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Fulltext Visual impairment and its associated factors among the adult population of Kuala Pajam village, Branang, Selangor, Malaysia

Rozhan, S.M.R., Halim, I., Shamsul Azhar Sha

Malaysian Journal of Community Health, 2009;15(2):1-8.
MyJurnal

Background : Visual impairment among the rural community has rarely been studied in this country. The purpose of this study is to determine the prevalence of visual impairment and its related factors among the adult population of Kampung Kuala Pajam, Branang.
Methodology : A cross sectional study was carried out in Kampung Kuala Pajam, Mukim Beranang from 25th of December till 30th of December 2007. Universal sampling is adopted and the sample size consists of 321 respondents who is 18 years and above. Trained interviewer has been used to obtain the data through questionnaire and eye examinations using logMAR chart, Red Reflex eye test, Relative Afferent Pupillary Defect (RAPD) test and Pin-Hole test.
Result : A total of 261 respondents who fulfil the criteria were interviewed and had eyes examination during the study period. The prevalence of visual impairment in this population was 9.2% and factors that showed significant association were age (p

Matched MeSH terms: Pupil Disorders
Visual Presentation and Factors Affecting Visual Outcome in Children with Craniopharyngioma in East Coast States of Peninsular Malaysia: A Five-year Review

Mohd-Ilham IM, Ahmad-Kamal GR, Wan Hitam WH, Shatriah I

Cureus, 2019 Apr 08;11(4):e4407.
PMID: 31205829 DOI: 10.7759/cureus.4407

Purpose To describe the visual presentation and factors affecting visual outcome in pediatric patients treated for craniopharyngioma at a referral center in the East Coast states of Peninsular Malaysia. Methodology A retrospective review of medical records of children aged 17 years and below who had been treated for craniopharyngioma in Hospital Universiti Sains Malaysia from January 2014 to December 2018. The data collected included age, gender, presenting symptoms and duration, visual acuity, visual fields, color vision, light brightness, relative afferent pupillary defects, fundus examination and cranial nerves examination. The best corrected visual acuity during presentation, and after a one-year post-operative period, was documented. Records on investigations, surgical procedures, therapeutic modalities and recurrences were also reviewed. Results A total of 11 pediatric patients (22 eyes) were recruited. Fifty percent presented with optic atrophy. The mean duration of the onset of symptoms before consultation was 22.3 (24.5) months. A final best corrected visual acuity of 6/12 (20/40) or better was observed in 50% of the patients. There was a statistically significant association between presenting visual acuity, optic nerve function and visual field defects, and the final visual outcome. Conclusions Visual presentations in our study were fairly similar to previous reported studies. One-third presented late with permanent visual loss. Almost half had significant visual impairment after one-year post-operative period. Significant associations were observed between presenting visual acuity, duration of symptoms, impairment of optic nerve function tests, and visual field defects during presentation, and final visual acuity at one year after treatment.

Matched MeSH terms: Pupil Disorders
Unequal pupils in an asthmatic child

Ng DC, Shangkeree RP, Khoo EJ

J Paediatr Child Health, 2017 10;53(10):1024-1025.
PMID: 28975762 DOI: 10.1111/jpc.1_13531
Matched MeSH terms: Pupil Disorders/etiology*
Tonic Pupil, a Paraneoplastic Neuro-Ophtalmological Disease Associated with Occult Breast Cancer

Peyman A, Kabiri M, Peyman M

Breast J, 2015 Sep-Oct;21(5):543-4.
PMID: 26174775 DOI: 10.1111/tbj.12451

Here, we present a case of tonic pupil associated with occult breast cancer as a paraneoplastic neuro-ophthalmology syndrome. A 45-year-old woman developed progressive photophobia and blurred vision due to unilateral Adie's tonic pupil. Magnetic resonance image of her brain and neurological examination (including deep tendon reflexes) were normal at first visit. Follow-up examinations performed by ophthalmologist every 6 month without any change in her condition. After 2 years, patient discovered a mass in her breast which identified to be malignant after diagnostic procedures. Despite surgical and medical treatment for cancer, no change in the ocular condition was happened.

