Amar Pujari

Orbital cystic schwannoma masquerading as hydatid cyst

Gradually increasing abaxial proptosis in a middle-aged female patient revealed a large well-defined cystic lesion behind the globe extending till the orbital apex. B scan ultrasound and CT findings were favouring a diagnosis of orbital hydatid cyst. Thus as a diagnostic/curative surgical protocol, the cystic lesion was removed in total. However, intraoperative gross specimen examination was not classical of hydatid cyst, thus a further histopathological evaluation was carried out, which confirmed the diagnosis of orbital schwannoma with extensive cystic degeneration. Postoperatively the clinical course was uneventful at the end of 1 year.

Tarsal buckle with conjunctival prolapse following levator plication for unilateral congenital ptosis

An 8-year-old child underwent uneventful levator plication surgery for unilateral congenital ptosis. Postoperative course for initial few days was uneventful but on day 7, the patient was brought with conjunctival prolapse from the undersurface of upper eyelid due to tarsal kinking and eversion. Early medical management was initiated with frequent surface lubrication to avoid conjunctiva dryness. Under general anaesthesia, right-sided conjunctival repositioning was performed with an eyelid spatula supplemented by three forniceal stay sutures to retain the conjunctiva in its anatomical place. To reverse the tarsal kinking, continued downward traction suture was placed for a period of 2 weeks. At the end of 4 weeks, the conjunctival prolapse was completely resolved with a well-formed superior fornix. At the end of 3 months, the symmetric eyelid position was maintained without any additional complications.

Floppy eyelid syndrome: delayed diagnosis is not desired

A 52-year-old obese man presented with the history of redness, watering, photophobia and decreased vision in the left eye (hand movement close to face in the left eye and 20/40 in the right eye) for the past 6 months. History revealed that the patient had undergone surgical intervention twice for the left upper eyelid (surgical details not available) without successful outcome. Examination showed bilateral lax upper and lower eyelids, palpebral conjunctival congestion and papillary reaction (figure 1A–C). Right side cornea was normal, but left side cornea showed perforated central cornea with shallow anterior chamber along with normal corneal sensations. Ultrasonography of the left eye posterior segment was anechoic; therefore for the left eye, the patient underwent glue application with bandage contact lens under …

Limbal cyst following blunt trauma in an operated case of congenital cataract: a rare scenario

A 15-year-old male patient with the history of bilateral operated congenital cataract surgery 5 years back now presents with gradual painless diminution of visual acuity in left eye following a blunt trauma with a fist. Ocular examination showed a well-defined slightly bluish-tinged limbal-based conjunctival cyst without any irregularities in the anterior chamber/pupil. Intraocular pressures were 16 mm Hg in the right eye and 10 mm Hg in the left eye; retinal examination showed findings consistent with hypotonic maculopathy. Anterior segment ultrasound biomicroscopy revealed a well-defined limbal cyst with anterior chamber communication. Under local anaesthesia, the cyst was completely excised with the reconstruction of the sclerocorneal defect. At the end of 6 months, the patient is symptom-free with pretraumatic visual acuity.