ABSTRACT
PURPOSE: To investigate the relationship between refraction and ocular axial length in albinos. PATIENTS AND METHODS: A cross-sectional, analytical study was carried out from June to November 2021 at the Central Hospital of Yaounde (Cameroon), which included consenting albino subjects aged over 15years. All subjects underwent visual acuity testing, axial length measurements and objective refraction under cycloplegia. RESULTS: We included 51 albino subjects. The mean age was 26.06±9.47years, and the sex ratio was 0.5. Type 2 oculocutaneous albinism (OCA2) was predominant, representing 82.4% of cases. The mean uncorrected visual acuity was 0.93±0.25 logMAR, and the most common ametropia was myopic astigmatism (52.9%). The mean axial length was 24.65±2.54mm with extremes of 21.54 and 30.33mm. Eyes with myopia and myopic astigmatism had significantly longer axial lengths than those with hyperopic and mixed astigmatism. A strong, significant negative correlation (r=-0.93; PË0.001) between the spherical component of the refraction and axial length was found. CONCLUSION: The spherical component of the refraction decreases significantly with increasing axial length in albinos.
Subject(s)
Axial Length, Eye , Refraction, Ocular , Humans , Male , Female , Refraction, Ocular/physiology , Adult , Cross-Sectional Studies , Young Adult , Adolescent , Axial Length, Eye/pathology , Middle Aged , Refractive Errors/epidemiology , Refractive Errors/diagnosis , Refractive Errors/physiopathology , Visual Acuity/physiology , Cameroon/epidemiology , Albinism/epidemiology , Albinism/complications , Myopia/diagnosis , Myopia/epidemiology , Myopia/physiopathology , Myopia/complications , Myopia/pathology , Correlation of DataABSTRACT
PURPOSE: To study the effect of type 2 diabetes on pupil diameter. PATIENTS AND METHODS: We carried out a case-control study at the Douala Obstetrics, Gynecology and Pediatric Hospital over a 5-month period. The cases were type 2 diabetic patients, and the controls were non-diabetic patients paired for age and gender. We studied the correlation between the duration of diabetes, fasting blood sugar and the horizontal pupil diameter. RESULTS: We included 35 patients in each group. The mean age was 56.6±10.01 years. Both groups included 17 males and 18 females. The mean duration of diabetes was 2.72±4.31 years, and the mean fasting blood sugar was 2.02±0.69g/L. The mean pupil diameter was similar in the two groups. On the right side, it was 4.75±0.73mm for controls and 4.52±0.69mm for cases (P=0.179). On the left side, it was 4.70±0.68mm and 4.42±0.73mm respectively for each group (P=0.101). The duration of diabetes was correlated to pupil diameter in the right eye (r=-0.43; P=0.01) and left eye (r=-0.45; P<0.01). No additional risk was found to be associated with diabetes for right pupil diameters (OR=0.79; P=0.33), or for left ones (OR=0.76; P=0.24). CONCLUSION: Pupil diameter is similar in diabetic and non-diabetic patients. However, the duration of diabetes appears to affect pupil diameter.
Subject(s)
Blood Glucose/physiology , Diabetes Mellitus, Type 2/pathology , Pupil/physiology , Adult , Aged , Blood Glucose/metabolism , Cameroon/epidemiology , Case-Control Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Diabetic Retinopathy/blood , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/epidemiology , Diabetic Retinopathy/pathology , Female , Humans , Male , Middle Aged , Organ Size , Reflex, Pupillary/physiologyABSTRACT
INTRODUCTION: In an environment where strabismus is poorly understood and management centers rare, we studied the epidemiological, clinical and therapeutic aspects of neglected childhood strabismus. MATERIALS AND METHODS: This was a retrospective study carried out from March 1st, 2013 to September 30, 2018. Neglected childhood strabismus was defined as strabismus occurring in the first 5 years of life, for which the patient was over 7-years-old at the time of first consultation. The variables studied were age at first consultation, gender, age of onset, type of strabismus, etiology of strabismus, angle of deviation and rate of surgery. RESULTS: We found 113 cases of neglected childhood strabismus among the 430 cases of strabismus seen during the study period. There were more females (n=64) than males. The mean age was 17.7±10.5 years. There were 73 exotropias (64.6 %). The mean angle of deviation was 41.2±12.2PD. Strabismus was early in 70.8 % of cases. Innervational strabismus accounted for 86.7 % of cases. The most frequent refractive error was hyperopic astigmatism (55.3 %). Of the 45 patients who were seen again after full-time wear of their full cycloplegic correction, 2 were orthotropic. Surgery was performed in 60.5 % of cases. The average postoperative angle of deviation was 6.6±9.4PD. CONCLUSION: Management of neglected childhood strabismus provides good results and should therefore be encouraged in order to improve the quality of life of affected patients.
