A case of orbital tuberculoma presenting with proptosis and gross diminution of vision in a young girl 20 years is reported. The tuberculoma disappeared within 3 months of antitubercular therapy and there was marked improvement in visual acuity. Because of its rarity in the younger age group, the case is being reported.

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A case of basal cell carcinoma presenting in an unusual manner as orbital myiasis is reported. Orbit was full of maggots. Histopathology examination from the margin of the ulcerative area confirmed the diagnosis of basal cell carcinoma, which was infested secondarily with larvae of flies. Turpentine oil packs were used to remove the maggots.

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A case of destructive ocular myiasis resulting in complete loss of the globe in two days time is documented. To the best of our knowledge this is the first report of such a severe involvement in a healthy and non-compromised host. Mechanical removal and good local hygiene helped heal the wound. The larvae were isolated to be that of Chrysomyia bezziana (screwworm fly). This is possibly the first report of destructive ocular myiasis caused by Chrysomyia bezziana from the Indian subcontinent and the second in world literature. Infestation of human eyes with larvae of flies (myiasis) has been reported. Serious consequences of destructive myiasis are seen in emaciated and diseased patients. Only one report of total destruction of the globe by maggots of Chrysomyia bezziana exists in the literature. As in previous communications, the patient in this report had no predisposing factors both systemic and local. We here in document a case of orbital myiasis leading to rapid destruction of the globe within two days in a healthy and a non-compromised patient.

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A rare case of histopathologically proved case of congenital cystic eye in a one day old girl is described. It was an unusually large cystic mass bulging forwards stretching the upperlid. There was no rudimentary eyeball in the orbit. The cystic eye's predilection for the left eye has been pointed out for the first time in this article.

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In this study, 86 eyes in 66 cases (20 bilateral) of congenital dacryocystitis were analysed for fungal growth. Fungi alone were isolated in 12 eyes (13.95%) and in 14 eyes (16.28%) together with bacteria--a total of 26 positive for fungus in 86 eyes (30.23%). These 26 eyes yielded on fungal culture a total of 28 isolates (in 2 eyes, another fungus was isolated on repeat culture). 11 types of fungi were cultured--C. albicans and A. niger accounted for 5 each out of 28. To the best of our knowledge this is the first report in the literature of fungal flora analysed in congenital dacryocystitis--not surprisingly, more than 30% of eyes were positive for fungus. Systemic studies of fungal flora in dacryocystitis are very few, and hardly any literature on this subject exists in congenital dacryocystitis. This study is an attempt to determine the frequency and clinical significance of fungi isolated from cases of congenital dacryocystitis.

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A case is reported of a 9-year old male who presented with abnormal behaviour and progressive diminution of vision. Pupils were middilated in both eyes but the pupillary reflexes were preserved. Fundus examination revealed a bilateral optic atrophy and radiological investigations showed a bilateral occipital calcification. We hereby document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions. Transsynapptic neuronal degeneration of optic nerves consequent to occipital lobe lesions is a rare phenomenon. Experimentally occipital lobe ablation in non-human primates has been shown to result in optic atrophy. Herein, we document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions.

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30 patients with Graves' ophthalmopathy were subjected to exophthalmometry in the upright and supine positions to determine if the difference in exophthalmometer readings in these two situations are significantly different and would help in distinguishing the early and late Graves' ophthalmopathy patients. The cases were divided into two groups (of 15 patients each) of early Graves' ophthalmopathy (Grades 0,1,2) and late Graves' ophthalmopathy (Grades 3,4,5) according to the American Thyroid Association classification. In addition, 15 age and sex matched normal individuals who served as controls, also underwent similar investigation. Contrary to earlier observations, the results showed statistically insignificant increase in exophthalmometer readings when going from the erect to the supine position. It was concluded that postural change in exophthalmometer readings neither helps in distinguishing normal subjects from patients of Graves' ophthalmopathy nor can it differentiate between various grades of Graves ophthalmopathy.

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Iris Angiography in a case of Fuchs' heterochromic iridocyclitis (FHI) is described. The finding of iris angiography and hylainzed iris vessels on histopathology suggested ischemic etiology of FHI. This is the first report on Iris Angiography in a pigmented eye with Fuchs' heterochromic iridocyclitis.

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An unidentified nematode in the retina of an otherwise healthy young lady causing inflammation and exudation is reported. The worm was destroyed by Xenon photocoagulation, There was complete recovery and remarkable improvement in visual acuity.

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Presented is a rare case of cavernous sinus thrombosis of nasal septic origin leading to ophthalmoplegia and blindness of the ipsilateral eye and contralateral visual field involvement. An attempt is made to correlate the aetiopathology with the clinical features.

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Tumours arising in the sweat glands of the eyelids are rare. A case of Eccrine Acrospiroma, otherwise, called clear cell hidradenoma, a benign sweat gland tumour of the lid in a female aged 70 years is being reported because of its rarity.

