Trachomatous entropion-trichiasis. Case in a 16-month-old infant.

Abstract

Entropion-trichiasis is seen mainly in adults. It was observed only in old people in South West Africa (Eiselen and Gear, I960), and in Casamance was rarely present in children under I5 years and not at all in infants (Vellieux, Le Breton, Oliveau, and Larmane, I959). It was not found amongst 556 trachomatous schoolchildren in Senegal (Vola, 1958). In a Gambian village of 400 inhabitants there were four cases, all in adults (Sowa, Sowa, Collier, and Blyth, I965). I have seen it infrequently in Gambian children but not hitherto in an infant. This paper describes severe bilateral entropion-trichiasis in a i6-month-old baby.Case report A x6-month-old baby boy was brought to the ophthalmic out-patients clinic with a history of discharging eyes for a year after birth and in-turning eyelashes for the last 5 months. There were two older siblings who had no eye trouble. ExaminationThe baby was healthy and well-nourished. His exact age is known because it was recorded by a government midwife; he was still mainly breast fed and the dentition and physical development were consistent with that of a Gambian child of I6 months.There was severe entropion-trichiasis of both upper eyelids (Fig. i). Slit-lamp examination of the upper tarsal conjunctivae showed some oedema and hyperaemia with a few papillae and mature follicles in the canthi, and linear scarring in both eyes, worse in the left. In the corneae there was fine trachomatous punctate keratitis with a vascularized opacity in the lower half of each, corresponding to the rubbing lashes. There was no abnormality of the upper limbus. Scrapings from the upper tarsus were examined by the iodine method (Sowa and others, I965), but no inclusion bodies were found.