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Biomedical subjects

Neelam Pushker

Publications and source records attributed to Neelam Pushker.

At least 37 records · Page 2Linked to original sources
PubMed2003

Phthisis bulbi with a large protruding foreign body--a rare complication of penetrating injuries.

Spontaneous extrusion of a retained intraocular foreign body is a rare occurrence. An unusual case is described in a 30-year-old male, where a foreign body remained in the eye for four years and then, as phthisis set in, the foreign body gradually extruded, causing constant irritation of the upper lid. Such a situation has not been documented before. Its management along with the histopathologic features are discussed in the light of the available literature.

Adult↗
PubMed2003

Multifocal cavernous hemangioma: a rare presentation.

Periorbital cavernous hemangiomas involving other facial structures usually occur in young adults. We now report a case with multifocal involvement of the eyelid, orbit, conjunctiva, cheek, palate, and temporal fossa, simultaneously, which is quite rare. These lesions are slow-growing and may be associated with systemic abnormalities. Clinical and imaging parameters are employed to differentiate them from other vascular malformations. Depending on the site and severity of the tumor, appropriate treatment modalities are initiated to minimize cosmetic disfigurement and functional deficit in the patient.

Adult↗
PubMed2003

Dentigerous cyst in the maxillary sinus: a rare cause of nasolacrimal obstruction.

The main types of maxillary cysts are antral mucoceles, retention cysts, pseudocysts, dentigerous cysts and keratocysts. Despite the theoretical possibility of maxillary sinus cysts leading to nasolacrimal duct obstruction, only two cases have been reported in the literature so far. The present authors report this rare presentation of a dentigerous cyst with a tooth in the roof of the maxillary sinus, which led to nasolacrimal duct obstruction.

Adult↗
PubMed2002

Optic nerve cysticercosis.

Cysticercosis of the optic nerve is an extremely rare entity and only seven cases have been reported in the world literature. A case of optic nerve cysticercosis in a 25-year-old woman is reported, along with a review of literature. The patient presented with two episodes of pain, diminution of vision and proptosis. Computed tomography and ultrasonography revealed an intraneural cyst with scolex in the retrobulbar portion of the optic nerve. A positive enzyme-linked immunosorbent assay test for cysticercosis further confirmed the diagnosis. Medical therapy in the form of oral albendazole and steroids resulted in complete resolution of the cyst, with few visual sequelae.

Adult↗
PubMed2002

Orbital and adnexal cysticercosis.

Orbital and adnexal cysticercosis is emerging as a far commoner disease than previously considered, both in endemic and nonendemic areas of cysticercosis. A review of the literature on orbital and adnexal cysticercosis found that it has a predilection for children and young adults with no definite sex predilection. The extraocular muscle form is the commonest type of orbital and adnexal cysticercosis. Lodgement of cysts in the subconjunctival space is another common site, followed by the eyelid, optic nerve, retro-orbital space and lacrimal gland. Association of orbital cysticercosis with systemic cysticercosis is quite rare. The clinical manifestations of orbital or adnexal cysticercosis are entirely different and depend on the location, size, relation to adjacent structures and stage of evolution of the cyst. Diagnosis of cysticercosis is based mainly on orbital imaging because of its highly specific appearance. Tissue diagnosis is not essential for initiating treatment. Medical therapy is the recommended treatment for the extraocular muscle form and retro-orbital cysticer-cosis. Surgical removal is advocated for subconjunctival and eyelid cysticercosis. Because of the limited number of cases of optic nerve and lacrimal gland cysticercosis, their treatment is controversial.

Adult↗
PubMed2002

Inverted papilloma invading the orbit.

Inverted papilloma is an unusual entity for many ophthalmologists. We report a case of inverted papilloma of the nasal cavity and sinuses, invading the orbit in a 33-year-old man. The patient presented with a right medial canthal mass, proptosis, diminution of vision, epiphora and nasal obstruction. In the past, he underwent multiple procedures for surgical removal of the tumor with frequent recurrences. A computed tomographic scan revealed a mass filling both the nasal cavities and sinuses, destroying adjacent bones and invading the medial aspect of the orbit, leading to proptosis. Excision of the tumor was performed by a lateral rhinotomy approach. The tumor proved to be an inverted papilloma with focal transformation to transitional cell carcinoma. Post-operative CT scan revealed residual tumor, which responded to radiotherapy, with no recurrence over six months. Histopathologically, these tumors are benign, but locally invasive. The tumors that invade the orbit are usually locally aggressive, highly malignant and recur frequently. Radical excision of the tumor is technically difficult and often incomplete, so radiotherapy should be considered as an adjunct to surgery.

Adult↗
PubMed2002

Neurofibroma of the lacrimal sac.

Neurofibroma is an extremely rare neural tumor of the lacrimal sac. We present a case of neurofibroma of the lacrimal sac in a 45-year-old lady. Based on the history of intermittent epiphora, presence of a mass in the lacrimal sac region, dacryocystogram suggestive of space occupying lesion within the lacrimal sac and computed tomographic image of a tumor lying in the lacrimal fossa region, a tentative diagnosis of lacrimal sac neoplasm was made. Excision of the tumor with repair of the lacrimal sac was performed. Histopathology proved it to be neurofibroma of the lacrimal sac. Until now, only four cases have been reported worldwide. The paucity of reported cases limits our knowledge regarding the natural course, treatment, results and prognosis of this tumor.

Eye Neoplasms↗
PubMed2002

Cystadenoma of the lacrimal gland.

