<b><i>Objective:</i></b> The aim of the study was to describe the clinical presentation, management strategies, and outcomes in a case series of primary lacrimal sac tumors. <b><i>Methods:</i></b> This retrospective study was conducted in Sheikh Fajilatunnessa Mujib Eye Hospital and Training Institute, Bangladesh, from July 1 to December 31, 2020, and included all patients who were evaluated, treated, and followed up for at least 6 months from January 2013 to October 2020. One patient developed a recurrence of the adenocarcinoma of the lacrimal sac after 1 year of primary treatment. Patients’ demographic data were analyzed and reviewed from published articles on lacrimal sac tumors. We assessed patients clinically, followed by radiological evaluation. We also analyzed the biopsy technique, treatment modality, and recurrence. An oncologist reviewed all patients to prepare a plan for adjuvant treatment. <b><i>Results:</i></b> Ten patients with lacrimal sac tumors were included in this study. Swelling in the medial canthal region was the most common presenting feature (100%), followed by epiphora (60%) and pain (30%). Open biopsy was preferred over fine-needle aspiration biopsy. Incisional biopsy or complete excisional biopsy was performed for all suspected malignancies. Malignant tumors were found in 7 (70%) cases, and benign tumors in 3 (30%) cases. Non-Hodgkin’s lymphoma (NHL) (40%) was the most common malignant lacrimal sac tumor. Mucosa-associated lymphoid tissue lymphoma was 75%, and diffuse large B-cell lymphoma was 25% among the cases of NHL. Patients with epithelial malignancy were treated with external beam radiation therapy, while NHL patients were treated with chemotherapy (CHOP regimen). Recurrence was noted in 1 case (10%) of epithelial malignancy after 1 year of treatment. <b><i>Conclusion:</i></b> Successful management of lacrimal sac tumors requires a high index of suspicion, as these are fatal tumors, often misdiagnosed as dacryocystitis. Nonepithelial malignancies are more predominant than epithelial malignancies, and hematolymphoid tumors are most frequent.
Purpose This study is aimed to determine the frequency, sociodemographic profile, clinical presentation, patterns of injury, treatment and outcomes of cases of simultaneous bilateral ocular trauma treated in a teaching hospital of Northern India. Methods This retrospective study was conducted from May 2015 to April 2019. The medical records of patients presenting with bilateral ocular injuries were reviewed. Results Among the 402 patients presenting with ocular injuries, 34 (8.5%) had simultaneous bilateral ocular trauma. The majority were male (70.6%), and the mean age was 26.82 ± 15.86 years (range: 2-70 years). The most frequently affected age group has been 16-25 years (35.3%). Most injuries occurred away from home (64.7%), mainly on roads (32.4%) or playgrounds (14.7%), and the vast majority (91.2%) were non-occupational in nature. Mechanical injuries were most frequent (47.1%), followed by cracker (17.7%), chemical (17.7%) and thermal (11.8%) injuries. Most cases occurred due to assault (26.5%), road traffic injury (20.6%) or sports/recreational activities (17.7%). The majority of victims were not using protective devices at the time of injury (82.4%) and had associated polytrauma (58.8%). Closed and open globe injuries accounted for 29.4% and 14.7% of cases, respectively, mostly involving zones I (55.0%
Loa loa is a nematode that is highly endemic in the tropical rainforests of Western and Central Africa. It is also known as “African eye worm”. Occasionally the adult parasite is seen in the subcutaneous tissue space of humans and occasionally into the subconjunctival space. Our case is a 29-year-old male presented to the outpatient department with history of swelling, redness and foreign body sensation in the inferior bulbar conjunctiva of his right eye. Slit lamp examination shows, a nodular swelling in the inferior conjunctival space and diagnosed as subconjunctival granulomatous lesion. In the operation theater, the lesion was explored and a live worm was removed from the subconjunctival space. The worm was measured about 3.5 cm in length. The worm was confirmed to be a Loa loa adult specimen. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. Ophthalmologists should be aware of the typical manifestations and possible unusual presentations. An increasing number of subconjunctival Loa loa cases are reported from non-endemic areas are due to increased travel and migration. This report illustrates an unusual ocular disease, which is usually not found outside of Africa, but easily diagnosed and treated.
