Several cases of intraocular lens (IOL) opacification have been reported in the past few years following intraocular injection of gas or air in corneal and vitreoretinal surgery. The opacity can be associated with severe reduction in patients’ quality of vision which might necessitate IOL exchange. We report a short case series, an observational study, of IOL opacification following three cases of intracameral air injection in endothelial keratoplasty (EK), a triple procedure (cataract surgery with EK) and Descemet’s membrane detachment (DMD) repair post cataract surgery.

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We report a case of retinochoroidal coloboma in a 32 year old Nigerian female who first presented to the eye outreach clinic with a history of poor vision in the left eye of two years duration. The best corrected visual acuity was 6/5 and light perception with accurate light projection in the right and left eyes respectively. She was subsequently referred to the retina clinic for Neodymium:yttrium- aluminium- garnet (Nd:YAG) laser capsulotomy on account of a left posterior capsular opacity after cataract surgery at the eye outreach clinic with a best corrected visual acuity of 6/5 and 6/36 respectively in the right and left eye. Dilated binocular indirect ophthalmoscopy of the left eye revealed a large, wedge-shaped, excavated retinochoroidal defect with hyperpigmented edges involving the nasal retina extending across approximately five clock hours from 7 to 10 o’clock. The apex of the coloboma was approximately three disc diameters away from the optic nerve head and extended peripherally up to the ora serrata. The right fundus was normal. Retinochoroidal colobomas may occur in the absence of the known blinding sequelae like retinal detachment, choroidal neovascular membrane amongst others. Our patient had a cataract in the same eye with the retinochoroidal coloboma with subsequent visual gain post-surgery and increasing myopia.

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Objectives: To describe the hospital incidence and pattern of ocular and adnexal cancers at the Guinness Eye Center, Onitsha. Materials and Methods: The case files of all new patients seen with ocular and adnexal tumors at the Guinness Eye Center, Onitsha, between 2005 and 2017 were reviewed. Those with histological diagnosis of malignancy were selected and analyzed. Information obtained included age, sex, disease duration, diagnosis and co-morbidity. Results: There were 85 patients (0.1% of all the new patients), made up of 42 males and 43 females. The median age was 5 years; range: 5 months–70 years. The commonest cancers were retinoblastoma, 45 patients (52.9%) and conjunctival squamous cell carcinoma, 30 (35.3%). Twenty eight (93.3%) squamous cell carcinoma patients were HIV-positive. No child had squamous cell carcinoma. All retinoblastoma patients were aged ≤6 years. Conclusions: The incidence of ocular and adnexal cancers at the Guinness Eye Center, Onitsha, was low with retinoblastoma and conjunctival squamous cell carcinoma accounting for most of the cancers. While retinoblastoma would most likely be suspected in a child with ocular tumor, young adults with squamous cell carcinoma should be evaluated for HIV infection. Since these lesions threaten sight and life, the public should be educated on the early signs of the diseases and the need to report to hospital early.

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Background: Over the years several pterygium surgical techniques have been developed with the aim of having the least possible recurrence rate. This has been from bare sclera excision which had an unacceptable recurrence rate to the current use of conjunctiva autograft with or without various adjuncts. This study was to review the current practice in a typical multi-specialist ophthalmic department. Method: The ophthalmic theatre operating register was retrospectively reviewed to obtain information on all patients who had pterygium excision at the University College Hospital, Ibadan, over a 4-year period from January 1, 2014, to December 31, 2017. Results: A total of 324 pterygium surgeries were performed and final analysis was on 249 (76.9%) surgeries which met the inclusion criteria, male to female ratio of 0.96:1. The commonest surgical technique was excision + 5-Flourouracil (5FU) + conjunctival autograft accounting for 187(75.1%) eyes. In total, postoperative recurrence was recorded in 40 (16.1%) eyes. The subgroup of excision + 5FU + autograft had the least recurrence rate of 18 (9.6%) eyes. Conclusion: A significant majority of the excision was with conjunctiva autograft with an acceptable low recurrence rate compared with most studies.

