|Year : 1973 | Volume
| Issue : 3 | Page : 143-145
Hydatid cyst in eyelid
SC Sen1, AK Mukherji2
1 Department of Ophthalmology, B. S. Medical College, Bankura, West Bengal, India
2 Department of Pathology, B. S. Medical College, Bankura, West Bengal, India
S C Sen
Department of Ophthalmology, B. S. Medical College, Bankura, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sen S C, Mukherji A K. Hydatid cyst in eyelid. Indian J Ophthalmol 1973;21:143-5
Hydatid cysts are formed by lodgment of embryo of Echinococcus granulosus at different sites. They occur chiefly in liver 70 per cent and lungs 10 per cent to 12 per cent.  Ocular involvement of Hydatid cyst is rare. The incidence varies from 0.7 per cent to 1 per cent of all orbital tumours.  HARIMOHAN AND GUPTA did not get a single case of Hydatid cyst out of one hundred and forty one cases of proptosis seen over a period of five years.
Orbital hydatid cysts are relatively more common than intraocular cysts.  Though fairly a large number of orbital hydatid cysts have been reported in other parts of the world, only five cases so far have been reported from India HUIGOL  from Mysore, Roy et al  from Calcutta; AHLUWALLA et al,  from Nagpur; MARIA AND KALE, from Aurangabad and SINGHA, from Amritsar). Apart from orbit, localisation of a hydatid cyst within the eye or in eyelid or in conjunctiva is exceptionally rare.
| Case Report|| |
A Hindu male, aged 18, cultivator by profession attended our Ophthalmic Department on 21-12-71 with a swelling on lateral half of the right upper eyelid for about seven years, the swelling did not exist at birth or in early childhood.
It was of the size of small betel nut, painless and remained constant in size for seven years. The swelling was gradually increasing in size for the last six months. There was no history of association with dogs.
Examination - Right Eye: An oval swelling 3.5 cm. x 2.5 cm. was present in the lateral third of upper eyelid. It extended upwards upto the eyebrow and laerally 1.5 cm. lateral to the lateral canthus, overlying upper and inner angle of bony orbit and causing mechanical ptosis of upper eyelid [Figure - 1]. There was no tenderness. Skin overlying the swelling was healthy and free from deeper structure. Feel of the swelling was firm and it was not fixed to the bone. Right preauricular and submandibular lymph nodes were not enlarged. There was no proptosis, ocular movements were normal, vision was 6/6 and fundus oculus was healthy. Left eye: There was no abnormality.
General Examination - The build was average and general health was good. Liver and spleen were not palpable.
Investigations: - E.S.R. - 8 mm./ 1st hour. W.B.C. - 9,700/cmm. Neutrophil - 57%, Lymphocytes - 26%, Eosinophil-17 % . X-ray of Chest and abdomen showed nothing abnormal. Casoni's test (done after operation) was positive.
Operation: The patient had undergone operation on 5-1-72 and an oval cyst like structure was removed from the subcutaneous tissue of lateral part of right upper eye lid and adjacent region. The cyst was thick walled, opaque and had the appearance of a small hard-boiled egg. The postoperative period was uneventful.
Pathological Examination:- The cyst on cutting open was found to be unilocular, containing pale yellow fluid. Since hydatid cyst was not suspected the fluid was not examined for scolices. The cyst wall, on histological examination was found to consist of laminated hyaline membrane enveloped by a fibrous layer. The appearance was diagnostic of hydatid cyst.
| Discussion|| |
The infection of hydatid disease in man is generally acquired during childhood. This may partly be owing to greater susceptibility, but association with infected dogs is almost a sine qua non for its development. The hydatid cyst is a slow growing condition and may grow for five to twenty years before it is detected. It occurs preferentially in young people between 10 to 30 years of age. Clinical diagnosis of hydatid cyst is difficult. In majority of cases, there are no symptoms, except those due to pressure, and thus simulate a slow growing neoplasm. The presence of hydatid cyst may be suspected on clinical grounds, corroborated by immunological tests like Casoni's test and rise in eosinophil count of blood. The final diagnosis is made by demonstration of scolices in the fluid and histological appearance of the cyst wall after the operation.
The case under review did not suggest a diagnosis of hydatid cyst from history or clinical examination. It rather appeared to be a slow growing benign neoplasm, like lipoma. The histological diagnosis came as a surprise, since hydatid involvement of the eye lid is extremely rare and seldom thought of in differential diagnosis. As stated by DUKE-ELDER,  GRLOFF has reported one case in the upper eyelid and HARE, one case in the subcojunctiva. Casoni's test, which was carried out after the operation, was positive.
| Summary|| |
A case of hydatid cyst in eyelid is described and the literature has been compendiously reviewed.
| References|| |
Ahluwalia, P. P., Agarwal, R. V. and Padmawar, B. U.: Orbital hydatid cyst. J. A11-India Ophthal, Soc.
16: 101-102 (1968).
Chatterjee, K. D.: Parasitology and Parasitic Diseases, 1st Edition, Calcutta P. 675 (1952).
Duke-Elder, S.: Text Book of Ophthalmology, Vol. V. 1st Edition, Henry Kimpton, London, P. 4924 (1952).
Faust, E. C. and Russel, P. F.: Clinical Parasitology, 7th Edition, Lea and Febiger, Philadelphia, P. 685
Hare: Quoted by DUKE-ELDER in System of Ophthalmology Vol. VIII. Part-I, Henry Kimpton, London, P. 422 (1965).
Hari Mohan and Gupta, A. N.: Proptosis-A Clinical analysis of 141 cases, J. All-India Ophthal. Soc.
16: 91-97 (1968).
Huilgol, A. V.: Cited by Roy, I. S. et al
(1967) vide Ref. No. 10.
Maria, D. L. and Kale, M. Di: Unilateral Proptosis due to Hydatid Cyst of Orbit, Orient, Arch. Ophthal:
9: 51-53 (1971).
Orloff: Cited by DUKE-ELDER, S. (1952). vide Reference No. 3.
Roy, I. S; Banerjee, A., Guha, P. K. and Choudhury, A. B.: Hydatid cyst of Orbit, J. All-India Ophthal. Soc.,
15: 35-37 (1967).
Singha, S. S.: Hydatid cyst of Orbit, Orient Arch. Ophthal., 9:
Sorsby, A.: Modern Ophthalmology,
Vol. II. - Systemic Aspects, Butterworth, London, P. - 215 (1963).
Sverdlic, J. Cited by Ahluwalia, P. et al
(1968) vide Ref. No. 1.
[Figure - 1]