Aim: The study aims to determine the magnitude of glaucoma at KCMC and assess the efficacy of treatment. Study Design: This was a hospital-based retrospective cross-sectional study. Place and Duration of Study: The study was conducted in the Eye Department of Kilimanjaro Christian Medical Centre in Moshi, Tanzania, and data collection and analysis were performed between 04 September 2013 and 04 September 2014. Methodology: This was a hospital-based retrospective cross-sectional study conducted at the Eye Department of Kilimanjaro Christian Medical Centre in Moshi, Tanzania, and included all patients coded as glaucomatous who attended in 2012. It was descriptive and observational, with the main outcome measures being Snellen visual acuity, intraocular pressure in mmHg, optic disc excavation, and visual field score in decibels. Statistical Package for Social Sciences version 16.1 was employed. Results: There were 847 glaucomatous patients with a mean age of 61.38 years (SD 21.42); 518 were male and 329 were female. Primary open-angle glaucoma was the most common type, accounting for 85.4%. Mean intraocular pressure at diagnosis was 27.45 mmHg in the right eyes and decreased to 19.36 mmHg over a mean follow-up period of 3.86 years. There was an 11.11 mmHg reduction in intraocular pressure in the trabeculectomy group compared with a 6.35 mmHg reduction in the Timolol-eye-drops-only group. Cupping progressed in both eyes, but this was not found to be statistically significant. At diagnosis, 15.1% of the patients were blind according to the WHO classification; this proportion increased to 16.1% at the last visit. Some 55 patients progressed to visual impairment when visual acuity in the better eye was considered, while 36 eyes showed improved vision when visual acuity in the worst affected eye was considered. Conclusions: Patients presented late at diagnosis; however, there was a good response to treatment, with a reasonable reduction in intraocular pressure and no rapid progression of visual impairment, suggesting that the therapeutic approach at KCMC was efficacious.
Background: Capillary haemangioma is a benign vascular tumour characterised by proliferation of capillary-sized blood vessels and is most commonly encountered during infancy and early childhood. Presentation involving the eyelid during adolescence is uncommon and may create diagnostic difficulty because it can resemble other vascular or neoplastic lesions. Case Presentation: A 14-year-old male presented with a progressively enlarging swelling of the left upper eyelid for 2 months. Examination showed a solitary, reddish, sessile growth measuring approximately 3 cm × 3 cm. The lesion was firm, rubbery, non-compressible, non-pulsatile, and increased in size during the Valsalva manoeuvre. No associated ocular abnormality, regional lymphadenopathy, or other vascular lesion was identified. Surgical excision was performed. Intraoperatively, the lesion had an indistinct capsule, and increased bleeding was encountered during dissection. Histopathological examination demonstrated a benign vascular neoplasm composed of lobular proliferation of capillary-sized vascular channels separated by fibrocollagenous connective tissue. The capillaries were lined by round-to-oval endothelial cells with bland nuclear morphology, without nuclear atypia, pleomorphism, or mitotic activity. These findings confirmed capillary haemangioma. The postoperative course was uneventful, and no recurrence was observed during follow-up. Conclusion: Capillary haemangioma should be considered in the differential diagnosis of progressive eyelid masses even beyond the typical infantile age group. Histopathological examination is important for definitive diagnosis, and complete excision can provide effective management for a localised lesion.
Mucoceles are benign, expansile pseudocystic lesions of the paranasal sinuses caused by sinus ostial obstruction and chronic inflammation. They are rare pathologies, mainly affecting adults, and are most commonly located in the fronto-ethmoidal sinus system. Mucoceles are characterized by clinical polymorphism, insidious onset, and slow progression, which explains why they are often discovered at the stage of ophthalmological complications. Diagnosis is clinical and radiological, and management is essentially surgical. We report the case of a 65-year-old diabetic male with no previous ophthalmological history who presented with permanent diplopia lasting two weeks. Clinical examination revealed constant vertical binocular diplopia with limited mobility of the left eye, associated with homolateral non-pulsatile ptosis and exophthalmos, without inflammatory signs. The left eye was deviated downward and outward. The remainder of the ophthalmological examination was unremarkable. Diagnosis was established by orbital magnetic resonance imaging (MRI), which showed a left frontal sinus mucocele with orbital extension The patient underwent endoscopic marsupialization, with a favorable postoperative outcome outcome : complete visual recovery; exophthalmos and diplopia resolved, and oculopalpebral motility normalized by day 15. This case highlights that persistent diplopia may be the presenting sign of a frontal sinus mucocele, underscoring the importance of early imaging for timely diagnosis and management. In conclusion, paranasal sinus mucoceles are rare benign lesions that most often present with ophthalmological symptoms. Their severity lies in the risk of compression of vital adjacent structures. Diagnosis is based on clinical and radiological findings, and treatment is surgical.
