Vision reduction in his eye.

5 yr old boy with white forelock and blue eyes . On further examination sensorineural hearing loss present . What is the probable diagnosis ?

a20 yr old down's syndrome girl with uncontrolled epilepsy was brought by her family for rapidly progressing neck pain and dysphagia. endoscopy very edematous pharynx and larynx. xray neck showed prevertebral widening with gas formation, straightening of cervical vertebrae and suspected foreign body at post cricoid level. ? large retropharyngl abcess on questioning the parents they give history that she hurriedly had fish a few days ago. As it was a high risk condition she wasn't taken up at many places. it was heart wrenching looking at her , she's unable to understand what's happening to her all that she wasn't able to swallow anything and had excruciating pain. she was taken up for exploration under GA under high risk thanks to my anaesthetist who dared to give her anesthesia. intra op big sharp fish bone was found at post cricoid region anteriorly abutting laryngeal mucosa posteriorly piercing pharyngeal mucosa, after it's removal 20 ml of foul smelling pus evacuated. it was very difficult to make her retain her ryles tube post surgery, with a lot of her mischief we managed to keep it for 4 days and she made a good diet speedy recovery. *parents of MR children should never leave them unattended when they are consuming food with Sharp particles like meat, and small round food items (can cause aspiration). *we have to take calculated risks *retropharyngeal abcess should be managed before they turn into near fatal mediastinitis.

Patients has past history of Carcinoma on the Rt side. & know SLE pt Treated now for white patches on left later Tongue by LASERS Biopsy showed displasia (Keratotic) Pt will be followed for long periods of time for Displasia Lekoplakia Keratotic lesions. Malignant changes. Oral pathologists see the -Staging -Cellular nuclear-cytoplasmic ratio. -Evident mitosis with a typical findings & mitosis in upper layer of epithelium -Visible changes of pleomorphism in cell size, shape. -Rounded Rete ridges (saw tooth) -Abnormal keratinization -Carcinoma in situ or frank squamous cell carcinoma. We as clinicians try to eradicate in early stages. However note- Biopsy is very mandatory to know the staging; for patients information; documentation. When biopsy shows Displasia evidence lesion has chances of becoming Carcinoma (even after removal of lesion) & also reverse may be true where tissue responds to regain a state of health So, One has to focus on positive style/ diet. Lesion still yet to heal As progressions continues (fig-5) invasion of basement membrane will occur & gets it's designation of Carcinoma.

What may be the probable diagnosis ? Identify the clinching sign from the image?

A 28-year-old female with a history of Marfan syndrome. she complained of reporting a progressive decrease in vision and worsening glare in both eyes. what could be the reason?