Purpose To study the clinical and histopathological features of eyelid sebaceous gland carcinoma (SGC) and to evaluate the prognosis in the Asian-Indian population. Methods This is a retrospective study of 191 patients with SGC. Results The mean age at presentation of eyelid SGC was 57 years (median, 56 years). The tumor epicenter was most commonly located in the upper eyelid (n = 125, 65%). The mean tumor basal diameter was 15 mm (median, 10 mm). There was evidence of tumor extension into the orbit (n = 30, 16%), paranasal sinuses (n = 3, 2%), and brain (n = 1, 1%). Wide excision biopsy (n = 146, 78%) was the most common treatment modality. Tumor recurrence was noted in 42 (24%) patients over a mean follow-up period of 29 months (median, 20 months). On the basis of the Kaplan-Meier estimate, lymph node metastasis occurred in 18%, systemic metastasis was detected in 10%, and death occurred in 2% of patients at 10 years. On multivariate analysis, the factors predicting locoregional lymph node and systemic metastasis were medial canthal involvement (P = 0.004; P = 0.013), lateral canthal involvement (P = 0.013; P = 0.025), tumor basal diameter 410 mm (P = 0.002; P = 0.002), and perivascular invasion (P = 0.043; Po0.001), respectively. The factors predicting death due to metastasis on multivariate analysis were medial canthal involvement (P = 0.012) and tumor basal diameter 410 mm (P = 0.001). Conclusion Advanced eyelid SGC is a tumor associated with poor prognosis. In this study, canthal involvement, larger tumor diameter, and perivascular invasion were poor prognostic factors.

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P. insidiosum keratitis needs to be considered in the differential diagnosis of severe fungal keratitis. It can be identified using the zoospore formation method and confirmed by ITS DNA sequencing. Lack of response to currently used antifungal drugs calls for evaluation of newer drugs for medical therapy and consideration for early penetrating keratoplasty.