Outcome of Esotropia Surgery in 2 Tertiary Hospitals in Cameroon.

PURPOSE: To evaluate the ocular alignment following esotropia surgery in our setting. PATIENTS AND METHODS: We conducted a cross sectional descriptive study which spanned 19 years, from October 1999 to September 2018 at the Douala General Hospital and the Yaoundé Central Hospital. Complete medical records of patients who underwent surgery for esotropia during the study period were included. Data collected included age at diagnosis, sex, age of onset of esotropia, age at surgery, refractive error, type of surgery performed, pre and post-operative angle of deviation. The outcome was considered good when the postoperative angle was ≤10 prism diopters (PD). RESULTS: Four hundred and ninety patients with primary esotropia were seen during the study period. Only 155 returned for follow-up after wearing the full cycloplegic correction for a minimum period of 3 months. Accommodative esotropia was found in 32 cases (20.6%). Among the 123 cases requiring surgery, 63 cases underwent surgery (51.2%). Fifty-nine complete records were included (59.3% females and 40.7% males). The mean age at the time of diagnosis was 6.5 ± 6.1 years and the mean age at the time of surgery was 8.7 ± 6.1 years. The mean preoperative angle at distance was 42.8 ±10.8 PD. The outcome was good in 91.5% of cases. No factor influenced the outcome of surgery. CONCLUSION: The outcome of esotropia surgery was good in this study. This could serve to increase patient motivation to accept surgery in our setting.

[Age of onset of presbyopia in the black cameroonian subject]. / Age de début de la presbytie chez le sujet noir camerounais.

INTRODUCTION: Addition in patients of less than 40 years is not uncommon in our practice. We investigated the need for addition after objective refraction and thus determine the average age of onset of the presbyopia. METHODS: We conducted a cross-sectional descriptive study of patients aged 35-45 years at the Central Hospital of Yaoundé over a period of three months. All patients underwent cycloplegic refraction. Distance visual acuity was corrected after instillation of cycloplegic eye drops while near addition was assessed two days later when the cycloplegia was no longer effective. Possible additional distance correction was done 2 days after cycloplegia. Statistical analysis was done using IBM SPSS 20.0 software. RESULTS: We examined 55 patients, 110 eyes. The average age of patients was 41.87±2.5 years, the sex-ratio was 0.28. There was a female predominance. Hypermetropic astigmatism was the most common ametropia (58.2% of cases) followed by hyperopia (24.6%).No patient was myopic. the average age of presbyopia onset in this age group was 43.2±1.7 years. After objective correction of distance visual acuity, no patient needed for addition before the age of 40. Moreover, 4 out of 10 patients with hypermetropic ametropia did not need addition before the age of 40. Addition was significantly associated with age. CONCLUSION: The average age of presbyopia onset is 43.2±1.7 years. Before the age of 45, addition must be preceded by objective refraction.

Color vision deficiency among biomedical students: a cross-sectional study.

PURPOSE: To determine the prevalence of color vision deficiency (CVD) among first-cycle students of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I. PATIENTS AND METHODS: A cross-sectional descriptive study was carried out between October 1, 2015 and May 31, 2016. Distant visual acuity was measured and color vision test done for all consenting students. Ishihara's plates were used to test all the participants. Those who failed the test were tested with the Roth's 28 Hue test for confirmation of CVD and classification. RESULTS: A total of 303 students were included, among whom 155 were males (50.8%) and 148 were females (49.2%). The mean age was 20.2±2 years. Five students (1.6%) failed the Ishihara's plate testing. Roth's 28 Hue test confirmed CVD in 4 of those cases, giving a prevalence of 1.3%. There were equal numbers of protan and deutan CVD. CONCLUSION: Despite its low prevalence among first-cycle students of the Faculty of Medicine and Biomedical Sciences, CVD screening should be performed in order to raise awareness, which will go a long way to help orientate the choice of future specialty.

Phthirus pubis Infestation of the Eyelids Presenting as Chronic Blepharoconjunctivitis in a 6-Year-Old Girl: A Case Report.

PURPOSE: To report the case of Phthirus pubis infestation of the eyelashes presenting as chronic blepharoconjunctivitis. CASE REPORT: A 6-year-old girl presented with a 2-month history of blepharoconjunctivitis unresponsive to topical antibiotics in the left eye. Slit-lamp examination revealed the presence of nits and adult parasites on the eyelashes. Parasitological examination confirmed adult forms and nits of Phthirus pubis. There was no evidence of infestation elsewhere. Outcome was favourable with mechanical removal and application of petroleum jelly. CONCLUSION: Careful slit-lamp examination of the eyelashes should be done in all patients presenting with ocular irritation symptoms.

