Md Shahid Alam

Sankara Nethralaya · orbit oculoplasty reconstructive and aesthetic services

Lacrimal canaliculitis is an inflammation of the proximal lacrimal drainage system. It classically presents with symptoms of redness, mucopurulent discharge, medial canthal swelling, epiphora, and pouting punctum. Despite having classical clinical characteristics it is frequently misdiagnosed. The cause can be primarily due to various infectious ag...

Aim: To report a case series on canaliculocoele and to review the existing literature. Methods and materials: A retrospective analysis of the case records of all patients diagnosed with canaliculocoele between January 1st, 2018, and December 31st, 2019, was conducted. Only histopathologically proven cases of canaliculocoele with a minimum follow...

Eccrine spiradenoma is a rare sweat gland tumor and usually presents as a solitary, painful nodule. A solitary spiradenoma involving the eyelid is quite rare. A 39-year-old Indian female presented with a gradually increasing, painless, nodular upper eyelid mass for the past 4 years. On examination, a non-tender approximately 4 × 3 mm cystic mass wa...

Purpose To study the epidemiological profile of various pediatric orbital tumors and determine their clinicopathological correlation over 20 years. Methods A retrospective analysis of all pediatric patients with orbital tumors from the medical records between 1995 and 2015 was done. Tumors were categorized based on their cellular origin. Demograph...

A 69-year-old female presented with complaints of persistent watering in the left eye for the past 8 years. She underwent a left external dacryocystorhinostomy (DCR) 8 years ago. On examination, left lacrimal passage irrigation showed regurgitation of fluid from opposite punctum. She underwent a revision external DCR with bicanalicular intubation a...

The role of neoadjuvant chemotherapy (NACT) in eyelid and orbital malignancies is not well defined. It has been tried with good success in cases of eyelid sebaceous gland carcinoma but there is very limited literature on its role in cases of ocular surface squamous neoplasia. A 54-year-old man presented with gradually increasing swelling of the rig...

A 7-year-old male child presented with complaints of lagophthalmos and lid retraction of the right eye since birth. Magnetic resonance imaging (MRI) showed diffuse thickening of right superior rectus and levator-palpebrae complex along with a hypointense, irregular, and ill-defined lesion in the adjoining fat abutting the lacrimal gland. Biopsy fro...

Purpose: To study the efficacy of dacryocystectomy (DCT) in reducing epiphora in cases of primary acquired nasolacrimal duct obstruction. Methods: This was a prospective, nonrandomized, interventional study conducted over a period of 12 months. All cases who either opted or satisfied our criteria for DCT in primary acquired nasolacrimal duct obs...

Purpose: To analyze the clinical presentations, risk factors, and management outcomes in patients presenting with dysthyroid optic neuropathy (DON). Methods: This is a retrospective, single-center study carried out on consecutive patients presenting with DON over a period of 4 years (2013-2016). The VISA classification was used at the first visi...

Purpose: To describe the clinical spectrum and management outcomes of ocular rhinosporidiosis. Methods: All histopathologically diagnosed cases of ocular rhinosporidiosis between January 2000 and December 2016 were included in the study. The lesions were classified based on the site of involvement, namely conjunctiva, lacrimal sac, eyelid, and o...

Purpose To evaluate the efficacy of intermittent manual carotid compression (IMCC) in the management of low-flow carotid cavernous fistulae (CCF). Materials and methods Patients diagnosed with low-flow CCF and treated with IMCC over a period of 13 years were retrospectively analyzed. Data analyzed included demographic details, clinical features, t...

Purpose: To evaluate the role of tranexamic acid in controlling intra-operative and immediate post-operative bleeding during external dacryocystorhinostomy. Methods: This was a double-blinded randomized placebo-controlled trial. All patients diagnosed with primary acquired nasolacrimal duct obstruction presenting between June 2018 to December 20...

Purpose: Idiopathic elevated episcleral venous pressure (IEEVP) is a rare cause of secondary glaucoma and is a diagnosis of exclusion. The aim of this study was to describe the clinical presentation and analyze the outcomes of medical and surgical management in eyes diagnosed with idiopathic elevated episcleral venous pressure. Methods: A retros...

Purpose: To analyze the microbiological spectrum and antibiotic sensitivity patterns in children with congenital nasolacrimal duct obstruction (CNLDO). Methods: One hundred thirty-four eyes of 123 children in the age group of 0-16 years with a diagnosis of CNLDO who underwent lacrimal surgical procedures were included in this prospective compara...

