education and living near the forest are factors that increase the probability of such animal injuries. We report the case of a 35-year-old woman who suffered a severe penetrating head injury with scalp and bilateral eye avulsion, which was managed successfully.
Background: Traumatic luxation of the eye ball is rare with only 106 cases reported in PubMed till date. The anatomic location of the eyeball within the socket and the resilience of the globe to pressure force, attachment to extraocular muscles and optic nerve prevents luxation during trauma.
Case: Road traffic accidents (RTA) is the most common cause for these injuries and the outcome can vary from complete recovery on repositioning to visual loss due to globe perforation or optic nerve injury. We report two unique cases of traumatic right globe luxation and complete optic nerve transection due to RTA and give a brief review of literature.
Conclusion: RTA leading to eye ball luxation though rare can be a challenging situation when encountered. Given the limited time for the salvage of the eye early intervention is not always possible especially in developing countries where there is delay in reaching the hospital. Despite all these confounding factors attempt must be made to salvage the eye either for functional, cosmetic or psychological reasons.
Cerebral tuberculoma of the brain are uncommon presentation of tuberculosis (1%). A 17-year female presented to the emergency with a Glasgow Coma Score of (eye-1, verbal-1 and motor-3), 5/15 bilateral fixed pupils with laborious breathing. The radiological features were suggestive of aintracerebral abscess/ glioma. Intraoperatively the brain was very tense and a large, vascular, mass was present that was excised completely. Her histopathology revealed features of tuberculoma and she was started on anti-tubercular treatment. She is discharged home with regular follow-up for the last 10 months.Cerebral tuberculoma although uncommon should be thought of in developing countries as differential of cystic enhancing lesions of the brain.Keywords: Abscess; central nervous system; glioma; tuberculoma; tuberculosis
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