|Year : 1968 | Volume
| Issue : 2 | Page : 101-102
Orbital hydatid cyst
PP Ahluwalla, RV Agrawal, BU Padmawar
Medical College Hospital, Nagpur, India
|Date of Web Publication||22-Dec-2007|
P P Ahluwalla
Medical College Hospital, Nagpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ahluwalla P P, Agrawal R V, Padmawar B U. Orbital hydatid cyst. Indian J Ophthalmol 1968;16:101-2
Hydatid cyst is one of the commonest parasitic affection in the temporate climate of the World ((CHARTERJEE  ). Involvement of the orbit by a hydatid cyst though not very uncommon is rarely seen. It occurs preferentially in young people between 10 to 30 years of age; no definite predilection for any particular site within the orbit has ben observed, though upper and inner quadrant of the orbit is more commonly affected. Orbital hydatid cysts are more common than intraocular cysts (SORBS). According to HUILGOL  the incidence varies from 0.7 per cent to 1 per cent of all orbital  tumor cases.
Clinical diagnosis of hydatid cyst in the orbit is extremely difficult, because of its lack of characteristic presentation. SVERDLICK  claims to be the first to diagnose clinically intraocular hydatid cyst. Eyes at times have been removed due to mistaken diagnosis of absolute glaucoma (SOSRBY  ) or intraocular tumours. Eosinophilia and a positive Casoni's test are helpful in the diagnosis. Histological examination is the only confirmatory feature. Ideal treatment is extirpation of cyst without puncture. HANDOUSA  and TONJUM  are of the opinion that some portion of the fibrous pericyst be left during operation to prevent post-operative enophthalmos.
Six cases of orbital hydatid cyst have been reported in literature since 1952 (MANZAR,  two cases; RAPAPORT,  - one case; TENJUM,  one case; HUILGOL,  - one case; and ROY AND BANERJEE,  - one case).
Out of these, the last two case reports are from India.
The present paper deals with the clinical and histological findings in a case of hydatid cyst of the orbit.
| Case report|| |
A Hindu female aged 30 years from Amravati District attended the hospital with the complaint of proptosis of right eye and dull type of headache on right side, of two months duration. There was no history of injury or any association with cattle and dogs.
On examination the general build and health of the patient were satisfactory. Temperature, pulse and respiration were within normal range. There was no lymph adenopathy. Liver and spleen were not palpable.
The right eye showed slight eccentric proptosis in the down and in quadrant. The proptosis was not reducible. Fluctuation could not be elicited. The upper eye lid was tightly stretched [Figure - 1]. There was chemosis of both the conjunctiva. On eversion of the upper eye lid, the anterior lobe of lacrimal gland was prominently seen. Ocular movements were very much restricted in all directions. The vision was counting fingers from I m. The fundus revealed papilloedema. Other systems were normal.
Investigations: Total leucocytic count -9,200/c.mm. Differential leucocytic count - Poly. -63%; Lymppho. -33% and Eosino. 3%. Haemoglobin 10 gms.%. X-ray of the orbit did not show any bony lesion.
| Operation|| |
An anterior approach with lateral extension was performed. In the superior quadrant, a thick fibrous condensation was seen. On incising the fibrous mass, an egg white cyst of nearly 2.5 cm. in diameter, was seen. The cyst was deep in the orbit extending upto the apex and it leaked during its removal. The entire cyst with its surrounding fibrous mass was removed. Unfortunately the lateral rectus had to be severed during the operation.
The fluid from the cyst revealed presence of scolics. Histologically the diagnosis of hydatid cyst was confirmed. [Figure - 2].
Post-operatively, the patient had mild local anaphylactic reaction which was treated and controlled. On discharge the patient's ocular movements, and vision had improved; the papilloedema had subsided, no enophthalmos was observed.
| Discussion|| |
The maximum number of cases of hydatid disease from Vidarbha region showed lung, liver and spine to be the common sites of affection (NIGAM AND GHARPURE,  MOKADAM  ). The present case is also from the same district, thereby suggesting the possibility of high incidence of Echinococcus granulosus infection amongst dogs in the district.
Close contact with dogs was found in only 55 per cent of the cases (MOKADAM,  ). In the present case also there was no history of contact with cattle or dogs. In such cases, ingestion of hexacanth embryo from polluted water supply with excreta of dogs is suggested. This is the first case report of orbital involvement from Vidarbha region.
| Summary|| |
First case report of orbital hydatid cyst from Vidarbha region in a middle-aged Hindu female is reported with its clinical and histological studies. A brief review of literature on the subject has been made.
| References|| |
CHATTERJEE, K. D. (1952): Human Parasites and Parasitic Diseases. Calcutta. p. 666-78.
HANDOUSA, B. (1951): Am. Jr. Ophthal. 35: 606-613.
HUILGOL, A. V. (1963): Jour. All India Ophthal. Soc. 11: 78-81.
MANZAR, M. (1954): Brit. Jour. Ophthal. 38: 753.
MOKADAM, A. D. (1967): Thesis for M. S. (General Surg.) Nagpur University.
NIGAM, R. AND GHARPURE, V. G. (1954): Ind. Jour. Surg. 16: 85-86.
RAPAPORT, M. (1957): Quoted by Ref. No. 10.
ROY, BANERJEE and others (1967): Jour. All-India Ophthal. Soc. 15: 35-37.
SORSBY, A (1963): Modern Ophthalmology, Vol. II - Systemic Aspects. Lond., Butterworths, p. 251.
SVERDLIC J. (1961): Am. Jour. Ophthal. 52: 981.
TONJUM, A. M. (1962): Acta Ophthal. 41: 445-448.
[Figure - 1], [Figure - 2]