Eye Socket Research Articles

Comparative investigations into the growth details of Histoplasma capsulatum var farciminosum on four different agar media.

Epizootic equine lymphangitis (EEL) is a chronic fungal disease that affects equids. The causative agent is a dimorphic fungus called Histoplasma capsulatum var farciminosum. H. capsulatum var farciminosum field strain 7 (D 2878/2023) isolated from the eye socket of an EEL Ethiopian horse was sub-cultured on 4 different solid media and incubated at 26°C and 37°C for 6 weeks. Details of growth morphology were recorded and shown in images during 6 weeks of incubation. H. capsulatum var farciminosum grew best at 26°C on all 4 agars, but only on sheep blood agar at 37°C as small, white dry colonies.

ORBITAL WALL FRACTURE IN COMBINED INJURIES OF BONES OF THE FACIAL SKELETON

Combined injury of the maxillofacial region remains one of the topical problems of maxillofacial traumatology. Combined trauma to the maxillofacial region requires joint medical care by several specialists. Trauma of the upper and middle zones of the faceis often accompanied by trauma of the eye socket, paranasal sinuses. They are difficult to diagnose, in case of untimely diagnosis and rendered assistance lead to secondary defects and deformities. Damage to the walls of the orbit, leads to scarring changes in the fiber of the eye socket, eye muscles, persistent diplopia, ocular nerve impingement, persistent eye asymmetry, decreased or loss of vision is the cause of frequent disability.

Changing the geometry of polymer spherical orbital implants

BACKGROUND: Over the past decades, various polymer implants have been actively used in the rehabilitation of patients with anophthalmos to form a volumetric support stump and improve the results of cosmetic prosthetics.
 AIM: To assess clinical symptoms and features of the X-ray picture in patients with anophthalmos after implantation of polymeric spherical endoprostheses with a modified geometry.
 MATERIALS AND METHODS: The study is based on the analysis of 30 patients with anophthalmos after enucleations (23) and eviscerations (7) performed using various methods of procedure and insertion into tissues of an implant made of domestic polytetrafluoroethylene. All patients underwent a multispiral computed tomography (MSCT) of the eye sockets according to the same algorithm.
 RESULTS: On the basis of the performed studies, the fact of making a change in the geometry of the implanted spherical implants was revealed, while the parameters of the modified part of the spheres were different and ranged from 14 to 18 mm of final diameters with the initial diameters of the spheres ranging from 18 to 20 mm. A decrease in the volume of spheres with modified geometry from 0.114 to 0.651 cm3 was revealed with initial diameters ranging from 18 to 20 mm.
 CONCLUSIONS: Changes in the geometry of the orbital spheres do not improve the results of cosmetic prosthetics in patients, increase the percentage of implant exposure at different times after surgery, and increase the manifestations of anophthalmic syndrome.

Correlation of the apparent diffusion coefficient with the standardized uptake value in meningioma of the skull plane using [68]Ga-DOTATOC PET/MRI.

To evaluate a correlation between an MRI-specific marker for cellular density [apparent diffusion coefficient (ADC)] and the expression of Somatostatin Receptors (SSTR) in patients with meningioma of the skull plane and orbital space. 68 Ga-DOTATOC PET/MR imaging was performed in 60 Patients with suspected or diagnosed meningiomas of the skull base and eye socket. Analysis of ADC values succeeded in 32 patients. ADC values (ADC mean and ADC min ) were analyzed using a polygonal region of interest. Tracer-uptake of target lesions was assessed according to corresponding maximal (SUV max ) and mean (SUV mean ) values. Correlations between assessed parameters were evaluated using the Pearson correlation coefficient. One out of 32 patients (3%) was diagnosed with lymphoma by histopathological examination and therefore excluded from further analysis. Median ADC mean amounted to 822 × 10 -5 mm²/s -1 (95% CI: 570-1497) and median ADC min was 493 × 10 -5 mm 2 /s -1 (95% CI: 162-783). There were no significant correlations between SUV max and ADC min (r = 0.60; P = 0.76) or ADC mean (r = -0.52; P = 0.79), respectively. However, Pearson's test showed a weak, inverse but insignificant correlation between ADC mean and SUV mean (r = -0.33; P = 0.07). The presented data displays no relevant correlations between increased SSTR expression and cellularity in patients with meningioma of the skull base. SSTR-PET and DWI thus may offer complementary information on tumor characteristics of meningioma.

