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ABSTRACT Objective Compare the thickness of conjunctival autografts in pterygium surgery using the Moscovici dissection technique with manual dissection and assess the difficulty of the techniques. Methods In this randomized clinical trial, 30 eyes of 30 patients undergoing pterygium surgery were divided into the Moscovici Dissection Technique Group and the Manual Dissection Group. The patients were treated at the Hospital Oftalmológico Visão Laser (Santos, São Paulo, Brazil). Optical coherence tomography was performed to measure graft thickness three months postoperatively. Three images were obtained from each eye, and three measurements were taken at a distance of 1.5mm perpendicular to the limbus in each capture. The surgeon graded the difficulty of obtaining the graft with the technique performed from one (lowest difficulty) to four (highest difficulty). Results We found statistically significant difference between the difficulty of the two techniques and the mean conjunctival autograft thickness in the two groups (p=0.01 e p=0.05, respectively). The average difficulty rating for the Moscovici Dissection Technique Group (Air Group) was 1.47, while that for the Manual Dissection Group (MD group) was 2.20. The mean thickness of the three measurements was 252µ in the Air Group and 298µ in the MD Group, with medians of 250µ and 278µ, respectively. Conclusion Our study showed that the Moscovici technique results in thinner grafts and can be performed with greater surgical ease.

Objective. To investigate the association of high-risk hu­man papilloma virus (HR-HPV) and other risk factors with ocular surface squamous cell neoplasia (OSSN). Materials and methods. We obtained DNA from 22 fresh frozen OSSN tissues and 22 pterygia as controls, we used a broad-spectrum HPV DNA amplification short PCR fragment to identify HPV infection in all specimens and then genotyped HPV by a reverse hybridization line probe assay. We also obtained demographic, sun exposure, and tobacco consump­tion information. Results. HR-HPV frequency was 40.9% in the OSSN group and 4.5% in the pterygia group (p=0.009). After covariate adjustment, OSSN was associated with HR-HPV (OR=16.3, 95%CI=1.2,218.1, p=0.03) and sunburn (OR=10.8, 95%CI=1.8,86.0, p=0.02). Conclusions. Ocular surface squamous cell neoplasia is a multifactorial disease. The strong association between HR-HPV and OSSN, suggests that HR-HPV could play an etiological role in OSSN development.

Molluscum contagiosum is a cutaneous viral infection, usually benign and self-limited, caused by the molluscum contagiosum virus, of the genus Molluscipoxvirus. It is more common in pediatric population, sexually active young people and immunosuppressed patients. Clinical presentation is characterized by umbilicated white to flesh-colored or pearly papules, which rapidly spread and can affect any muco-cutaneous membrane. Although the eyelid presentation is atypical, we herein present two young, immunosuppressed patients, with diagnosis of palpebral molluscum contagiosum, in which the initial clinical diagnosis was wrong. We emphasize the importance in making a timely diagnosis of papular lesions localized on the eyelids and the correlation of these lesions as a cutaneous manifestation of immunosuppression.

ABSTRACT Objective: To describe ocular surface findings in impression cytology obtained from healthy rabbit conjunctiva treated with interferon alpha-2b eyedrop, and compare them to findings after use of mitomycin C 0.02%. Methods: An experimental study using a rabbit model was performed between September 2013 and October 2014 at the Faculdade de Medicina de Marília, Universidade Federal de São Paulo, Clínica de Olhos Moacir Cunha. Thirty New Zealand white rabbits were divided into 6 groups and received interferon alpha-2b or mitomycin C 0.02%. Impression cytology (IC) was performed prior to topical applications and at15, 30 and 60 days of use. The following variables were analyzed in impression cytology: goblet cells, cellularity, cell-to-cell adhesion, nucleus/cytoplasm ratio, nuclear chromatin, inflammatory cells keratinization, and cytomegaly. Results: The major findings in impression cytology after us of interferon alpha-2b included loss of goblet cells (50.8%), reduced cell-to-cell adhesion (26.2%), abnormal nucleus/cytoplasm ratio (20%) and reduced cellularity (15.4%). After use of mitomycin C 0.02%, the most common changes included loss of goblet cells (46.2%), abnormal nucleus/cytoplasm ratio (25.6%), less cell-to-cell adhesion (23.1%), and reduced cellularity (20.5%). There were no significant differences in any variable when comparing impression cytology after interferon alpha-2b and after mitomycin C 0.02%. Goblet cell loss was more pronounced at days 30 and 60, as compared to impression cytology at day 15 for both drugs. Conclusion: The loss of goblet cells, reduced cell-to-cell adhesion and cellularity, along with abnormal nucleus/cytoplasm ratio were the most common findings in impression cytology after use of interferon alpha-2b. These findings are similar to those described for use of mitomycin C 0.02%. ..

