Sima Das

• Consultant at Dr. Shroff’s Charity Eye Hospital

Neuroblastoma, the most common extracranial solid tumor in children, typically originates in the adrenal glands but can occasionally present as primary orbital neuroblastoma. This rare condition, arising from the ciliary ganglion, poses significant diagnostic and therapeutic challenges. We report a case of primary orbital neuroblastoma in a 2.5-yea...

Purpose: Description of clinical profile, surgical technique, and outcomes in patients having severe entropion secondary to cicatricial ocular surface disorders, who underwent entropion repair and posterior lamellar augmentation using auricular cartilage graft. Methods: A retrospective review of electronic medical records was performed over a 4-...

Purpose: To describe the epidemiological profile and clinical characteristics of ocular and periocular tumors in patients presenting to three tertiary care referral centers in North and Central India. Methods: Hospital-based consortium study. Settings and design: Retrospective, descriptive, observational study. Results: A total of 3184 patie...

A 64-year-old male was referred for complaints of blood in tears and bloody discharge of unknown cause in the left eye. The patient was a chronic bandage contact lens (BCL) user. He had no history of recent trauma. A bloodstained BCL was present on the cornea in the left eye, which was removed. The ocular surface was dry with vascularization of the...

Dacryocystectomy (DCT) is a relatively minor oculoplastic procedure with specific indications and remains a common lacrimal surgery in the Indian subcontinent. A 66-year-old hypertensive female with a mature cataract complained of painful vision loss on postoperative day 1 of DCT surgery. Visual acuity of nil light perception in the right eye with...

Purpose: To assess the utility of pig head model as an oculoplastic surgical training tool. Methods: Fresh pig head was availed for surgical workshop for entropion correction, eyelid margin repair, and evisceration with implant for oculoplastic surgery-naïve participants. Skill improvement, surgical understanding, and performance of the particip...

Histoplasmosis is a granulomatous infection caused by dimorphic fungus-Histoplasma capsulatum. Ocular involvement is mainly in the form of retinal or choroidal involvement as presumed ocular histoplasmosis mostly in immunocompromised patients. Conjunctival, scleral, and adnexal involvement is rarely reported. We report a case of disseminated histop...

Purpose: To investigate the utility of a hand-held digital otoscope for nasal endoscopy and as a pedagogy tool for residents and fellows in patients undergoing external dacryocystorhinostomy (DCR) surgery Methods: A digital otoscope (MS450-NTE, Teslong Inc., USA) comprising a digital screen device and a connectible camera probe was used for perform...

Context This study adds to the existing body of literature on the role of optical coherence tomography (OCT) parameters in active thyroid eye disease (TED) among the Indian population. Purpose Comparison of choroidal vascularity index (CVI) and subfoveal choroidal thickness (SFCT) in active and inactive TED. Settings and Design An observational,...

Purpose To evaluate the association between obstructive sleep apnea (OSA) and thyroid eye disease (TED) and its effect on disease activity. Methods A prospective case–control study was conducted from January 2020 to March 2022. All TED patients (group A) were clinically evaluated. The activity of thyroid eye disease was calculated based on the cli...

Dacryoadenitis can be a rare presentation following COVID-19 infection or can be an immunological response post COVID-19 vaccination. Herein we report two cases of lacrimal gland involvement, one post COVID-19 infection, and the other post COVID-19 vaccination. A definitive causal relationship, however, remains uncertain.

Giant congenital melanocytic nevi involving the face are benign lesions and malignant transformation to cutaneous melanoma involving the eyelid has been rarely reported. This report highlights the rare association of a giant facial melanocytic nevus and conjunctival primary acquired melanoses and melanoma.

AIM: This study aims to evaluate the treatment outcomes of periocular capillary hemangioma with oral propranolol (OP) and list the factors predictive of recurrence and incomplete resolution after treatment. METHODOLOGY: Data were collected by retrospective review of medical files of patients with infantile hemangioma (IH) treated with OP during Jan...

Purpose: To evaluate the efficacy of secondary and salvage intra-arterial chemotherapy (IAC) as a globe salvage treatment modality in advanced and refractory intraocular retinoblastoma. Methods: A retrospective chart review of advanced intraocular retinoblastoma (groups D and E International Classification of Retinoblastoma [ICRB] classification...

