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ABSTRACT: Although cataracts cause 47% of global blindness, their epidemiologic impact in different countries is notoriously uneven and the world can be divided into two zones according to economic conditions. In advanced countries where care is good, cataracts account for only 5% of blindness while cataracts still account for 50% of blindness in developing countries. After a brief overview of historical, clinical and therapeutic aspects, this article updates epidemiological data on cataracts in the world. It also provides insight into political, socio-economic, and cultural factors adversely affecting care availability in developing countries thus making cataracts a major public health problem and an obstacle for development. Finally this article offers a few recommendations for reducing the backlog of cataracts in the world and for consolidating advances made over the last two decades thanks to experience gained in various National Blindness Prevention Programs (NBPP).
Médecine tropicale: revue du Corps de santé colonial 01/2008; 67(6):644-50.
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ABSTRACT: To describe the main characteristics of intraocular pressure (IOP) in Benin, the frequency of ocular hypertension (OHT) and primary open-angle glaucoma (POAG). Material and methods: A retrospective study was conducted in a private ophthalmological clinic in Cotonou, Benin, between January 1 and June 30, 2001. It involved 4159 patients aged 20 years and over in whom IOP was systematically measured within a glaucoma screening program. The parameters studied were age, sex, and IOP.
The patients recruited were between 20 and 85 years old. The age group from 41 to 50 years was the largest (30.1%); 56.4% of the sample were women. IOP values ranged from 8 to 60 mmHg: 52.3% were lower or equal to 13 mmHg. For both sexes, IOP followed a Gaussian distribution, with a peak between 11 and 13 mmHg. OHT frequency was 3.8%, with a male predominance and a regular increase with age. Among the OHT cases, 41.6% were isolated OHT and 58.4% of the POAGs turned out. Of the glaucoma patients, 16% were less than 40 years old, 25% were under 30 years old.
In this study, it was found that the IOP peak was low and glaucoma appeared prematurely in the Beninese population. Glaucoma screening must therefore be set up from the age of 20 years and even earlier.
Journal Français d Ophtalmologie 07/2005; 28(6):623-6. · 0.51 Impact Factor
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ABSTRACT: Apert's syndrome is a type of acrocephalosyndactylia that is from part of the great group of craniofacial synostoses. It is characterized by craniofacial dysmorphia and syndactylia on hands and feet, which differentiates it from Crouzon's disease. It is a rare affection that is often transmitted through an autosome dominant mode, but sporadic cases exist. We report the case of a 15-year-old girl who presented characteristic clinical signs of Apert's syndrome with normal karyotype without parental consanguinity. The Ser 252 Trp mutation of the FGFR2 gene was found, confirming the molecular diagnosis. This study illustrates the severity of ocular and neurological problems of untreated Apert's syndrome. The presence of hemoglobinopathy (Hb AS) is also a mark of its originality.
Journal Français d Ophtalmologie 10/2003; 26(7):738-42. · 0.51 Impact Factor
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ABSTRACT: Xerophthalmia is a term covering a range of ophthalmologic manifestations due to vitamin A deficiency. This condition occurs in preschool children in tropical regions affected by protein-caloric malnutrition. Clinical manifestations of the disease have been summarized in the 1974 five-grade WHO classification. Clinical diagnosis was traditionally made using a slit lamp to detect the pathognomonic manifestations and consequences of corneal and conjunctival xerosis. Currently diagnosis is greatly facilitated by determination of plasma levels using a micromethod, especially the relative dose response (RDR) test, and by conjunctival impression cytology (CIC). CIC is a simple and reliable method which allows mass screening and thus more effective evaluation of the impact of xerophthalmia on public health in Africa. The relationship between xerophthalmia and measles is complex. Vitamin A deficiency promotes measles which can in turn hasten perforation of keratomalacia especially in undernourished children. Vitamin A has a beneficial effect on both xerophthamia and measles. Curative and prophylactic administration of vitamin A at doses recommended by the W.H.O. considerably reduces not only xerophthalmia-related morbidity but also child mortality in tropical areas.
Médecine tropicale: revue du Corps de santé colonial 02/1995; 55(4 Pt 2):434-8.