Subject(s)
Delayed Diagnosis , Strabismus/diagnosis , Strabismus/epidemiology , Strabismus/therapy , Adolescent , Adult , Age of Onset , Child , Child Abuse/statistics & numerical data , Cross-Sectional Studies , Delayed Diagnosis/statistics & numerical data , Esotropia/diagnosis , Esotropia/epidemiology , Esotropia/therapy , Exotropia/diagnosis , Exotropia/epidemiology , Exotropia/therapy , Female , Humans , Lost to Follow-Up , Male , Ophthalmologic Surgical Procedures/statistics & numerical data , Quality of Life , Retrospective Studies , Young AdultABSTRACT
OBJECTIVE: To assess the anatomical and functional results of intravitreal bevacizumab injections in retinal vein occlusions at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. PATIENTS AND METHODS: A prospective and descriptive study was conducted from October 2016 to August 2017 at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. All eyes with edematous or mixed retinal vein occlusion were treatment naive and received at least 3 intravitreal injections spaced at least 28 days apart of bevacizumab 25mg/ml at a dose of 0.05ml per session according to the strategy of 3 injections or "3 I". At least 3 months after the final injection, visual acuity and macular thickness, assessed by optical coherence tomography, were analyzed with the IBM-SPSS 22 software. The Student's test was used to compare means, with a significance P<5%. RESULTS: We included nineteen eyes of 18 patients with a mean age of 62.83±9.57 years. The male to female sex ratio was 0.8. Branch vein occlusion was predominant in 14 (73.68%) eyes. The edematous type was noted in 17 (89.5%) eyes. Serous retinal detachment was present in 6 (31.6%) eyes. The mean number of injections was 4.2±1.2. The mean baseline visual acuity changed from +0.9 Log MAR (40 ETDRS) to +0.6 Log MAR (55 ETDRS) at 6 months, while the mean macular thickness went from 550.16±180µm to 338.58±127µm, with statistically significant differences. CONCLUSION: Intravitreal bevacizumab injections proved to be effective in the management of edematous retinal vein occlusions in our practice setting despite the lack of market authorization for this indication.
Subject(s)
Bevacizumab/administration & dosage , Retinal Vein Occlusion/drug therapy , Aged , Aged, 80 and over , Bevacizumab/adverse effects , Cameroon/epidemiology , Female , Follow-Up Studies , Hospitals, Military , Hospitals, Teaching , Humans , Intravitreal Injections , Male , Middle Aged , Prospective Studies , Retinal Vein Occlusion/epidemiology , Treatment Outcome , Visual Acuity/drug effectsABSTRACT
PURPOSE: To measure lacrimal secretion and to investigate dry eye symptoms in chronic hemodialysis patients. PATIENTS AND METHODS: This was a cross-sectional descriptive study carried out in the hemodialysis center of Douala General Hospital from June to August 2016. The degree of symptomatology related to dry eye was assessed by the Ocular Surface Disease Index (OSDI) questionnaire. Lacrimal secretion was measured by the Schirmer test without anesthesia. We defined normal as wetting>10mm and hyposecretion as a value≤10mm after 5minutes. RESULTS: Thirty-five patients were involved in the study, 16 men (45.7%) and 19 women (54.3%) for a total of 70 eyes examined. The mean age was 41.9 years, with an average duration of dialysis of 35.5 months±30.2. The symptoms were "normal" for 21 patients (60%), "minimal" for 5 (14.3%), "moderate" for 8 (22.9%) and "severe" for 1 (2.8%). Lacrimal hyposecretion was found in 19 eyes (27.1%). It was severe in 8 eyes. A correlation was found between diabetes, gender and hyposecretion. CONCLUSION: Hemodialysis patients are likely to develop lacrimal hyposecretion mostly because of comorbities. It is therefore important to systematically evaluate lacrimal secretion in these patients.
