Category: Tropical papers

How bad do our patients instill the eyedrops? Case of Nigeria

https://pubmed.ncbi.nlm.nih.gov/34655378/

Assessment of eye drop instillation techniques among patients with primary open angle glaucoma in a Nigerian tertiary hospital
Olapeju A Sam-Oyerinde et al. Int Ophthalmol. 2021.

Approximately everyone does not wash their hands before the instillation. And ~30-40% touch the eye during inatillations. This was tested in Nigeria on glaucoma patients.

When should one treat choroiditis with oral antitubercular therapy?

New consensus on treating presumed tubercular choroiditis with oral antitubercular therapy

https://pubmed.ncbi.nlm.nih.gov/32115264/

Fluoresceine and applanation tonometry

Lack of Fluoresceine is a constant feature of working in tropics. I was always wondering, if measurement without staining (which was often a case) makes sense. Actually, it’s not bad!

Vernal-like keratoconjunctivitis in adults with HIV

An Entity, of which I was not aware…

The role of human immunodeficiency virus in the pathogenesis of vernal keratoconjunctivitis-like disease in adults: A demographic and epidemiological study
Indian J Ophthalmol. 2020 Aug;68(8):1551-1554. doi: 10.4103/ijo.IJO_1608_19.
Authors
Anine Kritzinger 1 , Anthony G Zaborowski 1 , Wilbert Sibanda 2 , Linda Visser 1
Affiliations
1 Department of Ophthalmology, University of KwaZulu-Natal, Durban, South Africa.
2 School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa.
PMID: 32709773
PMCID: PMC7640813
DOI: 10.4103/ijo.IJO_1608_19
Free PMC article
Abstract
Purpose: The purpose was to identify and describe patients with new-onset vernal keratoconjunctivitis-like (VKC-like) disease after puberty.

Methods: The study consisted of two parts: a prospective observational descriptive study of patients with new-onset VKC-like disease, and a case-control study to determine the relationship of a CD4 count with VKC-like disease in adults, in the setting of human immunodeficiency virus (HIV). Patients were recruited between January 2016 and November 2017 from a Provincial Eye hospital, one of two large referral hospitals in KwaZulu-Natal, South Africa. Patients presenting to the eye clinic were screened and diagnosed at the Primary Eye Care Unit. Inclusion criteria: age 15 years and older with signs and symptoms of new-onset VKC-like disease. Exclusion criteria: a history of childhood atopic diseases, atopic keratoconjunctivitis and patients who declined HIV testing. Data collected included HIV status, CD4 count, antinuclear antibodies and total serum immunoglobulin E.

Results: Thirty-three patients were included; females n = 16 and males n = 17. The mean age at presentation was 32.45 ± 9.93 years, 95% CI = 28.94-35.97. Twenty-six patients (78.8%) were HIV positive, 95% CI (62-89). The proportion of HIV positive patients was statistically different from the HIV negative group, Chi-squared = 21.866, P value <0.0001. In the group of HIV positive patients, 72% were classified as immunodeficient according to their CD4 counts. An association was proven between severely immunodeficient patients and the risk of VKC-like disease (Chi-squared = 4.992, P value = 0.0255).

Conclusion: In this cohort, a statistically significant association was found between VKC-like disease in adults and an HIV positive status. This association calls for more research on the subject.

Keywords: Allergy; VKC-like disease in adults; immunocompromised; ocular manifestations of HIV; vernal keratoconjunctivitis.