Apjit Kaur

Mesenchymal Chondrosarcoma of the Orbit: A Report of Two Cases and Review of the Literature

Mesenchymal chondrosarcoma, an uncommon lesion in bone and extraskeletal tissue, is extremely rare in the orbit. Two cases of orbital mesenchymal chondrosarcoma in young adults presenting with proptosis and diminution of vision are reported. The diagnosis was established by histopathological examination in both cases, which showed undifferentiated mesenchymal cells with islands of cartilage. Both patients underwent exenteration followed by chemotherapy and radiation therapy and are alive with healthy orbits after two years of follow-up.

Orbital tuberculosis - an interesting case report.

Orbital tuberculosis is a relatively uncommon disease. A 17-year-old male presented with an intraorbital lesion suggestive of orbital pseudotumor. Initial clinical response to oral corticosteroid therapy was followed by development of a mass lesion in the left orbit, which led to the formation of a discharging sinus in relation to the orbit and simultaneous cervical lymphadenitis. Diagnosis of tuberculosis was confirmed and patient responded to four drug antitubercular therapy. The patient had an unusual presentation and the disease course was altered by corticosteroid therapy. This case highlights the need for keeping a high index of suspicion for tuberculosis, especially in patients on immunosuppressive therapy.

Oxidative stress profile in graves' ophthalmopathy in Indian patients.

Purpose: To report the oxidative stress profile in patient of Graves’ ophthalmopathy and to study the effect of hormone level normalization on oxidative stress profile. Methods: All first time reporting patients with Graves’ ophthalmopathy to Department of ophthalmology CSM Medical University (erstwhile King George’s Medical University) Lucknow during the period January 2006 to December 2008 formed the cohort. Before initiating treatment a proforma directed detailed history, complete ophthalmological examination and investigations were done. Blood sample for pro/antioxidant enzyme were withdrawn for study after taking an informed consent. Patients were treated with antithyroid drugs alone to achieve a stable euthyroid status for at least 6 months following which a blood sample was again withdrawn to study the pro/anti oxidant enzyme status following treatment. Results: On normalization of thyroid status the values of reactive oxygen species decreased significantly (p<0.05) and levels of antioxidants also got corrected significantly (p<0.05). However both these values remained significantly (p<0.05) altered as compared to normal persons. Conclusion: We demonstrated that even after normalization of thyroid hormone level, the oxidative stress levels remain elevated. Moreover, activity of Superoxide Dismutase (SOD), Catalase (CAT), Glutathione reductase (GSHR), Glutathione peroxidise (GPx) showed decrease which could be attributed to altered metabolism and already prevalent deficiency of essential micronutrients like zinc, copper, mercury, and selenium in the Indian population. Hence, this gives way to the thought that the supplementation of these nutrients may have a role as an adjuvant to hormonal therapy in patients with Graves’ ophthalmopathy.

Lacrimal Canalicular Obstruction by Cysticercus Cellulosae

Ocular adnexal infestation in cysticercosis is unusual. A case of lacrimal canalicular obstruction by cysticercus cellulosae in a 35-year-old female is reported. The diagnosis was established by histopathological examination of the cyst, surgically removed from the above patient with a suspected benign neoplasm in the lacrimal passage. To our knowledge, this is the first case report of lacrimal canalicular obstruction by cysticercus cellulosae.

Eosinophilic granuloma: Presenting as a draining fistula

A case report of an orbital eosinophilic granuloma presenting as a fistula in a 15-year-old boy is presented. The patient had a history of a painful right upper eyelid swelling which required drainage and was considered as an abscess. An increase in swelling occurred and a small fistula appeared in the area subsequently. Computed tomography scan revealed a large soft tissue lesion in right superolateral orbit having intracranial extradural extension with destruction of bony orbital margin. Fine needle aspiration biopsy of the lesion revealed eosinophilic granuloma. A complete excision of the lesion was performed by a brow incision and histopathological examination of the excised specimen confirmed diagnosis. Although upper eyelid area eosinophilic granuloma is known to occur, its presentation as a fistula is not known.

Cysticercosis of the Bony Orbit—A Rare Entity

Bone involvement in cysticercosis is a rare occurrence. A case of cysticercosis of the frontal orbital bone in a thirty-year-old female is reported. The diagnosis was established by computerized tomographic scanning of the orbit and histopathological examination of the cyst, surgically removed from the cavity in the orbital plate of the frontal bone. To our knowledge, this is the first case report of cysticercosis of the bony orbit.

Quality of life after orbito-facial trauma

ABSTRACT In the wake of high incidence of orbito-facial trauma, there has been a growing need to assess not only the visual outcome, but also the psychological impact of the traumatic event. This is a single questionnaire based evaluation of 100 consecutive patients with orbito-facial trauma (blow-out and Le fort type II and III fractures) at six months of trauma. 84% of the patients had a NEI VFQ- 25 score of less than 50, with 49% having a score less than 25, reflecting the grim impact the trauma has on the quality of life. The three parameters of the questionnaire - general health, difficulty with activities and response to vision problems were significantly positively correlated. Quality of life is considerably affected following orbito-facial trauma, disturbing physical, mental and social health. Poor vision is positively correlated with poor general health. Psycho-social impact of trauma needs to be recognized as an important sphere in the management of orbito-facial trauma.