Эндокринная офтальмопатия: исторические аспекты

The article presents the history of the development of the treatment of endocrine ophthalmopathy from the first mention of disparate symptoms of the disease in 110 ad to the principles of therapy accepted today. Caleb parry was the first to describe 8 such patients, but his work did not attract the attention of the medical community. In 1835, the Englishman robert graves, in his «clinical lectures», described 3 patients with a disease that was later named after him. a little later, the clinical cases of 4 patients were presented by Karl Basedow, who also suggested that the body was «poisoned» with a toxin as a result of the disease. treatment of toxic goiter with exophthalmos remained symptomatic for a long time. Surgery was resorted to as a «treatment of despair» in neglected patients, which led to high mortality after operations. attempts at surgical intervention on the eye sockets were also ineffective. But at the beginning of the 20th century, several discoveries were made that significantly influenced the effectiveness of treatment. Since 1902, x-ray and then radioisotope irradiation of the thyroid gland entered clinical practice, which led to the recovery of 2/3 of patients. developing after radiotherapy and surgery, hypothyroidism began to stop thyroxine, synthesized in 1926 by charles harrington. the discovery of the thyrostatic properties of thiourea by Edwin astwood in 1946 made it possible to significantly improve the effectiveness of the treatment of patients with hyperthyroidism. the modern era in the treatment of endocrine ophthalmopathy began in the 90s of the last century, when pulse therapy with high doses of glucocorticoid hormones was first proposed. therapy with high-dose corticosteroids remains the «gold standard» for the treatment of endocrine ophthalmopathy to this day. Keywords: endocrine ophthalmopathy, exophthalmos, goiter, thyroid gland, study history

Surgical outcomes of unwrapped acrylic orbital implants: A review of 192 patients

The purpose of this study is to report the results in a series of acrylic orbital implant placements without the use of wrapping material. We retrospectively reviewed the records of the patients who underwent enucleation with acrylic orbital implant insertion without scleral wrapping at the Department of Ophthalmology, Poznań University of Medical Sciences, Poland, between 2013 and 2020. There were 192 patients: 102 women and 90 men, mean age: 60 years (range: 13-90 years). In the majority of cases, the reason for enucleation was uveal melanoma (148 patients-77.1%), followed by secondary glaucoma in 22 patients (11.5%) and painful, phthisical eye in 16 (8.3%). The median follow-up was 23 months (range: 1-96 months). The stability of the implants was satisfactory in the majority of cases, and there were no cases of implant migration identified during the study period. We noted a total of 4 (2%) implant exposures. Other postoperative complaints included eyelid malposition-21 patients (11%), Tenon's capsule thinning (15 patients-7.8%) and post-enucleation eye socket syndrome (PEES)-7 patients (3.6%). The rate of postoperative complications was associated only with a history of previous ocular surgery (P=0.006). The stability and functional outcomes of unwrapped acrylic orbital implants in this group of patients were satisfactory during the follow-up period.

Non-fabricated ocular prosthesis posteviseration

Eyeball loss is a traumatic process as it can cause functional, media, psychological and aesthetic problems. Patients who re-quire treatment with specialised eye prostheses are those who have lost ocular structures through removal of orbital contents or orbital enucleation to accelerate physical and psychological healing and improve aesthetics. This article reports the fabrication of an eye prosthesis as a rehabilitative treatment in a patient who had undergone orbital enucleation. A 38-year-old man came to RSGMP Universitas Hasanuddin Makassar referred by an ophthalmologist with complaints of left eyeball loss due to trauma. The patient wanted to have a prosthetic eye made immediately to restore his appearance and self-confidence. Examination of the eye socket showed a healthy conjunctiva and no infection. The treatment was the fabrication of a non-fabricated eye pros-thesis made from acrylic resin. The fabricated non-fabricated eye prosthesis had advantages in terms of retention, stability, aes-thetics and patient comfort. It was concluded that the ocular prosthesis can reduce the psychological trauma caused by the loss of the eyeball, thus increasing the patient's confidence in social life.