Recently there has been upsurge in the cases of Obstructive Sleep Apnea (OSA) with increased prevalence of obesity in the general population. It has been continuously proved that OSA and metabolic syndrome go hand in hand and hence OSA predisposes an individual to a series of cardio-vascular disorders like ischemic heart disease, myocardial infarction, arrhythmia etc. In this article we have emphasized the possibility of ocular involvement in OSA patients. Several studies have shown ocular associations like floppy eye lid syndrome, glaucoma, dry eye syndrome, papilledema, keratoconus, non-arteritic anterior ischemic optic neuropathy etc. Through this review, we would like to highlight the ophthalmological associations of OSA, their pathogenesis and outcome with the treatment of OSA.
Purpose: To describe a minimally invasive technique of harvesting fascia lata, and also to analyze the clinical uses and the outcome of fascia lata in Ophthalmic Plastic and Reconstructive surgery. Methods: This interventional study was done in three tertiary care eye hospitals in Bangladesh from July 2014 to June 2020. We obtained autologous fascia lata for the correction of congenital ptosis with poor levator function (⩽4 mm), covering the ciliary staphyloma, repair of the extruded implant following anophthalmic socket surgery, and was also used to wrap the orbital implant after enucleation. Preserved FL was used only for children before 6 years of age for the treatment of congenital ptosis. Results: Out of 60 subjects, 38 (63.3%) were male and 22 (36.7%) were female. Autogenous fascia lata was used for frontalis brow suspension (FBS) in 25 (41.67%) patients of congenital ptosis with poor levator function, as patch graft in ciliary staphyloma (11 cases, 18.3%), to wrap orbital implant following enucleation in intraocular malignancies (nine cases, 15%), to repair of implant extrusion following evisceration (five cases, 8.3%), and as fascial sling to correct recurrent paralytic ectropion (one case, 1.67%). Allogeneic or preserved fascia lata was used to correct congenital ptosis in patients less than 6 years of age (nine cases, 15%). Mean follow-up time was 5.32 months. Conclusion: Fascia lata (autogenous and allogeneic preserved) has varied uses in ophthalmic plastic surgery. Harvesting fascia lata (FL) using with minimally invasive method was successful with the least scar on the thigh to correct congenital ptosis, ciliary staphyloma, repair of extruded implant, and in wrapping implant after enucleation to get better cosmesis and motility.
Pterygium is an ocular surface disorder associated with fibrovascular growth and elastotic degeneration of the collagen in conjunctiva and cornea. It has high incidence in tropical countries like India especially in males because of abundance of UV light exposure. It does not hamper vision until in later stages when visual axis is involved. But the burden of disease has increased due to recurrence rates post surgery which is considered to be mainstay of pterygium treatments. Recently there have been advances regarding understanding of pathophysiology and management of pterygium. This article aims to review the recent developments in pathophysiology including genetics, various treatment modalities available beside surgery e.g. adjunctive therapies and management of recurrence pterygium.
To assess the interference of patient care due to COVID 19 related restrictions and to formulate the future guidelines.This cross-sectional online survey-based study was carried out among the ophthalmologist of Bangladesh in the early lock down period (01 April to 30 April) 2020. Total 93 ophthalmologists responded to the study. Most of the ophthalmologist were seeing the patients with red eye (40.9%), ocular trauma (40.9%), acute infections and inflammations (35.5%), and vision loss (31.2%). 80.6% responder informed that they wear Mask, gloves, and head cap during patient evaluation. 51.6% used Personal protection equipment. 55.9% used a breath shield with the slit lamp settings. 60.4% maintained hand wash, and disinfectant facilities for the patients. 85.7% ophthalmologist had ensured for wearing the mask to all patients before entering the examination and consultancy room. 86% ophthalmologist of our study had performed their surgeries for ophthalmic emergency.Wearing mask is an important tool to prevent transmission of COVID-19 for both patients and ophthalmologists in working place. Maintaining normal ophthalmic practice and surgery are challenging during COVID-19 pandemic.
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