Revue internationale du trachome et de pathologie oculaire tropicale et subtropicale et de sante publique : organe de la Ligue contre le trachome avec la collaboration de l'International Organization against Trachoma et des organisation...最新文献

Cataract and trachoma, the principal causes of blindness in the world, are two ubiquitous diseases with different origins and distributions. They may coexist in the same patient due to their high frequency. They have complex interrelations which raise epidemiological, diagnostic and particularly therapeutic problems which are sometimes difficult to resolve, especially in the case of the commonest combination of senile cataract and presumably cicatricial trachoma. The public health problem raised by these two diseases in developing countries must be resolved. Two easily curable or preventable diseases should no longer be the principal causes of blindness in the world.

A retrospective study of 101 blind patients seen in daily consultation has been done in Sikasso's Yeelen Center from January 1988 to October 1989. The results obtained show that the frequency of blindness is 1.3% and that more than 75% of the causes of losing the seeing are due to the pathology of the posterior segment. The optical atrophy represents the major cause of blindness (63% of the cases) with usually a glaucoma excavation. Corneal opacities and the chorioretinal scarrings take respectively the second and the third place with 13% and 10%.

The author considers the main causes of blindness in VIETNAM which are a little different from the studies of W.H.O. These are: 1. Trachoma. 2. Avitaminosis A. 3. Senile cataract. 4. Glaucoma. 5. Eye injuries in workers and in current life. For each cause, the author considers the efforts. Which are already made and which be made in the future. In case of trachoma, the author hopes that it will be eradicated in the year of 2000.

A study was performed on 321 patients with paratrachoma: acute follicular conjunctivitis-189, subacute-132. The first group of patients (108) received 1% Tetracycline ointment 4 to 5 times daily, the second group (103 patients)-1% Tetracycline ointment + 0.1% Dexamethasone eye drops, the third group (110 patients)-Eubetal ointment (tetracycline 0.5%, betamethasone 0.1%, chloramphenicol 1%, colistin). Therapeutic efficacy was higher in groups were antibiotics combined with corticosteroids. Cured in 4 weeks in group I-46.3%, in group II-72.8%, in group III-71.8%, cured in 6 weeks-75.9%, 88.3% and 86.4% respectively.

Among 214 children living at Blindness Institute of Bir El Kassaa the causes of blindness were determined. Main causes were: congenital glaucoma, tapeto retinal degeneration and congenital cataract because of high prevalence of consanguinity. The importance of prevention based on genetic council is raised.

A study was carried out in the North of Cameroon concerning the frequency of trachomatous blindness among 3,326 cases of blindness. A 4.63% frequency was found. The results show a 2 women for one man sex ratio and differences between the studied ethnic groups. The role of hygiene is stressed in order to explain these numbers.

Cataract is the first blinding disease in VIETNAM. Its frequency was studied in Central VIETNAM. Trachoma and xerophthalmia are very common. The evaluation of the prevention program against blindness in Central Areas of VIETNAM is set up. The authors point out an important improvement of the situation. Nevertheless they stress the necessity of carrying on the anti-trachomatous and anti-xerophthalmic campaign. A higher number of cataract operations could be performed since a sufficient number of operating kits was allowed.

Limbal Vernal kerato-conjunctivitis is the 6th most frequent diagnosis in the Ophthalmology service of CHU, Yaounde, Cameroon, and accounts for 2.8% of all clinic consultations. Only grades I and II of the disease (Diallo's classification) are found in this forest zone of Africa. Advanced stages which may cause corneal blindness being probably due to absence of xerophthalmia in this part of Africa. Both sexes are equally affected. Association with other allergic diseases is very rare and there is no hereditary tendency. Serum and tear Immunoglobulin assays in patients and controls of the same parent-hood showed no statistical differences (P > 0.05). Mast cell immunocytological studies might be more rewarding. Relief of pruritus is best with sodium cromoglycate and Naaga. However, in severe cases interrupted systemic steroids (not exceeding one week each time) are utilized. Poor drug compliance, due to costs is frequent; probably cautious cryo application in severe cases, might together with infrequent Naaga or sodium cromoglycate, procure longer remissions.