Graves’ ophthalmopathy (GO) is a complex inflammatory condition affecting the orbit and is often associated with Graves’ disease (GD). This study aims to determine the levels of thyroid-stimulating immunoglobulin (TSI) and thyroid-stimulating hormone receptor autoantibody (TSHR-ab) in the serum of patients with GO, compare it with the GD, and deter...

Purpose: The purpose of this study was to study the outcome of single-staged entropion surgery along with lid margin mucous membrane grafting for cicatrizing ocular surface disease. Methods: Retrospective review of medical records of patients who underwent single-staged surgical correction of cicatricial entropion along with lid margin mucous me...

Primary yolk sac tumor of the orbit is a rare entity. Orbital involvement is usually seen in young children and proptosis is the commonest presentation. Aggressive orbital involvement and presentation as a fungating mass is rarely seen. We report a case of primary orbital yolk sac tumor with an aggressive presentation that responded well to systemi...

Purpose: To evaluate the efficacy of multimodal treatment in adenoid cystic carcinoma (ACC) of the lacrimal gland. Methods: A retrospective comparative case series of 40 consecutive patients with ACC of the lacrimal gland without systemic metastasis at the initial presentation and primarily managed by one of the 3 treatment protocols-surgery + e...

Nocardia is a rare cause of endophthalmitis in immunocompetent individuals with poor visual outcomes. We, herein report a 15 month otherwise healthy child, who presented with hyphema, vitreous hemorrhage and secondary glaucoma following a vague history of trauma in the left eye 2 months before presentation. He presented a week later with features o...

Purpose: To analyze data on eyelid malignancy in India, clinical and pathologic features, and outcomes. Methods: A multicentre study, from oculoplastic practices in four geographic zones in India. The centers perform similar documentation and protocol-based management for eyelid tumors. Clinical features, pathology, American Joint Committee on C...

Purpose: To describe the clinical features of thyroid eye disease (TED) in patients presenting at a tertiary eye care centre in North India and to identify factors predictive of severe disease. Methods: This observational cross-sectional study involved clinical evaluation of all patients with TED who presented at the oculoplastic clinic based on...

Lymphangioma is a benign hamartomatous lesion of vascular system which frequently involves orbit and ocular adnexa. A 35-year-old male patient presented with a subconjunctival mass extending from limbus to fornices. There was a history of recurrent swellings following episodes of upper respiratory tract infection. Bleomycin is an antineoplastic age...

Ocular amylodosis, although a rare entity, is known to affect the conjunctiva, extraocular muscles, orbit, lacrimal gland, and skin around the eyes. Intraocular deposition of amyloid mainly confines to the vitreous and cornea. In this report, we describe two cases of intraocular amyloidosis presenting as multiple iris and anterior chamber cysts. Hi...

Purpose: To evaluate the efficacy of unilateral tarso-frontalis silicone sling without levator extirpation or disinsertion in dampening the jaw wink in patients with congenital ptosis associated with Marcus Gunn Jaw Winking synkinesis phenomenon. Methods: Retrospective review of medical records of all patients of congenital ptosis with moderate...

Congenital nasolacrimal duct obstruction

Introduction: The aim of this study was to determine the prevalence of buried probe variant of complex congenital nasolacrimal duct obstruction (CNLDO) and to evaluate the outcome of probing and irrigation in such cases. Institutional review board approval was taken. Material & Methods: A total of 309 eyes (258 patients) were diagnosed with CNLDO d...

Epiphora or watering is one of the most common symptoms of any ocular pathology. Though most cases of epiphora are due to non-patency in the lacrimal outflow pathway, others like eyelid and adnexal disorders and corneal and ocular surface pathology can also manifest as watering. In this context, it is important to distinguish between epiphora and p...

Cyclic oculomotor nerve paresis and spasm is a rare disorder characterized by alternating spastic and paretic phase of the muscles supplied by the oculomotor nerve. A 26 year old male presented with abnormal right eyelid movements since early childhood. Examination findings were consistent with diagnosis of right eye cyclic oculomotor nerve palsy....

Pneumatocele of the lacrimal sac is an uncommon entity and has been rarely reported in literature. The valvular function of the Hasner's valve at the lower end of nasolacrimal duct is presumed to prevent the retrograde reflux of air into the lacrimal sac with increased intranasal pressure as in valsalva maneuver. Loss of this valvular function as n...

