Purpose: To study the correlation between thyroid eye disease (TED) with type-2 diabetes mellitus. Methods: A cross-sectional cohort study was conducted from Jan 2018 to Dec 2018, in patients presenting with thyroid eye disease to orbit and oculoplasty clinic of a tertiary eye care hospital. A total of 105 patients were included in the study. All patients underwent detailed ophthalmic evaluation and thyroid eye disease workup. Patients were categorized into mild, moderate, and severe/sight-threatening TED based on EUGOGO classification. Systemic history of diabetes was noted. RBS was done in all patients. Results: Mild disease was noted 61 patients of which 11 were diabetics, moderate in 26 patients (8 diabetics), and severe disease in 18 patients (14 diabetics). All patients were treated accordingly. Among the TED patients, the percentage of diabetic patients was noted to be in increasing order toward the severity spectrum of TED. The prevalence of severe TED was found to be much higher in diabetic patients accounting upto 77.77% of 18 patients. A statistically significant correlation was noted ( P = 0.014) between severe TED and type-2 diabetes mellitus. In addition, early onset of thyroid eye disease was noted in type-2 diabetes patients. Even though female preponderance was noted, severe TED was more in men (66.6%). Conclusion: An autoimmune etiology for the association of thyroid and type-1diabetes has been well established. This study shows that type-2 diabetic patients can have more severity in the clinical presentation of TED. Therefore, the presence of type-2 DM in patients with TED can be a predictive factor for onset, progression, and severity of disease. Hence, a high concern of interest among treating ophthalmologists and endocrinologists regarding this entity would help in early prediction and decreased morbidity among such patients.

Purpose: To report a case of Acanthamoeba endophthalmitis after an uneventful cataract surgery. Methods: Description, management, and outcomes of a biopsy-proven case of Acanthamoeba endophthalmitis. Results: Two days after a routine cataract surgery elsewhere, the patient presented with acute endophthalmitis diagnosed as a bacterial infection based on timing and severity. When conventional methods of management failed, the patient was referred to us. Only the presence of an atypical ring infiltrate suggested Acanthamoeba as a probable cause. Subsequent diagnostic evaluations confirmed the initial suspicion. Management with topical antiamoebics and intracameral and intravitreal voriconazole was attempted. Systemic voriconazole and metronidazole were also administered. However, because of relentless disease progression, the eye had to be eviscerated. The cornea, aqueous, vitreous, and sclera were positive by culture and/or polymerase chain reaction and histopathology. Conclusions: Acanthamoeba usually causes a chronic smoldering keratitis and, very rarely, scleritis. This report, which is the first of its kind, emphasizes the fact that fulminant endophthalmitis with associated scleritis can occur after ocular surgery in an immunocompetent individual, with no significant ophthalmic history.

Purpose: To study the awareness on mucormycosis among outpatients who visited six tertiary eye care hospitals at Madurai, Pondicherry, Coimbatore, Tirunelveli, Chennai, and Tirupati. Methods: This was a telephone-based survey conducted using questionnaires consisting of 38 questions in five sections from July 5 to 25, 2021. Patients visiting the eye hospitals for an examination were contacted over their phones and responses were directly entered onto the Google forms platform. Results: A total of 4573 participants were included in the study. Among all participants, a cumulative 83% of participants had some knowledge of mucormycosis. More than 80% of them reported that their prime source of information was through mass communication like television or radio. Around 34.8% of the respondents were aware that it can occur after treatment for coronavirus disease 2019 (COVID-19) infection, only half of them (54.3%) knew that systemic steroids were the main risk factor. The knowledge scores were higher for participants who were diabetics ( n = 1235) or had been affected by COVID-19 earlier ( n = 456) or whose friends had mucormycosis earlier ( n = 312). Knowledge, attitude, and practice (KAP) scores of nonprofessional health-care workers ( n = 103) were much better compared to patients. Conclusion: Such KAP studies give us an idea of the impact of the measures taken for educating the public. In this study, a cumulative 83% of participants had some knowledge of mucormycosis and 86% knew that this was an emergency. More than 50% of the participants were not aware that diabetes is a risk factor for mucormycosis.

Eosinophilic angiocentric fibrosis is a rare condition presenting with tumefactive lesions of the nasal cavity, paranasal sinuses, upper respiratory tract and rarely the orbit; and has characteristic histopathological features. We report the case of a 38-year-old lady with a mass lesion in right orbit. Histopathological examination of the biopsy specimen revealed extensive areas of perivascular fibrosis showing a characteristic angiocentric whirling with onion skin pattern; along with perivascular exudates of eosinophils accompanied by collection of plasma cells and lymphocytes. Rheumatology review and autoimmune screening was negative. She underwent surgical debulking followed by tapering course of oral steroids and was completely free of orbital disease at her last follow-up visit.

Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.