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ABSTRACT: Harada's disease is a uveo-meningitis syndrome characterized by meningo-encephalic manifestations preceded by bilateral posterior uveal lesions. The etiology of Harada's disease is still unclear but it probably involves an auto-immune reaction to melanocytes. This mechanism would account for the high incidence of Harada's disease in dark-skinned patients. This report describes a case of Harada's disease that occurred in a 28-year-old woman from North Africa. Ophthalmologic manifestations were typical with regard to clinical features and course involving bilateral papillary edema followed by exsudative detachment of the retina and diffuse cicatricial epitheliopathy of the posterior poles. However neurologic signs were mild, the main finding being atypical headache, and this particularity delayed diagnosis. Limited cerebral involvement that did not coincide with ocular lesions explains the fact that a thorough search for posterior uveal involvement with the aforesaid features was necessary. Although it occurs mainly in dark-skinned Asians, Harada's disease deserves the attention of physicians practicing in tropical areas.
Médecine tropicale: revue du Corps de santé colonial 02/1995; 55(4 Pt 2):459-61.
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ABSTRACT: The most common manifestations of Lyme disease are neurologic and rheumatologic, but ophthalmologic lesions can also occur and may even be dominant. The authors describe a case of bilateral optic neuropathy associated with Lyme borreliosis that quickly led to near-total blindness. In addition to a loss in visual acuity and field bilateral papillary edema was documented by angiofluorography. A spectacular improvement was obtained under combined antimicrobial therapy using doxycycline and corticosteroid therapy. The patient rapidly recovered full vision. These observations are discussed within the context of Lyme disease with a review of other relevant ophthalmologic complications. The importance of careful interpretation of serology is emphasized.
Médecine tropicale: revue du Corps de santé colonial 02/1995; 55(4 Pt 2):462-5.
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ABSTRACT: ObjectifLes auteurs ont voulu mettre en évidence les principales caractéristiques du tonus oculaire chez le Béninois, la fréquence des hypertonies oculaires (HTO) et du glaucome primitif à angle ouvert (GPAO).Matériel et méthodesNous avons mené une étude rétrospective dans une clinique privée d’Ophtalmologie de Cotonou du 1er janvier au 30 juin 2001 (6 mois). Elle a concerné 4 159 patients âgés de 20 ans et plus, chez qui le tonus oculairea été mesuré systématiquement dans le cadre du dépistage du glaucome. Les paramètres étudiés étaient l’âge, le sexe et le tonus oculaire.RésultatsLes patients ainsi recrutés étaient âgés de 20 à 85 ans. La tranche d’âge de 41 à 50 ans était la plus représentée (30,1 %). 56,4 % de l’échantillon étaient des femmes. Les valeurs de tonus oculaire s’étalaient de 8 à 60 mmHg, dont plus de la moitié (52,3 %) étaient inférieures ou égales à 13 mmHg. Quel que soit le sexe, la répartition des tonus oculaires suivait approximativement une courbe en « cloche », avec un pic entre 11-13 mmHg. La fréquence des HTO a été de 3,8 % avec une prédominance masculine et une augmentation régulière avec l’âge. Parmi les cas d’HTO, 41,6 % étaient des HTO isolées et 58,4 % des GPAO avérés. Seize pour cent des glaucomateux avaient moins de 40 ans, dont 25 % avaient moins de 30 ans.ConclusionDe cette étude, il ressort une valeur basse entre 11-13 mmHg du pic moyen du tonus oculaire et la précocité d’apparition du glaucome chez leBéninois. Le dépistage du glaucome doit donc être institué dès l’âge de 20 ans et même plus tôt.PurposeTo describe the main characteristics of intraocular pressure (IOP) in Benin, the frequency of ocular hypertension (OHT) and primary open-angle glaucoma (POAG).Material and methodsA retrospective study was conducted in a private ophthalmological clinic in Cotonou, Benin, between January 1 and June 30, 2001. It involved 4159 patients aged 20 years and over in whom IOP was systematically measured within a glaucoma screening program. The parameters studied were age, sex, and IOP.ResultsThe patients recruited were between 20 and 85 years old. The age group from 41 to 50 years was the largest (30.1%); 56.4% of the sample were women. IOP values ranged from 8 to 60 mmHg: 52.3% were lower or equal to 13 mmHg. For both sexes, IOP followed a Gaussian distribution, with a peak between 11 and 13 mmHg. OHT frequency was 3.8%, with a male predominance and a regular increase with age. Among the OHT cases, 41.6% were isolated OHT and 58.4% of the POAGs turned out. Of the glaucoma patients, 16% were less than 40 years old, 25% were under 30 years old.Conclusion
In this study, it was found that the IOP peak was low and glaucoma appeared prematurely in the Beninese population. Glaucoma screening must therefore be set up from the age of 20 years and even earlier.
Journal francais d'ophtalmologie 28(6):623-626. · 0.51 Impact Factor