Morphological and histological study of the third eyelid in hedgehogs.

The third eyelid in animals plays an important role in maintaining eye health. Like other organs of the body, the third eyelid can be afflicted with minor or deep injuries, inflammations or even tumours in different species. The current study investigates the morphological and histological characteristics of the third eyelid in hedgehogs. Eight healthy adult hedgehogs (male and female) weighing 500-700g were included in this study. Deceased animals were used for this study. Few incisions were applied around the eye and eye socket. The eye was removed, and the samples were fixated in 10% formalin solution to prepare for the histological study. To evaluate the morphological characteristics, the third eyelid was placed in 2% and 4% formalin solutions. The histological study revealed that the third eyelid cartilage is an elastic cartilage and includes chondroblasts and chondrocytes. The cells of this cartilage were either distributed individually or in isogenic groups. The bulbar and palpebral surfaces of the eyelids were devoid of any glands and were covered with a non-keratinized stratified squamous epithelium. The anatomical examination also showed that the third eyelid had an oval-shaped cartilage. Comparing the results of this study with reports on other rodents showed that the morphological and histological structure of the cartilage in the hedgehog's third eyelid is mostly like the structure of this tissue in Indian mongoose (Herpestes javanicus).

Transorbital Penetrating Intracranial Trauma with a Pen. A case Report

Intracranial injury by penetrating foreign bodies through the eye socket is an unusual form of traumatic brain injury. Postoperative complications, such as meningitis, bleeding and brain abscess are some of the most common in these rare cases. In this study, we are reporting a case of a 54-year-old man who stuck a pen in his left eye socket with the aim of committing suicide. The patient arrived via emergency with clinical manifestations of hemiparesis and ophthalmoplegia, CT scan was performed which showed the presence of a foreign body (a writing pen) in the projection of the left orbit, the course of which crosses the apex of the orbit and the basal part of the brain (without displacement of medial structures) penetrating the upper part of the left cerebellar hemisphere. After successful extraction, the patient was in our neuro-intensive care unit for a period of 3 days. The patient was prescribed intravenous administration of broad-spectrum antimicrobials, but 5 days after the injury, developed secondary bacterial meningitis so it was decided to change the antibiotic therapy. After 12 days of admission, the patient presented a noticeable improvement while his relatives asked for discharge at their request and, 3 weeks later the patient is readmitted with symptoms of hydrocephalus. In the control CT, can be seen a marginal lamellar fracture in the apex of the left orbit, accompanied by purulent meningitis and post-traumatic occlusive hydrocephalus.

Orbital complications of rhinogenic etiology in children: some aspects

Introduction. Rhinosinusogenic orbital complications (RSOC) rank first among all serious complications of inflammatory diseases of the paranasal sinuses and require timely diagnosis and an interdisciplinary approach in the administration of this category of patients.The aim of the study. was to study the features of the nature of the course, diagnosis and tactics of managing children with RSOC according to the children’s ENT department of the OKB No. 2, Tyumen.Materials and methods. A retrospective analysis of the medical records of children with RSOC was carried out. The leukocyte shift indices (LSI) were calculated. The microbiological landscape in purulent RSOC and the tactics of introducing patients with these complications were studied.Results and Discussion. Among the entire pathology of the paranasal sinuses, RSOS were observed in 12.9% of cases. In 53.6% of cases, RSOC occurred in boys. Reactive edema of the tissue of the eyelids and orbits was in 86.1% of cases, other forms were less common. Of the microflora, the leading positions were occupied by Staphylococcus spp. In 54.2 % of cases, only conservative therapy was used, in every third case − minimally invasive manipulations, in 11 % − surgery. In 84.6 % of cases, empiric therapy was started with protected aminopenicillins, 3rd generation cephalosporins (12.8 %). In the presence of a subperiosteal abscess or phlegmon of the orbit (23.1 %), a transfer was made to reserve preparations. LSI values greater than 3.58 were more typical for purulent-septic complications of the eyelids and orbit, which required early surgical intervention and prevention of intraorbital and intracranial complications.Conclusion Among RSOC in children, reactive edema of eyelids and eye sockets predominates. The microbial landscape in purulent orbital complications was characterized by pronounced polymorphism, which makes it difficult to choose empirical antibiotic therapy. Calculation of the LSI allows for early diagnosis and timely therapy with the choice of the optimal scope of medical intervention and an interdisciplinary approach, which reduces the risk of developing purulent-septic complications of the orbit and eyelids.

