Case Report: Corneal Pyogenic Granuloma: Rare Complication of Infectious Keratitis

Background: Pyogenic granuloma is an excessive proliferation of granulation tissue that usually develops after minor trauma or surgery. Ocular involvement usually happens on the external surface and cornea is rarely involved. The objective of our report is to describe the clinicopathological feature of this rare disease and give insight on clinical features that help in the diagnosis.Case Report: This report presents a case of a four year old child who had fleshy growth of one week duration on the right eye after seven weeks of pain and redness. Slit lamp examination showed vascularized central corneal mass with surrounding stromal infiltrates. The mass was excised, and histopathological examination confirmed pyogenic granuloma of the cornea.Conclusion: Corneal pyogenic granuloma could be a rare complication of infectious keratitis. Therefore, it should be considered as a differential diagnosis in corneal mass especially after an infection or trauma.Keywords: Pyogenic Granuloma, Corneal pyogenic granuloma, Keratitis, Post-infectious granulom

Ocular morbidity among refugees in southwest Ethiopia

Background: Low vision and blindness are recognized as one of the major  public health problems worldwide, especially in developing countries. The prevalence and cause of blindness and low vision vary from region to region, among different age and population groups in a country or  geographical region. The objective of this study is thus to determine the causes of blindness and ocular morbidity among refugees in Southwest Ethiopia.Methods: A cross-sectional clinic based study was conducted on 1,054 refugees in Southwest Ethiopia. A basic anterior and posterior segment examination was done by ophthalmologists with Magnifying Loupe 2.5X and Direct Ophthalmoscope. Data were analyzed using SPSS version 16.0.Results: The most common causes of ocular morbidity identified were trachoma 547(21.2%), cataract 501(19.4%), refractive error 353(13.7%), conjunctivitis 240(9.3%), glaucoma 130(5.1%) and climatic droplet keratopathy 112(4.4%). The overall prevalence of blindness was 26.2% and the prevalence of childhood blindness was 0.7%. The prevalence was higher among females (16.9%) than males (9.3%) and age groups 60 years and above (15.9%) than other age groups (10.3%) (P<0.05). The overall prevalence of low vision was 25.8% and the prevalence of low vision in pediatric age group was 0.9%. The leading causes of blindness were cataract 112(40.6%), trachomatous corneal opacity 58(21.0%) and glaucoma 49(17.8%). The commonest cause of low vision was cataract 102(37.6%) followed by trachomatous corneal opacity 49(18.1%) and refractive error 35(12.9%).Conclusions: There is a very high burden of blinding eye diseases among refugees. Integrated multidisciplinary intervention strategies for the  prevention and control of blindness and low vision in the study settings should be initiated.Key words: Blindness, low vision, ocular morbidity, refugees, Ethiopi

Periocular necrotizing fasciitis following retrobulbar injection

Yeshigeta Gelaw, Aemero Abateneh Department of Ophthalmology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia Abstract: Necrotizing fasciitis is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. While necrotizing fasciitis classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites, primary involvement of the eyelids is a rare but well known entity. We present a 33-year-old female patient who developed periocular necrotizing fasciitis after local retrobulbar anesthesia injection and facial block for cataract surgery in the left eye and canthotomy/cantholysis for treatment of moderate retrobulbar hemorrhage in the same eye. Surgical debridement was done and necrotic foul-smelling eyelid and deep orbital tissues were removed, and culture grew Staphylococcus aureus. Despite initial surgical debridement and intravenous antibiotic therapy, the disease progressed rapidly; orbital exenteration was considered, but the patient declined the surgery and self-discharged. Periocular necrotizing fasciitis remains predominantly a clinical diagnosis, and is often missed early in its presentation because of the difficulty in distinguishing it from other common soft tissue infections, especially in the presence of surgical wounds and retrobulbar hemorrhage. A high index of suspicion, early recognition, and prompt therapeutic interventions are indispensable for optimal visual outcome and patient survival. Keywords: periocular necrotizing fasciitis, eyelid necrosis, deep fascia, surgical debridement, fasciiti