Matched MeSH terms: Tonic Pupil/diagnosis; Tonic Pupil/etiology*; Tonic Pupil/therapy
Fulltext The incidence of acute angle closure in Scotland: a prospective surveillance study

Chua PY, Day AC, Lai KL, Hall N, Tan LL, Khan K, et al.

Br J Ophthalmol, 2018 Apr;102(4):539-543.
PMID: 28794074 DOI: 10.1136/bjophthalmol-2017-310725

PURPOSE: To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC).
METHODS: Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up.
RESULTS: There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP.
CONCLUSION: The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.

Matched MeSH terms: Pupil
Fulltext The blue man who presented with a stroke

Koh KC, Wong MH

Malays Fam Physician, 2011;6(1):29-31.
PMID: 25606217 MyJurnal

A 19-year-old man presented with sudden onset of right eye ptosis, diplopia and giddiness. He had no previous medical illnesses with negative history of exertional dyspnoea, epistaxis, haemoptysis, palpitations, chest pain and chronic cough. Examination revealed central cyanosis, digital clubbing, polycythaemia, partial ptosis of right eye, diplopia on right gaze and dilated right pupil. Examination of the chest revealed pectus excavatum but no cardiac murmurs were heard. Investigations revealed a solitary right pulmonary arteriovenous malformation with two feeder vessels which were successfully embolized surgically.

Matched MeSH terms: Pupil
Fulltext Severe orbital cellulitis secondary to chronic sinusitis: challenges in saving the eye

Diymitra, K. G., Mushawiahti, M., Aida Zairani, M. Z.

Journal of Surgical Academia, 2018;8(1):47-50.
MyJurnal

Orbital cellulitis is a relatively common disease affecting predominantly the paediatric population. Most cases occur as a result of spread from the nearby sinuses. Other causes include penetrating trauma or extension from infected adjacent structures.If left untreated, this condition may result in devastating sequelae such as orbital apex syndrome, cavernous sinus thrombosis, meningitis, cranial nerve palsies, intracranial abscess formation and even death. A 47 year old immunocompetent Burmese lady presented with left eyelid swelling of 2 days duration associated with eye redness, blurring of vision and diplopia. Previously, there was history of right maxillary sinusitis and parapharyngeal abscess 9 months prior to presentation. On examination, she was afebrile with vision of 1/60 for the left eye with positiverelative afferent pupillary defect (RAPD). The eye was proptosed and swollen with restricted extraocular movements in all gazes. Conjunctiva was injected with chemosis and there was corneal epithelial bedewing. Otherwise anterior chamber was quiet and intraocular pressure was 51mmHg. Bilateral fundus examination was normal. Computed tomography (CT) scan of the orbit and paranasal sinus showed dense sinusitis and periosteal abscess at the lateral orbital wall.She was started on intravenous (IV) Cefuroxime and Metronidazole and underwent Functional Endoscopic Sinus Surgery (FESS) and orbital decompression. Intra-operatively there was pus and debris at the left anterior ethmoid, maxillary and sphenoid air sinuses and cultures revealed Klebsiella pneumoniae which was sensitive to Cefuroxime. Despite medical and surgical treatment, left orbital swelling only reduced minimally. However after starting intravenous Dexamethasone the swelling dramatically improved. She completed 10 days of intravenous Dexamethasone. Upon discharge, she was given oral Dexamethasone 2mg daily for 2 weeks and completed 2 weeks of oral Cefuroxime and Metronidazole. Intraocular pressure normalised and vision recovered to 6/9. A repeat CT orbit 3 weeks later showed resolving preseptal and periorbital collection.

