Non-trachomatous corneal opacities in the Gambia—aetiology and visual burden

Bowman, Richard; Faal, Hannah; Dolin, Paul; Johnson, George

doi:10.1038/sj.eye.6700027

Cited by 14 publications

(12 citation statements)

References 13 publications

(14 reference statements)

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“…In Thailand, these were infections (35.6%), surgical bullous keratopathy (27.8%), and trauma (14%) 19. In Gambia, vitamin A deficiency (7.8%) was an important cause of corneal blindness in addition to infectious keratitis (22.7%) and trauma (14.3%) 20. Thus, contrary to popular belief and previous studies,17 19 20 the predominant cause of corneal blindness in the current study was not infectious keratitis but corneal decompensation following cataract surgery.…”

Section: Discussioncontrasting

confidence: 69%

“…In Gambia, vitamin A deficiency (7.8%) was an important cause of corneal blindness in addition to infectious keratitis (22.7%) and trauma (14.3%) 20. Thus, contrary to popular belief and previous studies,17 19 20 the predominant cause of corneal blindness in the current study was not infectious keratitis but corneal decompensation following cataract surgery. Addressing the issue of improving the quality of cataract surgical services in the country will help reduce the requirement for corneal transplantation.…”

Section: Discussioncontrasting

confidence: 69%

“…In the South Indian population, corneal blindness was predominantly due to infectious keratitis (59.5%) and trauma (23.2%) 17. Studies from Thailand and Gambia also report the common causes of corneal blindness 19 20. In Thailand, these were infections (35.6%), surgical bullous keratopathy (27.8%), and trauma (14%) 19.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of corneal diseases in the rural Indian population: the Corneal Opacity Rural Epidemiological (CORE) study

et al. 2014

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Section: Discussioncontrasting

confidence: 69%

Section: Discussioncontrasting

confidence: 69%

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Prevalence of corneal diseases in the rural Indian population: the Corneal Opacity Rural Epidemiological (CORE) study

et al. 2014

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“…1 As trachoma and vitamin A deficiency become less common, suppurative keratitis is becoming the major cause of corneal blindness in the developing world. 13 While contact lens use is a major risk factor for corneal ulceration in the developed world, a high prevalence of fungal infections, agriculture related trauma, and use of traditional eye medicines is unique to the developing world. 14 15 A significant percentage of patients with microbial keratitis referred to our tertiary hospital are at a stage of impending or established corneal perforation.…”

mentioning

confidence: 99%

Risk factors for perforation in microbial corneal ulcers in north India

Titiyal

Negi²,

Anand³

et al. 2006

British Journal of Ophthalmology

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Aim: To identify predisposing factors leading to corneal perforation in patients with microbial keratitis. Method: Two groups of 60 patients each, with perforated corneal ulcers and healed/healing corneal ulcers, respectively, were recruited in a case-control study conducted in northern India. The cases and controls were matched by age and time of presentation. A standardised proforma was used to identify potential predisposing factors for demographic, social, medical, ocular, and treatment history. All participants underwent a detailed ocular examination. Corneal scrapings were performed where relevant. Results: The characteristics associated with corneal perforation in microbial keratitis were outdoor occupation (p = 0.005), illiteracy (p = 0.02), excessive alcohol use (p = 0.03), history of ''something falling into eye'' (p = 0.003), trauma with vegetable matter (p = 0.008), vision less than counting fingers at referral (p,0.001), central location of ulcer (p,0.001), lack of corneal vascularisation (p,0.001), delay in starting initial treatment (p,0.001), failure to start fortified antibiotics (p,0.001), and monotherapy with fluoroquinolones (p = 0.002). The lack of corneal vascularisation (OR 6.4, 95% CI 4.2 to 13.5), delay in starting initial treatment (OR 35.6, 95% CI 6.9 to 68.2), and failure to start fortified antibiotics (OR 19.9, 95% CI 2.7 to 64.7) retained significance on a logistic regression model. Conclusions: This study characterises microbial keratitis cases at increased risk of corneal perforation and reinforces the need for standardised referral and treatment protocols for patients with corneal ulcer on their first contact at primary care level in the developing world. M icrobial keratitis is an important preventable cause monocular blindness worldwide.1-3 Several studies have evaluated the aetiology, management, and outcome of microbial keratitis.4-11 However, there are regional variations in the prevalence, risk factors, and outcome in corneal ulcers.6 12 In the developing world, corneal ulcers appear to be occurring in epidemic proportions, being 10 times more common than in the developed countries.1 As trachoma and vitamin A deficiency become less common, suppurative keratitis is becoming the major cause of corneal blindness in the developing world.13 While contact lens use is a major risk factor for corneal ulceration in the developed world, a high prevalence of fungal infections, agriculture related trauma, and use of traditional eye medicines is unique to the developing world.14 15 A significant percentage of patients with microbial keratitis referred to our tertiary hospital are at a stage of impending or established corneal perforation.10 This study was conducted in an attempt to identify the predisposing factors for corneal perforation in microbial keratitis. METHODSA case-control study was conducted in a tertiary ophthalmic centre in north India.Sixty cases with perforated infective corneal ulcers were matched with 60 control patients with healed or healing infective corneal ulcers ...

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“…Corneal opacities vary greatly in extent and location and are usually associated with other anomalies [17], for example the bilateral congenital choanal atresia and congenital right accessory nasal deformity in our patient. Because corneal opacity is a cause of blindness [18], timely treatment is crucial. A study has shown that 64.92% of patients underwent cosmetic treatment after the primary visit [16].…”

Section: Discussionmentioning

confidence: 99%

Bilateral congenital choanal atresia and osteoma of ethmoid sinus with supernumerary nostril: a case report and review of the literature

Cai

Zhang

et al. 2011

J Med Case Reports

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IntroductionCongenital choanal atresia is a relatively rare deformity, especially bilateral congenital choanal atresia. We report a case of bilateral congenital choanal atresia in a 22-year-old Chinese man, who was also diagnosed with congenital right accessory nasal deformity, osteoma of his left ethmoid sinus and congenital keratoleukoma of his right eye.Case presentationA 22-year-old Chinese man presented with mouth breathing, sleep snoring and difficult feeding after birth, with no olfactory sensation. Three-dimensional computed tomography revealed bilateral choanal atresia and a high density bony shadow in his left ethmoid sinus that extended to his left frontal sinus.ConclusionsChoanal atresia is often accompanied by other congenital abnormalities. To the best of our knowledge, this is the first report of choanal atresia accompanied by congenital accessory nasal deformity and congenital keratoleukoma.

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Non-trachomatous corneal opacities in the Gambia—aetiology and visual burden

Cited by 14 publications

References 13 publications

Prevalence of corneal diseases in the rural Indian population: the Corneal Opacity Rural Epidemiological (CORE) study

Prevalence of corneal diseases in the rural Indian population: the Corneal Opacity Rural Epidemiological (CORE) study

Risk factors for perforation in microbial corneal ulcers in north India

Bilateral congenital choanal atresia and osteoma of ethmoid sinus with supernumerary nostril: a case report and review of the literature

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