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   Table of Contents      
ARTICLES
Year : 1979  |  Volume : 27  |  Issue : 2  |  Page : 52-53

Subperiosteal hydatid cyst of orbit


1 Deptt. of Ophthalmology, Government Medical College, Surat, India
2 Asst, Professor in Pathology, Government Medical College, Surat, India

Correspondence Address:
A S Chitale
Deptt. of Ophthalmology, Government Medical College, Surat
India
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Source of Support: None, Conflict of Interest: None


PMID: 541033

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How to cite this article:
Chitale A S, Vachhrajani M V, Dave A B. Subperiosteal hydatid cyst of orbit. Indian J Ophthalmol 1979;27:52-3

How to cite this URL:
Chitale A S, Vachhrajani M V, Dave A B. Subperiosteal hydatid cyst of orbit. Indian J Ophthalmol [serial online] 1979 [cited 2019 Dec 6];27:52-3. Available from: http://www.ijo.in/text.asp?1979/27/2/52/31241

Involvement of orbit in the hydatid diseases is relatively uncommon (1%). The cysts are known to occur in any region of the orbit; the orbital apex (central surgical space) and the muscles (superior rectus, medical rectus, are common sites. Chronis reported its presence in the peripheral surgi­cal space i.e. between the periosteum and the muscle cone.[2] Only 10 cases have been reported in the literature since 1951.[1],[3],[4],[5],[6],[7],[8],[9],[10],[11] To the best of our knowledge hydatid cyst at the orbital apex in the Subperiosteal space in the orbit has not been reported so far, hence we report such a case.


  Case Report Top


A Muslim girl S. aged 11 years attended the Eye O.P.D. at New Civil Hospital, Govt. Medical College Surat on 5-10-'77 complaining the forward protrusion of her right eye and increasing pain for the past 5 months. The proptosis was gradual in onset without any apparent cause. There was no history of association with pets.

Ocular Examination

Right eye showed axial proptosis. It was non tender, non reducible and associated with marked chemosis of conjunctiva. Eye movements were severely restricted in all the direction of gaze. Anterior segment appeared normal. The direct pupillary reaction was ill sustained. Fundus examination revealed retinal striae over centrocaecal area. Field, on confrontation, was reduced to approximately 5 degrees around fixation point. Left eye was clinically normal. Visual acuity right eye was counting fingers at 2' and left eye 6/12.

Routine haemogram and urinalysis were normal. X Ray orbit and chest were normal. On Orbitopneumo­graphy, the muscle cone space could not be visualised as the injected air quickly dispersed out in the Subconjunc­tival space, leading to marked increase in chemosis. Casoni's test was not done.

Management

Lateral Orbitotomy (modified Kronlein's) of RE was done under G.A. While introducing a lid plate between wall and the periosteum, a sudden gush of clear fluid was noticed suggesting the presence of hydatid cyst. The fluid was aspirated and sent for examination for presence of scolices and booklets. Intravenous steroid was immediately administered to counteract possible anaphylactic reaction. After removal of the lateral bony wall, a collapsed glistening white sac was seen at the apex of the orbit which was easily dissected out. A deep indentation was seen on the medially retracted orbital periosteum. The operation was completed uneventfully.

On the 3 rd. post-operative day, the vision of right eye had improved to 6/12. There was severe restriction of abduction; rest of the movements were normal. Fundus examination revealed regression of retinal striae. Fields by confrontation was full.

Follow up examination after 2 months later showed a well healed orbitotomy scar and normally situated eye without proptosis. There was persistent restriction of abduction with full movements in other directions of gaze. Fundus showed slight temporal pallor of the right disc without deterioration either in the field or in visual acuity.

Histopathological examination of the cyst revealed the typical bilaminated nature of hydatid cyst wall. Scolices were not seen.


  Summary Top


A unique case wherein the hydatid cyst was found to be arising in the sub-periosteal space of the orbit near its apex leading to unilateral proptosis is reported.

 
  References Top

1.
Ahluwalia, B.K., and Chandra, P. (1973), East. Arch. Ophthal., 1, 75.  Back to cited text no. 1
    
2.
Duke Elder, S. 1974, System of Ophthalmology, Vol. XIII p. II, pp. 925, Henry Kimpton: London.  Back to cited text no. 2
    
3.
Handousa, Bey, A. 1951, Brit. J. Ophthal., 35, 607  Back to cited text no. 3
    
4.
Huilgol, A.V. 1963, Jour. All India Ophthal. Society., 11, 79.  Back to cited text no. 4
    
5.
Jerath, S.K., 1976, Ind. Jour. of Ophthal., 23, 34.  Back to cited text no. 5
    
6.
Mazhar, M., 1954, Brit. Jour. of Ophthal., 38, 753.  Back to cited text no. 6
    
7.
Maria, D.L., Kulkarni, R.G. and Patel, S.D., 1975, Ind. J. Ophthal., 37.  Back to cited text no. 7
    
8.
Maria, D.L., and Kale, M.D., 1971, Orient. Arch. of Ophthal., 9, 51.  Back to cited text no. 8
    
9.
Rapaport, M., et. al. 1957 Rev. As. Med. Grgent, 71, 189.  Back to cited text no. 9
    
10.
Sed, S.C., and Mukherji, A.K., 1973. Ind. J. Ophthal., 143.  Back to cited text no. 10
    
11.
Tonjum, AM. (1963). Acta. Ophthal., 41, 445..  Back to cited text no. 11
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]



 

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