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Ocular Oncology and Pathology Aug 2023The aim of this study was to report the nearly ubiquitous prevalence of melanocytic hyperplasia in benign pterygia/pingueculae and establish that the entity is...
INTRODUCTION
The aim of this study was to report the nearly ubiquitous prevalence of melanocytic hyperplasia in benign pterygia/pingueculae and establish that the entity is insufficiently recognized.
METHODS
This is a retrospective immunohistochemical pathology case series of 30 consecutive pterygia/pingueculae samples selected from an ophthalmic pathology database at a single institution. Histopathologic and immunohistochemistry analyses with anti-SOX-10 and anti-MART-1 antibodies were used for identifying melanocytes. The number of squamous cells intervening between melanocytes was determined.
RESULTS
The frequency of dendritic melanocytes was found to meet the criteria for dendritic melanocytic hyperplasia in 29 of 30 pterygia/pingueculae samples using specific antibodies. Melanocytes were found in several patterns: diffuse (28%), multifocal (28%), and focal (44%). In each case, the melanocytes were distributed as single melanocytes at the base; clusters of melanocytes were seen in 17% of samples. There were an average of about two intervening epithelial cells between melanocytes at the base.
CONCLUSION
When diagnosed with immunohistochemistry, dendritic melanocytic hyperplasia is nearly ubiquitous in pterygia and pingueculae. Melanocytic hyperplasia may have a distribution that includes nests and single melanocytes above the basal layer, which can be confused with forms of primary acquired melanosis. It is important for pathologists to recognize these lesions as a distinct benign clinicopathologic entity.
PubMed: 38376097
DOI: 10.1159/000530514 -
BMJ Case Reports May 2016We describe the case of a presumed metastatic adenocarcinoma discovered in the conjunctival limbus of a 75-year-old male with a history of prostate adenocarcinoma. After...
We describe the case of a presumed metastatic adenocarcinoma discovered in the conjunctival limbus of a 75-year-old male with a history of prostate adenocarcinoma. After an initial clinical diagnosis of pinguecula and unsuccessful topical steroid therapy, the lesion was excised and sent for pathological evaluation and special staining. The histopathological evaluation was consistent with a diagnosis of adenocarcinoma, without evidence of lacrimal tissue. Surprisingly, results from special staining were most consistent with lung adenocarcinoma rather than that from a prostate origin. Systemic radiographic evaluation did not locate the primary tumour, and the patient did not present with any symptoms consistent with malignancy. Watchful waiting was chosen as the therapeutic strategy to manage the patient. This is the first report of an adenocarcinoma, likely metastatic, at the conjunctival limbus.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Aged; Conjunctival Neoplasms; Diagnosis, Differential; Disease Management; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Watchful Waiting
PubMed: 27190113
DOI: 10.1136/bcr-2016-214501 -
Optometry and Vision Science : Official... Jun 2016Information on ocular anomalies can help in developing specific interventions to prevent visual impairment especially among children. The aim of this study was therefore...
PURPOSE
Information on ocular anomalies can help in developing specific interventions to prevent visual impairment especially among children. The aim of this study was therefore to determine the prevalence, the causes of ocular anomalies, and their impact on vision of schoolchildren in Ghana.
METHODS
A cluster random sampling technique was used to select four government primary schools in Ashaiman Municipal for this study. Each pupil underwent ocular examination involving visual acuity, external examination, anterior and posterior segment examination, and objective and subjective refraction. They also answered questions relating to ocular problems affecting them.
RESULTS
A total of 811 pupils were sampled, with ages ranging from 6 to 16 years. The mean age of the sampled population was 10.6 years (95% confidence interval, 10.4 to 10.8). Prevalence of ocular anomalies was 27.3% (95% confidence interval, 24.2 to 30.5). Allergic conjunctivitis (17.3%) and refractive errors (6.8%) were the main causes of ocular anomalies. Others include pinguecula (1.2%), pterygia (0.9%), infectious conjunctivitis (0.3%), corneal opacity (0.1%), lens opacity (0.1%), and retinal degeneration (0.1%). Ocular anomalies and refractive errors were significantly associated with sex (p = 0.04 and p = 0.01, respectively). Presenting visual acuity in the better eye 20/40 or worse was identified in 5.3% of schoolchildren, and 0.5% had moderate visual impairment. Only 11.8% of schoolchildren with ocular anomalies had been treated for their ocular problems before the study.
CONCLUSIONS
The prevalence and causes of ocular anomalies found in this study suggest a need for more targeted eye health interventions such as school eye screening for early diagnosis and treatment of any presenting conditions among schoolchildren.
