Functional Vision of Pseudophakic Children Attending a Pediatric Ophthalmology Clinic in Southwest Nigeria.

PURPOSE: To determine the functional vision of pseudophakic children attending a child eye health tertiary facility in southwest Nigeria. METHODS: A hospital-based descriptive study of pseudophakic children attending the Pediatric Ophthalmology outpatient clinic of a tertiary facility in southwest Nigeria was conducted between June and November 2021. Details of demography and clinical examination findings were obtained using a semi-structured questionnaire. Information about functional vision was obtained using the Pediatric Eye Questionnaire (PedEyeQ). Data obtained from the PedEyeQ were entered into a Rasch-calibrated PedEyeQ Excel response data sheet. Data analysis was done using Statistical Package for Social Sciences (SPSS) software version 22 (SPSS, Inc). RESULTS: A total of 196 pseudophakic children were recruited. Their ages ranged from 2 to 16 years with a mean of 9.8 ± 3.4 years and there was a male-to-female ratio of 2.2:1. The median functional vision score of pseudophakic children across all age groups was 90.0. The functional vision scores were associated with the laterality of cataract, type of cataract, presence of comorbidities, visual acuity (distance and near) in the better eye, and number of surgeries. CONCLUSIONS: The functional vision scores of pseudophakic children were low. Significant predictors of low functional vision scores include surgery for congenital cataract, low average family income, longer duration of time between surgery and recruitment into the study, and poorer best corrected visual acuity in the better eye. The routine assessment of functional vision should be considered an important aspect of pseudophakic children's eye care with a view toward optimizing psychological and social well-being. [J Pediatr Ophthalmol Strabismus. 2024;61(2):138-146.].

Outcome of surgery for traumatic cataract in children in a child eye health tertiary facility, Ibadan, Nigeria.

OBJECTIVE: The objective of this study was to describe the outcome of surgery for traumatic cataract and associated factors in children aged 16 years and below operated in a tertiary facility. METHODS: This was a retrospective review of records of children who had surgery for traumatic cataract between August 2015 and August 2019. Information on biodata, preoperative visual acuity, surgical methods, complications, and postoperative visual acuity were retrieved. Data were analyzed using IBM SPSS Statistics 20.0. RESULTS: Traumatic cataract accounted for 87 (14.7%) of 593 eyes operated for childhood cataract during the period. Of these, a total of 79 records were available for review. There were 56 (70.9%) males with a mean age of 10.11 (±3.39) years. All injuries were unilateral; closed globe injuries accounted for 70 (88.8%) of the cataracts and the left eye was affected in 42 (53.2%) patients. Fifty-two (67.09%) eyes had other ocular injuries apart from cataracts. The morphology of the cataract was membranous in 44 (55.7%) eyes, and 76 (96.2%) eyes had cataract surgery with intraocular lens (IOL) implantation; 39 (51.3%) of these IOLs were implanted within the capsular bag. The preoperative best corrected visual acuity was worse than 6/18 in all 79 (100%) eyes and improved to 6/18 or better in 32 (40.5%) eyes at 3 months postoperatively. CONCLUSION: Traumatic cataract accounted for less than a quarter of all childhood cataracts in our center. Majority of the eyes had successful IOLs implantation during surgery, and the best corrected visual acuity improved in a moderate proportion of these patients.

Epithelial Lacrimal Gland Tumours in Nigeria: Clinicopathological Features and Treatment.

