1/45. Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.PURPOSE: To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis. methods: A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations. RESULTS: The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions. CONCLUSION: This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/45. Kimura disease of the orbit and ocular adnexa.Kimura disease (KD) is a distinct clinicopathologic entity that has been the subject of considerable confusion and debate. Although common in Asia, KD rarely occurs in non-Asian patients. Kimura disease shares both clinical and histopathologic features with angiolymphoid hyperplasia with eosinophilia (ALHE). Because of this overlap and the rarity of KD in europe and the united states, KD and ALHE have been used synonymously in the Western medical literature, as they were thought to represent variations of the same disease. Some pathologic reports have called for distinguishing KD and ALHE as two separate entities, based on their histologic features. Kimura disease occurs most commonly in the head and neck region and has been described in the orbit, eyelids, and lacrimal gland more frequently than ALHE. Because both diseases can cause proptosis, lid swelling, ocular dysmotility, or a palpable mass, they should be considered in the differential diagnosis of orbital lesions occurring in adults. We report two cases of KD involving the orbit and ocular adnexa, and review additional cases reported in the literature. The ophthalmic literature does not clearly reflect the current understanding that KD and ALHE are best considered two separate clinicopathologic entities.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/45. Histological findings in the eyelids of AIDS patients.PURPOSE: The eyelids of 15 AIDS patients (17 specimens) were examined histologically at postmortem. methods: Formalin-fixed, paraffin-embedded and haematoxylin-eosin stained sections were examined by conventional light microscopy. The presence of calcific deposits was confirmed by special stains and elemental analysis (X-ray energy dispersive spectroscopy). RESULTS: 6 cases had abnormal microscopical findings. In two cases deposits of calcium oxalates were observed in the wall of dermal blood vessels and in epithelial cells of sweat and sebaceous glands, respectively. Precipitates of calcium phosphate were observed in the superficial substantia propria of the palpebral conjunctiva in an additional patient. Other histological findings in the remaining three patients included flat warts, an unusual elastotic degeneration of the forniceal palpebral conjunctiva and more common lesions (chalazion, Demodex folliculorum infestation of the eyelashes, trichilemmal cyst). CONCLUSION: The presence of microscopical lesions in nearly half of this small series demonstrates that the eyelids may be affected subclinically in AIDS patients.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/45. Distichiasis-lymphoedema: clinical features, venous function and lymphoscintigraphy.Distichiasis-lymphoedema is a rare variant of the genetically determined lymphoedemas; distichiasis is the abnormal development of the meibomian glands causing aberrant growth of eyelashes. However, a better understanding of this clinically distinct subgroup may provide useful information on the genetic inheritance of all types of lymphoedema. This report provides phenotype data on a very large family with distichiasis-lymphoedema. lymphoscintigraphy and light reflection rheography (venous function) were undertaken to identify the phenotype more clearly. As a result of lymphoscintigraphy several subjects were reclassified phenotypically (unaffected or affected) with implications for genetic linkage studies. Associated congenital abnormalities were found and venous abnormalities were almost always present in affected limbs. A dominant inheritance with incomplete penetrance was confirmed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/45. Lid swelling and diplopia as presenting features of orbital sarcoid.Sarcoid is an idiopathic multisystem non-caseating granulomatous disease with protean clinical manifestations. In the eye, the common sites of involvement are the skin of eyelid, conjunctiva, uveal tract, retina, optic nerve and lacrimal gland.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/45. False diagnosis caused by Warthin tumor of the parotid gland combined with actinomycosis.A case is reported in which a unilateral parotid gland cystadenolymphoma was combined with actinomycosis. A 48-year-old woman presented with a mass in the left parotid region and paresis of the lower left palpebra. The computed tomography, echography, and parotid radiographic findings did not exclude a neoplasm of the left parotid gland. The ramus of the mandible was involved in the process. Intraoperative freezing histology, total parotidectomy, and partial mandibulectomy were performed, with sacrifice of the facial nerve followed by nerve reconstruction. The final histological evaluation was Warthin tumor with actinomycosis. Four years after treatment, the patient is free of disease. No similar cases seem to have been reported thus far.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
