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   Table of Contents      
ARTICLE
Year : 1967  |  Volume : 15  |  Issue : 1  |  Page : 35-37

Hydatid cyst of the orbit


Institute of Ophthalmology, Calcutta; School of Tropical Medicine, Calcutta, India

Date of Web Publication18-Jan-2008

Correspondence Address:
I S Roy
Institute of Ophthalmology, Calcutta; School of Tropical Medicine, Calcutta
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Roy I S, Banerjee A, Guha P K, Choudhury A B. Hydatid cyst of the orbit. Indian J Ophthalmol 1967;15:35-7

How to cite this URL:
Roy I S, Banerjee A, Guha P K, Choudhury A B. Hydatid cyst of the orbit. Indian J Ophthalmol [serial online] 1967 [cited 2020 Dec 3];15:35-7. Available from: https://www.ijo.in/text.asp?1967/15/1/35/38678

Compared with the other parts of the body ocular involvement of Hydatid cyst is rare. Orbital involvement is of Hydatid disease constitute only 0.7% to 1%, of the published cases. Since 1952 only five cases of orbital Hydatid cysts have been reported in the litera­ture. Rapaport et al published one case from Argentine in 1957; Mazhar reported two cases of hydatid cyst of orbit from Aden in 1954; Tonjum re­ported one case from Sweden in 1963. As far as our knowledge goes Huilgol reported the first case of Hydatid cyst of orbit from Mysore in 1963. This case of ours is the first one from this part of the country.

It occurs commonly in countries where sheep and cattle raising is an industry and where exists a close asso­ciation between sheep, the optimum intermediate host and man, and dog the optimum definitive host. That is the reason why it is so uncommon in a tropical country like India.

Dog is the optimum definitive host. The larval stage is passed in sheep, cattle, pig or man which represent the intermediate host of the parasite. The eggs swallowed by man, due to inti­mate handling of the infected dogs, reach the stomach where their cell walls are digested and active hexacanth embroys hatch out and bore their way through the walls of the gut and enter the portal circulation to reach the liver, the first filter. Due to the large size embroys they are mostly caught here producing here the highest incidence of hydatid cyst. If they escape this filter they are caught in the pulmonary bed, the second filter. If however they escape both these filters they may settle in one or other peripheral parts. This is the reason why orbital involve­ment is so extremely low.

The pericyst of the Hydatid cyst is essentially the product of the tissue reaction on the part of the host. Of the two proper cyst walls of the embryo the endocyst gives rise to scolices and brood capsule under suit­able conditions. The rate of growth of `H' cyst is usually slow. There is not much predilection for sex or the site of the orbit; however, it is more com­monly seen in the younger age group. The cyst may occur in any part of the orbit but more commonly in the upper quadrant.

Not having any clinical characteris­tics, diagnosis is extremely difficult and surgical exploration of the orbit has proved to be the most reliable method of diagnosis. Presence of the charac­teristic 3 paired hooklets under mic­roscope from the scrapings of the lining of the cyst wall is confirmatory. Some clue may however be obtained from eosinophilia of blood and if the Caso­nis test if positive. The best form of treatment is extirpation of the cyst without puncture. Handousa and Ton­jum opine that some portion of the fibrous pericyst be left during opera­tion to prevent post-operative Enoph­thalmos.


  Case Report Top


Shankari Bala Dasi, Hindu female child aced 7 was admitted in the Eve Infirmary, Medical College Hospital on 12-1 1-65 for the treatment of her left proptosis of 18 months duration. There was slight pain for the last 2 months.

There was definite history of intimacy with dogs.

On examination, a huge irreducible eccentric proptosis down and in on the left side was present. Extraocular movements were practically nil. Vision was reduced to finger counting from 1 metre.

Nothing abnormal was detected in the other systems, laboratory findings and X-Ray of the orbital foramina.

A Kronline type of lateral orbitotomy was performed and the large cystic mass deep in the orbit was isolated.

The cyst puncture revealed clear yellowish fluid with expulsion of sago­grain like bodies and scraping from the cyst wall revealed scolices with typical 3 paired hooklets.

A week after the operation Casoni's test was performed and surprisingly it was found to be negative. Post opera­tive recovery was uneventful, except for a lateral rectus palsy and some enophthalmos.


  Comments Top


Deep seated position of the cyst in the orbit eluded its true nature till the surgical exploration was performed and the subsequent microscopy done.

That, Casonis test is not always re­liable is proved by its negative result in this histologically confirmed case.[7]

 
  References Top

1.
Chatter ice. K. D. Parasitology. 5 th Edition, 1965.  Back to cited text no. 1
    
2.
Duke Elder, S: Text Book of Ophthal­mology, Vol. 4-1952 p. 5473-76.  Back to cited text no. 2
    
3.
Handousa Bey A: (1951). J. Opthal­mology 35: 606-613.  Back to cited text no. 3
    
4.
Huilgol. A. V. (1963). J. All India Ophth. Soc. 11: 79-81.  Back to cited text no. 4
    
5.
Mazhar, M. (1954). Brit. J. Ophth. 38: 753.  Back to cited text no. 5
    
6.
Rapaport. M. et al: (1957). Rev. As Med. Argent. 71: 189-191.  Back to cited text no. 6
    
7.
Tonjum. A. M. (1963), Acta Ophth. 41: 445-448: 1963.  Back to cited text no. 7
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]



 

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