Experience with Extra-capsular Cataract Exraction and Intra-ocular Lens Implant in Children

BACKGROUND: In developing countries congenital cataract has become an important cause of treatable blindness in childhood. However; difficulty in correcting aphakia is one of the reasons for poor visual outcome. OBJECTIVE: To determine the visual outcome after extra capsular cataract extraction and intra ocular lens implant and factors militating against good visual outcome in children. METHODS: A prospective interventional study of cataract extraction in children with intra ocular lens implant. Extra capsular cataract extraction with intra ocular lens implant was performed using the superior limbal approach. Polymethyl Methacrylate lenses were inserted. Posterior capsulotomy was done with a 25G needle bent at the tip in 26 eyes. RESULTS: Thirty two eyes of twenty five children aged between 4 months and 16 years were operated. Extra capsular cataract extraction with posterior chamber intraocular lens implant was done in 27 (83.4) eyes; plain extra capsular cataract extraction in 3 (9.4) eyes; extra capsular cataract extraction with anterior chamber intraocular lens implant in 1 (3.1) eye and vectis extraction in 1 (3.1) eye. Twenty six eyes had primary posterior capsulotomy. Thirty-two (100) eyes and 15 (60) children were blind before surgery. Result of post operative visual acuity in 18 children after refraction was 6/18 or better in 4 (22.2) children 6/24-6/60 in 11 (61.1) and 3/60 in 3 (16.7) children. CONCLUSION: Visual rehabilitation following extra capsular cataract extraction with Intra Ocular Lens Implant is encouraging in children

Uniocular Blindness among Children in the Gambia

Background: Uniocular blindness in children though not uncommon has not been given prominence; as emphasis is placed on binocular blindness.Aim: To determine the common causes of uniocular blindness in children; and to suggest strategies for prevention.Methods: A prospective study involving children seen at the Eye Clinic of the Royal Victoria Hospital; The Gambia was undertaken; from the 1st December 1999 to 30th June 2000. All newly diagnosed cases of children who attended the clinic and were blind in one eye during the period of the study were included. A history was taken; visualacuity using age specific methods and ocular examinations were carried out. When necessary an examination under anaesthesia was performed.Results: Out of 470 children; 45(10) had uniocular blindness; 39(86) were aged 6-15years. The male - female ratio was 4:1. Common causes were trauma 28(62); uveitis 4(9); and corneal ulcer 3(7) . Others included congenital cataract; glaucoma and retinoblastoma.Conclusion: The commonest cause of uniocular blindness was ocular trauma. Focus should be directed towards the prevention; early referral and appropriate treatment of ocular trauma in children. Strategies for the prevention of childhood blindness would also be applicable to uniocular blindness in The Gambia

Profil des affections oculaires en milieu hospitalier au Congo

Les auteurs exposent les motifs de consultation et le profil des principales affections observees dans le service d'ophtalmologie du Centre Hospitalier et Universitaire de Brazzaville de 1981 a 1989. Les principaux motifs de consultation sont representes par les inflammations de la region oculaire 30 pour cent; les vices de refraction 31 pour cent; les douleurs et les genes oculaires 22 pour cent; les traumatismes oculaires 8 pour cent; la fatigue visuelle 2 pour cent; le larmoiement 2 pour cent et les autres affections 5 pour cent. Les causes des maladies oculaires peuvent etre reparties de la maniere suivante: vice de refraction 31;1 pour cent; conjonctivites 17;1 pour cent; inflammations de l'oeil 11;8 pour cent; cataractes 9;3 pour cent; nevrites optiques et retinites 3;6 pour cent; glaucomes 3 pour cent; le pterygion 2;4 pour cent; atteintes corneennes 2;2 pour cent; les autres maladies de la retinite et du nerf optique 1;8 pour cent. L'analyse des resultats montre qu'environ 60 pour cent des activites pourraient etre assumees au niveau des centres primaires ou secondaires de sante. Cet encombrement du service universitaire ne lui permet pas de repondre pleinement a sa vocation de formation et de recherche. Les auteurs soulignent l'interet dans le stade actuel du developpement socio-economique de dynamiser et organiser la decentralisation des centres tertiaires; de la formation des Ophtalmologues et de concevoir un programme national de depistage et de traitement des principales maladies cecitantes

Semaine operatoire de la cataracte au Niger: 13-20 septembre 1991

Les auteurs relatent ici le deroulement d'une semaine d'operation de la cataracte au Niger touchant 250 personnes sous l'egide de l'Agence Musulmane d'Afrique dans le cadre du programme national de prevention de la cecite au Niger

Pattern of eye diseases in Nigerian children seen at Lagos University Teaching Hospital : a decade after

Analysis of 1;000 new paediatric eye patients over a one year period showed that conjunctival diseases were the commonest as opposed to refractive error found a decade ago. More cases of eye injuries; neuro-ophthalmological conditions; squints and congenital abnormalities were also encountered. Females attend hospital more readily than males constituting 50.9 per cent and 29.8 per cent of new patients seen were children 16 years and below. Uveitis and chronic open angle glaucoma were uncommon compared to adult patients. Trachoma was not found in this environment as opposed to Nothern Nigeria. Some of these eye diseases cause blindness which can be prevented if suggested steps are taken. The demand on specialist services could be reduced if eye care delivery is incorporated into primary health care programme

Prevention de la cecite chez l'enfant : une methodologie d'evacuation simplifiee

Parmi les causes de cecite rencontrees dans les pays en developpement et precisement au Mali; la xerophtalmie et le trachome affectent plus particulierement les enfants. Leur prise en charge; sur le plan de la sante publique; necessite non seulement la connaissance de la situation epidemiologique initiale; mais aussi celle de son evolution sous l'effet des mesures prises. Ceci implique l'utilisation de methodes d'evacuation qui soient non seulement fiables; mais aussi suffisamment simples et peu couteuses pour pouvoir etre utilisees aussi souvent qu'il faut

Controlling river blindness with ivermectin

This paper deals with onchocerciasis which is in large areas of Africa. And the number of people at risk of contracting river blindness in endemic areas rises to 78 million in Africa. Therefore the dicovery of ivermectim is a new weapon in the war against river blindness