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Spectrum of Orbital Disease in South India: An Aravind Study of 6328 Consecutive Patients

Kim, Usha R. M.D.*; Khazaei, Hadi M.D.*; Stewart, William B. M.D.; Shah, Akash D. M.D.*

Ophthalmic Plastic & Reconstructive Surgery: September-October 2010 - Volume 26 - Issue 5 - p 315-322
doi: 10.1097/IOP.0b013e3181c32f2f
Original Articles

Aim: To review the incidence of orbital diseases in South India and to compare with other case series published.

Methods: Retrospective review of 6328 consecutive patients with orbital disease evaluated at Aravind Eye Hospital between January 1997 and December 2008. The main outcome measure was incidence of orbital disease in South Indian population, as determined by clinical and histopathologic criteria. A literature review was conducted to compare the results of this study with those of previously published reports.

Results: Of the 6328 patients, 2161 (34.1%) had inflammatory orbital disease, 1965 (31.0%) had systemic conditions involving the orbit, 1277 (20.1%) had neoplasm, 600 (9.4%) had congenital lesions, 308 (4.8%) had trauma, and 17 (0.2%) had vascular disease. Of the 2161 patients presenting with inflammatory disease, 1473 (68.1%) had idiopathic orbital inflammation, 270 (12.5%) had infection, 126 (5.8%) had dacryoadenitis, and 292 (13.5%) had other etiologies. Among the 1965 patients presenting with systemic disease involving the orbit, 1938 (98.6%) were diagnosed with thyroid orbitopathy, 22 (1.1%) with amyloidosis, and 5 (0.2%) with sarcoidosis. Of the 1277 patients with neoplasm, the tumor was vascular in 369 (28.8%), neural in 336 (26.3%), lymphoid or leukemic in 131 (10.2%), secondary neoplasm in 82 (6.4%), epithelial in 68 (5.3%), adipose in 53 (4.1%), metastatic in 39 (3.0%), and fibrous, fibro-osseous, striated muscle, histiocytic, and other cellular origin in 40 (3.1%), 37 (2.8%), 23 (1.8%), 21 (1.6%), and 78 (6.1%), respectively. Of the 600 patients with congenital lesions, 427 (71.1%) had dermoid and 170 (28.3%) had dermolipoma, followed by meningoencephalocele.

Conclusions: The most common causes of orbital disease in South India are inflammatory (34.1%) and systemic conditions (31.0%). With the exception of higher incidence of inflammatory etiologies, these data are largely consistent with prior published reports.

The authors describe the spectrum of orbital disease in South India, involving 6328 consecutive patients who presented at the Orbit and Oculoplasty clinic at Aravind Eye Hospital, Madurai, during January 1997 to December 2008.

*Orbit and Oculoplasty Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India; and †Institute for Health & Healing California Pacific Medical Center, San Francisco, California, U.S.A.

Accepted for publication September 27, 2009.

The authors have no financial interest related to this research.

Address correspondence and reprint requests to Usha R. Kim, D.N.B. Ophthalmology, Orbit, Oculoplasty and Oncology Clinic, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India. E-mail:

©2010The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.