Pattern of Conjunctival Masses Seen At Guinness Eye Centre Luth Idi-Araba

Background: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations.Objective: To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995- Dec 2007).Method: A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded.Results: Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85years with a male to female ratio of 1.26: 1. Three hundred and eightyeight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients.Conclusion: Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.Key words: Conjunctival masses, pterygium, pingueculu

Central corneal thickness changes following manual small incision cataract surgery

Olufisayo Temitayo Aribaba,1 Olusesan Adetunji Adenekan,1 Adeola Olukorede Onakoya,1 Adekunle Rotimi-Samuel,1 John Olutola Olatosi,2 Kareem Olatunbosun Musa,1 Akinyele Oyedele Oyefeso,1 Folashade Bolanle Akinsola11Guinness Eye Centre, Lagos University Teaching Hospital, 2Department of Anaesthesia, College of Medicine, University of Lagos, Lagos, NigeriaAim: To determine changes in post-cataract surgery central corneal thickness (CCT) at Lagos University Teaching Hospital by assessing the time it takes for the cornea to return to its preoperative thickness value.Methods: This study is a prospective, hospital-based open within-patient controlled study with the unoperated eye controlling for the operated one.Results: Two hundred patients with 400 eyes were analyzed, with bilateral mature cataract in 47.0%. All the patients had manual small incision cataract surgery with posterior chamber intraocular lens implant. There is an increase in mean baseline CCT from 520.6±20.3 µm by 76.9 µm (597.9±30.4 µm) 24 hours after cataract surgery followed by relative reduction in the mean CCT to 555.2±24.7 µm and 525.1±19.7 µm at 2 weeks and 12 weeks, respectively. Increase in mean CCT in the unoperated and contralateral eyes were recorded in this study.Conclusion: There was a transient increase in corneal thickness following cataract surgery with subsequent decrease to preoperative thickness by 12th and fourth week in the operated and unoperated eyes, respectively. Corneal manipulations during cataract surgery must be minimal to reduce visual rehabilitation time to barest minimum. Postoperative refraction will be better at eighth week to 12th week considering the time it takes for the CCT to return to its stable preoperative values.Keywords: post-cataract surgery visual rehabilitation, pachymetry, recovery time, unoperated ey

Two cases of Vogt–Koyanagi–Harada’s disease in sub-Saharan Africa

Tunji S Oluleye,1 Adekunle O Rotimi-Samuel,2 Adetunji Adenekan,2 Olubanke T Ilo,2 Folashade B Akinsola,2 Adeola O Onakoya,2 Olufisayo T Aribaba,2 Adebukunola Adefule-Ositelu,2 Kareem O Musa,2 Yele Oyefeso2 1Retina and Vitreous Unit, Department of Ophthalmology, University College Hospital, Ibadan, 2Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria Abstract: Vogt–Koyanagi–Harada’s (VKH) disease has been reported to be rare in sub-Saharan Africa. Two Nigerians with the disease are presented in this report. The first patient, a 32-year-old pregnant Nigerian woman presented with a 1-month history of bilateral blurring of vision, persistent headache, and alopecia. Presenting visual acuity was 1 m counting fingers in both eyes. Examination revealed vitiligo and poliosis with bilateral panuveitis as well as bilateral exudative retinal detachment. A clinical assessment of complete VKH disease was made. The patient commenced systemic and topical steroids that resulted in remarkable recovery of vision and control of inflammation. The second patient, a 56-year-old Nigerian woman presented with severe headache, tinnitus, and visual loss in both eyes of 2 weeks duration. There was associated redness of both eyes and photophobia. Examination showed visual acuity of Hand motion (HM) and counting fingers at 1 meter (CF). in the right and left eye, respectively, with bilateral panuveitis and bilateral exudative retinal detachment. Subsequent follow-up showed poliosis, vitiligo, and sunsetting fundus appearance. The patient improved with systemic and topical corticosteroids. Developing a high index of suspicion is necessary in diagnosing VKH disease, even in sub-Saharan Africa. Prompt institution of appropriate treatment prevents blindness. Keywords: Vogt–Koyanagi–Harada’s disease, exudative retinal detachment, vitiligo, ­sub-Saharan Afric