Mimansaa Agasti

Abstract

Introduction: A chalazion is a chronic, sterile lipo-granulomatous inflammatory lesion caused due to the blocked sebaceous secretion from the Meibomian and other sebaceous glands. Its painless and harmless, until it becomes an enlarged upper lid chalazion producing mass effect on the cornea leading to blurred vision and astigmatism. Aim: The aim of our study was to inject 0.1 ml of triamcinolone intralesionally and compare the results in both paediatric and adult age group. We assessed how much time was required for the regression of the lesion and how many patients were in the need for re-injection. We also assessed the need for incision and curettage in such patients. Materials and Methods: Sixty-seven patients were included in the study, out of which 23 were children and 44 were adults. 0.1 ml of triamcinolone (40 mg/dl) was injected intralesionally using a 26 gauge needle. The eyelid was everted and the injection was given transconjunctivally into the centre of the lesion. The eye was not patched. Results: Most lesions resolved within 1 week, the maximum time being 3 weeks in both study populations. Repeat injection was needed in only 1 case in paediatric age group and 15 cases in adult age group. None of our patients developed any adverse effects. Conclusion: Usually, chalazion is a self-limiting disease and intralesional injection of triamcinolone is a very effective modality for treatment. It can be done under topical anaesthesia, causing much less bleeding and the risk of scarring is almost not there. It is a very quick procedure, performed in a sterilized out-patient setting, requires no special instruments and is very less painful. Its safely tolerated by both children and adults and should be considered as a preferable procedure over incision and curettage. Keywords: Intralesional, Chalazion.

View Article

Abstract

Thyroid Eye Disease (TED) or Thyroid Ophthalmopathy or Grave’s Ophthalmopathy is the single most common cause of bilateral proptosis in adulthood. It is associated with orbital involvement in 25-50% of patients and 5-10% of patients may develop serious complications like compressive optic neuropathy improved motility and inflammation. The characteristic clinical signs may include a combination of eyelid signs, lid lag, globe lag, proptosis, restrictive extraocular myopathy and optic neuropathy. Werner’s classification is helpful in summarizing the clinical classification of Grave’s Ophthalmopathy. Various diseases such as myasthenia gravis, orbital myositis, CPEO etc mimic thyroid eye disease and its important to know how they can be differentiated. Finally blood investigations and imaging studies are very helpful in endorsing the clinical signs and help one arrive at the diagnosis. Since various medical and surgical management is amenable to us, establishing the correct diagnosis of TED is extremely important. This disease may have sight threatening complications, if not diagnosed on time, therefore, it is important to know the clinical signs of TED. The management is conservative most of the times and a better understanding of the immunological pathogenesis may propel the medical management of the disease in a different direction. Keywords: Proptosis, Rrestrictive myopathy, Thyroid ophthalmopathy.

View Article