7/45. Wolfring dacryops.BACKGROUND: A unique series of 13 cases of ductal cysts of the accessory lacrimal glands of Wolfring is presented. Once appreciated, they are an easily recognized clinical entity. methods: The 13 cases were verified histologically as arising from ductal epithelium. Biochemical analyses for serum and cyst fluid concentrations of IgA, IgG, and IgM were performed on three of the cases. Histologic staining of the cyst wall using monoclonal antibodies to immunoglobulins was performed on one case. FINDINGS: All patients had evidence of extensive trachomatous scarring. High levels of IgA were found in the cyst fluid, consistent with an active secretory mechanism. Monoclonal antibody staining suggested a significant role for paraductal IgA-secreting plasma cells. CONCLUSION: The formation of a ductal cyst appears to require two successive, inter-related events. The first is an ongoing active secretory process, and the second is an occlusion of the duct. The sequential occurrence of these two events is forwarded as the explanation of dacryops formation. Excision using a conjunctival approach is recommended. A small strip of tarsal border should be removed with the cyst to prevent cyst rupture. The excretory ducts of the Wolfring glands exit through this area.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
8/45. Ocular rosacea in childhood.PURPOSE: To describe the clinical characteristics and treatment response of ocular rosacea in the pediatric population. DESIGN: Retrospective case series. methods: The clinic charts of consecutive pediatric cases of ocular rosacea were evaluated over a 34-month period. Minimal diagnostic inclusion criteria were the presence of posterior eyelid inflammation including meibomian gland inspissation and lid margin telangiectasis, in conjunction with conjunctival injection or episcleritis. RESULTS: Six patients ranged from 3 to 12 years of age at presentation. All shared a long history of ocular irritation and photophobia. Five patients (83%) were female and had bilateral involvement. Eyelid telangiectases and meibomian gland disease were present in all cases. Three patients (50%) had sterile corneal ulcers. Only two patients (33%) had cutaneous involvement at the time of diagnosis. All patients experienced significant improvement with a combination of oral antibiotics (doxycycline or erythromycin), with or without topical antibiotics (erythromycin or bacitracin) or topical steroids (fluorometholone). CONCLUSION: Ocular rosacea in children may be misdiagnosed as viral or bacterial infections. Unlike in adults, associated cutaneous changes are uncommon. Most disease is bilateral, although involvement may be asymmetric. Response to conventional treatment is excellent, although long-term treatment may be necessary to prevent relapses.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
9/45. Ocular symptoms and signs in patients with ectodermal dysplasia syndromes.PURPOSE: The ectodermal dysplasia syndromes are underestimated although precise inclusion criteria have been formulated. The purpose is to establish easily detectable ophthalmologic symptoms and signs as reliable criteria for ectodermal dysplasia syndromes. methods: Thirty-six patients with confirmed ectodermal dysplasia syndromes were included in an observational case series: hypohidrotic ectodermal dysplasia (30), EEC syndrome (3), AEC syndrome (2), Gorlin-Goltz syndrome (1). Each patient was examined ophthalmologically. The principal outcome measures were ocular symptoms and signs in patients with different ectodermal dysplasia syndromes of varying severity. methods: Some 94.4% of the patients suffered from dry eye symptoms. Reduction of eyebrows was seen in 94.4%; the lashes were altered in 91.6%. Changes of the meibomian glands were detected in 95.45%. Corneal changes such as pannus occurred later in life. CONCLUSIONS: Alterations of the meibomian glands, which were detected by meibomianoscopy, are the most reliable ocular sign of ectodermal dysplasia syndromes.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
10/45. Increased tear evaporation in a patient with ectrodactyly-ectodermal dysplasia-clefting syndrome.PURPOSE: To describe the tear function and ocular surface disorders in a patient with ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome. methods: Routine ophthalmic examinations were performed, including slit-lamp biomicroscopy, anterior segment photography including transillumination photos of the lids, Schirmer tests I and II, tear film break-up time (BUT) assessment, corneal fluorescein staining, DR-1 tear film lipid layer interferometry, and tear evaporation rate measurements. RESULTS: Slit-lamp examination revealed conjunctival hyperemia, superficial punctate keratopathy, and corneal leucoma with neovascularization. Although the Schirmer test values were within normal limits, the BUT value was 0 s in both eyes. transillumination of the lids showed the absence of meibomian glandular structures. DR-1 tear film lipid layer interferometry results were dry eye grade 5 with an irregular tear film, areas of corneal surface exposure, and several dry spots. The tear evaporation rate was elevated and was measured as 6.98 x 10(-7) g/cm2 per second (normal, 4.1 /- 1.4 x 10(-7) g/cm2 per second). CONCLUSION: The ocular surface disorder and shortened BUT in EEC syndrome were attributed to the absence of meibomian glands, leading to lipid layer deficiency in the tear film with a concomitant increase in tear evaporation.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
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