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ARTICLE
Year : 1967  |  Volume : 15  |  Issue : 3  |  Page : 120-122

Hydatid cyst of the orbit


Department of Ophthalmology, Institute of Post Graduate Medical Education and Research, Chandigarh, India

Date of Web Publication21-Jan-2008

Correspondence Address:
I S Jain
Department of Ophthalmology, Institute of Post Graduate Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Jain I S, Rangbulla V. Hydatid cyst of the orbit. Indian J Ophthalmol 1967;15:120-2

How to cite this URL:
Jain I S, Rangbulla V. Hydatid cyst of the orbit. Indian J Ophthalmol [serial online] 1967 [cited 2020 Oct 22];15:120-2. Available from: https://www.ijo.in/text.asp?1967/15/3/120/38701

Hydatid disease of the orbit is of comparatively rare occurrence. The incidence of the orbital hydatid is about 1 % of all the published cases. (Duke Elder 1953).

Since hydatid disease is rather com­mon in the Punjab, the following case report is of interest as parasitic cyst can be a cause of unilateral proptosis in children where hydatid disease is endemic. It is perhaps the 3rd report from this part of the country. (Pre­vious cases are by Ramalingam 1962; Huilgol 1963).


  Report of the Case Top


A female patient aged 10 years from Digshai, Distt. Simla, came to the eye department for the first time on 28-7-1965 with the complaint of pro­trusion of the left eyeball since one month.

About 1½ months ago she started feeling pain in the upper left half of the face more in the evenings.

About 1 month ago the eye ball started protruding gradually. Redness in the outer part of the bulbar con­junctiva appeared along with the pro­trusion. There was no history of fever, trauma, or any bleeding dis­order. The patient did not complain of any pain in the bones or abdomen. [Figure - 1]


  Local Examination Top


Palpebral fissure on the left side was widened. The patient could not close the eye completely. Fullness above the upper lid on the outer side was pre­sent. The bulbar conjunctiva was con­gested on the outer side [Figure - 1]. Cor­nea, iris, Pupil and lens were normal. Fundi were normal, ocular movements were restricted in all directions. Some movement was present in the inner lower direction. No pulsation or bruit was present. The right eye was nor­ma1.

Visual acuity of the right eye was 6/9 and of the left 6/60.

General examination revealed slight temp. (99°F), the liver was just palp­able on deep inspiration but the spleen was not palpable. Lymph nodes were not enlarged.


  Investigations Top


Examination of the blood and urine showed nothing abnormal. X-Ray ex­amination of the chest abdomen and of the optic feramina were non-contri­butory.


  Treatment and Progress Top


Patient was initially put on anti­biotic systemically and locally. On the third day she developed 102°F fever with congestion of throat, which sub­sided within three days with increased close of crystalline penicillin.

Conjunctivitis appeared in the left eye which was cured within 3 to 4 days with the usual local treatment.

Proptosis gradually decreased during her stay in the Hospital in about 25 days time but there was hardly any improvement in the vision. On retrac­tion of the upper eyelid a cystic swell­ing in the outer and upper part was felt when the patient looked down and in. The conjunctiva over it was con­gested but there was no tenderness. All the borders could not be defined. On 24th August, aspiration was tried but no fluid could be drawn out. On mak­ing a small incision thin dirty yellow­ish pus came out. On widening the in­cision with an artery forceps, a whitish semitransparent cyst [Figure - 2] about the size of a human lens suddenly got ejected intact. [Figure - 2]

Staph. albus could be cultured from the pus. The cyst on histopathological examination proved to be a hydatid cyst. [Figure - 3],[Figure - 4]

Cesoni's test (done after the report) was positive.

On subsequent interrogation, history of keeping a dog in the house for the last two months was available.

After operation [Figure - 6] there was marked improvement in the movement, almost normal in the lower and inward directions. There was slight restriction of upwards movement but not much improvement in the movement out­wards.

The left eye vision could now be improved to 6/ 12 and with -1.5 D sph. to 6/6-P.


  Comments Top


Hydatid cysts tend to occur prefer­ably in young people and more than half the cases are seen between the ages of 10 and 30 years. There is however no difference between both the sexes and the orbits are equally liable to be affected. The clinical course is insidious and the full picture develops in a few months. When fully developed, the classical diagnostic triad of proptosis, tumor and pain occurs. The proptosis is irredu­cible with no special characteritics. A sudden exacerbation of pain, increase in proptosis and local inflammatory reaction in the eye is an important diag­nostic clue to hydatid cyst as an etio­logical agent. The present case report is of great interest to the paedeatricians and ophthalmologists as it presented a classical clinical course.


  Summary Top


A girl aged 10 years had developed proptosis, a cystic swelling in the upper and outer part of the left orbit and pain in the left half of the face. On making an incision in the conjunctiva over the swelling, a translucent cyst of the size of a human lens got ejected. Hydatid nature of the cyst was estab­lished on histopathological examina­tion. Staph. albus could be cultivated from the dirty-yellowish purulent con­tents. Cesoni's test was positive.


  Acknowledgements Top


We are indebted to Professor B. K. Aiket and Dr. B. N. Dutta, Department of Patho­logy, Post Graduate Institute, Chandigarh for examining the specimen and providing the microphotographs.[3]

 
  References Top

1.
Duke Eider: Text Book of Ophthal­mology. Vol. V. P. 5473. Henry Kimpton (London) 1952.  Back to cited text no. 1
    
2.
Huilgol. A. V.: (1963) J. All-India Ophthalmological Society, 11, 79.  Back to cited text no. 2
    
3.
Ramalingam T. T.: Ocular Localisation in Tropical Parasitological disease. See (1962) Abstract of 19th International Congress of Ophthalmology, P. 6.  Back to cited text no. 3
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]



 

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  In this article
Report of the Case
Local Examination
Investigations
Treatment and Pr...
Comments
Summary
Acknowledgements
References
Article Figures

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