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Introduction: Many countries from South-East Asia reported an epidemic of sino-orbital mucormycosis (SOM), otherwise a rare disease, during the coronavirus disease 2019 pandemic. SOM, a potentially fatal disease, is typically treated with orbital exenteration and systemic antifungals after metabolic stabilization. There is no clear evidence of survival benefit of exenteration in the literature, and thus, there have been attempts at globe conserving treatments like orbital infusion after limited debridement and intraorbital injections with Amphotericin B (IOAB). Methods: We conducted a prospective comparative interventional study at a tertiary eye care hospital to evaluate treatment outcomes with the use of adjunctive IOAB in cases of SOM with mild to moderate orbital disease. Results: Thirty-six patients of SOM with mild to moderate orbital disease were recruited in the study. In the intervention group, 23/26 (885%) eyes had stable orbital disease at the end of treatment (4-6 weeks). No deterioration in visual acuity was noted as a result of treatment. In 8/26 (30.77%) patients, inflammation was noted as a side effect of IOAB requiring temporary discontinuation of injections. The mean follow-up for cases was 14.2 months (range 12-15 months). 1/23 (4.35%) patients had relapse of orbital disease at 3 months. Twenty-one patients are alive on last follow-up. Of the patients who refused treatment (controls), 2/9 (22.22%) patients relapsed. One of these patients with relapse underwent exenteration, while the other was managed with IOAB. At a follow-up of 14 months (range 12-15 months), eight patients are alive. On evaluating the ocular parameters in salvaged eyes, improvement in extraocular movements was noted in 75-80% cases. The degree of proptosis and resistance to retropulsion did not change significantly. Conclusion: In the current study, an improvement in the globe salvage rates was noted in cases of SOM with mild to moderate orbital disease treated with adjunctive IOAB as compared to controls at a mean follow-up of 14 months, although it did not achieve statistical significance. The study supports the inclusion of IOAB in routine management of mild to moderate orbital disease. Keywords: Amphotericin B, orbital injection, sino-orbital mucormycosis, Author(s): Rachna Meel (corresponding author) [1]; Mandeep S Bajaj [1]; Neelam Pushker [1]; Sahil Agrawal [1]; Parag Tyagi [1]; Alok Thakkar [2]; Sanjay Sharma [2]; Shuchita S Pachaury [2]; Navneet [...]

Purpose: The coronavirus disease 2019 (COVID-19) pandemic led to overall interrupted medical care, resulting in disease progression and morbidity. The study aimed to evaluate clinicopathological presentations and severity of eyelid malignancy during the COVID era, comparing the results with patients presented during pre-COVID era and evaluating the reasons for delayed presentation in patients with advanced eyelid malignancy in the COVID-era. Methods: This was a comparative, ambispective observational study. Data regarding demographic, clinical, histopathology, and treatment modalities of confirmed cases of eyelid malignancy admitted during the period from March 2020 to September 2022 (defined as COVID era group) were collected and compared with retrospectively collected data from March 2017 to March 2020 (defined as pre-COVID era group). COVID era patients were further categorized as localized and advanced disease. Patients with advanced eyelid malignancy during COVID era were further subjected to a questionnaire to evaluate the reasons for delayed presentation. Results: In total, 115 patients of eyelid malignancy were studied [COVID era group 40 (35%) and pre-COVID era group 75 (65%)]. A statistically significant increase in the duration of disease (P = 0.0001) and advanced tumor T-stage (P = 0.03) was noticed in the COVID era group. Demographic, histopathology, and ocular morbidity details were similar in both groups. The common reasons that led to delay in presentation and treatment in advanced T-stage patients during the COVID era were fear of acquiring COVID, lockdown, and lack of medical facilities. Conclusion: During the COVID-19 pandemic, both hospital- and patient-related factors contributed to delay in presentation, leading to advanced-stage disease indicating need of triaging of eyelid malignancy in the event of such pandemics in future. Keywords: COVID, eyelid, lockdown, malignancy, pandemic, Author(s): B Mounica [1]; Neelam Pushker (corresponding author) [1]; Seema Kashyap [2]; Seema Sen [2]; Sahil Agrawal [1]; Rachna Meel [1]; Mandeep S Bajaj [1]; Sameer Bakhshi [3] The World [...]