Topics: Adolescent; Child; Conjunctivitis, Allergic; Cross-Sectional Studies; Female; Ghana; Humans; Male; Prevalence; Refractive Errors; Surveys and Questionnaires; Vision Disorders; Vision Tests; Visual Acuity; Visually Impaired Persons
PubMed: 26905691
DOI: 10.1097/OPX.0000000000000836 -
Journal of Ophthalmic & Vision Research 2017To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran.
PURPOSE
To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran.
METHODS
The study included patients who presented to ophthalmology clinic. The patients were divided into two groups: 210 diagnosed with pterygium or pinguecula (unilateral or bilateral), and 210 healthy controls. Demographic variables, living environment, disease type, disease laterality, family history of pterygium as well as history of smoking, working outdoors, baking, welding, ocular conditions (trachoma keratopathy, glaucoma, refractive error, and dry eye), use of glasses, ultraviolet light exposure, and systemic conditions were collected from both groups and compared for risk assessment.
RESULTS
Univariate analysis revealed that age ( = 0.001), sex ( = 0.001), family history of pterygium ( = 0.001), positive history of smoking ( < 0.001), history of baking ( = 0.045), welding experience ( < 0.001), severe blepharitis ( < 0.001), hyperopia ( < 0.001), dry eye ( < 0.001), hypertension ( < 0.001), ischemic heart disease ( < 0.001), obesity ( = 0.038), and primary residential area ( = 0.025) had significant associations with increased incidence of pterygium. However, in multivariate analysis, only family history of pterygium, cigarette smoking, history of baking, age, and severe blepharitis were significantly associated with the incidence of pterygium (<0.001, <0.001, = 0.002, = 0.023 and = 0.002, respectively).
CONCLUSION
This study tested more risk factors related to the prevalence of pterygium compared to previous studies. It also confirmed previously established risk factors. Family history of pterygium and blepharitis were risk factors that have not been reported in previous studies and were found to be significantly associated with the development of pterygium in this study.
PubMed: 28791059
DOI: 10.4103/jovr.jovr_85_16 -
Clinical Ophthalmology (Auckland, N.Z.) 2014To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
PURPOSE
To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
METHODS AND MATERIALS
This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded.
RESULTS
The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60%) eyes with grade 1 CCh; 15 (30%) eyes with grade 2 CCh; and five (10%) eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90%) eyes, and in the remaining five (10%) CCh was located in the superior bulbar conjunctiva. Ten (33.3%) patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6%) patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients.
CONCLUSION
Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora.
PubMed: 25210435
DOI: 10.2147/OPTH.S61851 -
Oman Journal of Ophthalmology 2024
PubMed: 38524339
DOI: 10.4103/ojo.ojo_200_22 -
Medical Hypothesis, Discovery &... 2023Bell's phenomenon, also known as the palpebral oculogyric reflex, is a critical reflex that protects the cornea. We developed an innovative, simple, and practical...
BACKGROUND
Bell's phenomenon, also known as the palpebral oculogyric reflex, is a critical reflex that protects the cornea. We developed an innovative, simple, and practical grading scale for Bell's phenomenon that includes the inverse Bell's phenomenon. Using this scale, we investigated the characteristics of Bell's phenomenon among asymptomatic individuals in different age groups and examined the frequency of ocular surface lesions in asymptomatic and symptomatic participants with different grades.
METHODS
In this cross-sectional study, we randomly included 330 eyes of 165 asymptomatic, healthy, White Turkish individuals who attended the outpatient eye clinic, with a male-to-female ratio of 1:1.4, in the control group. These were categorized into four age groups: 4 - 20 years, 21 - 40 years, 41 - 60 years, and > 60 years. Eighty eyes from 40 patients with ocular surface lesions and absence of grade + 2 Bell's phenomenon were included in the symptomatic group. Bell's phenomenon was classified into five grades: grade + 2 (strong positive), grade + 1 (weak positive), grade 0 (no Bell's phenomenon, no eye movement), grade -1 (weak inverse), and grade -2 (strong inverse).
RESULTS
We detected higher frequencies of grade + 2, + 1, and 0 in individuals aged 4 - 40, 41 - 60, and > 60 years, respectively. There was a significant difference between age groups in the frequencies of different grades ( < 0.001). Pairwise analysis revealed a significantly lower frequency of grade + 2 in the age group > 60 years compared with the 4 - 20 and 21 - 40 year groups (both < 0.05). Grade + 2 was the most frequent in both sexes. We detected grade 0 in 27.1% of men and 22.1% of women in the control group, with no significant difference in the frequencies of different grades between sexes ( > 0.05). We observed significant differences between grades with respect to the frequency of ocular surface lesions ( < 0.001). Pairwise analysis revealed a significantly higher frequency of ocular surface lesions in asymptomatic individuals with grade 0 and all four other grades (all < 0.001). However, the frequency of ocular surface lesions was comparable between sexes ( > 0.05). Of the 40 symptomatic individuals, 28 (70%), 5 (12.5%), 4 (10%), and 3 (7.5%) had grade 0, + 1, -1, and -2, respectively. The number of symptomatic patients was higher in grade 0 (n = 28) than in other grades (grade + 1, -1, and -2: n = 12 patients), and these individuals had a higher frequency of ocular surface lesions (n = 38 lesions) than others (grade + 1, -1, and -2: 7 lesions).