Subject(s)
Dry Eye Syndromes/diagnosis , Lacrimal Apparatus/metabolism , Renal Dialysis , Renal Insufficiency, Chronic , Tears/metabolism , Adolescent , Adult , Aged , Cameroon/epidemiology , Cross-Sectional Studies , Diagnostic Techniques, Ophthalmological , Dry Eye Syndromes/epidemiology , Dry Eye Syndromes/etiology , Female , Hospitals, General , Humans , Male , Middle Aged , Renal Dialysis/statistics & numerical data , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , Young AdultABSTRACT
PURPOSE: To study the characteristics of blindness after ocular trauma. METHODOLOGY: In this retrospective descriptive study, we considered the files of patients who had consulted the service for ocular trauma between January 2008 and December 2014. Included were patients of both sexes and all ages whose monocular or binocular vision with best optical correction was strictly below 1/20. Statistical analysis was performed with EPI Info version 3.5.4 software, and the Chi2 test was used with statistically significant values of P≤0.05. RESULTS: Over the period from 2008 to 2014, we found 100 cases of blindness (101 eyes) resulting from 591 cases of ocular trauma, for a frequency of 16.92 %. Among them, 75 men with a median age of 35.5±19.8 years. Children younger than 15 years accounted for 11 % of the series. The blindness was monocular in 99 % and binocular in 1 %, distributed as follows: 55 cases (55 %) category V, 27 (27 %) category IV and 18 (18 %) category III according to the CIM-10. In the anterior segment, cataract was responsible for category III and IV blindness, while in the posterior segment, retinal detachment was found in all categories. In all age ranges irrespective of sex, category V blindness was most frequent. CONCLUSION: Blindness following ocular trauma is frequent in our context. It can be avoided. Consequently, it is essential to put in place strategies for prevention of ocular trauma via education of the population through public awareness campaigns.
Subject(s)
Blindness/epidemiology , Blindness/etiology , Eye Injuries/complications , Eye Injuries/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Blindness/therapy , Cameroon , Child , Eye Injuries/therapy , Female , Hospitals, Military , Hospitals, Teaching , Humans , Male , Middle Aged , Referral and Consultation/statistics & numerical data , Retrospective Studies , Young AdultABSTRACT
PURPOSE: To evaluate the total cost of treatment of diabetic retinopathy by argon laser for a patient when indicated. PATIENTS AND METHOD: Prospective cross-sectional and descriptive survey, carried out in the angiography and laser center of the Yaoundé Central Hospital from October 2014 to October 2015. All consecutive diabetic patients with retinopathy and suitable indication for argon laser treatment were included. The costs related to the initial and final fluorescein angiography, the appointment for follow-up, round-trip transportation costs from the patient's home and the cost of laser treatment were included. RESULTS: Included were 43 (13 %) patients out of 330 with diabetic retinopathy. The mean age was 55.67±8.40years. There were 25 women (58.1 %) and 18 men (41.9 %) for a M/F ratio of 0.7. Unemployed patients were represented by 28 (65.1 %) versus 15 employed (34.9 %). Twenty-seven patients (62.8 %) were self-pay for all their expenses, 14 (32.6 %) were assisted by their families, and 2 (4.6 %) were insured. On average, the total expenditure was 86002±67197 f CFA per eye, corresponding to 131±102 euros with an exchange rate of 1 euro for 656 f CFA. CONCLUSION: The cost of treatment of diabetic retinopathy by argon laser is high, mostly increased by the additional costs related to transportation in our area. The creation of satellite centers in the 10 regions of Cameroon would reduce these costs.
