Primary Ewing's sarcoma of the orbit: a rare presentation.
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Child↗
Biomedical subjects
Neelam Pushker
Publications and source records attributed to Neelam Pushker.
Atypical presentations of retinoblastoma.
PURPOSE: To study the atypical presentations of retinoblastoma in our institution. METHOD: Retrospective, clinical study. RESULTS: A total of 392 cases of retinoblastoma were reviewed; 72.2% of the patients had leukocoria, 13% had proptosis, 10% had strabismus, 1.5% were asymptomatic (detected on screening), and 3.3% had atypical presentations. Fourteen different atypical findings were observed including endophthalmitis (0.76%), secondary glaucoma (0.76%), uveitis (0.5%), corneal edema (0.5%), phthisis bulbi (0.5%), orbital cellulitis (0.5%), cataract (0.25%), pseudohypopyon (0.25%), iris nodules (0.25%), hyphema (0.25%), iris neovascularization (0.25%), microphthalmos (0.25%), exposure keratopathy (0.25%), and corneal blood staining (0.25%). All of the patients had Reese-Ellsworth grade V disease. On histopathology, invasion of neighboring structures was seen in 10 patients. All patients underwent enucleation with adjuvant radiotherapy, chemotherapy, or both. CONCLUSIONS: Retinoblastoma can mimic any orbital or ocular pathology. Atypical presentations of retinoblastomas are usually associated with advanced disease. The possibility of ocular tumor should be entertained whenever there is an unusual presentation that is unresponsive to the usual therapy. Ultrasonography and computed tomography should be performed in all such patients, especially if the posterior segment is not visible.
Adolescent↗
Bilateral, multifocal orbital cysticercosis.
Orbital cysticercosis is a benign infection with a variety of clinical presentations. Awareness of all of the possible clinical manifestations could aid early diagnosis and prevention of late sequelae. We report a case of bilateral, multifocal, intraconal orbital cysticercosis, which is an extremely rare presentation.
Albendazole↗
Atypical presentations of orbital cysticercosis.
We describe three patients with orbital cysticercosis who presented with atypical clinical or radiologic features previously unreported. All three patients had a cyst with a scolex on imaging studies. After 6 weeks of treatment, all three had almost complete resolution of their features.
Adult↗
Atypical oculo-orbital complex choristoma in organoid nevus syndrome.
We report organoid nevus with left oculo-orbital choristoma fixing the globe in hypotropia, precanthal skin tag, and upper eyelid coloboma and right limbal dermoid. Computed tomography revealed a dilated lateral ventricle and cerebral atrophy. No neurologic deficit existed. The coloboma was repaired, choristoma debulked, and precanthal tag excised.
Calcinosis↗
Nasal endoscopy in congenital dacryocystitis.
PURPOSE: Controversy exists regarding the relationship between nasal pathology and congenital dacryocystitis. The recent advent of nasal endoscopes has greatly improved visualization of deep and hidden areas of nasal anatomy and has led to the elaboration of nasal anatomical variants and pathologies that were previously unknown. The current study aimed to evaluate for associations, if any, between anatomical abnormalities or variations in the lateral nasal wall and the presence and resolution of congenital dacryocystitis. PATIENTS AND METHODS: Phase I was a case-control study that compared the incidence of a predefined set of nasal endoscopic variations in infants with congenital dacryocystitis versus normal infants. Phase II was a cohort study that evaluated the impact of nasal endoscopic variations on the effectiveness of conservative treatment for congenital dacryocystitis. "Failure" to respond to conservative treatment measures was defined as the persistence of symptoms at the first birthday. RESULTS: Inferior turbinate hypertrophy and inferior meatal narrowing were significantly more frequent in the case group than in the control group. Conservative treatment measures resulted in 70 of 83 resolved cases on subsequent follow-up. The occurrence of inferior turbinate hypertrophy or inferior meatal narrowing at final examination was associated with non-resolution. The relative risk of non-resolution with inferior turbinate hypertrophy or inferior meatal narrowing was 7.7 (confidence interval, 2.32 to 25.72) and 12 (confidence interval, 3.7 to 39.2), respectively. CONCLUSION: Inferior turbinate hypertrophy and inferior meatal narrowing are more frequent in cases of congenital dacryocystitis. They are predictive of a poor outcome when congenital dacryocystitis is treated with conservative measures. This information should be considered when making clinical decisions for patients with congenital dacryocystitis.
Case-Control Studies↗
Microbial keratitis after laser in situ keratomileusis.
PURPOSE AND METHOD: To review the literature on microbial keratitis reported after laser in situ keratomileusis (LASIK). RESULTS: Forty-one eyes have been reported to have microbial keratitis after LASIK. The causative organisms vary from gram positive bacteria to atypical mycobacteria, fungal, and viral pathogens. The infection is usually acquired intraoperatively, but may also be caused by postoperative contamination. A majority of the patients present within 72 hours of the surgery with an acute onset of symptoms. Management of microbial keratitis after LASIK includes aggressive topical fortified antibiotic therapy, irrigation of stromal bed with antibiotic solution after lifting the flap, and sending the scraping of the infiltrate for microbiological evaluation. The keratitis heals with scarring and a best spectacle-corrected visual acuity of 20/40 or better can be obtained in the majority of the patients. CONCLUSION: Microbial keratitis is a sight-threatening complication of LASIK.
Anti-Bacterial Agents↗
Traumatic corneal rupture 18 years after radial keratotomy.
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Adult↗
Treatment of overhanging blebs with frequency-doubled Nd:YAG laser.
Large overhanging blebs can be associated with various complications (eg, overfiltration, endophthalmitis, and dellen formation). Argon laser treatment of such blebs has already been described. The authors used frequency-doubled Nd:YAG laser in 3 eyes of 3 patients with large filtering blebs. Gentian violet was used to stain the bleb surface and enhance the laser absorption. Laser spots were applied over the bleb surface. Bleb shrinkage and remodeling was observed in all 3 eyes. Intraocular pressure remained normal, suggesting that the filtering capability of the blebs was maintained.
Aged↗