Matched MeSH terms: Pupil Disorders
Fulltext Sequelae of neglected senile cataract

Azhany Y, Hemalatha C, Nani D, Rosediani M, Liza-Sharmini A

Malays Fam Physician, 2013;8(1):33-7.
PMID: 25606266 MyJurnal

Cataract is the most common cause of blindness in the world. An attack of phacolytic and phacomorphic glaucoma as a result of neglected cataract constitutes a medical emergency that must be addressed immediately. Ocular emergencies such as these is challenging for the surgeon with guarded or poor prognosis. We describe the presentation, management and prognosis of three cases of phacomorphic and phacolytic glaucoma. All three patients underwent aggressive management of intraocular pressure. Despite successful cataract operation with implantation of intraocular lens, there was only mild improvement of the vision. Optic nerve and pupil functions were permanently affected following the insult. Phacomorphic and phacolytic glaucoma present a very challenging problem to the surgeon with poor visual outcome. Public health education and awareness are important and health workers should encourage patients with cataract to seek early treatment for better prognosis.

Matched MeSH terms: Pupil
Fulltext Retinotopic effects of visual attention revealed by dichoptic multifocal pupillography

Rosli Y, Carle CF, Ho Y, James AC, Kolic M, Rohan EMF, et al.

Sci Rep, 2018 02 14;8(1):2991.
PMID: 29445236 DOI: 10.1038/s41598-018-21196-1

Multifocal pupillographic objective perimetry (mfPOP) has recently been shown to be able to measure cortical function. Here we assessed 44 regions of the central 60 degrees of the visual fields of each eye concurrently in 7 minutes/test. We examined how foveally- and peripherally-directed attention changed response sensitivity and delay across the 44 visual field locations/eye. Four experiments were completed comparing white, yellow and blue stimulus arrays. Experiments 1 to 4 tested 16, 23, 9 and 6 subjects, 49/54 being unique. Experiment 1, Experiments 2 and 3, and Experiment 4 used three variants of the mfPOP method that provided increasingly improved signal quality. Experiments 1 to 3 examined centrally directed attention, and Experiment 4 compared effects of attention directed to different peripheral targets. Attention reduced the sensitivity of the peripheral locations in Experiment 1, but only for the white stimuli not yellow. Experiment 2 confirmed that result. Experiment 3 showed that blue stimuli behaved like white. Peripheral attention showed increased sensitivity around the attentional targets. The results are discussed in terms of the cortical inputs to the pupillary system. The results agree with those from multifocal and other fMRI and VEP studies. mfPOP may be a useful adjunct to those methods.

Matched MeSH terms: Pupil/physiology*
Fulltext Photopic and scotopic multifocal pupillographic responses in age-related macular degeneration

Rosli Y, Bedford SM, James AC, Maddess T

Vision Res, 2012 Sep 15;69:42-8.
PMID: 22898702 DOI: 10.1016/j.visres.2012.07.019

We compared photopic and scotopic multifocal pupillographic stimuli in age-related macular degeneration (AMD). Both eyes of 18 normal and 14 AMD subjects were tested with four stimulus variants presented at photopic and 126 times lower luminances. The multifocal stimuli presented 24 test regions/eye to the central 60°. The stimulus variants had two different check sizes, and when presented either flickered (15 Hz) for 266 ms, or were steady for 133 ms. Mean differences from normal of 5 to 7 dB were observed in the central visual field for both photopic and scotopic stimuli (all p < 0.00002). The best areas under receiver operating characteristic plots for exudative AMD in the photopic and scotopic conditions were 92.9 ± 8.0 and 90.3 ± 5.7% respectively, and in less severely affected eyes 83.8 ± 9.7% and 76.9 ± 8.2%. Damage recorded at photopic levels was possibly more diffusely distributed across the visual field. Sensitivity and specificity was similar at photopic and scotopic levels.