Evaluation of [68Ga]-DOTATOC PET/MRI in Patients with Meningioma of the Subcranial and Intraorbital Space.

Meningiomas are known to express somatostatin receptor (SSTR) type 2 to a high degree. Therefore, radiolabeled somatostatin analogs, such as DOTATOC, have been introduced for PET imaging of meningiomas. However, the benefit of hybrid SSTR PET/MRI is still debated. Here, we report our experience with [68Ga]-DOTATOC PET/MRI. Methods: PET/MRI was performed in 60 patients with suspected or diagnosed meningiomas of the skull plane and eye socket. Acquired datasets were reported by 2 independent readers regarding local tumor extent and signal characteristics. Histopathologic results and follow-up imaging served as the reference standard. SUVs of target lesions were analyzed according to the corresponding maximal tracer uptake. The diagnostic accuracy of PET/MRI and conventional MRI was determined independently and compared with the reference standard. Results: In total, 60 target lesions were identified, with 54 considered to be meningiomas according to the reference standard. Sensitivity and specificity of PET/MRI versus MRI alone were 95% versus 96% and 75% versus 66%, respectively. The McNemar test was not able to distinguish any differences between PET/MRI and the reference standard or MRI and the reference standard. No differences were found between the 2 modalities with respect to local infiltration. Conclusion: SSTR PET/MRI and MRI yielded similar accuracy for the detection of meningiomas of the skull base and intraorbital space. Here, sequential low-dose SSTR PET/CT might be helpful for the planning of radioligand therapy or radiotherapy.

Craniological indices of cows of Angler breed on the example of the collection of the state museum of animal husbandry named after E. F. Liskun

Agricultural craniology is a branch of morphology fi rst studied in detail by academician E. F. Liskun. The purpose of the work was to characterize the indices of the craniums of cattle of Angler breed, which are in the collection of the State Museum of Animal Husbandry named after E. F. Liskun. The work was devoted to the calculation of indices based on measurements of the craniums of cattle of Angler breed, which are necessary for a detailed and more complete study of the craniological features of animals, as well as for conclusions about morphological changes within the breed that have occurred for a long time. As a result of the work carried out, a craniological characteristic of cattle of Angler breed was given. Based on measurements of craniums, the calculated indices characterize in detail the craniums of cattle of Angler breed and allow them to be characterized as follows: narrow, mediumlength forehead; the average distance between horns (for horned); the muzzle is relatively short, of medium length; the eye sockets are raised; the nasal bones are short and slightly wide; the mandibular bones are short and wide; the dentition is long, and the toothless space is of medium length; the profi le is low, the poll is high, of medium width. With the help of the indices of long-forehead, long-muzzle, length of nasal bones, the ratio of the length of the nasal bones to long-forehead, broad-forehead, distance between horns, broad-muzzle, broad-nose, height of the poll, the smallest width of the poll, length of the mandibular bones, it is possible to analyze the current state of this breed of cattle in comparison with its similar representatives of the late XIX – early XX century.

Reconstruction of Anophthalmic Sockets With Pedicled Nasoseptal Flap.

