Background: Choroidal melanomas are diagnosed in approximately 6 out of one million Americans per year, and although their incidence is low, they are the most common primary intraocular tumor in adults. Methods: Choroidal melanoma is rare tumors and till date no such reports with sclera involvement has been reported from Nepal. It is a prospective case series. The aim of this study is for awareness of the severity of the Choroidal melanoma and it’s management. Besides, it is also to study the demography, presentation, histopathological variations and management of cases of choroidal melanoma. All the consecutive cases of Choroidal melanoma presenting between Jan 2017 to May 2018 and those who were within the inclusion criteria were included in this study. Results: There were eight patients, five male and three female, within age range of 18-73, median age was 47. All patients presented with decreased vision ranging from 6/24 to PL of less then three months to 2 years duration. Fund us showed choroidal mass associated with Vitreous hemorrhage (VH), and retinal detachment (RD). Two patients were managed with enucleation with External beam radiotherapy (EBRT). Four underwent only enucleation. One patient with lesion size less then 10mm under went plaque brachy therapy. One patient underwent initially Plaque brachy therapy but later had to undergo Enucleation. Histopathological examination (HPE) of enucleated patient revealed epitheloid cell melanoma grade three in four and Spindle cell melanoma in three patients. Each one patient of epitheloid cell melanoma and spindle cell melanomahad scleral involvement. Indication for radiotherapy was scleral involvement. Conclusion: With 8 cases of Choroidal melanoma in a single year in a single hospitalgives us a clue that there may be much more undiagnosed cases of Choroidal melanomain Nepal that should be taken seriously. Going for annual eye examination with routine dilated fund us exams can help in prevention and early diagnosis of this life and sight threatening condition and to reduce the mortality rate.

Microphthalmos results from incomplete invagination of the optic vesicle or closure of theembryonic fissure. We present three patients with unilateral congenital microphthalmia withcyst. None of them had vision in the affected eye since birth, with gradually increasingmass encroaching towards lower fornix and lower eyelid ectropion. On examination andinvestigations, patients had large orbital cyst with microphthalmia pushing the eyeball superiorlyand posteriorly in affected orbit. Microphthalmic globe with cyst was surgically excised andhistopathologically studied. Orbital cavity was big enough to occupy the conformer and theprosthetic eye after 6 weeks. Diagnosis was confirmed by large communicating orbital cyst withmicrophthalmia without systemic association in all the patients. None of the mothers of patientshad (antenatal care) ANC check up. All the parents had consanguineous marriage. ANC checkup with ultrasound at 14-16 weeks of pregnancy is important for genetic counselling.

Introduction: Eye lid and adnexal tumours are one of the major problems we see in the oculoplastic department. Malignant eye lid tumours are rare in comparison to benign and diversity in its clinical presentation makes it difficult to diagnose earlier.  Eyelid malignancies can mimic a host of benign neoplasms and other less aggressive neoplastic or non-neoplastic inflammatory conditions and need differentiation before definitive therapy is planned. Out of 90% of all skin cancer occurring in head and neck region 10% occurs in the eyelid. A histopathological study confirms the diagnosis that can be correlated with patient history and other clinical data. Objectives: To study the clinicopathological correlation and its outcome in patients with malignant eyelid and adnexal tumours presenting at Biratnagar eye hospital. Methodology:   Details of the cases of histopathologically proven malignant eyelid and adnexal tumours presenting to the department of oculoplasty from July 2016 to August 2019 were recorded.  The duration of disease, presenting symptoms, risk factors, demographic data, clinicopathological correlation with its accuracy and mode of treatment were analyzed using SPSS 17. Results: Out of total 28 patients, male were 53.6% and female were 46.4%.  The mean age of presentation was 60.5±11.8 years. 53.6% tumors were located in upper lid, 39.9% were located in lower lid and 7.1 % were located in medial canthus.  Basal cell carcinoma and sebaceous gland carcinoma were the most common type of malignancies (35.7% each) followed by 28.6% of squamous cell carcinoma of eyelid. The clinicopathological correlation revealed 75% of clinical accuracy. Different types of reconstructions were done according to the size and site of the defect. Modified Hughes procedure for lower eyelid defect was the most common procedure performed (32.1%), followed by  14.3%  Cutler beard,  28.6%  Cutler beard with post auricular cartilage graft,  10.7%  Glabellar flap rotation 7.1% had combined procedure and  4.3%   direct closure . Conclusion:  Sebaceous cell carcinoma and Basal cell carcinoma were the most common malignant tumors followed by squamous cell carcinoma. The upper lid was the most common site for such malignancy. Histopathological examination was useful for the establishment of complete and accurate diagnosis, which led to further management and follow up protocol for malignant eyelid tumours.