Ophthalmic Manifestations in Chronic Inflammatory Rheumatic Diseases at a Referral Hospital of Yaounde, Cameroon.

PURPOSE: To determine the profile of ophthalmic manifestations in chronic inflammatory rheumatic diseases (CIRD). METHODS: Observational study at the Yaounde Central Hospital and Innel Medical Centre (2004 to 2012). RESULTS: The study population (n = 36) consisted of 14 men and 22 women with average age of 47.9 ± 17.2 years. Cases of CIRD were rheumatoid arthritis (n = 16), systemic lupus erythematosus (n = 8), ankylosing spondylitis (n = 8), mixed connective tissue disease (n = 2), scleroderma (n = 1), and juvenile idiopathic arthritis (n = 1). Ophthalmic manifestations found in 22 (61.1%) patients were dry eye syndrome (n = 7), cataract (n = 6), anterior uveitis (n = 6), glaucoma (n = 4), and suspected maculopathy (n = 1). No association was found between steroids used and supcapsular cataract (p = 0.06) or glaucoma (p = 0.06). CONCLUSION: Ocular manifestations occurred in 61.1% of CIRD. Dry eye syndrome and anterior uveitis were commonly observed.

Partially absorbed cataractous lens in the anterior chamber revealing neglected severe ocular contusion: a case report.

BACKGROUND: Ocular contusion can produce severe lesions, which if not treated appropriately and promptly, can lead to visual impairment. Ocular contusion in childhood may not be reported by children. CASE PRESENTATION: A 27 year old female presented with a partially absorbed cataractous lens that was dislocated into the anterior chamber of her left eye. There was mild anterior chamber reaction. She reported no history of ocular trauma; but associated findings and further investigations were in favour of a post-traumatic aetiology. CONCLUSION: All ocular injuries require a detailed ophthalmological examination to assess vision and the extent of lesions.

Correlation between Hertel exophthalmometric value and refraction in young Cameroonian adults aged 20 to 40 years.

PURPOSE: To study the relationship between exophthalmometric value (EV) and refractive error in Cameroonian young adults. PATIENTS AND METHODS: A prospective descriptive study was carried out in the ophthalmic unit of the Yaoundé Central Hospital from March to May 2015. Consenting patients aged 20-40 years with no intraocular pathology who were seen for refractive errors were included. Ocular protrusion was measured using the Hertel exophthalmometer. Automatic refraction was done following cycloplegia with cyclopentolate and tropicamide. RESULTS: A total of 200 patients were included (68% females and 32% males). The mean age was 27.2±6 years. Hyperopia was the most common refractive error (51%), followed by hyperopic astigmatism (19.3%). EV varied between 9 mm and 23 mm, with a mean of 14.8±2.5 mm in the right eye and 15.0±2.5 mm in the left eye. The mean EVs were 17.10±2.80 mm in myopia, 14.24±1.92 mm in hyperopia, 16.72±2.58 mm in myopic astigmatism, 14.07±2.19 mm in hyperopic astigmatism, and 14.77±2.40 mm in mixed astigmatism. The spherical value had a negative correlation with EV (P=0.0000). CONCLUSION: The mean EV of this Cameroonian population is smaller than that of other populations and is consistent with the known characteristic hyperopic status of the population. A study on a larger sample will determine the normative data of absolute and relative EV in our setting.

Conservative management in congenital bilateral upper eyelid eversion.

Aim. To report the case of congenital bilateral upper eyelid eversion with severe chemosis that was successfully managed conservatively. Report. The patient was a six-hour-old male neonate with bilateral congenital upper eyelid eversion and severe chemosis, following uneventful delivery. Conservative management consisted of the application of antibiotic ointment and padding the exposed conjunctiva with 5% hypertonic saline-soaked gauze. The eyelids reverted spontaneously on day 3 and the condition was completely resolved by the third week. Conclusion. Congenital upper lid eversion is usually a benign condition which responds well to conservative treatment. Creating awareness amongst healthcare professionals is essential.

Pattern of corneal pathologies in children seen at Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon.

