Objective: To report the epidemiology of canalicular lacerations and surgical outcomes of canalicular laceration repair with Mini-Monoka® (FCI Ophthalmics, Issy-les-Moulineaux, Cedex, France) intubation. Methods: This is a retrospective interventional case series of patients who underwent Mini-Monoka® intubation in the repair of canalicular laceration from 2010 to 2015 at a tertiary state-owned hospital in Manila, Philippines. Patient demographics, surgical outcomes, and complications were analyzed. Results: Fourteen patients (12 males and 2 females) underwent Mini-Monoka® intubation for monocanalicular laceration. The mean age at presentation was 27 years (range, 16-47 years). The mean duration of follow-up was 2.92 years (range, 1.28-6.15 years). Canalicular patency was achieved in 12 out of the 14 patients (86%). None of the 12 patients experienced epiphora following stent removal resulting in a functional success rate of 100%. Two patients had punctal slitting (14%). Premature stent loss occurred in 2 out of the 14 patients (14%). Conclusion Mini-Monoka® intubation is effective in maintaining the long-term anatomical patency of the lacerated canaliculus. It is a simple and minimally invasive procedure making it a safe and reasonable alternative to the traditional methods of canalicular repair.
Lacerations ; Eyelid Diseases

Massive retinal gliosis (MRG) is a rare, benign intraocular condition resulting from reactive glial cells undergoing exaggerated repair phenomenon. A 52-year-old male presented with 6-year history of enlarging mass in the right eye, associated with progressive vision loss and worsening proptosis. He reported history of trauma to that eye secondary to a vehicular crash one year prior. Magnetic resonance imaging (MRI) of the orbits revealed an intraocular lesion with calcifications raising the possibility of a malignant tumor. Enucleation of the right globe was performed and histopathologic examination revealed the entire vitreous cavity and retina replaced by glial cells arranged in interlacing bundles and whorls with foci of calcifications, highly suspicious of MRG. This was further confirmed by a positive, diffuse, and robust cytoplasmic expression of glial fibrillary protein (GFAP). The disease is known to have favorable outcomes as no complications, such as reemergence of the mass, active bleeding, and secondary infection, were observed from the patient during subsequent visits. Distinction of MRG from other intraocular neoplasms is clinically challenging, hence biopsy is necessary. MRG should be considered as a differential diagnosis when encountering intraocular tumors, especially if there is a history of eye trauma. This is the first reported case of MRG in the Philippines.
Human ; Female ; Middle Aged: 45-64 yrs old ; retinal tumor ; retinal neoplasms

Objective: To describe the clinicopathologic features and outcome of a patient with epithelial-myoepithelial carcinoma of the lacrimal gland who underwent modified lateral orbitotomy with en toto removal of the lesion and adjuvant radiotherapy. Methods: This is a case report. Results: A 31-year-old Filipino male seafarer presented with a 2-month history of an enlarging left superotemporal orbital mass and inferonasal displacement of the globe. Magnetic resonance imaging revealed a superotemporal extraconal mass within the lacrimal sac fossa with evidence of osseous infiltration of the superolateral orbital rim. Modified lateral orbitotomy was performed with en toto removal of the lesion and the clinically infiltrated adjacent lateral bony margin. Histopathologic diagnosis of epithelial-myoepithelial carcinoma of the lacrimal gland was made based on the classic and distinct biphasic morphology and was confirmed with immunohistochemistry studies (cytokeratin-7, S-100, and p63). Systemic surveillance using positron emission tomography and computed tomography scan with contrast revealed no evidence of regional or distant metastasis. Adjuvant radiotherapy of the orbital area was performed for increased local control. Twelve months postoperatively, the patient showed no evidence of tumor recurrence. Conclusion Epithelial-myoepithelial carcinoma of the lacrimal gland is a rare condition, and this is the first documented case from the Philippines. Accurate diagnosis is necessary for appropriate treatment. It should be included in the differential diagnosis of infiltrative lesions in the lacrimal gland fossa.
Lacrimal Apparatus

Background: Asians with Graves’ ophthalmopathy (GO) may have earlier compressive features due to narrower orbital apex and increased orbital volume. Objective: To determine the risk factors associated with activity and severity of GO among adults. Methodology: This was a cross-sectional analytical study of 163 adults with Graves’ disease (GD) from the outpatient clinics of the Philippine General Hospital. Demographics, clinical data, thyrotropin receptor antibody (TRAb) and urine iodine (UIE) levels were obtained. All participants were evaluated for activity and severity of GO by a single ophthalmologist. Results: The population was predominantly composed of females (81%) and nonsmokers (69%), with a mean age of 35 + 11 years and median GD duration of 2 years. Median TRAb was 8.9 U/L while UIE was 171 mcg/L. Eight percent exhibited active GO, with 85% having mild disease. Multivariate analysis showed male sex to be associated with severe disease (OR 3.71, p=0.041), while elevated TRAb was associated with both active (OR 1.03, p=0.002) and severe GO (OR 1.02, p=0.007). Conclusion Lower rates of active and severe GO were seen compared to previous reports. In this population of predominantly nonsmokers, elevated TRAb emerged as a risk factor for active and severe GO.
Graves Ophthalmopathy ; Graves Disease ; Long-Acting Thyroid Stimulator