Matched MeSH terms: Pupil/physiology*
Paradoxical pinpoint pupils with asenapine

Gill JS, Jambunathan S, Wong S, Wong A

Asia Pac Psychiatry, 2015 Jun;7(2):230.
PMID: 25923587 DOI: 10.1111/appy.12171
Matched MeSH terms: Pupil/drug effects*
Fulltext Optic nerve infiltration in adult acute lymphoblastic leukaemia (ALL)

Muhamad-Amin, R., Nur Hasnida Gani, Liza-Sharmini, A.T., Zamli, A.H.

Journal of Biomedical and Clinical Sciences, 2018;3(2):22-25.
MyJurnal

Acute lymphoblastic leukemia (ALL) is the most common
childhood leukaemia. It is a malignant neoplasm caused by the proliferation of
poorly differentiated precursors of the lymphoid cells. It is relatively
uncommon in adult. In adult ALL, central nervous system (CNS) involvement
is associated with poor prognosis. The incidence of CNS involvement has
been reported between 7% and 15 %. We report a case of optic nerve
infiltration in ALL in a 49 years old gentleman. He was diagnosed with
precursor-B ALL. He was treated with chemotherapy and CNS prophylactic
regime. He presented with sudden left eye loss of vision for one-day duration
with history of right eye inferior visual field loss for the past three months. His
visual acuity was no perception to light on the left eye and 6/9 on the right
eye. There was marked left relative afferent pupillary defect. The right eye
showed decreased in optic nerve function with inferior visual field defect.
Anterior segment examination was unremarkable in both eyes. Left optic disc
appeared normal but the right optic disc was pale. Blood investigation
showed no sign of infection or haemoconcentration. Cerebral spinal fluids
examination revealed abundant of white cells and blast cells. Magnetic
resonant imaging showed bilateral optic nerve enhancement suggesting of
bilateral optic nerves infiltration. He was started on a new regime of
chemotherapy followed by cranial radiotherapy. Unfortunately, he succumbed
to death due to septicaemia. There are variations in clinical presentation of
optic nerve infiltration in leukaemic patients. Normal appearance of optic disc
may not exclude the possibility of infiltration by malignancy. Assessment of
the optic nerve function and imaging is helpful for the detection of leukaemic
infiltration. Early detection of optic nerve infiltration is important for initiation or
change of therapy to prevent mortality.

Matched MeSH terms: Pupil Disorders
Optic Nerve Infiltration in Systemic Metastatic Retinal Lymphoma (SMRL): Multimodal Imaging and Challenges in Diagnosis

Mohd Fauzi Yap MFB, Mohd Zain A, Tumain NR, Palaniappan S, Nasaruddin RA, Md Din N

Ocul Immunol Inflamm, 2020 Sep 24.
PMID: 32967510 DOI: 10.1080/09273948.2020.1800050

A 45-year-old man was diagnosed with diffuse large B-cell lymphoma stage IV which was confirmed by celiac lymph node biopsy. He subsequently completed six cycles of R-CHOP chemotherapy. Six months later, he presented with panuveitis OU with positive relative afferent pupillary defect OD. OCT revealed hyper-reflective lesions and irregularity of the retinal pigment epithelium OU. Fundus fluorescein angiogram shows hyper-auto fluorescence and granular changes on the retina. A month later, he developed swollen optic disc OD and hemorrhagic retinitis OU and treated as presumed CMV retinitis. Anti-TB was started after a positive Mantoux test. He finally consented for a vitreous biopsy which showed atypical lymphoid cells highly suggestive for vitreoretinal lymphoma and subsequently received intravitreal methotrexate OU.
CONCLUSION: Optic nerve infiltration in systemic metastatic retinal lymphoma may have initial occult signs but with profound visual loss. Ocular infections like CMV retinitis and tuberculosis may mask and delay the diagnosis in immunocompromised patients.