Inadvertent globe perforation during posterior sub-tenon (PST) injection is rare, and the use of ultrasound biomicroscopy (UBM) in the diagnosis of occult globe perforation is not reported yet in the literature. We hereby intend to discuss the case of a 42-year-old male who presented with left eye loss of vision following PST triamcinolone acetate...

Purpose: To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature. Methods: A retrospective review of all the caruncular lesions between January 2000 and January 2020 was done at a single tertiary eye care hospital. The lesions were classified as benign and malignant lesions. Clinicopa...

PURPOSE: To analyze the correlation between patient‑reported regurgitation on pressure over lacrimal sac (ROPLAS) with the physician’s examination in diagnosing primary‑acquired nasolacrimal duct obstruction (PANDO). METHODS: A cross‑sectional study was done over 5 months (March–July 2018). All cases diagnosed as PANDO were included in the study. T...

Purpose: Fibrin glue was used for anastomosis of lacrimal sac and nasal mucosal flaps and was compared with the conventional suture technique in external dacryocystorhinostomy. Methods: A prospective interventional randomized control study in which 50 consecutive patients of primary acquired nasolacrimal duct obstruction (PANDO) were equally all...

Purpose: To study the risk factors for development of COVID-19 associated rhino-orbital-cerebral mucormycosis (ROCM) during the COVID-19 pandemic in India. Methods: Multi-centric retrospective case-control study conducted from October 2020 to May 2021. Cases comprised of consecutive patients of COVID-19-associated ROCM (CA-ROCM) presenting at th...

Purpose: To evaluate the effect of direct cell injury of cryotherapy on eyelid sebaceous gland carcinoma cells by an ex vivo cryotherapy experiment. Methods: It was a prospective interventional case series. Six patients with biopsy-proven nodular sebaceous gland carcinoma were included. After excision of the mass, a thin slice of the mass resemb...

Purpose: To compare the results between tarsofrontalis sling (TFS) and levator palpebrae superioris (LPS) excision with TFS in cases of ptosis with Marcus Gunn jaw winking syndrome (MGJWS). Method: A retrospective review of records of all patients undergoing either TFS (group A) or LPS excision along with TFS (group B) in cases of ptosis with MG...

Purpose: : To study the epidemiological pattern and diagnostic accuracy of histopathologically proven eyelid lesions over a period of two decades. Methods: : A retrospective study of all histopathologically proven eyelid lesions from April 1996 to March 2016 was conducted. The lesions were broadly categorized as benign or malignant. Inflammatory...

Purpose: To analyze the profile of patients visiting the ophthalmic emergency department during coronavirus disease-2019 lockdown and analyze its impact on a tertiary eye care center in South India. Materials and Methods: Retrospective analysis of Electronic Medical records of all patients presenting in the period from March 24, 2020 to May 3, 2020...

Orbital amyloidosis is an uncommon entity. Lacrimal gland, orbital soft tissue and extraocular muscles are the usual sites of involvement. Deposition of amyloid in the extraocular muscle can be either isolated or associated with systemic amyloidosis. We describe a case of a 43-year-old male with isolated amyloid infiltration of the right lateral re...

Aim: To describe, the impact of ongoing coronavirus disease 2019 (COVID-19) pandemic on ophthalmic surgeries at a tertiary eye care center of East India during and after the lockdown, and the positivity rate for novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). Materials and methods: A retrospective study of all o...

Purpose: Isolated cases of nasolacrimal duct obstruction (NLDO) secondary to rhino-orbito-facial reconstructive surgeries have been reported previously. We report the clinical profiles and management outcomes of a series of patients with iatrogenic INDO. Materials and methods: Case records of all patients who presented with secondary NLDO over 5...

Aim: The aim of this study is to study the prevalence, incidence, and the epidemiological characteristics of the patients of acquired dacryocystitis at a tertiary eye care center of Northern India. Materials and methods: It was a prospective, cross-sectional study carried out over a period of 2 years (July 2016-July 2018). The prevalence, incide...

Purpose: To describe the clinic-radiological, pathological profile, and management outcomes of primary alveolar soft-part sarcoma (ASPS) of the orbit. Methods: A retrospective analysis of all histopathologically proven cases of orbital ASPS that presented between May 2016 and September 2019 was done. Data collected included demographics, clinica...

Purpose: To report the epidemiology, histopathological spectrum, and surgical outcomes of peripunctal mass lesions. Methods: Multicentric retrospective case series involving 6 centers in India. All cases of peripunctal masses with histopathological diagnoses and minimum follow up of 3 months were included. Demographic data, clinical photographs,...

