[Lisch nodules: an ophthalmic marker of neurofibromatosis type 1]. / Nodules de Lisch: marqueur ophtalmologique de la neurofibromatose de type 1.

Von Recklinghausen disease or neurofibromatosis type I (NF1) is the most common phacomatosis. It is inherited in an autosomal dominant manner. Lisch nodules are the most common ophthalmic manifestation of NF1. They are reported in 73-95% of cases. We here report the case of a 49-year-old female patient referred for a consultation with an ophthalmologist for routine eye check-up after the onset of the following symptoms: coffee-with-milk colored spots and multiple neurofibromas (A). She reported similar family history. Visual acuity was 10/10 P2 in both eyes. Examination of the anterior segment showed several Lisch nodules in both irises. They were scattered over the entire iris surface and varied in size (B). Fundus examination was unremarkable. CT scan of the brain and the orbit as well as thoracoabdominal CT scan showed no associated lesion. The patient met NIH diagnostic criteria for NF1. Lisch nodules are small brown dome-shaped lesions developing on the surface of the iris, with well-defined edges, embedded in the stroma and lighter than iris pigmentation. Differential diagnosis includes iris mammillations, iris naevi, iris melanoma, iris granulomatous nodules. Unlike skin signs, the presence of multiple Lisch nodules are considered a specific indication of NF1. These nodules may occur in childhood and their prevalence and number increase with age. Thus, periodic eye examinations in subjects with suspected neurofibromatosis type I may help to improve early diagnosis.

Medicines Acceptability in Hospitalized Children: An Ongoing Need for Age-Appropriate Formulations.

Although knowledge on medicine acceptability remains fragmented, this multi-faceted concept has emerged as a key factor for compliance in pediatrics. In order to investigate the acceptability of medicines used in the University Medical Centre Ibn Sina (CHIS) of Rabat, Morocco, an observational study was conducted. Using a multivariate approach integrating the many aspects of acceptability, standardized observer reports were collected for 570 medicine intakes in patients up to the age of 16, then analyzed on a reference framework. Tablets appeared to be well accepted in children greater than 6 years old, but were crushed/dissolved for 90% of the 40 children aged from 3 to 5, and 100% of the 38 patients younger than 3. Moreover, the prescribed dose was fully taken for only 52% and 16% of these younger children, respectively. Despite this, tablets represented 24% of evaluations in children from 3 to 5 and 20% in infants and toddlers. Oral liquid preparations appeared to be better accepted than tablets in preschoolers, but not for those under 3. Overall, these findings highlight the lack of suitable alternatives for the younger children, especially for formulations of antiepileptics, antithrombotic, and psycholeptic agents in the local context.

[Unusual complication of radiation therapy, corneal perforation: about a case]. / Complication inhabituelle de la radiothérapie: la perforation cornéenne: à propos d'un cas.

Radiation-induced ocular complications are common during radiation therapy for cancers of the head and neck. Some are mild and transient, others can be very serious jeopardizing visual function. This rare and unusual case study aims to highlight the different clinical manifestations and the ocular but especially corneal complications associated with radiation therapy as well as the diagnostic and therapeutic procedures of a corneal perforation which is a serious complication of radiation therapy.

[Conjunctival granuloma following neglected thorn injury: about a case]. / Granulome conjonctival suite à un traumatisme par épine végétale négligé: à propos d'un cas.

It is sometimes difficult to detect a plant intraocular foreign body, mostly in cases where the history of ocular trauma is unclear, or in patients who consult several months after the trauma. We report a rare case of a 7 year old child with self inflicted trauma of the the left eye by a cactus thorn 3 months before admission, which resulted in a temporal conjunctival granuloma with higher inflammatory reaction of the anterior segment. Surgical exploration was performed allowing the extraction of the thorn with total excision of the granuloma. A slight clinical improvement in visual acuity was observed, but the eyeball secondarily atrophied few months after extraction.