CONCLUSIONS
Using a simple, practical grading scale for Bell's phenomenon that includes inverse Bell's phenomenon, we observed that inverse Bell's phenomenon is a reflex that may be present in healthy individuals and could have a protective effect on the eye, although not to such a degree as a strong Bell's phenomenon. Our observations imply that bilateral conjunctival calcifications/Vogt's limbal girdle may be associated with grades 0 and + 1 Bell's phenomenon. Further large-scale studies are needed to determine the frequency of Bell's phenomenon in the general population using this innovative, simple, practical grading scale, and to identify the protective or injurious effect of each grade on the ocular surface.
PubMed: 38601052
DOI: 10.51329/mehdiophthal1484 -
Klinische Monatsblatter Fur... Apr 2020
Topics: Fluorescein Angiography; Humans; Laser Coagulation; Pinguecula
PubMed: 32131121
DOI: 10.1055/a-1068-2628 -
The British Journal of Ophthalmology May 2017To investigate the role of high-resolution anterior segment optical coherence tomography (HR-ASOCT) in the assessment of pterygia.
AIMS
To investigate the role of high-resolution anterior segment optical coherence tomography (HR-ASOCT) in the assessment of pterygia.
METHODS
Single centre cross-sectional study. Patients with primary pterygium and/or pingueculae were included. Clinical assessment included HR-ASOCT, colour photography, keratometry followed by histology. Associations were tested between HR-ASOCT features of the pterygium and the degree of corneal scarring and elastotic degeneration, astigmatism and best-corrected visual acuity.
RESULTS
29 eyes of 26 patients with pterygium and 6 patients with pinguecula were included. Apical anterior stromal scarring was found in 23 cases (79.3%) reaching a mean depth of 68.8±21.7 µm (minimum: 33 µm, maximum: 126 µm). Increased stromal scarring and subepithelial elastotic degenerative tissue was significantly associated with HR-ASOCT features of flat bridging of the corneoscleral transition zone (p<0.01) reduced thickness of the pterygium head (p=0.01), and a greater degree of corneal astigmatism (p=0.04).
CONCLUSIONS
HR-ASOCT is a useful tool for the assessment and monitoring of pterygia in clinical practice. Features associated with increased stromal scarring and astigmatism are reduced thickness of the head of the pterygium and flat bridging of the corneoscleral transition zone.
Topics: Adult; Aged; Aged, 80 and over; Anterior Eye Segment; Cicatrix; Corneal Stroma; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pterygium; Tomography, Optical Coherence; Visual Acuity
PubMed: 27488179
DOI: 10.1136/bjophthalmol-2016-308685 -
Clinical Optometry 2021Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from...
BACKGROUND
Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from sunlight, can potentially damage any organ that is exposed to any part of its spectrum. Aside from the skin, the organ most susceptible to sunlight-induced damage is the eye. Ultraviolet radiation is reported to be the cause of multiple ocular problems ranging from benign conditions like pterygium and pinguecula to ocular malignancies such as basal cell carcinoma which finally leads to visual impairment and blindness. Protection practice is mandatory to avoid the burden of diseases caused by ultraviolet exposure and maximizing the protection measures implementation is important. To maximize this, it is essential to know the current practice and the associated factors affecting the usage of protective devices in the study area.
METHODS
Community-based cross-sectional study was conducted from April to May 2019 on 453 study participants. The study participants were selected through a systematic random sampling method. Data were collected using a pretested structured questionnaire. The analyzed result was summarized and presented using texts, tables and charts. A Chi-square test was applied to assess the significant association.
RESULTS
A total of 430 study subjects were participated and completed the questionnaire with a response rate of 94.92%. The mean age of the study participants was 35.3 (SD±6.68). Two hundred forty-three (56.5%) study participants were males. About 228 (53%) of participants were married, and 356 (82.8%) were Christian in religion. From the total study participants, 173 (40.23%) had good practice in protecting the eye from ultraviolet radiation damages while the remaining 59.77% had poor practice. A significant association was found between sex and protection practice of the eye from ultraviolet radiation damages.
CONCLUSION
The majority of the study participants had poor protection practice of the eye from ultraviolet radiation damages. Improving awareness and protection practice are vital to reduce the burden of ocular abnormalities due to excessive exposure to ultraviolet radiation.
PubMed: 33519252
DOI: 10.2147/OPTO.S291916