Background: Objective of the study was to determine the posterior segment findings in cases of Acute Encephalitic Syndrome(AES) in patients attending the paediatrics department of Assam Medical College.Methods: A prospective study of 36 cases of AES attending the paediatrics department of Assam Medical College during a period of 6 months was taken into consideration.Results: 36 cases of AES were studied during a period of 6 months. The maximum number of cases was around 5 years (41.6%).The number of cases in males were more than in females (63.8%vs 36.1%) .The posterior segment findings were papilledema (44.4%), optic disc hyperemia (52.7%),and retinal hemorrhages(3%).Conclusions: Analysis of posterior segment findings helps in early detection and preventing the sequalae and complications and therefore helps in saving the eye.

A 10-year-old girl presented to our O.P.D. with intra-orbital trauma. On radiological workup following admission, USG B Scan, MRI Brain and 3D reconstructed faciomaxillary imaging were indeterminate for presence of foreign body, whereas CT scan showed a hyperdense lesion suggestive of intra-orbital foreign body. In this condition of imaging dilemma, surgical exploration was decided since there was no improvement in clinical symptoms via lateral orbital approach. Two small wooden pieces were detected in orbital exploration. This case highlights the role of history taking, clinical judgement in all cases of intraorbital tumour more so in paediatric population than solely going by the investigative modalities.

Squamous cell carcinoma (SCC) is a malignant tumour of the squamous cell layer of the epidermis accounting for about 9.2% of all eyelid malignancies. We report a case of a 45 year old female patient presented with itching, sticky discharge and swelling over the right upper eyelid (RUL) for 20 days. Initially, it was diagnosed as a case of blepharitis of Right Eye and antibiotic eye ointment and lubricants were prescribed. And 2 months later she presented with a mass over the same site. Past history of trauma, burn and chronic exposure to sunlight was absent. Examination revealed a mass of 1.25cm-1.50cm width & 1cm-1.25cm in height approximately, shape was irregular & firm in consistency. Eyelid margin contour was lost with loss of eyelashes. Other ocular structures were within normal limits. No associated lymphadenopathy was noted. Incisional biopsy of the mass was suggestive of moderately differentiated SCC. Treatment: Wide excision of the mass was done. Full thickness defect of the upper eyelid was reconstructed with Cutler-Beard technique. Conclusion: Wide variation at presentation, delay in diagnosis and high propensity to recur with risk of perineural spread leads to difficulty in management. Therefore, any suspicious lesion eyelid lesion should be excised and biopsied.

Background: Choroidal osteoma is rare clinical entity of unknown etiology, characterized by formation of mature cancellous bone within the choroid. It typically affects young females, with no racial predilection. Vision loss occurs mainly due to photoreceptor degeneration secondary to decalcification and/or development of choroidal neovascularization especially if located at the subfoveal area. Case presentation: Our case is 9-year-old Indian (Indo-Aryan) boy identified incidentally with clinical features suggestive of choroidal osteoma with marked diminution of vision. Spectral domain optical coherence tomography demonstrated high reflectivity from the choroid and atrophy of the overlying retinal layers and B-scan ultrasound demonstrated multiple highly reflective calcified lesions within the choroid. Conclusion: Although available literature shows that the occurrence of this rare clinical entity is more commonly seen in young females, our case report has shown that it may be seen at a very early age. The treatment options are still not available if significant atrophy of retinal pigment epithelium has already occurred; however, vision loss due to associated choroidal neovascularization may be treated with currently available treatment options. In our case, the vision loss was due to the significant atrophy of the retinal layers. Choroidal neovascularization was not seen and our patient was advised to attend follow-up regularly.