Abstract The dog is the main domestic reservoir of Leishmania and font of infection for the vector, constituting an important host for the transmission of the parasite to humans. Non-invasive collection of swab samples for leishmaniasis diagnosis has been a promising alternative. This study analyzed the positivity of polymerase chain reaction (PCR) for the diagnosis of canine leishmaniasis in conjunctiva samples. DNA extraction was performed using SDS 20% and PCR was performed using 13A/13B primers that amplify 120-bp of Leishmania kDNA. Of the 77 dogs analyzed, 50 (64.93%) had ocular changes: 25 (32.47%) dogs had periocular lesion, 41 (53.25%) dogs had purulent eye discharge, and 17 (22.08%) dogs had both signals. PCR was positive in 35 dogs (45.45%), and there was no significant difference between dogs with and without ocular signals (p=0.4074). PCR positivity was significant higher in dogs without periocular injury (p=0.0018). Conjunctive PCR, a less invasive, fast, and painless collection technique, is indicated to complement the diagnosis, especially in dogs without periocular injury, independent of the presence of purulent eye discharge.

Conjunctival squamous cell carcinoma is a rare malignant tumor of the adnexa of the eye. It is associated with multiple risk factors, including infection with the human papillomavirus, which represents a serious health problem worldwide. This study presents the case of a 39-year-old female patient who visited the department of ophthalmology due to a lobulated lesion that affected the cornea in the right eye, of 6 months of progress, accompanied by scarce lacrimation and pain of mild intensity that was relieved with habitual analgesics. Due to the clinical and macroscopic characteristics of the lesion, it was interpreted as a conjunctival intraepithelial neoplasia. Surgery was decided to perform exeresis and anatomopathological study. The diagnosis reached was a moderately differentiated and infiltrating squamous cell carcinoma of the bulbar conjunctiva, associated with cytotoxic changes due to human papillomavirus, confirmed by nuclear and cytoplasmatic positivity for the p16 immunohistochemical marker.

Resumen El carcinoma escamoso de la conjuntiva es el tumor maligno más frecuente de la superficie ocular. Constituye una enfermedad rara con una incidencia de 0,13 a 1,9 por 100 000 habitantes que afecta principalmente a individuos entre los 50 y los 75 años. Suele tener un curso lento y poco agresivo. El tratamiento depende de la extensión tumoral. En presencia de compromiso intraocular la enucleación está indicada y en presencia de compromiso extraocular la exanteración orbitaria es el tratamiento estándar. Reportamos el caso de un paciente de 82 años con carcinoma escamoso conjuntival con compromiso intra y extraocular, se discute el caso y se revisa la literatura.

Raramente se informa la queratoconjuntivitis límbica superior en Medellín, Colombia, donde se la subdiagnostica o a menudo se la confunde con otras enfermedades como el síndrome de ojo seco. Presentamos los casos de tres mujeres con esta enfermedad tratadas exitosamente con la resección de una parte de la conjuntiva bulbar superior y la cápsula de Tenon subyacente, con lo que se logró mejoría de los síntomas irritativos y de la apariencia estética. Hacemos énfasis en la necesidad de sospechar clínicamente esta enfermedad y en su tratamiento quirúrgico.

