Advanced Case of Rhabdomyosarcoma of Orbit Mimicking Orbital Cellulitis

Rhabdomyosarcoma is a malignant neoplasm of primitive mesenchyme exhibiting skeletal muscle differentiation. Rhabdomyosarcoma, which can histo pathologically be of embryonal, alveolar, botryoid and pleomorphic types; is a rare tumor in children, with an annual incidence of 4.3 cases per million. Pleomorphic rhabdomyosarcomas is a rare variant, occurring more commonly in adults. 

We report a rare case of ocular pleomorphic rhabdomyosarcoma in an 18-month-old child with atypical presentation mimicking orbital cellulitis. A provisional diagnosis of orbital cellulitis was made based on clinical and radio logical examination and was planned for surgery. Histopathology confirmed the diagnosis of pleomorphic rhabdomyosarcoma. This case shows that pleomorphic rhabdomyosarcoma may also occur in children, it may mimic symptoms of orbital cellulitis, and any fast growing swelling should be carefully examined with a high degree of suspicion of this entity.

Keratoconus Management: Role of GP Contact Lenses

Keratoconus is a corneal disorder progressive characterized by thinning and steepening of the central and paracentral cornea, which leads to protrusion. The exact cause of the disease remains to be fully elucidated although its etiology probably is multi factorial with a genetic predisposition to keratoconus influenced by external environmental factors (eye rubbing and atopy) with different systemic involvement. In the early stages, keratoconus can be managed with spectacles or contact lenses (CL), but when keratoconus progresses, other surgical techniques are often required.

For example, anterior lamellar (dDALK) or penetrating keratoplasty (PK) permit than 3 of 4 patients achieve best-corrected visual acuity of 20/40 or better. Intra corneal ring segment(ICRS) are proposed to increase corneal stability and decrease the astigmatism a symmetry normalizing the corneal contour with slight improvement of patients’visual acuity. Corneal collagen cross-linking (CXL) is a common technique proposed to reduce disease progression with a light improvement of visual acuity (1 to 2 Snellen lines).