This was a prospective, interventional, comparative study conducted on patients with congenital simple severe ptosis. A novel method of silicone rod fixation to the tarsus (tarsal tunnel technique, group 1) was done compared with a conventional technique of silicone rod fixation (suture fixation technique, group 2) in frontalis suspension surgery. A total of 30 patients were randomized into two groups of 15 patients each. Postoperatively, MRD1, vertical palpebral aperture, and eyelid fold height were comparable in both groups till the last follow-up with stability in eyelid position. Patient satisfaction scores showed similar results with good-fair satisfaction grading in 13 patients in group 1 and 11 patients in group 2 at 6 months follow-up. No significant complications occurred in either group. Tarsal tunnel fixation of silicone rods is a novel method in sling surgery with optimal cosmetic and function outcomes. Further long-term studies are needed to validate the results of the technique. Keywords: Congenital ptosis, novel, silicone rod, sling surgery, suture fixation, tarsal tunnel fixation, Author(s): Neelam Pushker [1]; Manish Mahabir [1]; Sahil Agrawal (corresponding author) [1]; Mandeep Singh Bajaj [1] Frontalis suspension surgery is a routinely done procedure for the correction of severe congenital [...]

Introduction:Eyelid sebaceous gland carcinoma (SGC) is an aggressive malignancy. Surgical excision is the standard treatment for non-metastatic eyelid SGC. This study aimed to evaluate treatment outcomes with use of neoadjuvant chemotherapy (NACT) and any change in ease/difficulty of surgical treatment in such cases. Methods:This was a prospective interventional study conducted over 24-month period. Histopathologically, confirmed cases without any systemic metastasis were included. Clinico-demographic details were collected for 30 patients. 10 patients received NACT using cisplatin and 5-FU. Tumour response was evaluated using RECIST criteria. An ease of surgery questionnaire was used to assess difficulty of surgical treatment before and after NACT. Results:Of the 30 patients evaluated for recruitment, 37% had recurrent SGC and 72% had advanced tumour stage. Ten patients were recruited for NACT. There was partial response in 80% and complete response in 10% cases. Tumour T category downstaging was seen in 50% of cases. While tumour dimensions/volume reduced substantially, surgical ease improved in only 40% cases. Conclusion:A significant proportion of SGC patients evaluated in our study presented with recurrent and/or advanced disease. NACT caused tumour regression in 90% of cases. However, surgical ease improvement was limited, pointing to a need for surgical modification in such cases. Corneal ulceration was noted in 2 cases with large tumours causing a complete mechanical ptosis. Overall, the study introduced an ease of surgery questionnaire and provided insights into benefits and challenges of using NACT for eyelid SGC management.

Byline: Rachna. Meel, Seema. Kashyap, Meenakshi. Wadhwani, Mandeep. Bajaj, Sanjay. Sharma IgG4-related disease is a multisystem disorder characterized by tumefactive lesions comprising of IgG4-bearing plasma cells with fibrosis. We report [...]

Byline: Sujeeth. Modaboyina, Deepsekhar. Das, Mandeep. Bajaj, Sahil. Agrawal The superior ophthalmic vein (SOV) courses posteriorly and laterally between superior rectus and the optic nerve, exiting through the superior orbital [...]

Byline: Sahil. Agrawal, Swechya. Neupane, Sujeeth. Modaboyina, Mandeep. Bajaj, Deepsekhar. Das Bilateral superior ophthalmic vein thrombosis (SOVT) being extremely rare requires diligent evaluation for a definitive diagnosis. A 19-year-old male [...]

Byline: Deepsekhar. Das, Mandeep. Bajaj, Saloni. Gupta, Sahil. Agrawal A 15-day-old female with left orbital mass since birth, showed upper eyelid fullness with a palpable cyst underneath. It was translucent, [...]

Byline: Sahil. Agrawal, Mandeep. Bajaj, Saloni. Gupta, Deepsekhar. Das Globe luxation is a rare clinical event in which there is a complete outward prolapse of eyeball from the orbital cavity [...]

Byline: Sahil. Agrawal, Aishwarya. Rathod, Sujeeth. Modaboyina, Seema. Sen, Deepsekhar. Das, Mandeep. Bajaj Solitary fibrous tumor (SFT) is a rare spindle-cell neoplasm of mesenchymal fibroblast-like cells. A 47-year-old female, with [...]