Emilienne Epée

Central corneal thickness and intraocular pressure in the Cameroonian nonglaucomatous population

Aim: We performed a prospective, analytical study from 01 January to 31 March 2009 in the Ophthalmology Unit of the Gyneco-Obstetric and Pediatric Hospital of Yaounde, aiming to determine the profile of central corneal thickness (CCT) in the Cameroonian nonglaucomatous black population and its relationship with intraocular pressure (IOP). Results and discussion: Four hundred and eighty-five patients (970 eyes) meeting our inclusion criteria were selected for this study. The average CCT was 529.29 ± 35.9 μm in the right eye (95% confidence interval [CI]: 526.09–532.49), 528.19 ± 35.9 μm in the left eye (95% CI: 524.99–531.40) and 528.74 ± 35.89 μm in both eyes (95% CI: 526.48–531.00), range 440 to 670 μm. The average IOP was 13.01 ± 2.97 mmHg in both eyes (95% CI: 12.82–13.19). A rise in CCT by 100 μm was followed by an increase in IOP of about 2.8 mmHg (95% CI: 2.3–3.6) for both eyes taken together. Linear regression analysis showed that corneal thickness was negatively correlated with age and IOP was positively related with age. Conclusion: CCT in the Cameroonian nonglaucomatous black population was found to be lower compared with CCT values in Caucasian and Asian populations. On the basis of reference values ranging between 527 and 560 μm, an adjustment of IOP values by a correction factor is required for many Cameroonian patients. This will improve the diagnosis and follow-up of glaucoma by helping to detect true ocular hypertension.

Unilateral childhood blindness: a hospital-based study in Yaoundé, Cameroon

Introduction: We performed an analytic and prospective study over a period of 12 months from January 2nd to December 31st, 2008, at the Gynaeco-Obstetric and Paediatric Hospital of Yaoundé, Cameroon. Our aim was to determine the prevalence and causes of unilateral blindness in school children aged 6 to 15 years. Results: Among the 1,266 children aged 6 to 15 years who were recruited, 60 presented with unilateral blindness (4.7%): 42 boys (6.96%) and 18 girls (2.71%). The mean age was 10.15 ± 3.4 years. In patients with unilateral blindness, 65% was due to ocular trauma. Discussion: The hospital-based prevalence of unilateral blindness in children is relatively high and ocular trauma is the leading etiology. Conclusion: Unilateral blindness in school children is avoidable and its incidence could be markedly reduced by emphasizing an information strategy and education based on prevention of ocular trauma. Early management of nontraumatic diseases such as infantile glaucoma and some tumors could improve outcome and avoid blindness.

Prevalence and etiology of amblyopia of children in Yaoundé (Cameroon), aged 5-15 years

PURPOSE To determine the frequency of amblyopia and identify its causes in a population of children aged 5-15 years in Cameroon. SUBJECTS AND METHODS This retrospective study examined the files of children aged 5-15 years seen in a private eye clinic in Yaounde from January 2008 through December 2010. The subjects underwent a complete ophthalmic examination including assessment of the best corrected visual acuity on a LogMAR chart, cycloplegic refraction measurements, and an orthoptic examination. The slit-lamp microscope and eye fundus examinations made it possible to rule out organic diseases. Statistical analysis was performed with Epi Info software, version 3.5.3, to analyze the the frequency and laterality of amblyopia according to age, sex, and refractive errors. RESULTS Twenty-eight of the 314 patients studied had amblyopia, for a frequency of 8.9 % in the study population and 10.3 % in the subjects with ametropia (n = 271). The average age of children with amblyopia was 9.9 + / - 3 years. The frequency of amblyopia was higher among boys, but the difference was not statistically significant (p=0.3679). In order of frequency, the causes were refractive errors, for 93 % (26/28) of the children, and strabismus for 7 % (2/28). Astigmatism was the most frequent cause of ametropic amblyopia. Amblyopia had an anisometropic origin in 43 % (12/28) of cases. It was unilateral in 39.2 % (11/28) and bilateral in 61 % (17/28) of cases, severe in 18 %, moderate in 18 %, and mild in 64 %. CONCLUSION Ten percent of the subjects in our series had amblyopia, mainly due to refractive errors. Amblyopia was most frequently bilateral and mild. A systematic ophthalmological examination in childhood could provide early detection and management of refractive errors that cause ocular morbidity.

