Laceración palpebral y canalicular asociada a trauma obstétrico. Descripción de un caso / Eye lid and canalicular laceration due to obstetric trauma. Case report

Las lesiones oculares por trauma obstétrico son poco frecuentes. Su incidencia aumenta cuando el parto es asistido con instrumental, cesárea urgente y presentación anómala del feto. Presentamos el caso clínico de un recién nacido pretérmino varón asiático de 33 + 2 semanas, 1.500 g y embarazo gemelar, que nació por cesárea urgente. Se observó una laceración palpebral inferior de 5mm de longitud horizontal en el canto interno del ojo izquierdo con sección del canalículo inferior. Al séptimo día de vida se realizó la intubación con stent monocanalicular Mini-Monoka® (FCI, Issy-Les Moulineaux, Francia), consiguiendo la anastomosis de los extremos proximal y distal de la laceración. La piel se suturó con poliglactínico de 8/0 (Vicryl 8/0, Ethicon, Johnson & Johnson S. A., Madrid, España). El tratamiento postoperatorio fue con colirio de tobramicina y dexametasona 4 veces al día durante 10 días. La evolución fue favorable, la posición del punto lagrimal inferior fue adecuada y la siringación, normal. A las 14 semanas se retiró el Mini-Monoka®

Ocular injuries associated with birth trauma are rare. Their incidence increases in cases of instrument-assisted delivery, emergency cesarean section, and abnormal presentation of the fetus. We present the clinical case of a premature Asian male baby, aged 33 + 2 weeks and weighing 1,500 g. The infant was born out of a twin pregnancy and was delivered by emergency cesarean section. Following delivery, a 5 mm long lower eyelid laceration was observed in the inner corner of the left eye, with injury to the inferior canaliculus. A Mini-Monoka® (FCI, Issy-Les Moulineaux, France) monocanalicular intubation stent was inserted on the seventh day with anastomosis of the proximal and distal ends of the canaliculus laceration. The skin was then sutured with a polyglactin 8/0 (Vicryl 8/0, Ethicon, Johnson & Johnson S. A., Madrid, Spain) suture. The postoperative treatment consisted of tobramycin and dexamethasone eye drops four times per day for 10 days. A good progression was observed, the position of the inferior lacrimal punctum was adequate, and syringation was normal. The Mini-Monoka® was removed after 14 weeks

Eye lid and canalicular laceration due to obstetric trauma. Case report. / Laceración palpebral y canalicular asociada a trauma obstétrico. Descripción de un caso.

Ocular injuries associated with birth trauma are rare. Their incidence increases in cases of instrument-assisted delivery, emergency cesarean section, and abnormal presentation of the fetus. We present the clinical case of a premature Asian male baby, aged 33+2 weeks and weighing 1,500g. The infant was born out of a twin pregnancy and was delivered by emergency cesarean section. Following delivery, a 5mm long lower eyelid laceration was observed in the inner corner of the left eye, with injury to the inferior canaliculus. A Mini-Monoka® (FCI, Issy-Les Moulineaux, France) monocanalicular intubation stent was inserted on the seventh day with anastomosis of the proximal and distal ends of the canaliculus laceration. The skin was then sutured with a polyglactin 8/0 (Vicryl 8/0, Ethicon, Johnson & Johnson S. A., Madrid, Spain) suture. The postoperative treatment consisted of tobramycin and dexamethasone eye drops four times per day for 10 days. A good progression was observed, the position of the inferior lacrimal punctum was adequate, and syringation was normal. The Mini-Monoka® was removed after 14 weeks.