Introduction: Ocular cysticercosis is a preventable cause of blindness. It is caused by parasitic infestation caused by the larval form of Taenia solium. Poor sanitation and improper management of food and meat products are the major causes for cysticercosis infestation. Case: Two cases of myocysticercosis presented to our hospital differently. A 12 years boy, first case presented with drooping of right eye (RE) upper lid with recurrent swelling, pain, redness with mild headache and intermittent vomiting for 1 and half months. On examination swelling of RE upper lid, mild ptosis, abaxial proptosis with restricted motility in upgaze was noted. Orbital CT (computer tomography) scan and ocular ultrasound reports showed findings suggestive of myocysticercosis of superior rectus muscle of RE. Routine microscopic examination (RME) of stool demonstrated eggs of Taenia. Complete blood count (CBC) showed eosinophilia. As a suspected case of myocysticercosis and since the patient resided at an endemic zone, empirical therapy with albendazole and steroid was started to continue for 4 weeks. After one week the patient presented with features suggestive of RE orbital cellulitis. With proper counseling about medical therapy and cyst excision, the patient recovered well with only mild RE upper lid ptosis of 2mm. The histopathological examination (HPE) of the excised cyst was suggestive of inflammatory cystic lesion. A 55 years male presented as a second case to us with gradually increasing mass in the RE lower lid with a history of pain, difficulty in opening RE and intermittent swelling of RE 2 months back. On examination RE lower lid mass with exotropia of 15 degree, mild hypertropia was noted. CT scan showed presence of cystic mass 3.5x2x1.5cm in the right orbit involving the right inferior rectus muscle, abutting and displacing the globe superolaterally. CBC showed eosinophilia. Post cyst excision patient recovered well with remaining mild restriction in infraduction most probably due to fibrosis. HPE was conclusive of cysticercus cellulosae. Both the patients improved well with no recurrence until last visit 17 months in 12 years boy and 6 months in 55 years male after which he lost to follow. Conclusion: Myocysticercosis can occur at any age. There is equal importance of clinical, radiological, microbiological and histopathological support for proper diagnosis and management of cysticercosis. Medical therapy along with surgical excision of the cyst with it’s content may be needed in the management of myocysticersosis.

Introduction: A corneal foreign body is the most common occupational ocular injury that can cause secondary infection or scars on the visual axis, decreasing vision. The study aimed to find out practices of wearing protective eye devices in the workplace and the factors influencing the utilization of such devices among patients with corneal foreign body (CFB) injury. Methods: This cross-sectional study was conducted in a tertiary eye hospital in Bhaktapur from April 2021 to August 2021. All patients with CFB attending the hospital were included in the study. CFB was removed with ocular examination under a slit lamp biomicroscope, and face-to-face interview was conducted. Results: Among 142 patients, only one was female, and 41.5% had a previous history of CFB. The most common CFB particle was metallic (n=124, 87.3%),. Three-fourths (75.1%) of patients were not using eye-protective devices at the time of injury, and 45.1% tried physically removing the CFB in a harmful way. Nearly two in five (19.7%) had used topical antibiotics eye drops before presenting for CFB removal. Sixty-six (46.5%) reported never wearing any protective eye devices, and the main reason for not-wearing was the unavailability (48.4%) of such devices in their workplace. The awareness of the need for protective eye devices (p<0.001) was significantly associated with using protective eye devices during work. Conclusion: The workers should be made aware of the consequences of harmful practices following CFB injury. The workers should wear protective eye devices to minimize the risk of ocular injury and consequent visual impairment.