Background“Vision 2020 – the right to sight” is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections.MethodsThis was a hospital-based cross-sectional study, conducted from October 2004 to October 2006 at the Department of Ophthalmology of the Douala General Hospital, Cameroon. We included 407 diabetic patients who were referred from diabetes clinics for ophthalmologic evaluation. Ophthalmologic data included visual acuity, intra-ocular pressure, fundoscopy and fluorescein angiography.ResultsThe prevalence of blindness and poor vision were respectively 12.3% and 17.4% with regard to the worst eyes. Fifty nine (14.5%) patients were found with diabetic maculopathy, of whom 25.4% (15/59) had poor vision, and 25.4% (15/59) were blind. The prevalence of sight threatening retinopathy (severe non-proliferative and proliferative) was 17.4%. The degree of visual impairment was comparable in both diabetic types (p = 0.825), and it increased with the severity of retinopathy (p < 0.0001), as well as that of maculopathy (p <0.0001). The prevalence of glaucoma was 15% (61/407) when considering the worst eyes. The severity of visual impairment increased with the severity of glaucoma (p = 0.001). One hundred and twenty-one (29.7%) patients presented with cataract irrespective of its location or severity. Cataract was significantly associated with poor vision and blindness (p < 0.0001). Hypertensive retinopathy (4.9%), papillary ischaemia (2.7%), vaso-occlusive eye disease (2.5%), and age-related macular edema (2%) were the other potential causes of visual impairment and blindness encountered the most in our setting. Age ≥ 50 years, male sex, duration of diabetes and hypertension variously increased the risk of having glaucoma, cataract, diabetic retinopathy or maculopathy.ConclusionPoor vision and blindness are frequent in Cameroonian diabetics, and their causes are similar to those reported by various other surveys: mainly cataract, glaucoma, diabetic retinopathy and maculopathy.

BACKROUND AND OBJECTIVE: Screening for diabetic retinopathy (DR) is cost-effective when compared with disability loss for those who go blind in the absence of a screening program. We aimed to evaluate the sensitivity and specificity of a smartphone-based device for the screening and detection of DR. PATIENTS AND METHODS: A cross-sectional study of 220 patients with diabetes (440 eyes, all patients age 25 years or older) was completed. Tropicamide 0.5% was used for iris dilation followed by an indirect ophthalmoscopy using a 20-D lens. Retinal images were later obtained using a smartphone attached to an adaptable camera device. Retinal images permitted the visualization of the macular and papillary regions and were sent without compression via the internet to a retinal specialist for interpretation. Sensitivity and specificity were calculated for all cases and stages of DR. RESULTS: Using our standard examination method, the prevalence of DR and macular edema were 13.6% and 6.4%, respectively. With the smartphone-based retinal camera, the prevalence of DR and macular edema were 18.2% and 8.2%, respectively. Sensitivity and specificity for the detection of all stages of DR was 73.3% and 90.5%, respectively. For the detection of macular edema, sensitivity was 77.8%, and specificity was 95%. For severe nonproliferative DR (NPDR), sensitivity and specificity were 80% and 99%, respectively; for proliferative DR (PDR), they were both 100%. In the early stages of DR, specificity was 89.8% for mild NPDR and 97.1% for moderate NPDR. Sensitivity was 57.1% and 42.9%, respectively. CONCLUSION: Screening for DR using a smartphone-based retinal camera has a satisfactory specificity at all DR stages. Its sensitivity seems to be high only in the stages of DR necessitating a specific therapeutic decision (eg, macular edema, severe NPDR, and PDR). A smartphone-based retinal camera may be a useful device to screen for DR in resource-limited settings. [ Ophthalmic Surg Lasers Imaging Retina . 2019;50:S18–S22.]

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The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.

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