ABSTRACT
Cysticercosis is caused by the larval stage of Taenia solium (Pork tape worm). Humans are the definitive hosts where the life cycle is completed and pig is the intermediate host. Incidence in India varies from 2-38% based on the consumption of pork, general hygiene and socio-economic status of the population. The parasite on reaching the small intestine encysts itself in various tissues. Most commonly Brain, Eyes, subcutaneous tissue. Intravitreal cyst is the commonest intra ocular presentation. Death of the parasite and release of the contents of the cyst causes an intense inflammatory reaction that can be devastating. We report the condition in a nine-year-old boy who presented with mild right upper lid swelling wherein cysticercus cellulosae cyst was found within the mass of the right lateral rectus muscle. It becomes important to report this case because of the unusual site of the cyst which masqueraded as a lipo-dermoid.
Subject(s)
Cysticercosis/diagnosis , Dermoid Cyst/diagnosis , Eye Infections, Parasitic/diagnosis , Oculomotor Muscles/parasitology , Taenia solium/isolation & purification , Animals , Child , Cysticercosis/parasitology , Cysticercosis/surgery , Diagnosis, Differential , Eye Infections, Parasitic/parasitology , Eye Infections, Parasitic/surgery , Humans , Magnetic Resonance Imaging , Male , Oculomotor Muscles/diagnostic imaging , Ophthalmologic Surgical Procedures/methods , UltrasonographyABSTRACT
BACKGROUND: Duane's retraction Syndrome is a congenital form of strabismus characterized by horizontal eye movement limitation and globe retraction with palpebral fissure narrowing in attempted adduction. It may be associated with co-existing ocular and systemic pathologies. Crocodile tears, or a paradoxical gustatory lacrimal reflex can be either congenital or acquired. The congenital cases typically are associated with Duane's syndrome in most of the cases. CASE: We present in our case report, uncommon case of bilateral Duane's syndrome with bilateral crocodile tears - both of which can be assumed to be of probably central origin. Though several cases have been reported, there are very few from the Indian subcontinent. Here, we also review the literature of the syndrome with crocodile tears. CONCLUSION: All cases of Duane's retraction syndrome warrant a thorough screening for coexisting ocular and systemic abnormalities. Ours is a classic report of bilateral Duane's syndrome with bilateral congenital crocodile tears, the coexistence of these two anomalies emphasising the aetiology to be anomalous innervation occurring at central level i.e. is brain stem.
Subject(s)
Duane Retraction Syndrome/complications , Lacrimal Apparatus Diseases/etiology , Lacrimal Apparatus/diagnostic imaging , Tears/metabolism , Child , Duane Retraction Syndrome/diagnosis , Female , Humans , Lacrimal Apparatus/metabolism , Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus Diseases/metabolism , Visual AcuityABSTRACT
Diabetic retinopathy (DR) is a leading cause of blindness among working-age adults. Early diagnosis through effective screening programs is likely to improve vision outcomes. The ETDRS seven-standard-field 35-mm stereoscopic color retinal imaging (ETDRS) of the dilated eye is elaborate and requires mydriasis, and is unsuitable for screening. We evaluated an image analysis application for the automated diagnosis of DR from non-mydriatic single-field images. Patients suffering from diabetes for at least 5 years were included if they were 18 years or older. Patients already diagnosed with DR were excluded. Physiologic mydriasis was achieved by placing the subjects in a dark room. Images were captured using a Bosch Mobile Eye Care fundus camera. The images were analyzed by the Retinal Imaging Bosch DR Algorithm for the diagnosis of DR. All subjects also subsequently underwent pharmacological mydriasis and ETDRS imaging. Non-mydriatic and mydriatic images were read by ophthalmologists. The ETDRS readings were used as the gold standard for calculating the sensitivity and specificity for the software. 564 consecutive subjects (1128 eyes) were recruited from six centers in India. Each subject was evaluated at a single outpatient visit. Forty-four of 1128 images (3.9%) could not be read by the algorithm, and were categorized as inconclusive. In four subjects, neither eye provided an acceptable image: these four subjects were excluded from the analysis. This left 560 subjects for analysis (1084 eyes). The algorithm correctly diagnosed 531 of 560 cases. The sensitivity, specificity, and positive and negative predictive values were 91%, 97%, 94%, and 95% respectively. The Bosch DR Algorithm shows favorable sensitivity and specificity in diagnosing DR from non-mydriatic images, and can greatly simplify screening for DR. This also has major implications for telemedicine in the use of screening for retinopathy in patients with diabetes mellitus.
Subject(s)
Algorithms , Diabetic Retinopathy/diagnosis , Fundus Oculi , Mydriatics/administration & dosage , Photography/methods , Adult , Aged , Automation , Diabetic Retinopathy/physiopathology , Female , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Mycetoma is a chronic granulomatous infection. Lower extremities are commonly involved. A 20-year-old male came with complaints of multiple sinuses on scalp, left eyelid swelling with a sinus and dystopia, since one year. On examination there was relative proptosis in left eye of 2 mm. Computed tomography scan showed soft tissue swelling of the pre-septal area of the left upper eyelid with orbital involvement. Magnetic resonance imaging showed increased left orbital volume and evident dystopia. Microbiology testing of the erosive scalp and lid lesions showed genus Nocardia, suggestive of actinomycetoma. This case is presented as it shows an unusual involvement of the orbit.
