Vernal keratoconjunctivitis clinical features and complications in 123 patients in Gaza strip

This study was conducted to assess the clinical features and to detect ophthalmic complications of vernal keratoconjunctivitis in a group of patients who were treated in the Jordanian field hospital in the Gaza strip. This was a prospective hospital-based study conducted on patients with vernal keratoconjunctivitis at the Jordanian Field hospital in the Gaza strip between 15 March and 23 May 2012. Vernal keratoconjunctivitis diagnosis was made clinically. Ophthalmic examination included visual acuity using Snellen chart, eyelids, conjunctivae, anterior segment, dilated fundus to assess the retina and optic discs, and intra-ocular pressure measurement using slit lamp biomicroscopy. During the study period 1,753 patients attended the eye clinic, 123 [7%] of them were vernal keratoconjunctivitis sufferers. Out of the 123 patients 72 [58.5%] were males and 51[41.5%] were females with a male to female ratio of 1.4: 1. Their age ranged between four and 20 years with an average of 9.9 years. Moderate and severe vernal keratoconjunctivitis were seen in 55 [44.7%] patients. Of the moderate and severe forms mixed vernal keratoconjunctivitis was the commonest type seen in 25/55 [44.5%] patients, followed by limbal and palpebral, 20/55 [36.4%] and 10/55 [18.2%] patients, respectively. Severe vernal keratoconjunctivitis was seen in 31 [25.2%] patients: 16 [13%] patients of mixed type, 9 [7.3%] of limbal type, and 6 [4.9%] of palpebral type. One patient had Horner-Trantas dots that involve limbal and bulbar conjunctiva. Young age presentation and male predominance agree with that reported in literature but the male to female ratio was less. The commonest type was mixed followed by limbal and palpebral and this is different from that found in previous studies. Blepharoptosis and conjunctival inclusion cysts were seen more frequently. More representative sample over longer duration with collaboration of other local hospitals is needed to determine the true incidence, clinical features, complications, and seasonal variations of vernal keratoconjunctivitis in the Gaza strip

Corneal metallic foreign bodies among Jordanian soldiers

To review the spectrum of metallic foreign bodies among Jordanian soldiers and the efficacy of treatment. A retrospective review was conducted at Prince Rashid Bin Al-Hassan Hospital between August 2011 and March 2012. File and photographs review of 55 patients who attended the ophthalmology clinic and found to have corneal metallic foreign body were included in this study. The following data were extracted and analyzed: age, gender, past ocular history, mechanism and time of injury and whether any eye protective measures were taken for those who were exposed to trauma during work, time to receive treatment, method of corneal foreign body removal, number of foreign bodies, location, depth of foreign body in the cornea, whether the eye was patched or not after removal of corneal foreign body, associated ocular injury, presence of Bell's phenomenon, complications, and duration of absence from work. All patients were males and the age ranged between 17 and 55 years [mean 31.3 years]. Eighty- two percent of eye trauma occurred during work and all of them did not use any protective measure during their work activity. The mid third of the cornea was involved in 39% of patients followed by the paracentral zone in 27%. Corneal foreign bodies were removed by 27 gauge needle in 68% of patients. Eye patch was not used in 48% of patients after removal of foreign body. The most common associated finding was corneal rust in 63% of cases. Absence from work ranged between two to nine days. Corneal foreign bodies are potentially sight threatening that occurs mostly as a result of occupational accidents in male workers who do not comply with the use of eye protection. Educational and safety programs and patient counselling on proper eye protection are essential and must be implemented in the work places to prevent serious eye injuries and work loss.

Modified evisceration technique: post- equatorial sclerectomy and autogenous scleral patching

To describe and evaluate a modified evisceration procedure that is thought to augment the scleral shell volume, allowing the use of a larger-sized orbital implant, and enhancing the strength of the wound. A retrospective, descriptive, non-controlled study of evisceration with superior postequatorial sclerectomy, and patching the wound with autogenous scleral graft was conducted. We reviewed the files and analyzed the data of 52 patients [eyes] who underwent this technique from September 2003 to March 2011. Out of 52 patients, 26 were female [50%] and 26 were males [50%]. Age ranged from five to 90 years with an average of 47.6 years. The type of implant was silicone in 49 patients and hydroxyapatite in three patients. The diameters of the implants ranged between 14 and 20mm; four patients had 14mm, 14 patients had 16mm, 28 patients had 18mm, and six patients had 20mm implants. The commonest indication for evisceration was trauma in 23 [44.2%] patients. None of the patients had implant extrusion, exposure or migration. No scleral patch melting or displacement was encountered. The mean follow up period was 35.9 months [1.25 -104]. Technique of evisceration with post-equatorial sclerectomy and sclera patch graft was described. It was found safe and useful for implantation of larger implants. However, further comparative study is required