Purpose: To report the clinical profile and management outcomes of a series of cases of malignant tumors of the lacrimal drainage system (LDS). Materials and Methods: A retrospective analysis of all cases diagnosed with LDS malignancy over the past 24 years (1995–2019) was done. Patient characteristics, tumor types, management, and outcomes were an...

Purpose: The aim of this work was to study the clinical presentation, management and outcomes of orbital and adnexal amyloidosis. Methods: This retrospective analysis included all the patients diagnosed with orbital and adnexal amyloidosis between January 1990 and December 2019. Positive staining with Congo Red and apple-green birefringence on p...

Purpose: The aim of this study was to describe epidemiological and clinical characteristics of pediatric ocular motor cranial nerve palsy. Methods: This was a retrospective record-based study, carried out at a tertiary eye care hospital in India, between January 2011 and January 2015 and included patients up to 16 years of age at the time of pre...

We report two patients presenting with acute orbital inflammation as an unusual manifestation of metastatic carcinoid tumors. Neuroimaging revealed rim enhancing lesions mimicking orbital abscesses in both. Histopathology confirmed the diagnosis of metastatic neuroendocrine tumors with primary in the gastrointestinal tract. Atypical presentation of...

A 28-year-old male presented with gradually progressive swelling of the right lower eyelid along with a prominence of the eye for 6 months. He had received oral steroids and intraorbital triamcinolone acetonide injection in the inferior quadrant for active thyroid eye disease. External examination revealed right eye proptosis and swelling along the...

Purpose: The objective of this study was to analyze the role of neuroimaging and documenting various intracranial pathologies in primary and secondary hemifacial spasm. Methods: This retrospective study included patients with HFS who had undergone neuroimaging. The demographic profile, onset, progression, neuroimaging findings, and types of HFS...

Purpose: Assessing visual acuity (VA) is the cornerstone of an ophthalmic workup and needs VA charts in a four or six meters space. The objective of this study was to compare the performance of distant VA (DVA) on one meter mini-logMAR (MLM) with a standard six meter logMAR (SLM) chart. Methods: We developed a MLM chart to be used at 1 m with +1...

Aim: The aim of the study is to describe the triaging of patients based on their clinical profile and the management offered during the lockdown period due to the COVID-19 pandemic at a tertiary eye center. Methods: A cross-sectional study of patients who visited the emergency department during the lockdown (Phase 1 and Phase 2) from March 3,2020 t...

Purpose: To study the clinical profile and management outcomes of periocular basal cell carcinoma (BCC). Materials and methods: A retrospective analysis of all histopathologically proven cases of BCC between 1995 and 2015 was done. The demographic data, clinical presentation, histopathological subtype, and management outcomes were analyzed. Res...

Ichthyosis is a rare inherited skin disorder characterized by abnormal keratinization of the epidermis. Cicatricial ectropion is the most common ophthalmic feature of congenital ichthyosis. Progressive subepithelial cicatrization and abnormal cornification of eyelid skin cause progressive ectropion in both eyelids, leading to lagophthalmos and corn...

Purpose: In 1-12 years old children, we assessed correlation, regression, and agreement between spherical equivalents (SE) obtained on Mohindra's near retinoscopy (MNR) and the post cycloplegic refraction (PCRef), performed 72 h after a cycloplegic refraction (CRef) using cyclopentolate 1% drops. Methods: In this prospective comparative study, M...

Purpose: To describe the magnetic resonance imaging (MRI) features of the medial canthal tendon (MCT) insertion in a series of patients of the Centurion syndrome. Methods: This was a prospective study carried out over a period of 1 year. All patients clinically diagnosed with Centurion syndrome underwent MRI with surface coils. The insertion of bo...

A 52-year-old male presented with right eye prominence of 1-year duration. Right eye examination revealed proptosis and limitation of extraocular movements. Magnetic resonance imaging (MRI) of the orbit showed soft tissue mass in the inferomedial orbit with medial rectus involvement and involving lacrimal sac. The patient underwent an incisional bi...

Purpose To describe the Magnetic Resonance Imaging (MRI) features of the Medial Canthal Tendon (MCT) insertion in a series of patients of the Centurion syndrome. Methods This was a prospective study carried out over a period of one year. All patients clinically diagnosed with Centurion syndrome underwent MRI with surface coils. The insertion of bo...