Cystadenoma is a benign cystic tumor predominantly affecting the major and minor salivary glands. We present a case of bilateral cystadenoma of the lacrimal gland, which to the best of our knowledge has never been reported earlier. The patient had slowly increasing, painless, bilateral upper eyelid swelling. On examination, the tumors were multilobulated, mobile and transilluminant. Ultrasonography and CT-scan revealed cystic lesions with multiple septations in the region of both lacrimal fossae. Complete excision of the tumors was performed because of their potential for malignant transformation. The histopathological findings confirmed the diagnosis.

Cystadenoma↗
PubMedDate not supplied

Evaluation of amniotic membrane grafting in the reconstruction of contracted socket.

PURPOSE: To study the use of amniotic membrane for the reconstruction of mild to moderate grades of contracted socket and compare it to mucous membrane grafting. METHODS: A total of 20 patients with acquired, anophthalmic contracted socket of mild to moderate grades were studied and divided into two groups: the amniotic membrane graft (AMG) group (10 patients) and the mucous membrane graft (MMG) group (10 patients). The preoperative and postoperative measurements of forniceal depth and volume of socket were compared. After surgery, motility of the prosthesis was also compared. RESULTS: The mean preoperative depth of the lower fornix in the AMG group and the MMG group was 1.5 mm and 1.4 mm, and after surgery, at final follow-up was 5.4 mm and 5.5 mm, respectively. The preoperative mean height of the upper fornix in the AMG group and the MMG group was 10.3 mm and 10.7 mm, and after surgery, at final follow-up was 12.6 mm and 13.2 mm, respectively. The mean preoperative volume of the socket was 0.84 ml in the AMG group and 0.80 ml in the MMG group, and after surgery, at final follow-up was 1.43 ml and 1.48 ml, respectively. The various quantitative parameters including motility of the prosthesis were comparable in the two groups. CONCLUSIONS: Amniotic membrane grafting gave cosmetically and functionally acceptable results in cases of mild to moderate grades of anophthalmic socket contraction. The results were comparable to those of mucous membrane grafting.

Adolescent↗
PubMedDate not supplied

Disseminated hydatid disease involving orbit, spleen, lung and liver.

Orbital hydatid disease is rare, even in endemic areas. We present a case of disseminated hydatid disease involving the orbit, spleen, lung and liver in a lady aged 35 years. Based on a typical clinical presentation, presence of eosinophilia, a positive indirect haemagglutination test for hydatid disease and presence of similar disseminated, anechoic cystic masses in the liver, lung, spleen and orbit on imaging studies, the diagnosis of hydatid cyst was seriously considered before surgery. Aspiration of the cyst, followed by cryo-extraction of the cyst wall through transconjunctival route was safely performed. Histopathological examination confirmed the diagnosis. In conclusion, multisystemic involvement of liver, lung and spleen in a case of orbital hydatid cyst has never been reported before. The surgical technique adopted in this case is safe and effective.

Adult↗
PubMedDate not supplied

Simple dacryops: a case series and review of the literature.

In this prospective, small case series, 3 patients with simple dacryops were analyzed along with a review of literature. All 3 patients in this series had classical clinical features of simple dacryops. All of them underwent complete cyst removal with the aid of a cryoprobe. Histopathology was compatible with dacryops. In 2 of the 3 patients, the cyst revealed calcification, which to the best of our knowledge has not been reported. None of the patients developed a recurrence. In conclusion, simple dacryops is an easily recognized clinical entity. This entity has been infrequently reviewed in the older literature, and in the last decade only 6 cases have been reported. Most of the patients underwent complete excision of the cyst with no recurrences.

Adult↗
PubMedDate not supplied

Visual outcome in macular retinoblastoma treated with primary chemotherapy.

In this prospective clinical study, we treated 8 patients (8 eyes, 11 tumors) of macular retinoblastoma with chemotherapy alone, with the aim of avoiding visual loss because of retinal damage by radiation or adjuvant therapy and to assess their final visual outcome. The mean basal dimension of the tumor was 5.0 +/- 2.6 mm and the mean height was 2.9 +/- 1.3 mm. The fovea was involved in 4 patients (50%) and foveal detachment was present in 3 patients (37.5%). All the patients required less than 6 cycles for tumor control. Four patients (50%) obtained visual acuities ranging from 20/25 to 20/200. Two patients (25%) could gain visual acuity of 20/20. The mean follow-up of patients was 3.24 +/- 0.9 years (range 2-5). No patient developed recurrence or metastatic disease. In conclusion, recent trends for ocular salvage have favored chemoreduction followed by focal therapy for the treatment of retinoblastoma. This study supports the consideration of chemotherapy alone as the primary treatment in eyes with macular retinoblastomas, under close supervision, with satisfactory visual outcome.

Antineoplastic Agents, Alkylating↗
PubMedDate not supplied

Orbital spread of conjunctival squamous cell carcinoma following evisceration: a reminder of the importance of thorough evaluation before and after destructive surgery.

Evisceration is a neglected surgery usually performed by the most junior ophthalmologists in unsalvageable eyes with panophthalmitis. It is universal knowledge that evisceration is contraindicated in eyes with intraocular malignancy. We report 2 patients who presented to us with squamous cell carcinoma (SCC) in eviscerated sockets. While one of them was diagnosed with SCC on histopathological examination of the eviscerated contents, the other had history suggestive of conjunctival SCC prior to evisceration. The second patient presented to us with complaints of poorly fitting prostheses. We conclude that it is imperative to rule out not just intraocular but also adnexal malignancy prior to evisceration, and these eyes should be regularly followed up and carefully examined if poor fitting of the prostheses develops.

Adult↗