PURPOSE: To describe the different corneal pathologies and determine the prevalence of corneal blindness amongst children aged 0-15 years, seen at the ophthalmology unit of a tertiary hospital in Cameroon. PATIENTS AND METHODS: The medical records of all patients who presented to the Ophthalmic Unit between 2002 and 2010 were reviewed, retrospectively. The records of children aged 0-15 years, presenting with corneal pathologies, were further reviewed. Data collected included age, sex, past medical history, initial visual acuity, type of corneal lesion, and visual acuity at last follow-up. RESULTS: Of the 7,922 children seen over the study period, 168 had corneal pathologies: a prevalence of 2.1%. Males were more affected than females (male to female ratio: 1.4:1; P = 0.008). The age range was from 2 weeks to 15 years (mean age: 7.1 years; standard deviation: 4.4 years). The leading etiologies were trauma (48.2%; n = 81) and infection (28.0%; n = 47). Amongst those with available follow-up data, visual impairment and blindness occurred in 50% of the cases (n = 12), with one case being bilateral. CONCLUSION: Trauma is the most frequent cause of corneal blindness in children.

Eye malformations in Cameroonian children: a clinical survey.

SUMMARY: The aim of this work was to describe the clinical aspects of eye malformations observed at the ophthalmology unit of the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital. PATIENTS AND METHODS: We carried out a retrospective study of all malformations of the eye and its adnexae observed among children aged 0-5 years who were seen at the ophthalmology unit from January 2003 to December 2009. RESULTS: Out of the 2254 children who were examined, 150 (6.65%) presented eye malformations. The mean age was 14.40 ± 4 months. Eye malformations were diagnosed in 71.66% of cases during the first year of life. The most frequent malformations were congenital lacrimal duct obstruction (66.66%), congenital cataract (10.9%), congenital glaucoma (10.9%), microphthalmos (5.03%), and congenital ptosis (3.77%). CONCLUSION: Eye malformations among children can lead to visual impairment and are a cause for discomfort to children and parents. Therefore, systematic postnatal screening is recommended to enable early management.

Secondary cataract: an epidemiologic and clinical survey at the Yaounde Gynaeco-obstetric and Paediatric Hospital.

OBJECTIVE: To determine the incidence and risk factors of secondary cataract. MATERIALS AND METHODS: A retrospective study involving a review of medical records in the ophthalmology unit of the Yaoundé Gynaeco-obstetric and Paediatric Hospital in Yaoundé, Cameroon, was carried out. All patients who had cataract surgery between January 2006 and September 2010 were included. Variables included age, sex, past medical history, morphology of primary cataract, type of surgery, intraocular lens implantation, site of implantation, intra- and postoperative complications, and the time lapse for the presentation of secondary cataract. Both univariate and bivariate analyses were carried out. The χ(2) test was used to compare proportions, and P-values <0.05 were considered statistically significant. RESULTS: A total of 864 eyes of 718 patients had cataract surgery. Ninety-two eyes developed posterior capsule opacification, giving an incidence of 10.65%. The mean age of patients who developed secondary cataract was 52.3 ± 23.05 years, with a range of 4 years to 84 years. Secondary cataract was more frequent in the age group of 0-20 years. The time lapse for presentation of secondary cataract was 64.7 ± 9.53 days, with a range of 1 to 504 days. Risk factors for the development of secondary cataract were age (P = 0.000), sex (P = 0.011), cortical cataract (P = 0.000), and postoperative inflammation (P = 0.000). CONCLUSION: The incidence of secondary cataract, though high in this study, is lower than that reported in other studies.

Indications for destructive eye surgeries at the Yaounde Gynaeco-Obstetric and Paediatric Hospital.

OBJECTIVE: To determine the indications and rate of acceptance for destructive eye surgeries at the ophthalmology unit of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital. METHODS: A retrospective consecutive case series in which the medical records of all patients consulting in this unit over a 9-year period (2002 to 2010) were reviewed. Records in which destructive surgery was recommended were retained. Information collected included demographic data, eye affected, clinical diagnosis, acceptance or refusal of surgery, and the outcome in those in whom surgery was performed. RESULTS: A total of 48 patients had a recommendation for destructive eye surgery, of whom 30 (62.5%) were males and 18 (37.5%) were females. Mean age was 43.78 (SD = 28.11; range 1 month to 91 years). Children <10 years comprised 23.10%. The leading causes were endophthalmitis/panophthalmitis (47.9%), neoplasm (20.8%), and absolute glaucoma (14.6%). Surgery was done in 20 cases (41.7%). Evisceration was the most performed surgical procedure (50%), with endophthalmitis/panophthalmitis and neoplasm combined accounting for 65% of surgeries. CONCLUSION: The high rate of refusal is an indication of the psychological devastation undergone by patients or the families of children in whom eye removal is recommended. Awareness should be raised on preventive measures and the need to rapidly seek eye care.