Matched MeSH terms: Pupil Disorders
Ocular hazards of playing badminton

Chandran S

Br J Ophthalmol, 1974 Aug;58(8):757-60.
PMID: 4433488
Matched MeSH terms: Pupil
Fulltext Ocular dimensions of young Malays in Malaysia

Bariah Mohd-Ali, Muhammad Afzam Shah Abdul-Rahim, Zainora Mohammed, Norhani Mohidin

Jurnal Sains Kesihatan Malaysia, 2011;9(1):35-39.
MyJurnal

Kajian terdahulu banyak menunjukkan perbezaan dalam dimensi okular mengikut kaum. Walau bagaimanapun hanya terdapat sedikit data mengenai dimensi okular bangsa Melayu di Malaysia yang dilaporkan. Kajian ini bertujuan untuk menetapkan nilai normal dimensi okular bangsa Melayu muda di Malaysia. Seramai 584 orang telah diundang untuk menjadi subjek untuk kajian secara sukarela. Pengukuran yang dilakukan meliputi kelengkungan dan ketebalan tengah kornea, nilai esentrisiti kornea (e), diameter iris horizontal dan vertikal yang kelihatan, saiz pupil dan bukaan palpebral. Subjek dibahagikan kepada 3 kumpulan berikut mengikut umur dan dipadankan mengikut jantina dan umur: Kumpulan 1 (7-12 tahun, n = 188), Kumpulan 2 (13 to 18 tahun, n = 196) and Kumpulan 3 (19 to 24 tahun, n = 200). Pengukuran dilakukan menggunakan topografer kornea (CTK 922 dari Haag Streit, Jerman), pakometer ultrasonik (Corneo-Gage Plus 2 dari Sonogage Incorporated) dan auto refraktometer (Auto-Ref R1 dari Canon, Jepun). Dimensi okular bangsa Melayu yang diukur didapati lebih kecil dari bangsa lain di seluruh dunia. Perbezaan yang signifikan juga didapati untuk semua pengukuran dengan peningkatan umur (p < 0.05). Keputusan kajian ini boleh dijadikan rujukan untuk nilai dimensi okular populasi Melayu muda Malaysia di masa hadapan.

Matched MeSH terms: Pupil
Fulltext Neuroretinitis with dual infections

Kiu KH, Hanizasurana H, Zunaina E

Int Med Case Rep J, 2015;8:255-8.
PMID: 26527902 DOI: 10.2147/IMCRJ.S91323

A 22-year-old Malay female presented with left eye floaters for 2 weeks, associated with temporal visual field defect and metamorphopsia for 3 days. She has a guinea pig and a hedgehog at home, but denied being bitten or scratched by them. Her visual acuity at presentation was 6/12 on the left eye and 6/6 on the right eye. Her left eye relative afferent pupillary defect was barely positive with mild anterior chamber reaction. Fundus examination of the left eye showed mild vitritis, swollen optic disc with macular star, crops of active choroidal lesions at superonasal retina with a linear arrangement in the form of migratory track nasally. However, there were no nematodes seen on fundus examination. Investigations showed normal full blood count with no eosinophilia and positive serology test for Bartonella henselae. She was diagnosed to have dual infection - diffuse unilateral subacute neuroretinitis (DUSN), based on the presence of crops of choroidal lesions with migratory track, and cat scratch disease (CSD) based on a positive serological test. She was treated with oral albendazole 400 mg 12 hourly for 6 weeks for DUSN and oral doxycycline 100 mg 12 hourly for 4 weeks for CSD. Focal laser had been applied to the area of migratory track in the left eye. Her left eye vision improved to 6/6 at 1 month after treatment, with resolution of neuroretinitis.