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Objectives: To evaluate the demographic profile, aetiology, systemic and ocular associations and findings on neuroimaging, of children with cortical visual impairment (CVI) at a tertiary eye hospital in South India. Materials and Methods: Records of 85 children with CVI, undertaking visual stimulation therapy (VST), were retrospectively analysed between March 2016 and March 2018. The data obtained was analysed for the age and gender profile, aetiology, cycloplegic refraction, fundus evaluation, MRI findings, pre and post visual stimulation therapy vision. Other associated ocular and neurological abnormalities were also noted. Results: The records of 63 boys and 22 girls were analysed. The mean age was 1.93 years with 58.8% aged <2 years were analysed. Hypoxia ischemic encephalopathy (HIE) was found to be the most common aetiology (31.7%), followed by epilepsy (27%) and structural abnormalities of brain (24.7%). Amongst the ocular associations, refractive error was the most common, seen in 42 (49.4%) children, while strabismus (exotropia>esotropia) in 40 (47%), nystagmus in 34 (40%) while pale disc in 31 (36.5%) patients. Fifty-five(64.7%) children had associated developmental delay, while 40 (47%) had seizures. Other neurological associations noted were, cerebral palsy (14.1%), microcephaly (14.1%), hearing loss in 5 and hemiparesis in 1 patient. MRI abnormalities were present in 65 (76.4%), with ischemic encephalopathy (32.9%) being the most common change noted. Conclusion: In our study cohort, HIE was found to be the most common cause of CVI, with refractive error and strabismus being the common ocular associations, while seizures and developmental delay were the common neurological associations. Neuroimaging showed that the structural insult was at both the cortical and white matter levels.

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Aim: To determine surgical efficacy of 21G needle-assisted pterygium excision. Method: A pictorial review of pterygia excised at different levels of maturity and diverse clinical history using a 21G hypodermic needle and a colibri. Ten pterygia were excised of which grade 3 were six and grade 2 were four. Nine cases were primary pterygia and a case was recurrent. The author was the only surgeon. Result: Cases reviewed showed minimal or no residual pterygial tissues post-operatively. Pterygial beds had smooth corneal optical surfaces, there were no perforations or undue corneal “guttering” from irregular cuts, no exuberant tissue formation like pyogenic granuloma or recurrence at 6 weeks of follow-up. Overall, slit lamp images were comparable with conventional “grab and cut” with surgical blade or scissors. Conclusion: 21G Needle-Assisted Pterygium (21-GNAP) excision is cheap, safe, and easy-to-learn new modality of excising all forms of pterygial and ocular surface masses.

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Context: Lacrimal drainage system obstruction gives discomfort to patients and threatens intraocular surgeries by infection, thus, knowledge of its bacteriology leads to the choice of effective therapy. Aim: To determine the bacteriology of nasolacrimal duct obstruction in an adult Libyan patient population and to analyze the appropriate antimicrobial therapy based on susceptibility testing. Settings and Design: A prospective study was conducted at the Great River Eye hospital, Benghazi/Libya in the period between September 2005 and February 2007. Methods: Lacrimal swab materials collected from patients aged 18–62 years who were diagnosed as having lacrimal passage obstruction and referred for lacrimal drainage surgery. The specimens were cultured and results analyzed. Results: Of 86 cases, 87.2% yielded a positive culture result. The majority of microorganisms were gram positive bacteria (73.3%) with Staphylococcus Aureus being the most frequently cultured species (36%) of the sample. Gram negative bacteria represented 26.7% of the isolates. The most common gram negative bacteria were Pseudomonas, Klebsiella, and E. coli which were isolated in 8% of the cases each. Staphylococcus aureus was isolated from 28.6% of cases having epiphora with no clinical signs of lacrimal drainage system infection. Ciprofloxacin (96%) and Gentamycin (94.7%) were found to be the most sensitive antibiotics against isolated organisms. Conclusions: Adult patients with lacrimal drainage system obstruction harbor microorganisms in their lacrimal sacs indicating the importance of investigating patients before planning for intraocular surgeries and considering prophylactic use of antibiotics before lacrimal drainage procedures.

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Context:Corneal epithelial defect cause pain that leads to significant subjective complain, severe morbidity, and medical leave. Management of uncomplicated corneal epithelial defect using bandage contact lens (BCL) has many advantages compare to the pressure patching (traditional treatment). The use of BCL as an alternative therapy in uncomplicated epithelial defect is not yet declare as a standard protocol of treatment. Aims: To evaluate the efficacy of bandage contact lens use in patients with corneal epithelial defect compared to pressure patching in term of level of comfort, visual acquity, and wound healing period. Methods and Material: The literature search was conducted from online database. All relevant studies were reviewed based on Level of Evidence developed by Oxford Centre for Evidence-based Medicine Levels of Evidence 2011. The articles were divided into baseline characteristics and outcomes table. Details regarding the author, year of publication, level of evidence, number of samples, age, gender, follow up duration were recorded. Results: Six out of seven studies concluded that BCL is the better treatment for corneal abrasion due to trauma or related to ocular surface surgery. Four systematic reviews did not recommend pressure patching as corneal epithelial defect treatment. Conclusions: BCL was found to be superior in treating corneal abrasion compared to pressure patching. The BCL group showed significantly faster healing time, pain level reduction, and epithelial defect size reduction compare to the pressure patching group.

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