Analysis of central corneal thickness in black Cameroonian children

Correspondence: Andre Omgbwa Eballe Department of Ophthalmology, gynaeco-Obstetric and Pediatric hospital of Yaounde, PO Box 4362, Yaounde, Cameroon Tel +237 9965 4468 Fax +237 2221 2430 Email andyeballe@gmail.com Purpose: Our objective was to determine mean pediatric central corneal thickness (CCT) in black Cameroonian children, according to gender and age, using ultrasonic pachymetry. Materials and methods: A prospective, observational, consecutive case series in 102 children (204 eyes) aged 5–16 years was carried out from November 2009 to January 2010 at the Eye Unit of the Gynaeco-Obstetric and Paediatric Hospital in Yaounde, Cameroon. Descriptive and analytic statistics were performed for CCT measured by a hand-held ultrasonic pachymeter (Quantel Medical Inc, Clermont-Ferrand France, Model Pocket, Class II) according to demographic data. Results: The average CCT for both eyes in these children was 538.06 ± 38.03 μm. Average CCT was 541.41 ± 36.45 μm in boys and 536.15 ± 38.91 μm in girls, with no statistically significant difference between the two groups. There was also no statistically significant difference in CCT between the age groups, comprising Group 1 (5–7 years), Group 2 (8–10 years), Group 3 (11–13 years), and Group 4 (14–16 years). Conclusion: CCT has been suggested to be lower in black children than in Caucasian, Hispanic, and Japanese children. Nevertheless, our average CCT values were within the standard range, varying between 527 and 560 μm.

Isolated bilateral ectopic microspherophakia

Correspondence: Andre Omgbwa Eballe Department of Ophthalmology, Gynaeco-Obstetric and Pediatric Hospital of Yaounde, PO Box 4362, Yaounde, Cameroon Tel +64 237 996544 68 Fax +64 237 22212430 Email andyeballe@gmail.com Summary: An eight-year-old school girl presented to us with a bilateral ectopic microspherophakia. She was surgically managed in the ophthalmology unit of the GynaecoObstetric and Pediatric Hospital of Yaounde in Cameroon. The postoperative follow up was uneventful, and the patient returned to school with a best corrected visual acuity of 4/10 in both eyes to the great satisfaction of her parents.

Prevalence of diabetic retinopathy following a hospital based screening of diabetic patients at the Yaoundé Central Hospital

Introduction : the purpose was to determine the prevalence of diabetic retinopathy (DR) following screening in diabetic patients. Methods : this was a cross-sectional study in which consenting diabetic patients were screened for diabetic retinopathy, on the occasion of the world diabetes day 2016. Data collected included age, sex, duration of diabetes, type of diabetes, glycated haemoglobin values, visual acuity, intraocular pressure and the presence of DR on dilated fundus examination. Fluorescein angiography was done for grading.

Color vision deficiency among biomedical students: a cross-sectional study

Purpose To determine the prevalence of color vision deficiency (CVD) among first-cycle students of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I. Patients and methods A cross-sectional descriptive study was carried out between October 1, 2015 and May 31, 2016. Distant visual acuity was measured and color vision test done for all consenting students. Ishihara’s plates were used to test all the participants. Those who failed the test were tested with the Roth’s 28 Hue test for confirmation of CVD and classification. Results A total of 303 students were included, among whom 155 were males (50.8%) and 148 were females (49.2%). The mean age was 20.2±2 years. Five students (1.6%) failed the Ishihara’s plate testing. Roth’s 28 Hue test confirmed CVD in 4 of those cases, giving a prevalence of 1.3%. There were equal numbers of protan and deutan CVD. Conclusion Despite its low prevalence among first-cycle students of the Faculty of Medicine and Biomedical Sciences, CVD screening should be performed in order to raise awareness, which will go a long way to help orientate the choice of future specialty.