Purpose To evaluate the epidemiological characteristics and outcomes of ocular injuries resulting from the use of firecrackers during the Diwali festival in all age groups. Materials and Methods A single-center, retrospective, hospital-based case series presenting with ocular trauma consequent to fireworks usage in a tertiary eye care center in No...

Epiphora or watering is one of the most common symptoms of any ocular pathology. Though most cases of watering are due to nonpatency in the lacrimal outflow pathway, others like eyelid and adnexal disorders, corneal and ocular surface pathology can also manifest as watering. In this context, it is important to distinguish between the terms epiphora...

Orbital infections are a common cause for proptosis in clinical practice and generally present as symptomatic acute orbital inflammation caused by bacteria, fungi and parasites. Chronic indolent course is a characteristic feature of mycobacterial, several fungal and parasitic infections. A thorough history to determine the aetiology and predisposin...

The authors report a unique case of a broken motorbike handle that presented as a bilateral orbital foreign body. A 30-year-old male sustained an injury to the right side of his face when he skidded from his motorbike while riding. He had bilateral sudden loss of vision and presented to emergency services with bilateral proptosis, motility restrict...

A 4-month-old infant with epiblepharon of the right lower eyelid presented with medial eyelashes touching the corneal surface in primary gaze and resultant punctate epithelial keratopathy. Hyaluronic acid gel (Juvederm Ultra) 0.2 ml was injected in the suborbicular plane in the valley above the abnormal skin fold. Immediate out-turning of the eyeli...

A 6-month-old infant with congenital icthyosis was brought to the authors with bilateral cicatricial ectropion of the upper and lower eyelid with resultant exposure keratopathy. Skin autograft was not possible due to generalized skin involvement, leading to unavailability of a donor site. A maternal skin allograft was performed for both eyelids of...

To describe the clinical signs and outcome of surgery in cases with Centurion syndrome and highlight the clinical presentation of this syndrome. A retrospective review of records of patients with Centurion syndrome who underwent surgery between January 2002 and July 2007. The position of the punctum, nasal bridge prominence, Hertel exophthalmometry...

Blepharoplasty plays a vital role in facial rejuvenation, with direct aesthetic relation to the brow and the cheek. Upper and lower eyelid blepharoplasty are indicated for the treatment of excess skin and/or orbital fat. Preoperative evaluation should include a thorough medical and ophthalmic history, along with a detailed cutaneous and eye examina...

Metastatic bilateral endogenous panophthalmitis is a rare but devastating ocular infection. A young male presented with high-grade fever of 4 days duration along with rapidly progressive proptosis and loss of vision in both eyes. Systemic examination revealed bronchopneumonia and the blood culture was positive for Salmonella typhi. Ocular examinati...

Holi festival is celebrated in India traditionally by applying colors on one another. Various ocular adverse effects of these colors have been reported including conjunctivitis and corneal abrasion. We report a case of bilateral periorbital necrotizing fasciitis, following exposure to Holi colors. General physicians might encounter more such cases...

A bstract A 35‐year‐old man presented with decreased vision in both eyes. Fundus biomicroscopy of the right eye revealed a pseudohypopyon along with an area of hyperpigmentation and scarring at the macula (combined stage III and IVb Best's Vitelliform Macular Dystrophy [BVMD]). The left eye showed the presence of a pseudohypopyon along with macular...

Extra ocular muscles are the most common site of involvement in orbital cysticercosis. We present a case of retrobulbar cysticercosis masquerading clinically as optic nerve glioma.

A 32-year-old lady presented with bilateral painful proptosis and left infranuclear facial palsy. She was mildly anemic. Ocular examination revealed a firm non-tender mass in the super lateral quadrant of both orbits. Fine-needle aspiration cytology from the orbital mass showed the presence of lymphoplasmacytoid cells. Bone marrow aspiration also s...

We report an unusual case of disseminated cysticercosis having simultaneous intraocular and extraocular involvement. This 21-year-old male presented with recent loss of vision in one eye and history of a single seizure. Examination revealed intravitreal cysticercosis with exudative retinal detachment. Computed tomographic scan showed disseminated n...

To report the ulcer characteristics, microbiologic data, and outcome of infectious keratitis associated with climatic droplet keratopathy (CDK), suggesting that CDK is a predisposing factor for infectious keratitis. Medical records of 32 patients (34 eyes) in whom infectious keratitis was seen in association with CDK were retrospectively reviewed....