Subject(s)
Cost of Illness , Diabetic Retinopathy/surgery , Health Care Costs , Laser Coagulation/economics , Lasers, Gas/therapeutic use , Absenteeism , Aged , Cameroon/epidemiology , Cross-Sectional Studies , Diabetic Retinopathy/diagnostic imaging , Diabetic Retinopathy/economics , Diabetic Retinopathy/epidemiology , Female , Fluorescein Angiography/economics , Health Care Costs/statistics & numerical data , Humans , Insurance , Male , Medically Uninsured , Middle Aged , Prospective Studies , Transportation/economicsABSTRACT
Given the causative parasite hypothesis for tropical endemic limbo-conjunctivitis (TELC), we conducted an analytical case-control study of all children with tropical endemic limbo-conjunctivitis seen in the ophthalmology department of Laquintinie hospital in Douala during the period from January 2nd to April 30, 2015. RESULTS: We identified 64 cases of tropical endemic limbo-conjunctivitis out of 550 children seen; a hospital prevalence of 11.6%; thirteen cases (eight boys and five girls) did not meet inclusion criteria, and 51 cases were included, 31 boys (60.8%) and 20 girls (39.2%) with a male/female (M/F) sex-ratio of 1.41. For controls, we included 28 males (54.9%) and 23 girls (45.1%) for a M/F sex-ratio of 1.22. The prevalence of tropical endemic limbo-conjunctivitis in boys was 12.1%, and for girls it was 7.1% in the case group. Stage II was the most frequent at 29 cases (56.9%), as well as the mixed form at 31 cases (60.8%). The frequency of intestinal parasites was 14 cases (27.5%) in the group of tropical endemic limbo-conjunctivitis patients and 6 cases (11.8%) in the control group (P=0.08). Entamoeba histolytica in its cystic form was the most intestinal parasite found in both groups, 10 cases for tropical endemic limbo-conjunctivitis (19.6%) and 6 cases in the control groups (11.8%). The mean serum IgE among cases was 81.2 IU/ml, while in the controls it was 15.6 IU/ml (P=0.001) CONCLUSION: There is no relationship between intestinal parasitic infection and the occurrence of tropical endemic limbo-conjunctivitis.
Subject(s)
Conjunctivitis, Allergic/epidemiology , Endemic Diseases/statistics & numerical data , Intestinal Diseases, Parasitic/epidemiology , Intestinal Diseases, Parasitic/parasitology , Tropical Climate , Adolescent , Animals , Cameroon/epidemiology , Child , Child, Preschool , Conjunctivitis, Allergic/complications , Female , Humans , Infant , Infant, Newborn , Intestinal Diseases, Parasitic/complications , Keratoconjunctivitis, Infectious/epidemiology , Keratoconjunctivitis, Infectious/parasitology , Male , PrevalenceABSTRACT
But. Décrire les caractéristiques épidémiologiques et cliniques des occlusions veineuses rétiniennes en milieu hospitalier camerounais. Patients et Méthodes. Cette étude transversale descriptive a porté sur 5055 dossiers de patients diabétiques examinés de Janvier 2010 à Décembre 2015 au Centre de Référence de Rétine pour la Prévention et de Prise en Charge de la Rétinopathie Diabétique de Yaoundé. Les variables étudiées incluaient l'Åil atteint, la topographie des lésions, le type d'occlusion et les principaux facteurs de risque. Résultats. Soixante dix cas (72 yeux) d'occlusions veineuses rétiniennes ont été observés, soit une prévalence hospitalière de 1,38%. L'âge moyen des patients était de 61± 5,6 ans et le sex ratio de 1,33. L'Åil droit était atteint dans 43 (62,26 %) cas. L'occlusion était de branche veineuse dans 44 (61,10 %) yeux et centrale dans 28 (38,88 %). Le type Ådémateux prédominait avec 38 (54,90%) cas suivi de l'ischémique avec 27 (37,59 %) et du mixte avec 5 (7,48 %) cas. Les facteurs de risque étaient principalement l'hypertension artérielle avec 15 (21,42 %) cas, le diabète de type 2 avec 12 (17,14 %) et l'hypertonie avec 10 (14,28 %). Conclusion. Les occlusions veineuses rétiniennes sont fréquentes et devraient faire l'objet d'une recherche étiologique systématique pour chacun des cas dans notre milieu
Subject(s)
Cameroon , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/epidemiology , Risk FactorsABSTRACT