Phthirus pubis Infestation of the Eyelids Presenting as Chronic Blepharoconjunctivitis in a 6-Year-Old Girl: A Case Report

Purpose: To report the case of Phthirus pubis infestation of the eyelashes presenting as chronic blepharoconjunctivitis. Case Report: A 6-year-old girl presented with a 2-month history of blepharoconjunctivitis unresponsive to topical antibiotics in the left eye. Slit-lamp examination revealed the presence of nits and adult parasites on the eyelashes. Parasitological examination confirmed adult forms and nits of Phthirus pubis. There was no evidence of infestation elsewhere. Outcome was favourable with mechanical removal and application of petroleum jelly. Conclusion: Careful slit-lamp examination of the eyelashes should be done in all patients presenting with ocular irritation symptoms.

Correlation between Hertel exophthalmometric value and refraction in young Cameroonian adults aged 20 to 40 years

Purpose To study the relationship between exophthalmometric value (EV) and refractive error in Cameroonian young adults. Patients and methods A prospective descriptive study was carried out in the ophthalmic unit of the Yaoundé Central Hospital from March to May 2015. Consenting patients aged 20–40 years with no intraocular pathology who were seen for refractive errors were included. Ocular protrusion was measured using the Hertel exophthalmometer. Automatic refraction was done following cycloplegia with cyclopentolate and tropicamide. Results A total of 200 patients were included (68% females and 32% males). The mean age was 27.2±6 years. Hyperopia was the most common refractive error (51%), followed by hyperopic astigmatism (19.3%). EV varied between 9 mm and 23 mm, with a mean of 14.8±2.5 mm in the right eye and 15.0±2.5 mm in the left eye. The mean EVs were 17.10±2.80 mm in myopia, 14.24±1.92 mm in hyperopia, 16.72±2.58 mm in myopic astigmatism, 14.07±2.19 mm in hyperopic astigmatism, and 14.77±2.40 mm in mixed astigmatism. The spherical value had a negative correlation with EV (P=0.0000). Conclusion The mean EV of this Cameroonian population is smaller than that of other populations and is consistent with the known characteristic hyperopic status of the population. A study on a larger sample will determine the normative data of absolute and relative EV in our setting.

Bilateral intraorbital abscesses with intracranial complications in a young Cameroonian girl: a case report

Background: Intraorbital abscess is a very severe infection with ophthalmologic and neurologic complications that are sometimes life-threatening. Objective: To report the etiologic, clinical, radiologic, and prognostic features of one case of bilateral intraorbital abscesses with intracranial complications. Case report: A 15-year-old Cameroonian girl in a comatose state (11/15 on the Glasgow Coma Scale) with meningeal signs, right hemiplegia, right facial palsy, and bilateral exophthalmia was admitted for meningitis and cerebral abscess secondary to orbital cellulitis. A lumbar tap was carried out, no organisms were seen by Gram stain, and culture was negative due to previous antibiotic therapy. A computed tomography scan showed a left internal capsule infarct and a pansinus opacification. Bilateral superior orbitotomies were performed and the abscess evacuated. Microscopy and culture of surgical material were negative. The patient was discharged 4 weeks after hospital admission with a visual acuity of 0.1 in both eyes, aphasia, and right hemiplegia. Nine months later, there was complete visual recovery (visual acuity 1.0 in both eyes). Anterior and posterior segments were normal on slit-lamp examination. There was no aphasia, but right-sided hemiparesis persisted. Conclusion: The authors emphasize the need for prevention, early diagnosis, and adequate treatment of orbital cellulitis in order to avoid complications.