Objetivo: Evaluar la técnica del auto injerto de conjuntiva con las células límbicas en el tratamiento del pterigion primario en los pobladores de la provincia de Henan, Republica Popular de China. Método: se realizó una investigación aplicada, descriptiva y transversal, teniendo como universo a 235 pacientes chinos, en el período de enero a diciembre de 2009; se tomaron como muestra 132 de ellos, que fueron intervenidos de pterigium. Resultados: la edad media de los pacientes fue de 48,58 ± 14,32 años, siendo hombres el 57.5 %. El número de recidivas como complicaciones fue de solo 8 casos (6.06 %). El nivel de satisfacción de los pacientes fue óptimo en el 80 % de los casos. Conclusiones: el autotransplante libre de conjuntiva con las células límbicas es una técnica muy útil en el tratamiento del pterigium en la población china.Objective: to assess the procedure of conjuntival autograft with limbic cells to treat primary pterygium in the residents of Henan province, People's Republic of China. Method: an applied, descriptive and cross-sectional research was conducted having a target group of 235 Chinese patients from January to December 2009; the sample was comprised of 132 who were operated on pterygium. Results: the mean age of patients was 48.58±14, 32 and 57.5% were men. Recurrence and complications were present in 8 cases (6.06%). The level of satisfaction was good in the 80% of cases. Conclusions: conjuntival autograft with limbic cells is a very useful procedure to treat pterygium in Chinese population.

Introducción. El tracoma es la primera causa infecciosa de ceguera. En 2008 había 1'300.000 ciegos por su causa y 8 millones de personas tenían lesiones oculares que podrían conducirlos a la ceguera. En América Latina se ha documentado su presencia en Brasil, Guatemala y México. Objetivo. Informar por primera vez la presencia de tracoma en Colombia, en indígenas del departamento del Vaupés. Materiales y métodos. En 2003 y 2006 se visitaron las comunidades makú de San Joaquín y Santa Catalina, a 5 km de Brasil, y entre 2007 y 2009, las de San Gerardo, San Gabriel y Nuevo Pueblo, a 35 km de las anteriores. Resultados. En 2006, se examinaron 114 personas en San Joaquín y Santa Catalina. Se diagnosticó clínicamente tracoma en 21 (18,4%), 15 de ellas (13,2%) menores de 15 años. Se detectaron todas las fases de la enfermedad. Tres mujeres tenían opacidad corneal con notoria disminución de la agudeza visual. En las tres últimas comunidades se detectaron tres mujeres con tracoma avanzado, con opacidad corneal y ceguera. La vivienda precaria, la carencia de agua potable y de sistemas adecuados de disposición de los excrementos, y la abundancia de moscas domésticas del género Hippelates, constituyen factores de riesgo para la transmisión del tracoma. Discusión. El tracoma existe en Colombia, con incidencia frecuente en las comunidades estudiadas. Su localización definida hace posible su eliminación en programas de salud pública. Es necesario realizar una búsqueda del tracoma en otras comunidades indígenas del Vaupés con condiciones de vida similares.

OBJETIVOS: Identificar as bactérias que compõem a microbiota conjuntival de pacientes sadios com catarata senil, a susceptibilidade delas aos antibióticos testados e a eficácia de um regime de administração de antibióticos tópicos na redução dessa microbiota. MÉTODOS: Coorte prospectiva, não-randomizada, de 40 olhos de 40 pacientes divididos em 4 grupos de 10 pacientes cada, que utilizaram diferentes antibióticos tópicos (tobramicina, ciprofloxacino e gatifloxacino). Foram realizadas culturas de material conjuntival antes do uso dos medicamentos e 15, 30 e 60 minutos após o uso dos mesmos. Foram realizados testes de resistência bacteriana das bactérias isoladas e comparação da redução do crescimento bacteriano pela análise do número de unidade formadoras de colônias (UFC). RESULTADOS: Houve crescimento bacteriano em 92,5% dos pacientes. O estafilococo coagulase negativo foi a bactéria mais comumente encontrada (50% dos casos), seguido pelo Staphylococcus Aureus (23%) e pelas bactérias gram negativas (26%). Das bactérias isoladas, 81,8% foram sensíveis a todos os antibióticos utilizados no estudo. Houve cinco casos de resistência ao ciprofloxacino e à tobramicina e dois de resistência ao gatifloxacino. Em todos os grupos houve diminuição do número de pacientes com cultura positiva em relação ao momento zero e em relação ao placebo. CONCLUSÃO: As bactérias gram-positivas, especialmente o estafilococo coagulase negativo, foram os microrganismos mais encontrados na conjuntiva normal dos pacientes estudados. As bactérias isoladas mostraram alta taxa de susceptibilidade aos antibióticos testados. O regime de uso desses antibióticos diminuiu o número de unidades formadoras de colônias em relação ao grupo controle, embora sem significância estatística na maioria dos casos.PURPOSE: To evaluate the conjunctival bacterial flora of healthy patients and its antibiotic resistance pattern and determine the effective of a regime of topical antibiotics on reduction of endogenous microbiota. METHODS: Its a prospective non randomized study. Fourty eyes of 40 patients, divided in 4 groups of 10 eyes each, used four differents topical antibiotics (ciprofloxacin, tobramycin and gatifloxacin). One group served as a control group. Were performed conjunctival cultures before instillation of the antibiotics drops and after 15, 30 and 60 minutes. Were performed susceptibility tests of the specimes isolated to these antibiotics. We compared the reduction of bacterium growth by assessing the number of UFC (colonies forming units) before and after the instillation of antibiotics drops. RESULTS: Of the 40 eyes, 92,5% had positive cultures. The coagulase-negative Staphylococcus (CNS) was the most frequent organism isolated (50%), followed by Staphylococcus Aureus (23%) and gram-negative bacteria (26%). More than 81% of the isolates of this bacterium were susceptible to all antibiotics tested. Five bacterium isolates were resistant to ciprofloxacin and tobramycin and two to gatifloxacin. All groups had diminished the number of patients with positive culture specimes from the conjuntiva compared to moment zero and to placebo. CONCLUSION: The gram positive bacterium, specially the coagulase-negative Staphylococcus, were the most frequent microorganism found on conjunctiva of healthy patients. The most of the bacterium isolated were sensitivity to the antibiotics tested. The proposed regime of use of these antibiotics reduced the number of UFC (colonies forming units) compared to placebo although without statics relevance in most of cases.