Cutaneous leiomyoma is an infrequently occurring benign smooth muscle neoplasm of skin. Piloleiomyoma, angioleiomyoma, and genital leiomyoma are the three forms of the cutaneous leiomyoma. Piloleiomyoma arises from arrector pili muscle and is commonly seen in the adult population. Congenital piloleiomyoma is extremely rare and has never been report...

Aim The aim of the study is to describe intracanalicular antibiotic ointment loading as a treatment option for canaliculitis Material and Methods It was an interventional prospective study. The study was conducted over a 3 year period from June 2015 to June 2018. All patients of canaliculitis managed with intracanalicular antibiotic ointment loadi...

Purpose: To describe the clinical spectrum and management outcomes of Langerhans cell histiocytosis (LCH) involving the orbit. Methods: Retrospective review of patients with orbital LCH presenting at the Sankara Nethralaya, Chennai, India, over the past 15 years. Demographic details, presenting features, radiology, histopathology, immunohistoche...

Purpose: To report a rare case series of 14 patients of the Marcus-Gunn jaw-winking phenomenon (MGJWP) without ptosis. Methods: This was a retrospective noninterventional case series. The medical records of all patients diagnosed with MGJWP over the past 10 years were retrieved. Patients with documented evidence of absence of ptosis were segrega...

Orbital infections

Purpose To evaluate intranasal endoscopic findings in patients with unilateral primary acquired nasolacrimal duct obstruction and compare them with the normal cohort. Methods A prospective case-control study with 50 unilateral primary acquired nasolacrimal duct obstruction (PANDO) and 50 healthy controls. All patients were evaluated by endoscopic...

Plasma cell granuloma is a rare non-neoplastic inflammatory condition of unknown etiology commonly involving lung and gastrointestinal tract. Conjunctival disease per se is very rare and usually associated with involvement of other organs. We report a case of conjunctival plasma cell granuloma without any systemic involvement in a 9-year-old girl w...

AIMS: The aim of this study was to identify the ocular morbidity pattern among children attending a blind school in North India and comparing the data with similar studies conducted across India and abroad. STUDY DESIGN: This was a cross-sectional observational study. MATERIALS AND METHODS: A cross-sectional study was performed during September 201...

Purpose: To study the clinical profile and management outcomes of histopathologically proven cases of eyelid molluscum contagiosum (MC). Materials and Methods: A retrospective analysis of the medical records of patients presenting to a tertiary eye care center between January 1995 and December 2018 was carried out. Of 67 patients clinically suspect...

PURPOSE: To study the clinical profile and management outcomes of periocular basal cell carcinoma (BCC). MATERIALS AND METHODS: A retrospective analysis of all histopathologically proven cases of BCC between 1995 and 2015 was done. The demographic data, clinical presentation, histopathological subtype, and management outcomes were analyzed. RESULTS...

Purpose: To analyze the diagnostic accuracy of frozen section in orbital and adnexal malignancies. Methods: A total of 55 cases between January 2006 and December 2011 for which intraoperative frozen section was performed for various orbital and adnexal lesions were included in the study. The frozen section diagnosis was compared with the permane...

The princliples of management of orbital trauma differ from facial trauma due to the contents of the orbital cavity, i.e., the eyeball and the surrounding neurovascular structures being packed within a small space. In the last decade, due to the advances in imaging and implant materials, there have been changes in the way orbital injuries are manag...

Precis: Secondary ocular hypertension is common in carotid-cavernous fistulas. Management of elevated intraocular pressure (IOP) is possible with a multidisciplinary approach. The ipsilateral normal eyes may have higher IOP than the contralateral eyes. Purpose: To study the intraocular pressure (IOP) profile of the eyes of patients with a caroti...

Our aim is to study the varied posterior segment manifestations, level of visual impairment (VI) and its causes in carotid cavernous fistula (CCF) patients. A retrospective study was done, wherein data was obtained from 48 digital subtraction angiogram (DSA) proven CCF patients. CCF was classified according to Barrow et al., based on DSA into type...

Purpose: The purpose of this study is to assess the outcomes of lacrimal gland injections of botulinum toxin A (BoNTA) for epiphora secondary to lacrimal drainage disorders and functional epiphora. Methods: This was a retrospective interventional case series where cases were divided into functional and nonfunctional epiphora. Results: A total...

Purpose: To compare the cosmetic outcome of the surgical scar of external dacryocystorhinostomy by the subcuticular versus sutureless technique. Methods: This was a prospective interventional randomized control study conducted at tertiary level hospital. Fifty patients of primary-acquired nasolacrimal duct obstruction were included in this study...