HIV/AIDS in ophthalmic patients: The Guinness Eye Centre Onitsha experience.

OBJECTIVES: To determine the incidence and pattern of ocular problems of HIV/AIDS at the Guinness Eye Centre Onitsha, Nigeria. METHODS: The case files of all patients who had HIV test at the Guinness Eye Centre Onitsha over a 6-year period were examined. Those who tested positive for HIV were further analysed. Information obtained included patients' demographic characteristics, clinical diagnosis, ocular and systemic co-morbidity, visual acuity and follow-up. RESULTS: Of 1011 patients, 100 (9.9%), 51 males and 49 females, were confirmed HIV-positive. The age range was 21 - 80 years; median -31 years. Fifty-five patients (55%) were or had been married; 45 (45%) were single. Herpetic eye disease constituted 50% of the cases with herpes zoster ophthalmicus accounting for 48%. Bilateral ocular disease occurred in 19 patients (19%) viz: cytomegalovirus (CMV) retinitis (6%); corneal ulcers (6%); uveitis (4%); ocular motor palsy (2%) and ocular gunshot injury (1%). Non-HIV ocular lesions occurred in 20 patients (20%) as follows: bacterial corneal ulcer (8%); globe laceration (6%); non-CMV associated rhegmatogenous retinal detachment, cataract, and secondary orbital tumour (2% each). Systemic co-morbidities were present in 10 patients (10%), namely, emaciation (6%), pulmonary tuberculosis and abdominal malignancy with orbital metastases (2% each). Twenty three patients (23%) had bilateral blindness; 45 (45%) had uniocular blindness; 73.4% of the affected eyes were blind at presentation with 25% having no light perception (NPL). CONCLUSIONS: The incidence of HIV seropositivity doubled in the hospital over nearly 10-year period. Herpes zoster ophthalmicus remains the commonest ocular manifestation although CMV retinitis is becoming common. Since 20% of the patients had non-HIV ocular lesions, eye-health workers are advised to always take universal precautions in order to prevent the spread of the infection within and outside the hospital.

Tonometer-induced corneal injury: a report of two cases.

To avoid cross-infection, tonometers are sterilised before use on patients. When not carefully handled, the sterilising solutions could cause ocular injury. Two cases of corneal damage caused by alcohol used in sterilising the Schiotz tonometer are reported. Suggestions are made on how to avoid such iatrogenic injuries.