Biomedical subjects
Publications and source records attributed to F J Elsas.
We describe herein a 4-year-old girl with primary rhabdomyosarcoma of the right iris. Malignant cells were aspirated from the aqueous humor, and the eye was enucleated 7 months after the tumor appeared. To our knowledge, only two cases of primary rhabdomyosarcoma of the iris have been reported. Both of these patients received radiation therapy prior to enucleation.
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Of 76 members of a large pedigree with familial aniridia, 61% of the 38 affected patients had visual acuity of 6/9 (20/30) or better and only 5% had acuity of 6/60 (20/200) or worse. Cataracts were present in 18% of affected patients; glaucoma in 13%; and strabismus in 34%. Sixteen percent of affected patients had strabismic amblyopia. No patient had nystagmus or corneal pannus. The good visual acuity in this family, as compared to that in others, indicates that the absence of iris tissue alone cannot account for the severe visual problems usually associated with aniridia.
This study reports 398 excised eyelid lesions in 385 children from birth through age 15. This study analyzes and discusses the clinical and histological features of the 34 types of lesions which were encountered. This tabulation serves as a guide to the physician when confronted with lid lesions in children as to the types of lesions which may be found. More importantly, however, this study is the first comprehensive clinco-pathologic evaluation of eyelid lesions in children, a topic which had previously been written and discussed in a fragmentary manner. This study analyzes data from the Wilmer Institute during 1923-1974.
Three hundred two cases of epibulbar tumors in children were retrospectively reviewed histologically and examined by diagnostic categories over a 49-year period. Of the 302 cases, 33% were choristomas; 29% nevi; 11%, epithelial inclusion cysts; 7%, papillomas; 6%, pyogenic granulomas; and 5% granulomas. Three cases of sqamous-cell carcinoma and one of rhabdomyosarcoma occurred as well as a variety of benign lesions.
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The adjustable Harada-Ito procedure, as described by Metz, was performed on four patients. A hypotropia of 10 to 12 prism diopters (PD), in addition to incyclotorsion, was induced in two patients in whom the superior oblique tendon was split 8 mm, only enough to permit mobilization to its new location. Splitting the tendon for 15 mm eliminated the induced hypotropia while preserving incyclotorsion.
We report an unusual case of development of upper eyelid depigmentation in a child 4 months following corticosteroid injection of a periocular capillary hemangioma. Depigmentation has been described with local steroid injections for other dermatologic conditions, but has not been reported previously with treatment of infantile ocular adnexal hemangiomas.
Twenty-two children had a monocular cataract extracted between 1981 and 1986. Twelve of these patients eventually tolerated a monocular contact lens or anisometropic spectacle wear. Eleven patients initially would not tolerate conventional therapy, and epikeratophakia was performed. Of the 12 patients tolerating a contact lens or spectacles, eight (67%) now see 20/60 or better, and six (50%) see 20/40 or better. Only one (10%) of the patients maintaining the epikeratophakia graft developed vision as good as 20/70. Epikeratophakia did not facilitate occlusion therapy for amblyopia. The critical factor in the development of good vision following monocular cataract extraction was the patient's willingness to patch the better eye, not the method of correcting the refractive error.
Two patients developed exotropia with limited medial rectus function following endoscopic intranasal ethmoid sinus surgery. In both patients, fractures occurred in the medial orbital wall. The first patient required horizontal rectus muscle surgery to regain ocular alignment. The second required no surgery, but was left with limited horizontal motility secondary to scarring at the fracture site. While endoscopic techniques improve the surgeon's view of sinus anatomy, they do not eliminate the risk of entering the orbit and causing ocular complications.