En los defectos de espesor total del párpado inferior de gran magnitud, siempre ha sido regla de oro la reconstrucción de la lamela posterior (tarso y conjuntiva palpebral). Esto es debido a que el tono del músculo orbicularis oculi no alcanza a mantener el soporte necesario para resistir la acción de la gravedad y/o contractura cicatricial. Además la ausencia de conjuntiva provocaría lesiones sobre la córnea ocular. Es por ello que el empleo de injertos compuestos condromucosos ha sido insustituible. El presente trabajo de investigación fue realizado en 20 conejos albinos con el objeto de evaluar la posibilidad de emplear cartílago auricular para la reconstrucción del tarso sin colocación de mucosa a modo de conjuntiva sobre dicho cartílago. Los resultados obtenidos permiten confirmar por diferentes tinciones histológicas sobre biopsias comparadas con zonas testigo, el crecimiento de tejido conjuntival sobre el pericondrio sin provocar lesiones oculares (neogénesis de conjuntiva). Los hallazgos encontrados provocan importantes y sustanciales cambios en la cirugía reconstructiva del párpado inferior debido a que de esta manera, no sería necesaria la reconstrucción de la conjuntiva palpebral, siendo útil exclusivamente la colocación de cartílago.In a full-thickness defect of a lower eyelid, as a general rule, is mandatory to reconstruct the tarsal plate and the conjunctiva. The reason is that the orbicularis oculi muscle cannot support the effects of gravity and/or cicatricial contracture. The abscense of conjunctiva provokes corneal lesions. Therefore, a chondromucosal graft is obligatory. This research has been performed in 20 albino rabbits to evaluate the possibility of tarsal plate reconstruction with conchal cartilage graft without mucosa. The results of the research have demonstrated, by different histological biopsies, that the raw surface of the perichondrium is epithelized with a new conjunctiva (neoconjunctiva). These findings results are very important since they modify the principles of the lower eyelid reconstruction. We have confirmed that it is not necessary to reconstruct the conjunctive and there are regeneration from the sorrounding mucosa.

While ocular involvement is well documented in association with neurofibromatosis type 1 (NF-1), conjunctival neurofibromas are very rare. We describe a challenging NF-1 case of a patient with a conjunctival neurofibroma in association with lower lid involutional entropion and severe conjunctival chemosis. A 65 year-old male presented with age-related left lower lid laxity, retractor dehiscence, inferior conjunctival chemosis and significant ocular discomfort. The patient underwent a left lower lid lateral tarsal strip procedure with retractor plication without much improvement in the chemosis and discomfort. However post-operatively it became evident that an injected mass was present in the left inferior fornix. Surgical debulking of this mass allowed for resolution of the patient’s signs and symptoms as well as proper lower lid alignment. Histopathologic diagnosis with S100 and CD34 positivity confirmed a conjunctival neurofibroma. Although uncommon, it is important to consider the possibility of a conjunctival mass in a patient with persistent chemosis and recurrent lower lid instability, particularly when confronted with a neurocutaneous syndrome.

