Category: Tropical papers

Not every fornix-OSSN is to be exenterated

In our Setup in Zambia one rule which we used to have was: as soon as OSSN involves a caruncle or conjunctival fornices, the eye (no matter how good it could see) should be planned to exenteration or at least extended enucleation). I used to not to question this practice in the abscence of MRI at hand.

However, fellows from Duisburg (Germany) proved that an excision of forniceal OSSN can still be good compensated with buccal or amniotic mucous membrames. And recurrencies of ~30%. Which is actually not bad considering the mutilating alternative. A food for thought. https://pubmed.ncbi.nlm.nih.gov/35940212/

How white pipo discovered river blindness

I read with interest the introduction paper “Dem Ergründer der Flussblindheit in Afrika auf der Spur” of Raimund Balmes to the book “Dr. Jean Hissette’s Research Expeditions to Elucidate River Blindness” which I have just bought. Must be interesting to read. It tells us about 1930s in Congo with specific interest in discovering the association of “River Blindness” with microfilarial disease – onchocerciasis.
Interestingly, it is stated, that Dr. Hissette (belgian expeditor) is considered to be the first one to ascribe the river blindness to worms parasitosis. At the same time, it is stated, that local people had showed him explicitly, that the tubercles, that many of blind people had had on the skin and the blindness which they had are related to the flies, that cause this. So basically it was all known long time before the white discoverers had even though of going to Congo. However, he came, he saw, he discovered this for the humanity 🙂

It reminds me of “discovering” the Falls which had to be named “Victoria”. Also for the humanity probably. (“Mosi-oa-Tunya”, the native name of the Falls had been known since much longer time ago).

P.S. I never knew that scientists became Nobel Prize in 2015 for Ivermectin (Mectizan). Definitely deserved one.

P.P.S. I never knew as well, that there had never been onchocerciacis in Latin America until it was brought there with Slave Traders in earlier centuries.

When to start anti-TB treatment by presumed ocular tuberculosis?

The Collaborative Ocular Tuberculosis Study Calculator is an efficient, low-cost, evidence and experience-based clinical tool to guide antitubercular therapy initiation. While it holds substantial promise in improving standard-of-care for ocular-TB patients, future validation studies can help to as certain its clinical utility and reliability.


Can be accessed here 👇🏽

https://www.oculartb.net/cots-calc

SLT snd Glaucoma in Africa

At this moment it has become very clear, that laser treatment of glaucoma in Africa as a primary treatment (as opposed to eye drops) is an emerging standard of care in Tropics. SLT as substitution for eyedrops, Cyclophotocoagulation as a substitution for primary trabeculectomy… We are arriving at the new era.