Estudio comparativo de los hallazgos clínicos en la enfermedad orbitaria asociada a IgG4 con afectación unilateral vs. bilateral / Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease

OBJETIVO: Análisis descriptivo y comparativo de los pacientes diagnosticados de enfermedad orbitaria asociada a IgG4. MATERIAL Y MÉTODOS: Se revisaron y analizaron todos los casos diagnosticados de inflamación orbitaria asociada a IgG4 por el servicio de Patología del Hospital Dr. Luis Sánchez Bulnes. RESULTADOS: Encontramos un total de 9 casos. El 66% fueron mujeres, con una edad media de 48 años y tiempo medio de evolución al diagnóstico de 2 años. El 56% de los casos presentaron afectación unilateral: el 100% eran mujeres con clínica de dolor al ingreso y una respuesta óptima al tratamiento corticoideo en el 100% de los casos que precisaron tratamiento médico (un caso mostró resolución espontánea). En los casos bilaterales (44%) solo el 25% fueron mujeres y ninguno refirió dolor como síntoma de presentación. Además, el 25% de estos pacientes precisó de la combinación con inmunosupresores para conseguir el control del cuadro. CONCLUSIONES: La presentación clínica de los pacientes con inflamación orbitaria asociada a IgG4 difiere según sea una afectación uni- o bilateral

OBJECTIVE: Descriptive and comparative study of patients with orbital IgG4-related disease. MATERIAL AND METHODS: A review and analysis of the cases diagnosed with inflammatory orbital lesion related to IgG4 by the Ophthalmic Pathology Service in the Dr. Luis Sánchez Bulnes Hospital. RESULTS: A total of 9 cases were found, in which 66% were women, and with a mean age of 48 years and time to diagnosis of 2 years. Unilateral involvement was observed in 56% of cases. All the females experienced pain, and there was an optimal response to corticosteroid treatment in 100% of patients who required medical treatment (one case showed spontaneous resolution). In bilateral cases (44%), only 25% were female, and none had pain as a presenting symptom. Furthermore, 25% of these patients required a combination with immunosuppressants to control inflammation. CONCLUSIONS: Clinical presentation of patients with unilateral orbital IgG4-related disease differs from those with bilateral involvement

[Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease]. / Estudio comparativo de los hallazgos clínicos en la enfermedad orbitaria asociada a IgG4 con afectación unilateral vs. bilateral.

OBJECTIVE: Descriptive and comparative study of patients with orbital IgG4-related disease. MATERIAL AND METHODS: A review and analysis of the cases diagnosed with inflammatory orbital lesion related to IgG4 by the Ophthalmic Pathology Service in the Dr. Luis Sánchez Bulnes Hospital. RESULTS: A total of 9 cases were found, in which 66% were women, and with a mean age of 48 years and time to diagnosis of 2 years. Unilateral involvement was observed in 56% of cases. All the females experienced pain, and there was an optimal response to corticosteroid treatment in 100% of patients who required medical treatment (one case showed spontaneous resolution). In bilateral cases (44%), only 25% were female, and none had pain as a presenting symptom. Furthermore, 25% of these patients required a combination with immunosuppressants to control inflammation. CONCLUSIONS: Clinical presentation of patients with unilateral orbital IgG4-related disease differs from those with bilateral involvement.

Lesión linfoproliferativa del saco lagrimal: caso clínico / Lacrimal sac lymphoproliferative lesion: Case report

CASO CLÍNICO: Se presenta el caso de una mujer de 51 años con tumoración firme a nivel del canto interno del ojo derecho de 5 años de evolución. La biopsia excisional mediante dacriocistectomía estableció el diagnóstico de lesión linfoproliferativa de bajo grado (hiperplasia linfoide reactiva). DISCUSIÓN: Los tumores del saco lagrimal son muy raros, con un pico de incidencia en la quinta década de la vida. La clínica en fases iniciales es parecida a la obstrucción lagrimal por otras causas, de ahí que hasta un 40% de estos tumores no se sospechen y sean diagnosticados durante la realización de una dacriocistorrinostomía

CASE REPORT: The case is presented of a 51 year-old woman with a firm mass at the medial canthus of the right eye of five years onset. A low-grade lymphoproliferative lesion (reactive lymphoid hyperplasia) was diagnosed from an excisional biopsy. DISCUSSION: Lacrimal sac tumors are rare, with a peak incidence in the fifth decade of life. The initial clinical features are epiphora and medial canthus swelling. As it mimics nasolacrimal duct obstruction, up to 40% of these tumors are misdiagnosed until undergoing surgery

Lacrimal sac lymphoproliferative lesion: case report.