La rinosporidiosis ocular es una enfermedad muy poco común, causada por el parásito Rhinosporidium seeberi, la cual afecta diferentes órganos, entre ellos la conjuntiva. Debido a su poca frecuencia, es a menudo subdiagnosticada por oftalmólogos y patólogos. Se presentan tres casos que cumplieron con los criterios histológicos de la enfermedad y se revisan las características clínicas e histopatológicas de la misma.Ocular rhinosporidiosis is a very rare disease, caused by the parasite Rhinosporidium seeberi, which affects different organs including the conjunctiva. Because of its rarity is often underdiagnosed by ophthalmologists and pathologists. We present three cases that fulfilled the histological criteria of the disease and reviewed its clinical and pathological characteristics.

Se realizó un estudio descriptivo de carácter prospectivo longitudinal con el fin de establecer el status de vitamina A de las gestantes del Policlínico "Dr. Joaquín Albarrán" mediante una encuesta dietética y citología de impresión conjuntival; se tomó como universo la totalidad de las embarazadas captadas en el primer trimestre de 1994 (71 pacientes), a las que se aplicó el formulario de la encuesta, se les tomó una muestra citológica conjuntival entre las 8 y las 12 semanas de gestación, y se les determinó el peso y la talla. Igual procedimiento se repitió entre las 28 y las 32 semanas. Encontramos alteración de la citología conjuntival en una paciente al tomar la primera muestra para el 1,4 %. No hubo alteraciones conjuntivales en la segunda muestra (la gestante que presentó anomalías citológicas conjuntivales en la primera muestra, consumía limitadamente alimentos ricos en vitamina A, fue suplementada con el neovitamín II, cuando se tomó la segunda muestra ya había recobrado el patrón normal), lo que demuestra que no existe déficit de vitamina A como problema nutricional en las gestantes de nuestra área de salud en el grupo evaluado. Los resultados del estudio indican que aunque en las encuestas dietéticas se registran moderadas frecuencias de consumo de alimentos ricos en vitamina A, no se detectan deficiencias a nivel de órgano efector, ello posiblemente se deba a que la suma de los aportes alimentarios, más las dosificaciones que tienen los suplementos vitamínicos, satisfacen el nivel de seguridad de mantenimiento de reservas hepáticas, y por lo tanto, proveen la vitamina A más allá del umbral donde aparecen los signos de carencias.A descriptive study of longitudinal prospective character was carried out aimed at establishing the vitamin A status of pregnant women at the "Dr. Joaquín Albarrán" Polyclinic by means of a dietetic survey and a conjunctival impression cytology. All pregnant women treated during the first trimester of 1994 (71 patients) were considered as a universe of study. Questionaries were given to them and a conjunctival cytological sample was taken between the 8 and 12 weeks of pregnancy. Body weight and size were also determined. The same procedure was repeated between the 28 and 32 weeks. Alteration of conjunctival cytology was found in a patients on taking the first sample, for 1,4 %. There were no conjunctival alterations in the second sample (the pregnant woman who presented conjunctival cytological anomalies during the first sample consumed food rich in vitamin A limitedly. She was supplemented with neovitamin II and at the time of the second sample she had recovered the normal pattern), which shows that there is no vitamin A deficit as a nutritional problem among the pregnant women of our health area in the group evaluated. The results of this study demonstrate that in spite of the fact that there have been registered moderate frequencies of consumption of food rich in vitamin A, no deficiencies have been detected at the level of effector. This is possibly due to the fact that the amount of food contributions plus the vitamin supplements' dosifications satisfy the security level for keeping the hepatic reserves, providing vitamin A beyond the threshold where the deficiency signs appear