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A rare case of Ankyloblepheron Filiforme Adnatum in a new born is presented.

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An unusual retinal manifestation of arteriovenous communications is reported in a case showing a combination of Sturge-Weber and Kippel-Trenaunay syndromes. The arteriovenous communications are thought to be similar to those seen in the limbs in Parkes-Weber syndrome. This retinal finding indicates that the three syndromes are intricately related to each other and may be an incomplete manifestation of a single pathophysiologic entity which may be named neurocutaneous angiomatosis.

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A rare case of facio-orbital anamoly having dermolipoma with posterior extension, lid notch, ectropion, assymetric hypertelorism and lipoma of corpus callosum is presented. The classification of the facial cleft deformities and the surgical management is highlighted.

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A case of Kearns - Sayre Syndrome characterized by a triad of external ophthalmoplegia, retinal dystrophy and cardiomyopathy is discussed. Ocular examination and cardiologic screening of family members is requested.

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Embryonal rhabdomyosarcoma of orbit presenting as a case of rapid proptosis of the right eye is reported in a 4 year old male child. There was no evidence of recurrence during a follow up of 6 months. Rhabdomyosarcoma is one of the most common primary malignant orbital neoplasms of child hood. It usually produces a precipitously progressing unilateral proptosis of sudden onset. It is a highly malignant neoplasm of pleuripotential embryonic mesoderm, which commonly differentiates to form cells similar to rhabdomyoblasts of the foetus. Because of the presence of elongated cells that contain abundance of eosinophilic glycogen rich cytoplasm, it is generally referred to as embryonal form of rhabdomyosarcoma.

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The senile cataracts have been graded on the basis of density objectively. The letter visual acuity, laser interferometric visual acuity and pin hole visual acuity were compared in various grades of cataracts and controls (phakic and aphakic) in 140 eyes. It was found that good correlation exists in all eyes except when cataract density is grade III or IV. The laser interferometry has good prognostic value when the predictability is assessed in early stages of cataract (Grade I & II).

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The healing of graft and visual results were compared in 21 vascularized and 29 non-vascularized corneal lesion. The healing and visual results were better in those cornea which were non-vascularized.

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Pre-vitrectomy errors in diagnostic A & B mode ultrasound may result in affection of the surgical outcome. We have done a retrospective analysis of fifty patients who were screened by both A & B mode echography and analyzed the data which revealed that real-time kinetic echography is required for ac­curate interpretation of the vitreoretinal status. Besides, quan­titative A scan examination also has fallacies due to the echo beam not striking the scierochoroid complex at right angles, and a modification of this technique is suggested. Lastly old retinal detachments may not produce echo-patterns diagnostic of retinal detachments resulting in fallacious interpretation. We recommend that combined A mode and real time B-mode and often repeat echography is essential for accuracy in diagnosis.

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Standardized 'A' mode of Kretztechnik--7200 mA was used in 40 eyes of 20 patients for the measurement of extraocular muscle thickness. The mean thickness value of medial, lateral, superior and inferior rectus in the normal Indian population was found to be as 4.015 +/- 0.762 mm, 3.548 +/- 0.369 mm, 3.757 +/- 0.654 mm and 3.177 +/- 0.662 mm respectively.

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This study correlates the fundus signs with the severity and signs of hypertension and evaluates the role of fluorescein angiography in detecting changes in the retinal and choroidal capillary bed in hypertension and defines its advantages over direct ophthalmoscopy. 37 hypertensives belonging to all grades of hypertension were studied. A thorough physical examination, hypertension work up, direct ophthalmoscopy and fluorescein angiography was done in all cases. A significant association was found between the presence of marked arteriolar narrowing and the presence of severe hypertension, left ventricular hypertrophy (LVH) and cardiomegaly. Patients having definite arterio-venous crossing changes and exudative retinopathy had a higher incidence of LVH and cardiomegaly. Renal functions and neurological signs in hypertension showed no correlation with the fundus signs. Capillary bed and choriodal abnormalities could be better studied on fluorescein angiography. Hard exudates were not visualized on fluorescein angiography. There was total resolution of exudative phenomenon on treatment.

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10 patients of congenital simple ptosis having 3 to 5 mm of ptosis with variable levator action were operated. All the patients showed a good response of lid lift after instillation of phenyl ephrine drops showing the activity of Muller's muscle. With this technique the lagophthalmos was minimal and good lid folds were formed in all cases. The skin muscle lamina was not excised and was utilized for formation of lid folds which were equal in depth and dynamic in nature. However, the lid lag which is an unavoidable complication of any ptosis surgery was present in the present technique also.

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An analysis of the cases reported in Punjab, India, indicates the presence of genetic heterogeneity of Oguchi's disease, for which autosomal recessive inheritance has been documented earlier. The autosomal dominant inheritance pattern of this disease is associated with incomplete penetrance and a distinct sex bias towards females. This recognition is important for genetic counselling.

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