CASE REPORT: The case is presented of a 51 year-old woman with a firm mass at the medial canthus of the right eye of five years onset. A low-grade lymphoproliferative lesion (reactive lymphoid hyperplasia) was diagnosed from an excisional biopsy DISCUSSION: Lacrimal sac tumors are rare, with a peak incidence in the fifth decade of life. The initial clinical features are epiphora and medial canthus swelling. As it mimics nasolacrimal duct obstruction, up to 40% of these tumors are misdiagnosed until undergoing surgery.

Metástasis orbitaria pulsátil como signo de presentación de carcinoma renal de células claras metastásico / Orbital pulsatile metastasis as initial presenting sign of metastatic clear cell renal carcinoma

CASO CLÍNICO: Se presenta el caso de un varón de 56 años con tumoración pulsátil en región temporal de la órbita izquierda como signo de presentación de un carcinoma metastásico de riñón, así como una revisión de todos los casos diagnosticados de metástasis orbitarias en nuestro hospital entre 1957 y 2012. DISCUSIÓN: El carcinoma es el tumor renal más frecuente, sin embargo, rara vez metastatiza a la órbita. Ya que estos tumores pueden confundirse con otras lesiones amelanóticas o vasculares, es necesario un alto grado de sospecha diagnóstica para la detección precoz y tratamiento del tumor primario

CASE REPORT: We present the case of a 56 year-old male with a pulsating lesion in the temporal region of the left orbit as presenting sign of a renal cell carcinoma. A review is also presented of all cases of orbital metastases diagnosed in our hospital between 1957 and 2012. DISCUSSION: Carcinoma is the most common malignancy involving the kidney but, only rarely does it metastasize to the orbit. As these tumors can be confused with other amelanotic or vascular tumors, a high index of suspicion is required for early detection and management of the primary tumor

Enfermedad de Mikulicz. A propósito de un caso / Mikulicz's disease. A case report

CASO CLÍNICO: Se presenta el caso de un paciente de 48 años con afectación bilateral de las glándulas lacrimales y salivales que fue diagnosticado de enfermedad de Mikulicz mediante biopsia incisional de las glándulas lacrimales afectadas, presentando resolución completa del cuadro tras tratamiento corticoideo. DISCUSIÓN: La sialadenitis y/o dacrioadenitis esclerosante son enfermedades inflamatorias crónicas que, en la actualidad, se clasifican dentro de las enfermedades asociadas a IgG4. En concreto, la enfermedad de Mikulicz se define por agrandamiento persistente, bilateral y simétrico de las glándulas lacrimales y salivales junto a unas concentraciones elevadas de IgG4 sérica e infiltración tisular importante por células plasmáticas IgG4(+)

CASE REPORT: We report the case of a 48 year-old male with bilateral involvement of the salivary and lacrimal glands, which was diagnosed as Mikulicz's disease by incisional biopsy of the affected lacrimal glands, which was completely resolved after corticosteroid treatment. DISCUSSION: Sclerosing sialadenitis and/or dacryoadenitis are chronic inflammatory diseases that are currently classified into IgG4-related diseases. Specifically, Mikulicz's disease is defined by a persistent and symmetrical swelling of the lacrimal and salivary glands together with elevated serum concentration of IgG4 and tissue infiltration by IgG4 (+) plasma cells

Tumores del saco lagrimal que se presentan como obstrucción de la vía lagrimal. Estudio retrospectivo en la población mexicana durante 2007-2012 / Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in mexican patients 2007-2012

