NON-TRAUMATIC ECTOPIA LENTIS IN A PAEDIATRIC OPHTHALMOLOGY PRACTICE, IBADAN, NIGERIA

Background

Non-traumatic ectopia lentis is a rare ocular disorder usually associated with syndromes like Marfans's syndrome, Weil-Marchesani and Homocystinuria. Ectopia lentis can lead to profound visual loss from refractive errors, glaucoma as well as retinal detachment if left unattended.

Aim

The aim of this study was to describe the clinical profile of patients with non-traumatic ectopia lentis in a paediatric ophthalmology clinic in Ibadan, Nigeria.

Methods

The clinical records of children ≤16 years diagnosed with non- traumatic ectopia lentis at the Paediatric Ophthalmology Clinic, University College Hospital Ibadan, from May 1, 2015 to Dec 31, 2019 were retrospectively reviewed. Information on demography, family history, visual acuity (VA), mean refractive error (spherical equivalent), and management was retrieved.

Results

Clinical records of 25 patients were reviewed. The mean age was 8.9 (±3.41) years with a range of 2-15 years. Sixteen (64%) patients were males. All the patients had bilateral involvement. A positive family history of ectopia lentis was elicited in 6 (24%) patients. Thirteen (52%) patients had a Marfanoid habitus and superior displacement of the lens was observed in 26 (52%) eyes. The presenting visual acuity was <6/60 in 22 (44%) eyes. The spherical equivalent of the refractive errors ranged from -20.00DS to +13.25DS. Twenty (40%) eyes underwent surgery within the period of the study and the best corrected postoperative visual acuity improved by 2 or more lines in 12 (60%) of operated eyes.

Conclusion

Severe visual morbidity was common in this cohort of patients with ectopia lentis in our practice. Treatment provided some improvement in vision which highlights the need to encourage early presentation for care. Detailed family history is important as a few of the patients were diagnosed following acceptance of our invitation to siblings for ophthalmic evaluation.

Familial Cataracts: Profile of Patients and Their Families at a Child Eye Care Tertiary Facility in a Developing Country

PURPOSE

The aim of this study is to describe the clinical profile, pedigree charting, and management of children with familial cataracts at a child eye health tertiary facility in southwest Nigeria.

METHODS

The clinical records of children ≤16 years diagnosed with familial cataracts at the Pediatric Ophthalmology Clinic, University College Hospital Ibadan (Ibadan, Nigeria) from January 1, 2015, to December 31, 2019, were retrospectively reviewed. Information on demographic data, family history, visual acuity, mean refractive error (spherical equivalent), and surgical management was retrieved.

RESULTS

The study included 38 participants with familial cataract. The mean age at presentation was 6.30 ± 3.68 years, with a range of 7 months to 13 years. Twenty-five patients (65.8%) were male. All patients had bilateral involvement. The mean duration from onset of symptoms to presentation at the hospital was 3.71 ± 3.20 years, with a range of 3 months to 13 years. In 16 of the 17 pedigree charts obtained, at least one individual was affected in each generation. The most common cataract morphology was cerulean cataract, observed in 21 eyes (27.6%). The most common ocular comorbidity was nystagmus which was observed in seven patients (18.4%). Sixty-seven eyes of 35 children underwent surgery within the period of the study. The proportion of eyes that had best-corrected visual acuity ≥6 / 18 before surgery was 9.1%; this proportion had increased to 52.7% at the last postoperative visit.

CONCLUSIONS

Autosomal dominant inheritance appears to be the major pattern among our patients with familial cataract. The most common morphological type found in this cohort was cerulean cataract. Genetic testing and counseling services are vital for the management of families with childhood cataract.

Placenta Donation - The Expectant Mother's View

The placenta has been used in different facets of medicine however some low-income countries are yet to apply these uses for different reasons. A cross-sectional study of 150 expectant mothers attending antenatal clinic was conducted to determine the willingness to donate the placenta. Analysis was conducted using Statistical Package for the Social Sciences version 20 with a level of significance set at P ≤ .05. The mean age of the participants was 32.3 (SD±5.0) years. Almost all (98.7%) were married while 89.3% had tertiary-level education. The majority (82.7%) knew there was no connection between the placenta and baby after delivery; however, only 12.0% knew about placenta donation and 10.0% were willing to donate the placenta at delivery. About three quarters (74.0%) were unwilling to promote the donation of the placenta, most (55.0%) believed that the placenta was used for rituals, while some (19.0%) thought placenta donation would affect the child's future. Participants' occupation, 'knowledge about placenta donation and its uses' and willingness to promote donation were all significantly associated with their willingness to donate (P < .05). Willingness to donate the placenta at delivery was low in this study. Participants' occupation and their knowledge were some factors influencing willingness to donate the placenta for medical use.