Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Cataract Extraction , Cefuroxime/therapeutic use , Endophthalmitis/prevention & control , Eye Infections, Bacterial/prevention & control , Anterior Chamber/drug effects , Endophthalmitis/epidemiology , Endophthalmitis/microbiology , Eye Infections, Bacterial/epidemiology , Eye Infections, Bacterial/microbiology , Humans , Incidence , Povidone-Iodine/therapeutic use , South Africa/epidemiology , Surveys and QuestionnairesABSTRACT
A 24-year-old black female (HIV-positive) was referred to our clinic with a 4-week history of an ulcerative lesion of the right upper and lower eyelids. She was on treatment for pulmonary tuberculosis and had been admitted to a secondary level hospital. She had no other ocular symptoms or signs. A tissue biopsy of the lesion revealed multinucleate squamous cells with ground glass viral nuclear inclusion bodies, indicative of herpes simplex virus (HSV) infection. The ulcer healed with oral and topical acyclovir therapy, confirming a herpetic origin. There is only one other reported case of this type of ulcerative eyelid lesion caused by HSV; the patient in this case was also immunocompromised.
Subject(s)
Eyelid Diseases/virology , HIV Infections/complications , Herpes Simplex/complications , Opportunistic Infections/complications , Ulcer/virology , Acyclovir/therapeutic use , Adult , Antiviral Agents/therapeutic use , Eyelid Diseases/drug therapy , Female , Herpes Simplex/drug therapy , Humans , Opportunistic Infections/drug therapy , Ulcer/drug therapy , Young AdultABSTRACT
PURPOSE: To determine if there is a screening test or a combination of screening tests that may be suitable for cataract and glaucoma case detection in Vision 2020 programs in Africa. METHODS: Design-Screening methods validation study. Setting-Groote Schuur Hospital, Cape Town, South Africa. Subjects-African patients aged 40 years and older with known cataract or with known glaucoma, and accompanying relatives aged 40 years and older with no known eye pathology. Outcome measures-Sensitivity, specificity, positive and negative likelihood ratios, and accuracy of 6 screening tests, used alone and in various combinations. RESULTS: Testing the pinhole visual acuity using a cut point of 6/18 in 1 or both eyes has a sensitivity and specificity greater than 90%, a positive likelihood ratio greater than 10.0, a negative likelihood ratio less than 0.1, and an accuracy greater than 90% for case detection of cataract or glaucoma. Examination of the optic disk with a lens free direct ophthalmoscope using a cut point of 0.7 for the vertical cup:disk ratio combined with testing for an afferent pupil defect has similar values for case detection of glaucoma. CONCLUSIONS: These tests may be suitable for use in Vision 2020 programs in Africa.