OBJETIVO: Conocer las características demográficas y clínicas de los tumores primarios del saco lagrimal, que debutan clínicamente como obstrucción de la vía lagrimal. MÉTODOS: Estudio retrospectivo y descriptivo de los pacientes operados por obstrucción baja de la vía lagrimal en el Hospital Dr. Luis Sánchez Bulnes, Asociación para evitar la Ceguera en México I AP, entre los años 2007-2012. RESULTADOS: Los tumores primarios del saco lagrimal representaron el 2,5% de todas nuestras obstrucciones lagrimales, siendo más frecuentes en mujeres (8:1). El 89% fueron de estirpe no epitelial, siendo las más frecuentes las lesiones de naturaleza linfoide. Los tumores benignos se presentaron a edades más tempranas (50 años) que los malignos (70 años). El 33% de nuestros casos resultaron hallazgos inesperados durante el procedimiento quirúrgico (100% lesiones benignas).El 55% se correspondían a tumores malignos (1,4% de las obstrucciones), todos ellos lesiones linfoproliferativas. La clínica más frecuente fue tumoración en canto interno asociada o no a epifora. El tiempo de evolución varió en función del grado de agresividad del linfoma (3 meses-10 años). CONCLUSIONES: Los tumores del saco lagrimal son raros pero debemos tenerlos en cuenta ante la clínica de obstrucción de la vía lagrimal para un tratamiento adecuado

OBJECTIVE: To determine the demographic and clinical data of primary tumors of the lacrimal sac presenting as lacrimal obstruction. METHODS: Retrospective and descriptive study was conducted between the years 2007 to 2012 on all patients undergoing surgery for low lacrimal obstruction at Dr. Luis Sanchez Bulnes Hospital, an Association for the prevention of blindness in Mexico IAP. RESULTS: Primary tumors of the lacrimal sac represented 2.5% of all lacrimal obstructions, being more common in women than in men (8:1). The large majority (89%) of the cases were non-epithelial, with lymphoid lesions being the most frequent. Benign tumors were presented at a younger age (50 years old) than malignant (70 years old). One-third (33%) of cases were unexpected findings during surgery (100% benign). Just over half (55%) were malignant tumors (1.4% of obstructions), all of them lymphoproliferative lesions. The most frequent clinical tumor was in the inner edge, either with or without epiphora. The progression time varied according to the degree of aggressiveness of the lymphoma (3 months-10 years). CONCLUSIONS: Lacrimal sac tumors are rare, but they must be taken into account in patients with an unusual clinical presentation of lacrimal obstruction

[Lacrimal sac tumors presenting as lacrimal obstruction. Retrospective study in Mexican patients 2007-2012]. / Tumores del saco lagrimal que se presentan como obstrucción de la vía lagrimal. Estudio retrospectivo en la población mexicana durante 2007-2012.

OBJECTIVE: To determine the demographic and clinical data of primary tumors of the lacrimal sac presenting as lacrimal obstruction. METHODS: Retrospective and descriptive study was conducted between the years 2007 to 2012 on all patients undergoing surgery for low lacrimal obstruction at Dr. Luis Sanchez Bulnes Hospital, an Association for the prevention of blindness in Mexico IAP. RESULTS: Primary tumors of the lacrimal sac represented 2.5% of all lacrimal obstructions, being more common in women than in men (8:1). The large majority (89%) of the cases were non-epithelial, with lymphoid lesions being the most frequent. Benign tumors were presented at a younger age (50 years old) than malignant (70 years old). One-third (33%) of cases were unexpected findings during surgery (100% benign). Just over half (55%) were malignant tumors (1.4% of obstructions), all of them lymphoproliferative lesions. The most frequent clinical tumor was in the inner edge, either with or without epiphora. The progression time varied according to the degree of aggressiveness of the lymphoma (3 months-10 years). CONCLUSIONS: Lacrimal sac tumors are rare, but they must be taken into account in patients with an unusual clinical presentation of lacrimal obstruction.