Sebaceous adenoma of the conjunctiva is a very rare lesion of uncertain origin. It is usually associated with Muir-Torre syndrome in which neoplasms are also found in other parts of the body. We present the case of a 71-year-old man without a previous or family history of neoplasia, who presented with severe inflammation and an infection in his right eye associated with a tumor of the conjunctiva near the caruncle. The lesion was excised and histopathology revealed a sebaceous adenoma. Microsatellite instability was not observed immunohistochemically. He remains alive and well., (Copyright © 2019 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Con el objetivo de conocer los tumores de la conjuntiva más frecuentes en este medio, se realizó un estudio descriptivo retrospectivo de 202 pacientes operados Hospital Oftalmológico "Ramón Pando Ferrer" con diagnóstico histológico de tumores conjuntivales, en el período comprendido entre enero de 1985 y diciembre de 1995; 116 pacientes (57 %) fueron del sexo masculino y 86 (43 %) del sexo femenino. El 30 % se encontraba en el grupo de edades entre los 31 y 50 años. El 61,9 % de las lesiones se localizaba en la conjuntiva bulbar. Se obtuvo un total de 17 diagnósticos histológicos. Los tumores de la conjuntiva se observaron con mayor frecuencia entre los 31 y lo 50 años de edad. El sexo masculino fue el más afectado en nuestra serie. Se localizan preferentemente en la conjuntiva bulbar. Los tumores más frecuentes fueron los pterigion, los nevus y los granulomasTo know the most frequent conjunctiva tumors in our setting, a descriptive retrospective study of 202 patients with histological diagnosis of conjunctival tumors, who underwent surgery at "Ramón Pando Ferrer" Ophthalmological Hospital from January 1985 to December 1995, was made. One hundred and sixteen patients (57 %) were males and 86 (43 %) were females. 30 % were in the age group 31-50. 61.9 % of the injuries were located in the bulbar conjunctiva. It was obtained a total of 17 histological diagnoses. The conjunctiva tumors were more frequently observed in patients aged 31-50. Males were the most affected in our series. These tumors are preferably located in the bulbar conjunctiva. The most common tumors were pterygion, nevus and granulomas

Objective: The purpose of the present study is to describe the clinical characteristics and outcomes of patients diagnosed and treated for conjunctival melanoma in the Ocular Oncology Unit of the University Hospital Clinic of Valladolid., Methods: A retrospective observational case series study was conducted on patients diagnosed with conjunctival melanoma in the Ocular Oncology Unit of University Hospital Clinic of Valladolid, from January 1992 to December 2017. Demographic information and tumour features were recorded in a Microsoft Access database., Results: Among a total of 462 consecutive patients, the tumour was classified as melanocytic in 252 cases (54.5%), with 27 patients having the pathological diagnosis of conjunctival melanoma. The mean age at diagnosis was 59.2years (16-88), and there were 41% males and 59% females, with a mean follow-up of 6.1±6.8years. As regards the origin of conjunctival melanoma, 16 cases (59%) arose from primary acquired melanosis, 26% from nevus, and 15% developed de novo. The treatment performed was incisional or excisional biopsy in all patients, local adjuvant chemotherapy in 15 cases (56%) and brachytherapy in 5 patients (18%). The median survival was 18years and the probability of survival at 5 and 10years was 89% and 69%, respectively., Conclusions: Conjunctival melanoma is a rare disease, usually undervalued by the patient as well as being underdiagnosed, leading to insufficient and delayed treatment. Early diagnosis and treatment are essential to prevent recurrences and systemic extension, as well as to preserve vision and life., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Se presenta el caso clínico de un paciente ecuatoriano de 62 años, mestizo, con antecedente de orzuelos reiterados en el ojo izquierdo, atendido en la consulta de Oftalmología del Hospital del Tena, del Instituto Ecuatoriano de Seguridad Social de Ecuador, por presentar desde hacía 8 meses molestias en ese mismo ojo y presencia de una lesión en el párpado inferior que sangraba con facilidad, acompañado de dificultad al cierre palpebral, por lo cual se le realizó una resección quirúrgica de la lesión con biopsia incluida, cuyo resultado confirmó el diagnóstico de carcinoma epidermoide de la conjuntiva