Déterminer le taux de complications de la chirurgie de la cataracte à l'Hôpital Central de Yaoundé (HCY). Méthodologie. Nous avons réalisé une étude descriptive portant sur les dossiers de malades ayant été opérés de cataracte à l'HCY de mars 2013 à décembre 2017. Les dossiers incomplets ainsi que ceux des patients sans suivi postopératoire étaient exclus. Les complications ont été recensées et analysées. Resultats. Nous avons récensé 264 yeux opérés mais inclus 124 yeux de 97 patients, dont les dossiers étaient complets avec suivi postopératoire. L'âge moyen des patients était de 65,91ans ±16,02. La cataracte sénile était prédominante (91,75% des cas). Les complications per-opératoires les plus fréquentes étaient la rupture de la capsule postérieure (3,22%) et l'hyphéma (3,22%). L'hypertonie postopératoire transitoire était présent chez 4,84% des cas. Les complications tardives étaient représentées par la cataracte secondaire avec 26,56% des cas au 2ème mois post-opératoire. Aucun cas d'endophtalmie n'a été enrigistré. Conclusion. Le taux de complications de la chirurgie de la cataracte à l'Hôpital Central de Yaoundé est faible. Ce taux pourrait diminuer davantage avec l'expérience des chirurgiens
Subject(s)
Cameroon , Cataract Extraction/methods , Cataract/complications , PatientsABSTRACT
But. Évaluer les connaissances et les attitudes dans une population rurale au Mali en ce qui concerne la cataracte. Patients et méthodes. Nous avons mené une étude transversale descriptive pendant une période de 10 jours au cours d'une campagne de soins ophtalmologiques dans la localité de Baguinéda, commune rurale située à 30 km de Bamako (Mali). Etaient inclus, les personnes âgées de 16 ans et plus. Les questions relatives aux connaissances et aux attitudes vis-à-vis de la cataracte leur étaient posées. Les connaissances et les attitudes devant une cataracte ont été corrélées aux paramètres comme l'âge, le sexe, la profession et le niveau d'instruction. Résultats. Au total, 552 personnes ont participé à l'étude. Leur âge moyen était de 46,1 ans ± 16,5 et le sex-ratio Homme/Femme de 1,38. Près de la moitié (45,65%) était sans emploi et la majorité (62,7%) analphabète. Dans 83,7 % de cas, les patients avaient des connaissances justes sur la cataracte. Vingt-quatre (4,3%) patients savent que le traitement est chirurgical et 242 (43,8%) pensent que le traitement est traditionnel. L'âge, le sexe et le niveau d'instruction étaient significativement liés à la connaissance de la cataracte. Conclusion. la connaissance de la cataracte dans la localité de Baguineda, en milieu rural au Mali est satisfaisante tandis que les attitudes sur sa prise en charge restent insatisfaisantes. Les stratégies de sensibilisation sont indispensables afin de réduire le taux de cécité au sein de ces populations défavorisées
Subject(s)
Cataract , Cataract/prevention & control , Mali , Patients , Rural PopulationABSTRACT
But. Décrire les expériences visuelles des patients au cours de la chirurgie de la cataracte sous anesthésie péribulbaire. Patients et méthodes. Nous avons mené une étude transversale pendant une période d'un mois au CHU-IOTA (Bamako). Étaient inclus les adultes opérés de la cataracte sous anesthésie péribulbaire sans sédation. Les patients étaient interrogés 1 à 4 heures après l'intervention sur les sensations visuelles de l'Åil opéré, durant la chirurgie. Résultats. Deux cent sept (207) patients (105 hommes et 102 femmes) ont été retenus. Leur âge moyen était de 62,94 ans ± 12,5. L'acuité visuelle préopératoire des patients était comprise entre 1/10 et la perception lumineuse. Cent cinquante-huit (76,3%) patients ont rapporté des phénomènes visuels observés pendant l'intervention. Il s'agissait de la lumière (rapportée par 76,3% de patients), des couleurs (31,9%), des instruments (22,7%), des doigts du chirurgien (25,1%), de l'eau (27,1%) et des mouvements vagues (19,8%). Parmi eux, 38% étaient effrayés par ces sensations visuelles. Conclusion. Plus de trois-quarts de patients ont des expériences visuelles au cours de la chirurgie de la cataracte sous anesthésie péribulbaire. Certains sont effrayés par ces phénomènes visuels. Il est important de faire un counseling préopératoire approprié afin de réduire le stress des patients
Subject(s)
Anesthesia , Cataract , Cataract Extraction , Mali , Ophthalmologic Surgical Procedures , PatientsABSTRACT