Orbital pulsatile metastasis as initial presenting sign of metastatic clear cell renal carcinoma.

CASE REPORT: We present the case of a 56 year-old male with a pulsating lesion in the temporal region of the left orbit as presenting sign of a renal cell carcinoma. A review is also presented of all cases of orbital metastases diagnosed in our hospital between 1957 and 2012. DISCUSSION: Carcinoma is the most common malignancy involving the kidney but, only rarely does it metastasize to the orbit. As these tumors can be confused with other amelanotic or vascular tumors, a high index of suspicion is required for early detection and management of the primary tumor.

Mikulicz's disease. A case report.

CASE REPORT: We report the case of a 48 year-old male with bilateral involvement of the salivary and lacrimal glands, which was diagnosed as Mikulicz's disease by incisional biopsy of the affected lacrimal glands, which was completely resolved after corticosteroid treatment. DISCUSSION: Sclerosing sialadenitis and/or dacryoadenitis are chronic inflammatory diseases that are currently classified into IgG4-related diseases. Specifically, Mikulicz's disease is defined by a persistent and symmetrical swelling of the lacrimal and salivary glands together with elevated serum concentration of IgG4 and tissue infiltration by IgG4 (+) plasma cells.

[Retinal nerve fiber layer thickness analysis in children from 6 to 9 years of age]. / Análisis del espesor de la capa de fibras nerviosas en niños de 6 a 9 años.

PURPOSE: To establish a database of scanning laser polarimetry (GDx) parameters for children between 6 and 9 years of age and compare the results at each age. METHODS: The retinal nerve layer thickness of 116 children from one school was evaluated with GDx and the results were analyzed for each age and for the entire group to determinate the normal range for that population. RESULTS: In the global analysis of the software-derived GDx parameters, we obtained a TSNIT average of 59.43 (IC95% 58.41-60.45), a superior average of 71.35 (IC95% 69.99-72.70), an inferior average of 70.08 (IC95% 68.71-71.45), and a TSNIT Std. Deviation of 25.11 (IC95% 24.36-25.86). The results from the analysis for age were similar to the global results. CONCLUSIONS: Given the low level of cooperation required, GDx can be used without problem to study the retinal nerve fiber layer in 6-9-year-old children. GDx could provide objective information about the state of development of the retinal nerve fiber layer during this period of life.

Análisis del espesor de la capa de fibras nerviosas en niños de 6 a 9 años / Retinal nerve fiber layer thickness analysis in children from 6 to 9 years of age

Objetivo: Establecer una base de datos para el GDx-VCC representativa para nuestra población de entre 6 a 9 años y analizar los datos obtenidos por rango de edades. Método: Se analizó la densidad de la CFN mediante oftalmoscopía de barrido con láser (GDx) a 116 niños procedentes de un único colegio y los resultados fueron sometidos a estudio estadístico por edades y en global a fin de determinar el rango de valores considerable como la normalidad para esa población y las posibles diferencias entre ellos. Resultados: En el análisis global por cuadrantes de los datos estudiados por el GDx se encontró un promedio TSNIT de 59,43 (IC95% 58,41-60,45); superior de 71,35 (IC95% 69,99-72,70); inferior de 70,08 (IC95% 68,71-71,45) y una desviación estándar TSNIT de 25,11 (IC95% 24,36-25,86). En el análisis por edades se observan valores medios por cuadrantes comparables a los del global. Conclusiones: El estudio de la CFN mediante GDx se puede realizar sin problema en la población infantil de 6 a 9 años dada la mínima colaboración requerida, obteniendo así datos objetivos sobre su estado y desarrollo durante estas edades