En los defectos de espesor total del párpado inferior de gran magnitud, siempre ha sido regla de oro la reconstrucción de la lamela posterior (tarso y conjuntiva palpebral). Esto es debido a que el tono del músculo orbicularis oculi no alcanza a mantener el soporte necesario para resistir la acción de la gravedad y/o contractura cicatricial. Además la ausencia de conjuntiva provocaría lesiones sobre la córnea ocular. Es por ello que el empleo de injertos compuestos condromucosos ha sido insustituible. El presente trabajo de investigación fue realizado en 20 conejos albinos con el objeto de evaluar la posibilidad de emplear cartílago auricular para la reconstrucción del tarso sin colocación de mucosa a modo de conjuntiva sobre dicho cartílago. Los resultados obtenidos permiten confirmar por diferentes tinciones histológicas sobre biopsias comparadas con zonas testigo, el crecimiento de tejido conjuntival sobre el pericondrio sin provocar lesiones oculares (neogénesis de conjuntiva). Los hallazgos encontrados provocan importantes y sustanciales cambios en la cirugía reconstructiva del párpado inferior debido a que de esta manera, no sería necesaria la reconstrucción de la conjuntiva palpebral, siendo útil exclusivamente la colocación de cartílago.

Resumo O presente relato apresenta o caso de conjuntivite causada por Ralstonia pichettii em paciente imunocompetente usuária de lente de contato. A bactéria isolada da solução utilizada para desinfecção das lentes R. pichettii não pertente a microbiota humana mas infecta pacientes imunodeprimidos e está presente em soluções aquosas. Não há padronização de sensibilidade para esta bactéria e poucos antibióticos foram testados para bactérias não fermentadoras da glicose. Devido ao reduzido perfil de sensibilidade aos antimicrobianos demonstrado pela R. pichettii, torna-se importante a identificação correta deste agente etiológico em quadros de conjuntivite e ceratites. Este relato de caso ilustra que R. Pickettii é um patógeno mais importante do que se pensava anteriormente.

Case Report: We report a case of 70-year-old male from Sicily, who presented with a bilateral eyelid mass involving the tarsal conjunctiva, found to be Kaposi's sarcoma on histologic examination. Cutaneous and pulmonary Kaposi's sarcoma involvement was documented. The patient had no prior diagnosis of human immunodeficiency virus infection. This case was managed successfully after the completion of five cycles of chemotherapy with liposomal doxorubicin, and his eyelid, skin and pulmonary lesions disappeared., Conclusions: Location in the eyelid is a possible, though rare, initial solitary manifestation of Kaposi's sarcoma in elderly HIV-negative patients. Liposomal doxorubicin is a safe and effective treatment., (Copyright © 2018 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Case Report: A 35-year-old male patient with a large unilateral haemorrhagic conjunctival tumour lesion and another contralateral haemorrhagic conjunctival flat lesion associated with violaceous cutaneous macules on the extremities and angiomatous lesions in the upper gastrointestinal tract as initial clinical manifestation of HIV-related immunodeficiency. Cutaneous, gastric mucosal and conjunctival biopsy was consistent with Kaposi's sarcoma with complete remission after highly active antiretroviral therapy and systemic chemotherapy., Conclusion: HIV-related conjunctival Kaposi's sarcoma, even a large one, can have a good response to antiretroviral therapy and systemic chemotherapy without any additional topical eye treatment., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Non-interventional, observational, epidemiology study to assess clinical characteristics and frequency of adenovirus conjunctivitis diagnosed by AdenoPlus ® in patients who presented with signs and symptoms of acute conjunctivitis. Safety aspects during use of the test were analyzed as well., Method: This analysis presents the data obtained from the 386 patients enrolled in Spain. Patients had to present with acute signs and symptoms of conjunctivitis ≤7days. The minimum age was 1year old. Patients who had already used local antiviral therapies, topical steroids or immuno-modulators were not allowed to enter the study. A standardized questionnaire was used to collect patient's ocular history and test results., Results: A total of 386 patients were recruited in 22 sites, being analyzed 329 patients. Among them, the percentage of "AdenoPlus ® positive" was 36,2% (119/329). Before the test was performed, in 84,1% of the cases, investigators believed that the conjunctivitis was of viral origin but only 50,3% of the investigators had their clinical assessment confirmed by the test. Patients who tested positive for adenoviral conjunctivitis presented higher percentages of signs and symptoms than the rest of the patients., Conclusions: None of the signs or symptoms could be qualified as pathognomonic of the disease, being difficult for the clinicians to perform an accurate diagnosis. AdenoPlus ® test is an antigen based immunoassay test that detects the presence of adenovirus directly from tears, and it can be an useful tool to help early differential diagnosis in patients with conjunctivitis signs and symptoms lasting for less than or equal to 7days., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

The squamous cell carcinoma of the conjunctiva is a neoplasia of the ocular surface that may present with different macroscopic patterns. We present the case of a 75-year-old man that comes presenting this tumor for a long time, involving in an important way its vision.