Introduction. La phacoalternative manuelle sans suture (PhacoA) est une technique chirurgicale révolutionnaire adaptée à l'Afrique car sollicitant un minimum de matériel opératoire avec un bon résultat fonctionnel. Le but de cette étude était d'évaluer les résultats fonctionnels de la phacoA en chirurgie de masse de la cataracte de l'adulte. Patients et méthodes. Il s'est agi d'une étude descriptive et analytique qui s'est déroulée en mars et d'avril 2017 au Centre Hospitalo-universitaire d'Angondjé (CHUA). Tous les patients adultes présentant une cataracte ont été inclus. L'acuité visuelle de loin a été évaluée à l'aide de l'échelle de Monoyer. Une biomicroscopie a été réalisée à la recherche d'une cataracte et d'une pathologie oculaire associée. La pression intraoculaire a été mesurée chez tous les patients. La phacoA a été réalisée chez tous les patients. Les variables étudiées étaient l'âge, le sexe, l'acuité visuelle avant et après chirurgie, les complications per et post opératoires. Les données ont été saisies avec le logiciel Microsoft Access 2010 et analysées avec Microsoft Excel 2010. Résultats. L'âge moyen était de 67,3 ans ± 10,4. Les hommes représentaient 51,5% de la population. L'acuité visuelle avant la chirurgie était limitée à la perception lumineuse dans 32% des cas et après la chirurgie supérieure ou égale à 3/10 dans 75,4 % des cas. Les complications per et post-opératoires ont été décrites. Conclusion. La phacoalternative reste la technique de choix dans la chirurgie de masse de la cataracte de l'adulte
Subject(s)
Adult , Cataract , Gabon , Ophthalmologic Surgical Procedures , PatientsABSTRACT
But. Décrire les résultats fonctionnels sans correction de la chirurgie de la cataracte par la technique de la petite incision manuelle ou phacoalternative à l'Hôpital Central de Yaoundé (HCY). Méthodologie. Il s'agit d'une étude transversale descriptive et rétrospective. Les dossiers de patients opérés de cataracte par phacoalternative entre mars 2013 et décembre 2017 comportant les données recherchées ont été retenus. L'âge, le sexe, l'acuité visuelle pré opératoire et l'acuité visuelle de loin au 30e jour post-opératoire étaient les variables analysées. Nous avons utilisé la classification de l'Organisation Mondiale de la Santé (OMS) pour l'évaluation du résultat fonctionnel post-opératoire. Le résultat était bon si l'acuité visuelle de loin était ⥠3/10, limite si entre 1/10 et < 3/10 et mauvais si < 1/10. Résultats. Durant la période d'étude, 264 yeux ont été opérés, mais 94 patients (116 yeux) suivis jusqu'à un mois ont été inclus. Le sex-ratio homme / femme était de 1,25. L'âge moyen des patients était 66,87 ± 15,10 ans avec les extrêmes de 12 et 92 ans. A un mois post-opératoire, 53,45% des yeux opérés (n= 62/116) avaient un bon résultat sans correction. Conclusion. Le résultat fonctionnel de la chirurgie de la cataracte à l'HCY est bon dans 53,45% des cas. Ce chiffre est inférieur aux recommandations de l'OMS. L'amélioration de la disponibilité des implants selon la biométrie ainsi que le respect des protocoles de chirurgie et de suivi post opératoire par les chirurgiens devraient permettre d'améliorer le résultat visuel sans correction
Subject(s)
Cameroon , Cataract/nursing , Cataract/surgeryABSTRACT
Buts. Établir le profil épidémiologique et clinique des traumatisés oculaires et ou palpébraux victimes de la guerre qui oppose l'État du Cameroun à la secte terroriste Boko Haram dans la région de l'Extrême Nord. Patients et Méthodes. Nous avons mené une étude transversale descriptive de Janvier 2015 à Juin 2016 sur les lieux de conflit et à l'Hôpital d'Instruction, d'Application et de Référence des Armées de Yaoundé (HIARAY) de niveau 3. Les paramètres étudiés aussi bien pour les civils que pour les militaires portaient sur les données épidémiologiques et cliniques, les mécanismes lésionnels, la fonction visuelle. Pour les militaires, nous avons aussi évalué l'impact professionnel. Résultats. Pendant 18 mois, 24 cas de traumatismes oculaires et ou palpébraux ont été observés pour 29 yeux atteints. Quinze (62,50%) cas étaient des militaires et 9 (37,50%) des civils. La moyenne d'âge était de 29,29 ± 5,31 (extrêmes : 18 à 58) ans et le sex ratio de 7 H/F. Seize yeux étaient droits avec une acuité visuelle moyenne sans correction supérieure à 3/10 et 13 gauches à 4/10. Les principales lésions retrouvées étaient : les plaies palpébrales, 10 (34,48%) cas ; la cataracte, 