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A modified simple technique of sling operation is presented in 15 cases using the levator aponeurosis as the material for the sling as originally devised by Lemagne and Bemcher. The levator is cut behind the superior transverse ligament and the posterior part of the levator is cauterised and allowed to retract into the orbit. The horns are cut from behind forwards, and the levator, which is kept attached on the tarsal plate, is used to lift up the lid. This method eliminates the jaw winking phenomenon as well as lifting the lid. [ABSTRACT FROM PUBLISHER]

A modified simple technique of brow suspension by using 4-0 Supramid (non-absorbable thread) suture and only one skin incision is described in 25 eyes of 15 cases of ptosis, including cases of congenital and mechanical ptosis and ptosis with Marcus Gunn phenomenon. This technique avoids the use of any special instruments such as the Reese ptosis knife and Wright needle. [ABSTRACT FROM PUBLISHER]

Purpose: To describe the ultrasound features seen in orbital hydatid disease, which may confirm the diagnosis preoperatively., Design: Interventional case series., Methods: Nine patients of orbital hydatid cyst were evaluated preoperatively with ultrasound and computed tomography scans. The diagnostic features seen on ultrasound as well as the CT features are described. All patients underwent surgery to remove the cyst, and the diagnosis was confirmed surgically in all nine cases., Results: We found that ultrasound was most helpful in diagnosing a hydatid cyst, even more so than a computed tomography scan, and we saw a diagnostic "double wall" sign in all cases, on ultrasound, a sign not previously described in orbital hydatids., Conclusions: It is difficult to diagnose an orbital hydatid cyst preoperatively. However, we found that the double wall sign could be elicited ultrasonically in all cases of hydatid cyst, if looked for carefully, and the diagnosis could be confirmed.

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., (Copyright 2002 S. Karger AG, Basel)

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., (Copyright 2002 S. Karger AG, Basel)

Extraskeletal mesenchymal chondrosarcoma of the orbit is a rare tumour and generally presents in young females. We report the clinical presentation and histopathological features of a case of orbital mesenchymal chondrosarcoma in a middle-aged man. The prognosis of this tumour is poor and though rare it should be kept in the differential diagnosis of orbital masses.

A 5-year-old girl presented with a large swelling measuring 50 x 35 mm in the left upper lid. The mass was firm to hard in consistency. Fine-needle aspiration showed a few spindle-shaped cells arranged in clusters. The mass was excised in toto and the histopathological examination revealed dermatofibroma, which is an extremely rare condition affecting the eyelid.

A 15-year-old boy presented with diminution of vision which rapidly progressed to no perception of light. In the ocular fundus, a neuroretinitis-like picture was seen. On CT-scan & ultrasonography, an optic nerve swelling was detected with a shadow of scolex. Medical therapy in the form of steroids along with albendazole was ineffective. Surgical removal by lateral orbitotomy was done and a complete cyst with scolex was removed, which was confirmed histopathologically as a case of retrobulbar optic nerve cysticercosis.

Histopathology and various immunohistochemical markers were studied in 40 cases of human retinoblastoma. In histopathology, tumour type, extent and invasion were studied. In immunohistochemistry, both glial and neural markers were used to know the histogenesis of this tumour. The glial markers, glial fibrillary acidic protein and vimentin, were detected in retinal astrocytes and Muller's cells in normal retina and perivascular glia in retinoblastoma. The neural marker, neurone-specific enolase stained neurones in outer and inner nuclear layers in normal retina, Flexner-Wintersteiner rosettes in retinoblastoma and tumour cells is differentiated retinoblastoma. Another neural marker, neurofilament triplet polypeptide stained neurones in inner nuclear layer of normal retina and Flexner-Wintersteiner rosettes in well-differentiated retinoblastoma. These results support the view that retinoblastoma has predominantly neuronal origin.

