Nigerian Journal of Ophthalmology

Bilateral congenital anophthalmia and hydrocephalus in Calabar, Nigeria: A case report

Elizabeth D. Nkanga — 2023-11-02

Congenital anophthalmia is a rare deformity with a complex aetiology. It can co-exist with disorders of central nervous system. The aim of this report is to present the socio-demographic, clinical data and management challenges of an abandoned HIV-exposed neonate with bilateral congenital anophthalmia and hydrocephalus, in Calabar, Nigeria. A 6-day-old female term neonate presented to the Newborn Intensive Care Unit of a tertiary hospital in Calabar, Nigeria, with a history of inability of mother to see the baby’s eyeballs since birth. There was no family history of a similar eye defect, consanguinity, or other associated histories. Ophthalmic examination findings included: mucopurulent discharge, shortened eyelids and palpebral fissure and absent eyeballs. A Transfontanelle ultrasound scan of the large head showed an obstructive hydrocephalus. Mother abandoned the baby in the hospital. Management of bilateral congenital anophthalmia is multidisciplinary. There may be an association with HIV infection. Abandonment of malformed babies is of psychosocial importance.

Unilateral orbital compartment syndrome unmasking dengue haemorrhagic fever: An unusual presentation

Ankita Singh — 2023-11-02

Dengue fever may be a potentially life-threatening condition owing to massive capillary leakage and severe bleeding, causing dengue shock syndrome. The earlier literature did not classically describe ophthalmic manifestations in dengue fever. We report a case of a 43-year-old male who presented with sudden onset swelling and pain in the left eye for 2 days along with a history of fever with myalgia for 5 days, for which he did not take any treatment. After a clinical evaluation, a provisional diagnosis of orbital compartment syndrome was made, which required urgent decompression. On investigation, the patient had thrombocytopenia (platelet count of 10,000/mL). A positive dengue non-structural protein-1 (NS-1) antigen, along with thrombocytopenia, confirmed the diagnosis of dengue haemorrhagic fever. Dengue IgM antibodies were also found to be positive. The patient was given supportive therapy and urgent platelet transfusions. Lateral canthotomy for orbital decompression, performed after platelet transfusion. However, retropulsion was not possible despite the surgical intervention. During the follow-up period, the left eye chemosis was slightly reduced. However, the visual acuity did not show improvement in the left eye throughout the follow-up. It is recommended that ophthalmologists be aware of such ocular manifestations as the likely initial presentation of dengue fever. Prompt and appropriate treatment through a multidisciplinary approach should prevent sight-threatening complications.

A case of Usher syndrome presenting with a right lamellar hole

Yewande Olubunmi Babalola — 2023-11-02

A 23-year-old lady presented to the Eye Clinic with poor night vision since childhood, worse in the right eye. There was an associated history of difficulty hearing noticed by her mother, which has progressively worsened. The presenting visual acuity was hand movement in the right eye and 6/60 in the left eye, respectively. She gave a history of recent and frequent involvement in domestic and road traffic accidents, which precipitated her presentation to the eye clinic. There were no concurrent systemic illnesses. Binocular indirect ophthalmoscopy revealed bilateral widespread bone spicule pigmentation, waxy disc pallor, and attenuated vessels with bilateral atrophic changes worse in the left eye. The optical coherence tomography scan revealed a lamella hole in the right eye. The otorhinolaryngologist made a diagnosis of sensorineural deafness. A diagnosis of Usher syndrome with a right lamellar hole was made in light of the clinical findings.

Willingness to trade life for better vision: A study of time trade-off among glaucoma patients in a tertiary health institution in Nigeria

Nnenne N. Ani — 2023-11-02

Objectives: This study aims to determine the time trade-off (TTO) among glaucoma patients at the University of Port Harcourt Teaching Hospital in Rivers State Nigeria. Materials and method: This was a hospital-based study at the University of Port Harcourt Teaching Hospital of the time trade-off utility of glaucoma patients aged 18 years and older with no history of coexisting ocular pathology or chronic illness. Subjects were selected by a simple random sampling method, and a time trade-off utility questionnaire was administered. Ocular examinations done included visual acuity, applanation tonometry, gonioscopy, and slit-lamp examination using a + 78 diopter lens; refraction was also done for each patient. Perimetry was done using standard achromatic perimetry with a fast threshold central 24-2 strategy. Data obtained were analyzed using SPSS (Version 20), and the P-value was set at <0.05. Result: Two hundred and ninety-nine (299) subjects participated in the study. There were 141 males (47%) and 158 females (53%) giving a male: female ratio of 1:1.12. The age range was 20 to 86 years with a mean age of 53.61± 14.23 years. The mean score of time trade-off among the study population was 0.84 ± 0.1417 (95% CI 0.82–0.86). Worsening BCVA in the better eye (P=0.025) was shown to be the only predictive factor of lower TTO quality of life. Conclusion: This study shows that there is a reduced time trade-off quality of life among this cohort of glaucoma patients. Therefore, it is important for ophthalmologists to bear this in mind, noting the important role of counseling in the management of glaucoma patients.

Clinical and demographic review of corneal ulcers in University of Ilorin Teaching Hospital

FG Adepoju — 2023-11-02

Background: Corneal ulceration is one of the major causes of avoidable blindness and visual impairment globally. Objectives: The aim of this study was to analyze clinical and demographic data of corneal ulcers at the Department of Ophthalmology, University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara state between 2017 and 2021. Methods: A retrospective survey of all cases of corneal ulcer under review period was done. Demographic and clinical data were retrieved from hospital records and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 92 cases were reviewed, consisting of 66 males, majority (76.1%) are married, and traders and artisan accounted for 54.3%. The age ranges from 6 months to 78 years with 41.2 years as average. The major identified risk factors were trauma (16.3%) and harmful traditional medications (13%). Visual acuity (VA) in 82.6% of the patients at presentation was <3/60 to no perception of light (NPL), while 10.9% presented with VA of 6/6 to 6/18. The most dominant causes of corneal ulcers were microbial keratitis (72.8%) and hypopyon keratitis (12.5%). Time of onset to presentation was within 1 week in 33 patients (35.9%), 29 patients (31.5%) after a week, while others presented over a month. After treatment, VA was 69.5% (<3/60–NPL), 21.7% (6/6–6/18), and 8.7% (6/18–3/60). Five patients had evisceration, two out of which were auto-evisceration. Conclusion: Ocular trauma was the most common risk factor with microbial keratitis as the most dominant cause. Poor treatment outcome resulted from late presentation, use of herbal, self and over-the-counter medications. Appropriate health promotion activities need to be conducted to address the identified risk factors at all levels of care.

Can social media bridge the information gap in Africa and improve early diagnosis of glaucoma by improving health seeking behaviour?

Aisha Ismail Abubakar — 2023-11-02

No abstract.

Editorial Comments: Nigerian Journal of Ophthalmology, May-August 2023

Bolutife A. Olusanya — 2023-11-02

No abstract.