A population based survey on the prevalence of major blinding disorders was conducted in the Wenchi district in central Ghana between March and May 1991. In 10 villages, 1425 people of 30 years and older were screened, using the WHO eye examination record. The prevalence of bilateral blindness above 30 years proved to be 1.7% (best acuity <3/60): the prevalence oflow vision above 30 years was 20/0% (best visual acuity 6/18 to 3/60). The causes of blindness were determined as cataract (62.5%), onchocerciasis (12.5%), corneal opacity (non-trachomatous) (8.2%), refraction anomalies (4.2%), phthisis bulbi (4.2%), optic atrophy (4.2%), and vascular retinopathy (4.2%). In the Wenchi district, 1-0% of the population over the age of 30 years was found to need a cataract extraction because of blindness of both eyes. Another potential 1-0% needs a cataract extraction because of low vision. A minor second study (n=149) was undertaken in the same district, but in a village in an area near the Black Volta river in which onchocerciasis is endemic. The prevalence of blindness (8.1%) and low vision (3.4%) caused by onchocerciasis and cataract both proved to be higher. The survey provided the basis for a preventive and curative eye care programme. (BrJ Ophthalmol 1994; 78: 275-279)
Leprosy control programmes are highly successful. As a result, leprosy control will be more and more integrated into the general health services. The existing vertical, specialized control programmes will be dismantled. Eye complications in leprosy have decreased.
The significance of fa cial patches and Type I reaction fo r the development of fa cial nerve damage in leprosy. A retrospective study among 1226 paucibacillary leprosy patients
To determine the magnitude of eye lesions in newly diagnosed leprosy patients we examined their eyes. The Eastern Leprosy Control Project was supported by The Netherlands Leprosy Relief Association; we used the regional clinic in Biratnagar and 5 mobile clinics in surrounding districts as our survey area. All patients who presented at the clinics over 10 weeks, diagnosed as having untreated leprosy were included. Of the 260 examined patients 97 (37,3%, 95% confidence interval 28,3-40'3%) had an eye lesion; 12/260 patients (4'6%, 95% confidence interval 2,0-7'2%) had sight-threatening lesions (lagophthalmos, iris involvement, corneal anaesthesia), directly related to leprosy; 46 (17,7%) patients were diagnosed as having some degree of cataract; 2 patients were aphakic; 3 patients (1'2%) were blind according to the WHO definition. In this series of new and untreated leprosy patients many eye lesions found are not relevant or leprosy related. There were 9 new patients with lagophthal mos, some too longstanding to treat with steroids. We found 3 patients with iris involvement. The figures we found for eye lesions, sight-threatening lesions and blindness are low when compared to other studies. The number of patients with any grade of cataract is high. The average total of leprosy patients who were blind can be compared with the average total who are blind in the general population.
A report is given of the fundus changes in a 17-year-old boy suffering from SSPE, which clinically first manifested itself by visual disturbances. At first the right eye showed extensive yellowish-white oedema at the posterior pole, surrounded by smaller round, yellow, partly confluent lesions, passing into a scarring stage in about ten days. Fluorescein angiography of the right eye was performed, both in the acute stage, which suggested a Harada syndrome, and in the scarring stage, which resembled a disseminated chorioretinitis. Three weeks later, during the development of the general neurological symptoms, the left eye developed the same fundus picture and course as the right eye. The condition of the patient rapidly deteriorated, leading to death five weeks after the onset of his visual complaints.
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