Patients who undergo eye removal often present with orbital soft-tissue insufficiency and contraction of the eye sockets. The most commonly used reconstruction strategy is grafting the orbit with free grafts, which is associated with the drawback of harvesting tissue from an unconnected site. This study describes the use of the vascularized nasoseptal flap in the reconstruction and enlargement of the contracted anophthalmic cavity in patients with severe or recurrent contracted eye sockets and evaluates its efficacy. A sphenopalatine-pedicled flap from the nasal septum was harvested and mobilized into the anophthalmic orbit for the reconstruction, coverage, and enlargement of the socket in 17 patients with anophthalmic socket syndrome. Data regarding the demographics, preoperative status, postoperative findings, follow-up, outcomes, dates of mutilant and reconstructive surgery, and relevant clinical or imaging were collected. Krishna´s classification was used to assess the postoperative outcomes. The final rating improved in all patients at a median follow-up duration of 35 months. A greater impact was observed in patients who underwent reconstructive surgery before nasoseptal flap creation. Two minor complications occurred; however, major surgical intervention was not required. Implant extrusion was observed in 2 patients. The novel strategy of applying nasoseptal flaps in the reconstruction of anophthalmic sockets results in improved socket grading and a low rate of recurrence (socket contracture or implant extrusion), and complications. The vascular nature of the flap makes it suitable for use in complex cases.

Ocular Prosthesis: A Next Generation Cosmetic Management by an Eye for an Eye

An ocular prosthesis is an artificial eye that replaces an absent natural eye following an enucleation, evisceration or orbital exenteration. The prosthesis fits over an orbital implant and under the eyelids that covers the structures in the eye socket. It is a non-optical device designed only to improve the cosmesis of an individual with anophthalmic socket or disfigured eye. A normal facial appearance is one of the inherent human traits, if any changed or lost challenges physical, social, mental well-being, self-confidence and psychological influence on the affected people. The loss of an eye is a severe psychological trauma with negative impact on the quality of life of the patient. It is quite challenging to restore the normal look of the patient for bringing him to normality in society. In this view, an ocular prosthetic eye helps to improve the quality of life, satisfaction and appearance of affected eye to any injury or disease of the patient. It is given to uplift the patient’s behavioral, mental status and improve the confidence especially in children. Today, most artificial eyes are made of medical grade plastic acrylate (polymethyl methacrylate material) with an average life of about 2-3years depending upon the way that people use it. It is commonly known as “Device or Scleral Shell or Glass Eye or Fake Eye”. The children require more frequent replacement of the prosthetic eye due to rapid growth changes in the eye. The construction of an ocular prosthesis in the case of congenital and acquired anophthalmia differs in etiology but many concepts of management for a child are the same as for an adult. An early intervention with ocular prosthesis can stimulate orbital growth and prevent facial asymmetry.

Prosthetic approach following traumatic evisceration: a case report

A 20-year-old male patient was referred to Prosthodontic Department, Dental Hospital of Hasanuddin University, Makassar with chief complaint of disfiguration of the face. Medical history revealed a significant trauma to the left eye 6 months prior which stayed after evisceration. Patient has never used prosthetic eye afterwards. Examination of the left eye socket revealed a healthy conjunctiva covering the posterior wall of the anophthalmic socket with syn-chronous motions and absence of infection or inflammation signs. Sulcus depth was sufficient enough to retain prosthetic eye. This article presents rehabilitation of the ocular defect with customized acrylic-based ocular prosthe-sis to increase patient’s appearance and to prevent further shrinkage of the eye socket. Preliminary impression was done using customized tray fabricated from modelling wax and hydrocolloid irreversible impression material. An in-traocular custom tray for secondary impression was fabricated with acrylic resin and modified with a syringe that at-tached to the custom tray. Secondary impression of the defect was recorded using polyvinyl siloxane light viscosi-ty material followed by wax pattern fabrication using modelling wax. The wax pattern was tried in patient’s socket and checked for size, comfort, support, fullness, and then packed with tooth colored heat cure acrylic resin. After deter-mining the location and diameter of the iris with an optical vernier pupillary distance ruler, the color of sclera was de-termined by shade guide and confirmed with technician using digital photo. Ocular prosthesis was fabricated after-wards and inserted into the eye socket and evaluated for suitability, aesthetic and also movements with the contra-lateral eye. It is concluded that customized ocular prosthesis was significantly more aesthetic than pre-fabricated one with better contouring, color matching, and coordinated movements with the contralateral eye. This prosthetic ap-proach may restore patient’s appearance, increase their self-esteem, and improve their quality of life.