Background: Epithelial lacrimal gland tumours are uncommon orbital tumours and are not widely reported among African populations. Objective: This study aimed to describe the clinicopathological features, treatment, and outcomes of epithelial lacrimal gland tumours in Nigeria. Design: Retrospective case series. Setting: Ocular Oncology Unit, Ophthalmology Department and Pathology Department of University College Hospital, Ibadan, Nigeria. Materials and Methods: A review of the medical records of all patients with histopathological diagnoses of epithelial lacrimal gland tumours managed at a tertiary health facility, southwestern Nigeria over 11.5 years was carried out. Results: Eighteen patients with equal numbers of men and women, and mean age at presentation of 42.2 ± 15.7 years (median 42 years, range 17-70 years) were managed. All patients presented with orbital swelling and had nonaxial proptosis with palpable firm to hard mass in the superotemporal quadrant of the orbit. The mean duration of symptoms was 42.2 ± 38.6 months (median 24 months, range 3-120 months). Visual acuity was <3/60 at presentation in eight (44.4%) of the affected eyes. Thirteen (72.2%) patients underwent orbitotomy and tumour excision, while five (27.8%) patients had orbital exenteration, and two of whom (11.1%) had combined orbital exenteration and craniotomy. Histopathological examination of the specimens revealed pleomorphic adenoma in nine (50.0%) patients, low-grade mucoepidermoid carcinoma in three (16.7%) patients, high-grade mucoepidermoid carcinoma in two (11.1%) patients, adenoid cystic carcinoma in three (16.7%) patients, and adenocarcinoma "not otherwise specified" in one (5.6%) patient. Mortality was reported in four (44.4%) of nine patients with malignant tumours, while no mortality was noted in the patients with benign pleomorphic adenoma. The mean follow-up period for the patients was 28.9 months (median, 4.5 months; range, 2-140 months). Conclusion: The main presenting symptom of epithelial lacrimal gland tumours in our patients was an orbital mass and the most common clinical finding, in addition to the orbital mass, was nonaxial proptosis. The tumours were equally divided into benign and malignant lesions in our studied population. Pleomorphic adenoma was the only benign tumour while mucoepidermoid carcinoma was the commonest malignant lesion. Orbital exenteration was performed in a high proportion of our patients and high mortality was noted among patients with malignant tumours.

Contexte: Les tumeurs épithéliales des glandes lacrymales sont des tumeurs orbitales rares et ne sont pas largement rapportées parmi les populations africaines. Objectif: Cette étude visait à décrire les caractéristiques clinico-pathologiques, le traitement et le résultat des tumeurs épithéliales des glandes lacrymales au Nigeria. Conception: Série de cas rétrospectifs. Cadre: Unité d'oncologie oculaire, département d'ophtalmologie et département de pathologie du Collège Hospitalier Universitaire, Ibadan, Nigéria. Méthode: Un examen des dossiers médicaux de tous les patients présentant des diagnostics histopathologiques de tumeurs épithéliales des glandes lacrymales gérées dans un établissement de santé tertiaire du sud-ouest du Nigéria pendant 11,5 ans a été effectué. Résultats: Dix - huit patients avec un nombre égal d'hommes et de femmes et un âge moyen à la présentation de 42,2 ± 15,7 ans (médian de 42 ans, intervalle de 17 à 70 ans) ont été pris en charge. Tous les patients présentaient un gonflement orbital et avait l'exophtalmie non-axiale avec ferme à dur masse palpable dans le quadrant temporel supérieur de l'orbite. La durée moyenne des symptômes était de 42,2 ± 38,6 mois (médiane de 24 mois, intervalle de 3 à 120 mois). L'acuité visuelle était <3/60 à la présentation dans huit (44,4%) des yeux atteints. Treize (72,2%) patients ont subi une orbitotomie et une excision de la tumeur, tandis que cinq (27,8%) patients avaient une exentération orbitaire, dont deux (11,1%) avaient l'exentération orbitale et la craniotomie combinées. L'examen histopathologique des échantillons a révélé un adénome pléomorphe chez neuf (50,0%) patients, un carcinome muco-épidermoïde de bas grade chez trois (16,7%) patients, un carcinome muco-épidermoïde de haut grade chez deux (11,1%) patients, un carcinome adénoïde kystique chez trois (16,7%) patients et adénocarcinome "non autrement spécifié" (NOS) chez un patient (5,6%). La mortalité a été rapportée chez quatre (44,4%) des neuf patients atteints de tumeurs malignes, alors qu'aucune mortalité n'a été notée chez les patients présentant un adénome pléomorphe bénin. La période moyenne de suivi des patients était de 28,9 mois (médiane de 4,5 mois; intervalle de 2 à 140 mois). Conclusion: Le principal symptôme de présentation des tumeurs épithéliales des glandes lacrymales chez nos patients était une masse orbitale et le résultat clinique le plus courant, en plus de la masse orbitale, était une exophtalmie non axiale. Les tumeurs étaient également divisées entre les lésions bénignes et malignes dans notre population étudiée. L'adénome pléomorphe était la seule tumeur bénigne tandis que le carcinome muco-épidermoïde était la lésion maligne la plus courante. Une exentération orbitale a été réalisée chez une forte proportion de nos patients et une mortalité élevée a été notée chez les patients atteints de tumeurs malignes.