C Ebana Mvogo

[Epidemiological, clinical and therapeutic features of pediatric ocular injuries in an eye emergency unit in Île-de-France].

INTRODUCTION Ocular and orbital trauma is a leading cause of acquired monocular blindness in childhood. These injuries differ from those in adults in some aspects of the management and prognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemiological, clinical and therapeutic features of ocular trauma in children who consulted in an eye emergency department in Île-de-France. PATIENTS AND METHODS This was a descriptive, prospective and longitudinal study. Over a period of 6 months, we included children aged 15 years old or less, who consulted during calls for ocular trauma. Each child received an ophthalmologic examination as complete as his or her condition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocular burns were distributed respectively according to the Birmingham Eye Trauma Terminology and Duas classification. The visual prognosis was defined as the best corrected visual acuity of the affected eye, measured at the conclusion of treatment. RESULTS Among 586 children who consulted during the study period, 265 suffered from ocular trauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the injuries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the most frequent (12.45%). One hundred and fifty-seven patients consulted within 6 hours (59.19%). The cornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeball accounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbital injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment was required in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length of stay of 3 days. Four children developed sequelae, including 2 corneal scars and 2 cataracts. No case of blindness was recorded. DISCUSSION The high frequency of traumatic ocular and orbital pathology in our study may be due to its sudden and accidental onset, leading parents to seek emergency care. Most injuries occurred at home and at school, which reflects the presence in these places of potential hazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate may reach 73.4%. This clinical presentation is associated with a poor prognosis because of the risk of infection and sequelae causing decreased visual acuity and amblyopia. Few children were hospitalized. This could be explained by the predominance of mild to moderate trauma. CONCLUSION Ocular trauma accounts for nearly half of pediatric conditions encountered in the eye emergency unit. Adequate emergency care improves the visual prognosis.

La limboconjonctivite endémique des tropiques au nord Cameroun

INTRODUCTION A retrospective study was conducted in the ophthalmology unit of the Garoua regional hospital on children examined from January 2001 to December 2007. We aimed to determine the epidemiological aspects of tropical endemic limboconjunctivitis in northern Cameroon. Included were all the files of patients aged 0-15 years seen with a positive diagnosis of tropical endemic limboconjunctivitis. The data analyzed were obtained through inspection, interview, and a comprehensive ocular exam done for every case, assessing far visual acuity, slit lamp biomicroscopy, and funduscopy when possible. The variables analyzed were age, sex, signs and symptoms, residential area, associated pathologies, and the month and the year of the diagnosis. The data were analyzed with Epi-Info, version 6.04d (French) and the results compared with the Chi(2) test with a 95% confidence interval. RESULTS A total of 6453 children were included: 2036 had a positive diagnosis of tropical endemic limboconjunctivitis, with a frequency of 31.55%. The mean age was 6.5 years. The 1- to 4-year-old age group had the highest number of patients, with a frequency of 33.25%. There were 1120 males (55%). Itching was the most frequent complaint encountered in 60.90% of the patients. Ocular involvement was always bilateral. Tropical endemic limboconjunctivitis is an allergic conjunctivitis present throughout the year with two peaks in March and July. DISCUSSION Tropical endemic limboconjunctivitis can be considered an allergic conjunctivitis affecting boys more frequently than girls in warm and dry environments. It is frequent in children less than 5 years old and regresses with age. CONCLUSION Tropical endemic limboconjunctivitis is a tropical disease with an intertropical aspect.