Individual impression technique by using functional method on the custom ocular prosthesis: a case report

Enucleation leads to contracture of orbital tissue accompanied by reduction in volume and forniceal depth, which results in an inability to sustain a prosthesis. Shallow inferior fornix in contracted eye socket compromises adaptati-on, retention, stabilization and duplication of palpebral opening similar to natural eye in terms of size, support, con-tour and convexity make fabrication of custom ocular prosthesis become challenging. Hence, the present article describes the use of ocular prosthesis as conformer to obtain better appearance and enlarge orbital dimension in contracted socket. A 21-year-old male came to Dental Hospital Universitas Sumatera Utara with a complaint of un-aesthetic face appearance due to enucleation of left eye in the last 5 years old subsequent to trauma by sharp blades. The patient had already used an ocular prosthesis but lost it 6 years ago and didn’t used it until now. In cli-nical examination, the anopthalmic socket had good posterior wall mobility and absence of infection but, mild con-tracted socket (Grade 1) with shallow inferior fornix depth was examined. In this case, ocular prosthesis provides aesthetics as well as expanding the lid anteriorly, conjunctiva and fornix posteriorly that were successfully obtain-ed by performing functional impression using imprinted waxed up. This results in a favorable peripheral eye seal.

A Kist o’ Whistles

A Kist o’ Whistles

Enlargement of the Eye Socket Early after Birth with an Ocular Prosthesis for Clinical Congenital Anophthalmia

Clinical congenital anophthalmia causes facial asymmetry and difficulty in wearing ocular prostheses due to underdevelopment of the orbits. Orbital expansion must be started early after birth for treatment, but consensus regarding the treatment for clinical congenital anophthalmia has not been established. We report a successful orbital expansion using a thermoplastic splint. A one-month-old boy had left clinical congenital anophthalmia (ophthalmatrophia), right congenital glaucoma, and right anterior segment ocular dysgenesis. Two months after birth, left orbital expansion was initiated using a custom-made thermoplastic splint. The splint was replaced with larger ones in steps as the infant grew, and the orbit was successfully expanded. There is no appreciable size difference between the left and right orbit after 5 years of follow up. Treatment using a splint for the conjunctival sac is a simple and effective procedure that can be performed on an outpatient basis. Safer and simpler material should be widely used for the treatment.

Complications of anophthalmic orbits-Treatment and aftercare

The possible complications of anophthalmic eye sockets can occur due to many different pathomechanisms. A differentiation is made between allergic, infectious, inflammatory or mechanical causes. This article gives an overview on the different etiologies of socket complications with their pathophysiology and treatment options.

Modified Impression Technique of a Custom Made Hand Painted Iris For an Ocular Prosthesis: A Case Report

The enucleation of the eye due to variety of causes such as trauma, tumor and severe eye disease or infection has resulted to permanent defect of sight and aesthetic. Defects of the eye may include removal of a part of or the entire orbit which has affected patient’s psychology. Restoring the defect with pre-fabricated or custom-made ocular prosthesis will restore aesthetics and improves patient’s social confidence. This is a case report of construction a custom-made; hand painted iris of ocular prosthesis on a patient with missing left eye due to trauma using modified impression method. The case describes the process of constructing the custom-made ocular prosthesis with modification of impression technique to improve accuracy and fitting. It is aim to highlight the importance of custom-made prosthesis as compared to pre-fabricated ocular prosthesis on its property, fitting to eye socket, hygiene and aesthetic satisfaction.