Specific antibodies against neuron-specific enolase, leukocyte common antigen and desmin were assessed for their usefulness in the cytodiagnosis of 23 cases of pediatric orbital round cell tumors (10 cases of orbital recurrence of retinoblastoma, 11 cases of embryonal rhabdomyosarcoma and 2 cases of inflammatory pseudotumor). Alcohol-fixed, Papanicolaou-stained smears were decolorized and stained with monoclonal antisera using the peroxidase-antiperoxidase procedure. Twenty of 23 aspirates were positively immunostained with antisera against leukocyte common antigen, desmin and neuron-specific enolase. Eight of 10 cases of clinically diagnosed orbital recurrence of retinoblastoma showed strong monotypic staining with anti-neuron-specific enolase antiserum. More than 50% of tumor cells in 9/11 cases of embryonal rhabdomyosarcoma were also immunopositive with this antiserum. Desmin positivity was seen in 10/11 cases of embryonal rhabdomyosarcoma, whereas immunopositivity with leukocyte common antigen was detected in both cases of inflammatory pseudotumor. These results indicate that the use of a panel of monoclonal antibodies on aspirate smears is imperative for establishing the diagnosis and classification of pediatric round cell orbital tumors.

Background: Dermis fat grafts are used in orbital reconstruction in a variety of procedures. However, there have been few controlled studies testing their effectiveness. This is a prospective study on 40 patients., Methods: Primary and secondary orbital dermis fat grafts were evaluated with regard to the long-term cosmetic results of two thicknesses, 10 and 20 mm, of fat pad, keeping all other parameters as constant as possible. Adequacy of the socket, lid anomalies; superior sulcus deformity, exophthalmometry, and motility of the prosthesis were assessed periodically., Conclusion: There was a significantly lower incidence of enophthalmos and superior sulcus deformity with the use of a fat pad thickness of 20 mm, without any compromise in the motility of the prosthesis or take of the graft.

Fine needle aspiration (FNA) biopsy was performed on 35 patients with orbital and adnexal masses. Histopathologic study was performed on 15 of the cases. Examples of benign and malignant primary orbital neoplasms, as well as inflammatory lesions diagnosed this way, are described. The diagnostic accuracy of the technique in evaluating orbital masses was 97.1%; there was one false-negative case. The study indicated that this simple technique has considerable diagnostic value in palpable orbital masses.

Two patients with osseous hemangioma of the orbit, and with typical features on plain radiography and computed tomography, are reported. The typical features of osseous hemangioma of the orbit on computerised tomography (CT) are: expansile bony lesion limited by a thin sclerotic rim, bony trabeculae radiating from the centre to the periphery of the lesion, and absence of an associated extra-tumoral soft tissue mass. To the best of our knowledge this is the first report of osseous hemangioma of the orbit evaluated by CT.

Two unusual cases of Marcus Gunn phenomenon in adults are presented. The first case was characterised by a bilateral jaw-winking phenomenon along with an asymmetric bilateral congenital ptosis, whereas the second case had bizarre spontaneous movements of the affected lid, deficient abduction and pseudoptosis in association with jaw-winking. The pathogenesis of Marcus Gunn phenomenon is discussed.

A rare case of leiomyoma located anteroinferiorly in the orbit of a 39-year-old male patient is reported. The histopathogenesis and management is discussed.

A rare case of facio-orbital anamoly having dermolipoma with posterior extension, lid notch, ectropion, assymetric hypertelorism and lipoma of corpus callosum is presented. The classification of the facial cleft deformities and the surgical management is highlighted.

The results of split thickness autologous skin grafting along with the use of a dental impression material (Compo), a thermoplastic substance are presented in a series of 11 patients of acquired, severely contracted, anophthalmic sockets. Only the fornix fixation sutures and the central tarsorrhaphy were employed for the proper placement of graft without the use of retention devices. Artificial eyes were successfully fitted and retained subsequently after 6 weeks of grafting.

A modified simple technique for transconjunctival levator resection is presented. Fifteen patients with congenital ptosis with a varying amount of levator action were operated on with this technique. The modification included different techniques for passing the sutures and avoiding separate sutures to form the lid fold. Lidocaine injections administered subconjunctivally and beneath the skin orbicularis lamina facilitate the dissection of the levator, and as much of the levator can be resected as is required. The use of a ptosis clamp was avoided by means of white cotton stay sutures passed through the levator. The postoperative reaction was minimal, and excellent dynamic lid folds were formed.

A case of multiple wooden foreign bodies is presented. Any case presenting with a history of injury and a discharging sinus with osteomyelitis warrants a thorough exploration of the orbit. Anterior orbitotomy was performed and 4 pieces of arhar sticks were taken out. The guidelines for the management of the wooden foreign bodies are highlighted.