Purpose: To establish a database of scanning laser polarimetry (GDx) parameters for children between 6 and 9 years of age and compare the results at each age. Methods: The retinal nerve layer thickness of 116 children from one school was evaluated with GDx and the results were analyzed for each age and for the entire group to determinate the normal range for that population. Results: In the global analysis of the software-derived GDx parameters, we obtained a TSNIT average of 59.43 (IC95% 58.41-60.45), a superior average of 71.35 (IC95% 69.99-72.70), an inferior average of 70.08 (IC95% 68.71-71.45), and a TSNIT Std. Deviation of 25.11 (IC95% 24.36-25.86). The results from the analysis for age were similar to the global results. Conclusions: Given the low level of cooperation required, GDx can be used without problem to study the retinal nerve fiber layer in 6-9-year-old children. GDx could provide objective information about the state of development of the retinal nerve fiber layer during this period of life

[Limbal relaxing incisions and cataract surgery: our experience]. / Incisiones limbares relajantes y cirugía de la catarata: nuestra experiencia.

PURPOSE: To evaluate the reduction of pre-existing corneal astigmatism at the time of cataract surgery with limbal relaxing incisions (LRIs). METHODS: A prospective study of two groups of patients (treatment and control) with pre-existing astigmatism>or=1D was performed. The 30 patients in the control group had a temporal clear corneal phacoemulsification and the 32 patients of treatment group had combined temporal clear corneal phacoemulsification and LRIs. Holladay analysis was used to assess the efficacy of treatment. An astigmatism distribution and prevalence study in our population is also presented. RESULTS: Three months after surgery, the mean astigmatism change was -0.55D (-0.75 to -0.35) in the treatment group and 0.04D (-0.3 to 0.3) in the control group (p<.0001). CONCLUSIONS: LRI is a simple, safe and effective method not only for reducing pre-existing astigmatism during cataract surgery but in providing good unaided visual acuity.

Incisiones limbares relajantes y cirugía de la catarata: nuestra experiencia / Limbal relaxing incidions and cataract surgery: our experience

Objetivo: Evaluar la reducción del astigmatismo corneal preexistente en la cirugía de catarata mediante incisiones limbares relajantes (ILRs). Método: Estudio prospectivo de dos grupos de pacientes (tratamiento y control) con astigmatismo prequirúrgico ³1D. Los 30 pacientes del grupo control fueron sometidos a facoemulsificación por incisión temporal en córnea clara y los 32 pacientes del grupo tratamiento a ILRs junto a facoemulsificación por incisión temporal en córnea clara. Se usó el test de Holladay para valorar la eficacia del tratamiento. Asimismo, presentamos un pequeño estudio de la prevalencia y distribución del astigmatismo en nuestra población de trabajo. Resultados: El seguimiento promedio de los 62 pacientes fue de 3 meses, con un cambio astigmático medio a los 3 meses de -0.55D (-0,75 a -0,35) en el grupo tratamiento y de 0.04D (-0,3 a 0,3) en el grupo control (p<,000). Conclusiones: Las ILRs son un método sencillo y efectivo para conseguir reducir el astigmatismo previo durante la cirugía de catarata y con ello la dependencia de gafa

Purpose: To evaluate the reduction of pre-existing corneal astigmatism at the time of cataract surgery with limbal relaxing incisions (LRIs). Methods: A prospective study of two groups of patients (treatment and control) with pre-existing astigmatism ³1D was performed. The 30 patients in the control group had a temporal clear corneal phacoemulsification and the 32 patients of treatment group had combined temporal clear corneal phacoemulsification and LRIs. Holladay analysis was used to assess the efficacy of treatment. An astigmatism distribution and prevalence study in our population is also presented. Results: Three months after surgery, the mean astigmatism change was -0.55D (-0.75 to -0.35) in the treatment group and 0.04D (-0.3 to 0.3) in the control group (p<.0001). Conclusions: LRI is a simple, safe and effective method not only for reducing pre-existing astigmatism during cataract surgery but in providing good unaided visual acuity

[Somatostatin analogue treatment in Graves' ophthalmopathy: a case report]. / Tratamiento de la enfermedad de Graves con análogos de la somatostatina: caso clínico.

