Simplified and Safe Pterygium Surgery in Nigerians

Objective: To advocate a simplified and safe method of pterygium surgery to Ophthalmologists in Nigeria. Methods: After the routine standard preparation of the eyes for pterygium excision; 114 eyes that had the new procedure did not have the head of the pterygium shaved off the cornea with blade or knife in the usual standard manner; but was avulsed off the cornea unto the sclera . The cornea was then polished with the rough side of a broken ordinary razor blade. The pterygium was excised with a curved conjunctival scissors. Haemostasis and mitomycin C application were carried out in the usual standard manner. Results : All the 114 eyes that were operated using the new procedure had satisfactory cosmetic outcome of the pterygium excision and there was no complication encountered. Conclusion: The simplified method is both safe and effective for pterygium surgery

Bilateral Congenital Microphthalmos

Background: Microphthalmos ia a rare congenital anormaly of the eye. Aim: to report a case of microphthalmos in an otherwise normal neonate. Case report: A one-week-old full-term female neonate delivered by elective caesarian section to a mother who received ante-natal care in one of the choicest obstetric clinics in Port Harcourt is presented. The only congenital anomaly present was bilateral congenital microphthalmia. Conclusion: Microphthalmos is an uncommon condition whose management is very challenging. High motivation on the part of the parents can make the child live a fulfilled life and appear cosmetically acceptable

Presenting Visual Acuities in a New Eye Centre in Port Harcourt : Initial Report

Background: Visual acuity is a fundamental of an eye examination. It establishes in a quantitative way how well an eye can see. Apart from being a starting point in dealing with an eye; it is also a prognostic reference point and a medico-legal tool. Very few studies directly related to visual acuities are available as many authors concentrate on blindness and visual impairment. Aim: To document the presenting visual acuity of patients seen in a new Eye Centre in Port Harcourt over a 12 -month period. Methods: The visual acuities of the first 202 patients seen at a new private eye centre were obtained from case file records. The visual acuities were then analysed from 6/6 and better to No Light Perception. The visual acuities were further analysed into satisfactory vision; low vision; bilateral and uniocular blindness. Also analysed were age and sex distribution and a panoramic overview of the ocular problems of the patients. Results: Visual acuities 6/6 and better was seen in 32.2of the patients. In functional vision groupings 78.7had satisfactory vision; while 20.9had low vision. Bilateral blindness was found in 0.5and uniocular blindness in 0.9. Males were 54.0of the patients while 46.0were female. The age range 20-50 years accounted for 63.8of the patients. Conclusion: This study has documented the prevalence of satisfactory vision; low vision; bilateral and uniocular blindness in Port Harcourt and it will serve as a reference point in future visual acuity studies in the region

Live Adult Loa-Loa in the Anterior Chamber of a Nigerian female

Background: Live adult loa loa is not usually found in the anterior chamber of the eye. Where this occurs the diagnosis may be missed because of its rare occurrence. As such there has to be a high index of suspicion to be able to make a diagnosis of ocular loaiasis. Aim: To report a case of live adult loa-loa in the anterior chamber of the left eye of a 23-year-old Nigerian female and discuss the management and visual outcome following treatment. Setting: Department of Ophthalmology; University of Port-Harcourt Teaching Hospital; Port Harcourt. Case Report: A case report of live adult loa-loa in the anterior chamber of a 23-year-old Nigerian female is here presented. In May 2006; a 23 year old female presented at the Eye Clinic with a 3-week history of pain; itching and redness and a one-week history of poor vision in the left eye. Her presenting visual acuity was hand movement on the left and 6/5 on the right. She had a steamy cornea with a sluggishly reactive pupil and an elevated left intra-ocular pressure. An initial diagnosis of pan-uveitis with secondary glaucoma was made and patient commenced on treatment. Patient came back two days and a live adult loa-loa was extracted from the anterior chamber of the left eye. Patient's vision however remained at Counting Fingers despite aggressive treatment with topical and systemic steroids; and systemic diethylcabamazine. Conclusion: Ophthalmologist working in this environment should entertain loaiasis as a differential diagnosis of uveitis since it could masquerade as one and also know the current mode of treatment

Cancrum Oculi in HIV Positive Child : a Case Report

Background: Cancrum oculi; is a very rare type of noma. Very few cases have been reported worldwide.Aim: To report a case of cancrum oculi in a six- month-old HIV positive negroid female. Setting:University of Port Harcourt Teaching Hospital (UPTH); Port Harcourt; Nigeria. Case Report: A six-month-old HIV seropositive negroid female child was seen in UPTH with necrotizing chronic ulcer at the angle of the left eye. There was also an intense oral thrush initially managed by the paediatricians and later referred to the Ophthalmology department for management. Clinical examinations and various investigations suggested the diagnosis of cancrum oculi.Conclusion: Cancrum oculi; like other variants of noma complicate immuno-deficiency or can be a primary disease in immuno-competent patients with poor hygiene. It is a preventable disease