Matched MeSH terms: Pupil Disorders
Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery

Lay Suan AL, Hamzah JC, Ken TS, Mansurali VN

J Cataract Refract Surg, 2017 08;43(8):1031-1035.
PMID: 28917402 DOI: 10.1016/j.jcrs.2017.05.031

PURPOSE: To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0% and phenylephrine 1.5%) versus topical mydriatics (phenylephrine 2.5% and tropicamide 1.0%) in pupil dilation for phacoemulsification surgery in Malaysians.
SETTING: Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia.
DESIGN: Prospective comparative case series.
METHOD: Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded.
RESULTS: The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P = .86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P = .01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (-0.41 ± 1.04 mm) (P pupil dilation (P = .49). Each group had 1 complication (P = 1.00).
CONCLUSIONS: Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.

Matched MeSH terms: Pupil
Fulltext Hemangioblastoma in the setting of von hippel lindau disease: a case report

Raajini Devi K, Aida Zairani MI, Hazlita MI, Jemaima CH, Farizal F, Safinaz Mohd Khialdin

Journal of Surgical Academia, 2016;6(1):54-58.
MyJurnal

A 21-year-old Chinese gentleman with no known medical illness, presented with a history of right painless blurring of vision with central scotoma of two weeks duration. He also had a history of multiple episodes of seizures prior to presentation. Visual acuity was 1/60 with unremarkable anterior segment findings and no relative afferent pupillary defect. Fundus examination of the right eye revealed dilated and tortuous retinal veins with multiple retinal capillary hemangiomas and sub retinal hard exudates at the macula with edema. A diagnosis of Von Hippel Lindau disease was made when a posterior fossa mass suggestive of hemangioblastoma with obstructive hydrocephalus was seen on computed tomography of the brain. Craniotomy with nodule excision was performed. The retinal capillary hemangiomas were treated with the combination of laser photocoagulation and intravitreal Ranibizumab injections. Visual acuity subsequently improved to 6/36.

Matched MeSH terms: Pupil Disorders
Fulltext Frontal mucocele masked as upper lid abcess- a case report

Ng, WL, Umi Kalthum MN, Jemaima CH, Norshamsiah MD

Journal of Surgical Academia, 2016;6(1):43-45.
MyJurnal

Frontal mucocele is not commonly masked as upper lid abscess.A 72-year-old Chinese man with underlying hyperthyroidism complained of left upper eyelid swelling of 6 months duration. The swelling had persisted and worsen when intravenous antibiotic was changed oral type. Visual acuity on presentation was hand motion and reverse relative afferent pupillary defect was present. Because the swelling was large and resulted in mechanical ptosis and ophthalmoplegia, a CT imaging was performed, which showed huge left frontal mucocele eroding the supereromedial orbital rim. The left globe was displaced inferolaterally but there was no extension into brain parenchyma. Fundus examination showed pale optic disc with dull macula. Old laser marks were seen at peripheral fundus. Referral to ortholaryngologist was made and endoscopic sinus surgery and evacuation of mucopyocoele was done. Culture and sensitivity of the fluid showed no organism. He recovered well postoperatively with additional two weeks of antibiotics. We highlight the necessity of surgical drainage of mucocele, following a course of antibiotic.

Matched MeSH terms: Pupil Disorders
Fulltext Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

Zuhaimy H, Aziz HA, Vasudevan S, Hui Hui S

GMS Ophthalmol Cases, 2017;7:Doc04.
PMID: 28194321 DOI: 10.3205/oc000055

Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect. The fundus was normal. The extraocular movements were restricted in all directions of gaze. Nasal endoscopy revealed pansinusitis that corresponded with CT scan orbit and paranasal sinuses findings. Despite treatment, he showed no clinical improvement. Ethmoidal sinus biopsies performed revealed extranodal NKTCL. Further imaging showed involvement of the right orbital contents and its adnexa with intracranial extension into the right cavernous sinus and meninges over right temporal fossa. The patient underwent chemotherapy. However he succumbed to his illness two months after the diagnosis. Conclusion: Extranodal NKTCL is a great mimicker. This case demonstrated how an acute initial presentation of extranodal NKTCL can present as orbital cellulitis with pansinusitis.

Matched MeSH terms: Pupil; Pupil Disorders

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