5 (17,24%) ; les éclatements du globe, 5 (17,24%) ; les hémorragies intra oculaires, 5 (17,24%) ; les plaies de cornée, 5 (17,24%) et les corps étrangers intra oculaires, 4 (13,79%). Les explosions de mines artisanales (21/29), les accidents de circulation (06/29) et les armes à feu (02/29) étaient les mécanismes responsables. Dix-neuf personnes avaient une atteinte unilatérale et cinq une atteinte bilatérale. Le taux de cécité monoculaire était évalué à 37,92%, binoculaire à 6,89% soit 44,82% au total et celui de malvoyance à 62,06%. Les 15 militaires atteints ont été réformés. Conclusion. Les traumatismes oculaires en zone de conflit sont graves et dramatiques pour les personnes atteintes. Leur réparation par le chirurgien ophtalmologue est par ailleurs difficile. Des matériels de protection à type de casque avec visière et des lunettes balistiques permettraient d'en réduire la fréquence
Subject(s)
Cameroon , Case-Control Studies , Eye Injuries/epidemiology , Eye Injuries/prevention & control , Patients , Warfare and Armed ConflictsABSTRACT
INTRODUCTION: TELC, tropical endemic limbo-conjunctivitis, is a keratoconjunctivitis seen more frequently in dry intertropical settings than humid ones. We aim to determine the epidemiologic and clinical profile of this condition in a city with a humid equatorial climate. PATIENTS AND METHODS: During first third of 2014, we conducted a cross-sectional descriptive study in schools. Included were children aged 3-15 years who received parental consent. The selection was conducted in two steps. After an initial examination of children within the schools, the diagnosis was then confirmed by a complete ophthalmologic examination carried out in the hospital. For ethical clearance, the study received all necessary authorizations. The data were analyzed using the CSPro version 4.0 software in French and the comparison test used was χ2 with a confidence limit of 95 %. RESULTS: Out of 353 students examined, 129 were referred to the Yaoundé central hospital, among which 82 (23.2 %) were confirmed with TELC. The median age of the children diagnosed with TELC was 8.24+0.6 years. Boys (57.3 %) were affected more than girls. The age range of 6-12 years (64.6 %) was the most represented. A recrudescence of the attacks was observed during the dry season (93 %) of cases. Dust (49 %) and sun exposure (43 %) were aggravating factors. CONCLUSION: The prevalence of TELC observed in school in this study is significant.
Subject(s)
Conjunctivitis/epidemiology , Endemic Diseases/statistics & numerical data , Students/statistics & numerical data , Adolescent , Cameroon/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Schools/statistics & numerical data , Tropical ClimateABSTRACT
UNLABELLED: A prospective and longitudinal study was carried from January 2 to December 31, 2013 in which victims of commercial motor bike accidents presenting to the Laquintinie Hospital in Douala were examined in search of oculo-orbital injuries with the double goal of identifying and evaluating the physical impact of the observed oculo-orbital lesions. RESULTS: We included 88 cases with oculo-orbital trauma due to commercial motor bike accident. There were 71 males (80.7%) and 17 females (19.3%). The mean age was 32.8±10.6 years. Collision between two motorbikes was the most frequent mechanism and accounted for 42% of cases of oculo-orbital trauma (n=37). None of the 81 patients on a motor bike reported wearing a helmet at the time of the accident (7 pedestrians were victims). Injuries of the globe were present in 16.5% of eyes (n=29); while orbital injuries were present in 22% of eyes (n=39). The most frequent orbital injury was orbital wall fracture, occurring in 31 eyes (17.6%). Lesions of the eyelids were found in 50 cases (28.4%). ENT lesions were associated in 27 cases (30.7%), cranial trauma in 3 cases (3.4%). Orbital dystopia, oculomotor palsy, ptosis, ectropion and unilateral blindness (rate of 9%) were sequelae recorded after six months of follow-up. CONCLUSION: The existing rules and regulations on driving licenses, vehicle code and compulsory use of helmets in the area of commercial motorbike activity should be strictly applied in Douala to avoid these preventable oculo-orbital trauma which lead to unsightly scars and blindness.