Case Report: A 35 year-old male patient with a history of HIV infection characterized by progressive tumour growth in bulbar conjunctiva of the left eye, corresponding to conjunctival squamous cell carcinoma that responded to treatment with interferon alpha-2a., Discussion: Interferon alpha-2b has been used at conjunctival level as a topical immunomodulator treatment, with complete remission of epithelial neoplasms being observed. However, there have not been any previous publications on the use of interferon alpha-2a, which differs from interferon alpha-2b in a single amino acid, for the treatment of conjunctival squamous cell carcinoma., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Case Report: A 43-year-old woman presented with a salmon-coloured patch of 0.7mm diameter in the right eye that extended into the lower fornix in the bulbar and tarsal conjunctiva, with irregular edges, and highly vascularised. Incisional biopsy was performed, showing it to be a low-grade conjunctival non-Hodgkin B cell lymphoma (or a mucosa associated lymphoid tissue [MALT] lymphoma)., Discussion: The lesion remained stable for 24 months of follow-up, when a relapse of the condition occurred, producing an enlargement of the initial lesion. The definitive diagnosis is made by biopsy of the affected tissue and histopathologic study., (Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Clinical Case: Seven-year-old male patient, affected by xeroderma pigmentosum (XP) who was referred to ophthalmology due to the presence of numerous tumours in his left eye that affected the eyelids and conjunctiva. He had a tumour in his lower eyelid that affected the free edge, creating a secondary ectropion, and several lesions with a melanocytic appearance in conjunctiva. A resection of the eyelid tumour and the conjunctival lesions were performed by placing a skin graft and amniotic membrane, respectively, as covering., Discussion: XP patients have high probability of developing eye tumours. A thorough ophthalmic examination is necessary to establish an early diagnosis., (Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Case Report: We present a case of ocular loiasis with a subconjunctival filaria, 5.5cm long, and a severe microfilaremia, 1 microfilaria/ml, on a previously asymptomatic woman from Equatorial Guinea, with a past medical history of hypereosinophilia of unknown origin., Discussion: Ocular loiasis is an imported infestation with a very low rate in our country. Nevertheless, chronic infestation in immigrants coming from endemic areas of Africa may increase the rate of this disease in our country., (Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.)

Case Report: An 80-year-old woman diagnosed with a recurrent squamous conjuctival carcinoma treated with surgical excision of the lesion, zonal reconstruction and topical Interferon alpha 2-β., Discussion: Squamous conjunctival carcinoma is the most frequent neoplasm of the ocular surface. Surgical removal of the lesion is the traditional treatment, but this technique has a high recurrence rate. Interferons are glycoproteins that trigger intracellular pathways with antiviral and antitumoral properties. Recent studies have proven their activity against conjunctival carcinoma., (Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.)

SUNCT Syndrome (short-lasting unilateral neuralgiform headache with conjuntival injection and tearing) combines neuralgic, migraineus and autonomic headaches, three of four primary ones described in the International Classification of the IHS (International Headache Society). This work describes a paediatric case evaluated under MIDAS score in which a new therapeutic approach with topiramate (TPM) was used.

Case Report: We present the case of a patient who suffered from rupture of her left eye due to moderate blunt trauma. The lens, which was dislocated to the nasal and superior subconjunctival space, was extracted and the wound explored and repaired; when the process had stabilized secondary vitrectomy and suture of an IOL to the sulcus were performed, achieving a final visual acuity of 0.3., Discussion: Eye trauma is common and eye rupture may occur in those patients who have undergone ocular surgery or suffer from a debilitating condition of the eye. None of these predisposing factors existed in our case. Despite the seriousness of the problem, appropriate treatment achieved good visual function.