ResultsThe clinical information was limited in many of these cases, but the great majority of conjunctival biopsies had been diagnosed either as pterygium or pinguecula (Fig. 1), though the criteria for this differentiation were not constant. There were also some patients with a clinically invasive carcinoma (Fig. 2) and a few with other lesions such as papilloma.
HISTOPATHOLOGYThe main histological features and the diagnosis are shown in Tables 1 and 2; 167 lesions were reclassified as 'solar keratosis' with varying degrees of 102 on 11 May 2018 by guest. Protected by copyright.
Self-treatment for eye diseases is very common in most developing countries yet there has been little investigation of such attitudes and practices. In many settings, people do not proceed beyond self-treatment and do not receive care from either traditional healers or Western eye care providers. Visual impairment and blindness can be the result. We conducted population-based survey of use of eye care services and self-treatment in two districts of Malawi. Adults were administered a detailed interview regarding their use of eye care services (Western and traditional as well as self-treatment) and their knowledge and use of traditional eye medicines. Self-treatment was defined as use of either Western or traditional medicines by the individual for their most recent eye condition. Only eye conditions that were considered severe by the study subjects were correlated with treatment options. Interviews were carried out among 800 adults in the study areas. Self-treatment was reported for the last episode of eye disease by 39.8% of the study population. Factors associated with self-treatment included sex, religion and socioeconomic status. Even though 76.8% of the respondents reported treatment from the health center or hospital to be the least expensive option, many opted for self-treatment first. Among those opting for self-treatment 72% used traditional eye medicines. Even among cases that individuals considered to be quite severe (these included cataract, trachoma and conjunctivitis), self-treatment was the option of choice in 22.2% of cases.
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