BACKGROUND Lesions of the lacrimal fossa and gland constitute about 5%-13% of all orbital masses confirmed by biopsy. The diagnosis, the histopathological correlation and treatment of lacrimal fossa lesions are important to ophthalmologists. The aim of this study is to analyse retrospectively 31 cases of lacrimal fossa lesions diagnosed over a 10-year period. MATERIALS AND METHODS The clinical features and the histopathological features of 31 cases diagnosed as lacrimal fossa lesions between 2004 September and 2014 August were retrospectively analysed from case records in a tertiary care centre at

Background: Vernal keratoconjunctivitis (VKC) is a common, chronic, bilateral, recurrent, allergic, inflammatory disease of the ocular surface primarily affecting young males in dry, hot climates such as India. Objectives: To compare the efficacy, tolerability and safety of 0.03% tacrolimus eye ointment and 0.05% cyclosporin eye drops in the treatment of vernal keratoconjunctivitis. Methods: A prospective study of 72 patients conducted from December 2017 to February 2021. After having established a diagnosis of VKC and fulfilling inclusion and exclusion criteria, participants were divided into two groups. Group 1 was put on cyclosporin eye drops and group 2 was put on tacrolimus eye ointment. Detailed history and evaluation for symptoms, signs, visual acuity and IOP was done on first visit and subsequently after 6 weeks, 12 weeks and 24 weeks. Results: 72 patients were diagnosed to have VKC, of whom males were 86% and females 13.9%, all belonging to the age group 5 to 14 years and were divided into two groups. Both the groups showed significant reduction in the symptoms and signs with no significant difference in efficacy between the groups and they maintained normal IOP and visual acuity at 6 weeks, 12 weeks and 24 weeks. Conclusion: Both the immunomodulators were equally successful in resolving the signs and symptoms of VKC, tolerable with no significant adverse effects and proved to be a safer alternative to steroids as they caused no elevation of intraocular pressure or any complications associated with the use of steroids.

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Toxic Epidermal Necrolysis, Amoxicillin, Adverse Drug Reactions Adverse drug reactions are unintended hazardous effects of drug that can occur with any class of medication;however studies have shown a high incidence with antibiotics. Amoxicillin is a broad spectrum beta lactam antibiotic, commonly used in treating infections, is known to cause cutaneous skin eruptions. Toxic epidermal necrolysis (TEN) is a rare but severe life threatening dermatological reaction most often triggered by medications. Here we describe a case of TEN in a 69 year old male following Amoxicillin therapy presenting with mucocutaneous lesions with super added multidrug resistant bacterial infection requiring 20 days of rigorous hospital care.

PRESENTATION OF CASE 55 years old male presented to ophthalmology department in our hospital with the complaints of an insidious onset of gradually progressive visual loss and pain in right eye since 3 months. Left eye was normal. He was a non-smoker but alcoholic and is not a known case of hypertension. He was recently diagnosed with Diabetes mellitus and is a known case of dyslipidemia (Total cholesterol-234 mg/dl, TGL-269 mg/dl, HDL-30 mg/dl, LDL-150.2 mg/dl, VLDL-53.8 mg/dl, Total cholesterol / HDL ratio-7.80, LDL/HDL ratio-5.01). After examination his visual acuity in right eye was PL negative, left eye 6/12 and near vision less than N36. On admission his pulse was regular, his blood pressure was 120/70 mmHg. Other systems were normal. The ocular position of both eyes on forward gaze was fixed at the midline and extraocular movements were normal. The anterior segment examination showed rubeosis iridis in the right eye. Left eye was normal. Intraocular pressure was 20.6 mm Hg in the right eye and 17.3 mm Hg in the left eye. A dilated fundus examination of right eye showed neovascularization of disc, superficial hemorrhages and absent foveal reflex. Multiple microaneurysms and superficial haemorrhages were present in the posterior pole extending up to the mid periphery along with few cotton wool spots (Figure 1). Left eye fundus was normal. Visual fields in right eye could not be done due to absence of perception of light whereas visual field in the left eye was normal. Carotid Doppler study showed right carotid bulb plaque with stenosis of 60% and bilateral internal carotid arteries showed echogenic material with minimal flow-suggestive of occlusion (Figure 3).