Subject(s)
Accidents, Traffic/statistics & numerical data , Eye Injuries/epidemiology , Motorcycles/statistics & numerical data , Orbit/injuries , Adolescent , Adult , Cameroon/epidemiology , Commerce , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/etiology , Eye Injuries/etiology , Female , Humans , Male , Middle Aged , Off-Road Motor Vehicles/statistics & numerical data , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: Ocular and orbital trauma is a leading cause of acquired monocular blindness in childhood. These injuries differ from those in adults in some aspects of the management and prognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemiological, clinical and therapeutic features of ocular trauma in children who consulted in an eye emergency department in Île-de-France. PATIENTS AND METHODS: This was a descriptive, prospective and longitudinal study. Over a period of 6 months, we included children aged 15 years old or less, who consulted during calls for ocular trauma. Each child received an ophthalmologic examination as complete as his or her condition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocular burns were distributed respectively according to the Birmingham Eye Trauma Terminology and Dua's classification. The visual prognosis was defined as the best corrected visual acuity of the affected eye, measured at the conclusion of treatment. RESULTS: Among 586 children who consulted during the study period, 265 suffered from ocular trauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the injuries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the most frequent (12.45%). One hundred and fifty-seven patients consulted within 6 hours (59.19%). The cornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeball accounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbital injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment was required in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length of stay of 3 days. Four children developed sequelae, including 2 corneal scars and 2 cataracts. No case of blindness was recorded. DISCUSSION: The high frequency of traumatic ocular and orbital pathology in our study may be due to its sudden and accidental onset, leading parents to seek emergency care. Most injuries occurred at home and at school, which reflects the presence in these places of potential hazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate may reach 73.4%. This clinical presentation is associated with a poor prognosis because of the risk of infection and sequelae causing decreased visual acuity and amblyopia. Few children were hospitalized. This could be explained by the predominance of mild to moderate trauma. CONCLUSION: Ocular trauma accounts for nearly half of pediatric conditions encountered in the eye emergency unit. Adequate emergency care improves the visual prognosis.
Subject(s)
Eye Injuries/epidemiology , Eye Injuries/etiology , Adolescent , Child , Child, Preschool , Emergency Service, Hospital , Female , France/epidemiology , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Prospective StudiesABSTRACT
PURPOSE: To determine the epidemiologic and clinical characteristics of ocular trauma after evaluation with the ocular trauma score at the Army Teaching Hospital in Yaoundé, Cameroon. PATIENTS AND METHODS: A descriptive and retrospective monocentric hospital study was carried out from January 2008 to December 2010. Our sample included all patients with ocular trauma. Each traumatized eye was evaluated using the ocular trauma score after measurement of visual acuity. The most severe diagnoses observed were classified according to the Birmingham Eye Trauma Terminology system. RESULTS: The frequency out of 364 eyes was 3.56%. There were 204 men (61.44%) with a male/female ratio of 1.59. The mean age was 32.95 years with predominance of 21-30 years. The most affected groups were laborers and craftsmen (28.61%), followed closely by students (23.80%), then armed forces personnel (19.58%). Fights were noted as the most common cause in 31.02% of cases. Punches predominated in 21.39% of cases. In 37.34% of cases, patients were seen within 72 hours of the trauma. Three hundred (90.36%) traumas were unilateral vs. 32 (9.64%) bilateral. The mean visual acuity at the first consultation was 0.3 logMAR. Grading after evaluation was as follows, 13 eyes were grade 1, 19 grade 2, 25 grade 3, 54 grade 4 and 253 grade 5. Fragile and exposed anatomical structures were the most commonly injured. Seventeen eyes exhibited elevated IOP (22 to 45) vs. 7 which were hypotonous. Two hundred and one (55.22%) oculo-palpebral contusions were noted, followed by 110 (30.22%) lacerations. Visual loss was reported in 16.20% and blindness in 8.79% of cases. CONCLUSION: In the emergent setting, a good, timely clinical evaluation of each case according to the ocular trauma score may lead to effective management.