CASE REPORT: The effect of a somatostatin analogue in a patient with Graves' ophthalmopathy is presented, including data on the dose requirements and the results of therapy. DISCUSSION: There are few effective options for the management of Graves' ophthalmopathy, a cell-mediated immune co-morbidity of thyroid disease. Somatostatin analogues inhibit lymphocyte proliferation and activation, and accumulate in the orbital tissue during the active ophthalmopathy. Because of this, such therapy is able to inactivate the ophthalmopathy without complications occurring.

Tratamiento de la enfermedad de Graves con análogos de la somatostatina: caso clínico / Somatostatin analogue treatment in Graves' ophthalmopathy: a case report

Caso clínico: Se presenta la evolución de un paciente con oftalmopatía de Graves (OG) tratado con análogos de la somatostatina, así como las indicaciones, pauta y resultados obtenidos. Discusión: Son pocas las opciones terapéuticas efectivas para el manejo de la oftalmopatía asociada a disfunción tiroidea de origen autoinmune. Los análogos de la somatostatina inhiben la proliferación y activación de los linfocitos, y se acumulan en el tejido orbitario durante la fase activa de la enfermedad oftálmica. Así, nos permitieron en el caso presentado llegar a la fase inactiva de la enfermedad sin secuelas importantes

Case report: The effect of a somatostat in analogue in a patient with Graves' ophthalmopathy is presented, including data on the dose requirements and the results of therapy. Discussion: There are few effective options for the management of Graves' ophthalmopathy, a cell mediated immune comorbidity of thyroid disease. Somatostatin analogues inhibit lymphocyte proliferation and activation, and accumulate in the orbital tissue during the active ophthalmopathy. Because of this, such therapy is able to inactivate the ophthalmopathy without complications occurring

[Optic nerve glioma in a case of neurofibromatosis-1 in a child]. / Glioma de nervio óptico en un caso de neurofibromatosis-1 infantil.

CLINICAL CASE: The case of a three-year-old patient with neurofibromatosis type I is presented. Ophthalmologic evaluation revealed, by means of magnetic resonance imaging, the presence of a silent glioma in the optic nerve of the left eye. DISCUSSION: Neurofibromatosis-1 can present in multiple ways to the ophthalmologist, with a glioma of the optic nerve being one of the most frequent central nervous system presentations in this illness. Generally the glioma affects the optic chiasm and its course is indolent, with conservative management and close monitoring usually being advised until progression is defined.

Glioma de nervio óptico en un caso de neurofibromatosis-1 infantil / Optic nerve glioma in a case of neurofibromatosis-1 in a child

Caso clínico: Se presenta el caso de una paciente de tres años de edad con neurofibromatosis tipo 1. La exploración oftalmológica reveló, mediante resonancia nuclear magnética, la presencia de un glioma de curso silente en el nervio óptico del ojo izquierdo.Discusión: La neurofibromatosis-1 produce múltiples manifestaciones en el campo oftalmológico, siendo los gliomas de la vía óptica los tumores del sistema nervioso central más frecuentes en la enfermedad. Por lo general suelen afectar al quiasma y su curso suele ser indolente, aceptándose un tratamiento conservador con seguimiento estrecho hasta que se detecte progresión

Clinical case: The case of a three-year-old patient with neurofibromatosis type I is presented. Ophthalmologic evaluation revealed, by means of magnetic resonance imaging, the presence of a silent glioma in the optic nerve of the left eye. Discussion: Neurofibromatosis-1 can present in multiple ways to the ophthalmologist, with a glioma of the optic nerve being one of the most frequent central nervous system presentations in this illness. Generally the glioma affects the optic chiasm and its course is indolent, with conservative management and close monitoring usually being advised until progression is defined