Eyelid burns are a clinically significant subset of facial burns and may lead to permanent visual morbidity when corneal protection is not prioritised during acute care. The eyelids maintain ocular surface integrity through blinking, tear film redistribution and mechanical shielding; these functions may be rapidly impaired by thermal, chemical, electrical or radiation injury. Resultant lagophthalmos, cicatricial ectropion and eyelid retraction can initiate exposure keratopathy, which ranges from superficial punctate epithelial damage to persistent epithelial defects, stromal ulceration, secondary infective keratitis and corneal perforation. This critical review synthesises peer-reviewed literature published between 2009 and 2026, with supplementary inclusion of landmark earlier studies where clinically relevant, to examine acute management strategies for eyelid burns with particular emphasis on the prevention of exposure keratopathy. The review considers mechanisms of injury, clinical classification, acute ophthalmic assessment, medical corneal protection, surgical interventions and aetiology-specific considerations. The evidence supports prompt irrigation and decontamination for chemical burns, early ophthalmic assessment, frequent fluorescein-based monitoring, intensive preservative-free lubrication, moisture chamber protection and escalation to bandage contact lenses, temporary tarsorrhaphy or amniotic membrane transplantation when clinically indicated. Deep partial-thickness and full-thickness eyelid burns require early reconstructive planning to reduce cicatricial malposition and subsequent corneal exposure. The manuscript further emphasises the importance of multidisciplinary coordination between burn surgeons, plastic surgeons, ophthalmologists and nursing teams. Although available evidence supports a structured and proactive approach, practice remains variable across burn units. Standardised ocular assessment and protection protocols, together with prospective multicentre research, are needed to reduce avoidable corneal morbidity after eyelid burns worldwide.
Background: Central retinal artery occlusion is an ophthalmic emergency that commonly presents with sudden, painless monocular visual loss due to acute retinal ischaemia. Visual prognosis is often poor; however, the presence of a cilioretinal artery may preserve macular perfusion and contribute to better central visual function. Case Presentation: A 44-year-old male with a history of hypertension and irregular use of antihypertensive medication presented with sudden, painless loss of vision in the right eye for five days. On examination, his blood pressure was 160/104 mmHg. Best-corrected visual acuity was 6/9 in the right eye and 6/6 in the left eye. Intraocular pressure was 9 mmHg in both eyes. A relative afferent pupillary defect was present in the right eye, while anterior segment examination was unremarkable bilaterally. Fundus examination of the right eye showed generalised retinal whitening with sparing in the distribution of a cilioretinal artery, while the left eye was normal. Optical coherence tomography of the right eye demonstrated inner retinal hyperreflectivity in the affected retinal area, with relative preservation corresponding to the cilioretinal artery territory. Laboratory investigations showed dyslipidaemia and a mildly reduced estimated glomerular filtration rate. Echocardiography revealed features of hypertensive heart disease, while further cardiovascular and neurological evaluation was advised. The patient was started on antihypertensive therapy with nifedipine and losartan/hydrochlorothiazide. Conclusion: This case illustrates central retinal artery occlusion with cilioretinal artery sparing and relatively preserved visual acuity. Recognition of this anatomical variant is clinically important for diagnosis, prognosis, counselling, and systemic vascular risk assessment.
Background: Visual impairment, ranging from low vision to blindness, is a growing global problem affecting about 2.2 billion people in 2026, with many cases preventable. Retinal diseases are a major cause, especially in developing regions, emphasizing the need for early detection and intervention. Aims: To determine the burden and pattern of visual impairment and blindness, with focus on retinal diseases among new patients attending a tertiary eye-care centre in North-Central Nigeria. Study Design: A hospital-based, cross-sectional study Place and Duration of Study: Department of Ophthalmology, Jos University Teaching Hospital, Jos, Plateau State, conducted from June-December 2014. Methodology: Consecutive adult patients (≥18 years) were recruited. Presenting and best corrected visual acuity (VA) were assessed using standard protocols and classified according to WHO criteria. Ocular examination including mydriatic posterior segment examination was carried out to diagnose patients with retinal diseases. Data were analyzed using SPSS version 19, with statistical significance set at P< .05. Results: Of the 278 participants (556 eyes), 6.1% were blind, 1.4% had severe visual impairment (SVI) and 15.4% were visually impaired (VI) at presentation. After best correction, 5.4% remained blind, 0.7% had SVI, 7.9% had VI. Posterior-segment diseases were identified in 43.5% of patients and 49% of eyes. Of these, 25% of eyes were blind at presentation while 3.4% had SVI and 16.9% were visually impaired. Patients with retinal disease were nearly twice as likely to be blind both at presentation (9.5%) and after best correction (9.5%) compared to those with non-retinal conditions (4.9% and 3.9%, respectively), although the differences were not statistically significant (P > .05). Retinal diseases accounted for over 22% of blindness after best correction among affected eyes. Conclusion: The burden of visual impairment and blindness remains high in North-Central Nigeria, with retinal diseases emerging as a major contributor to irreversible blindness. These findings underscore the urgent need for early detection strategies, improved retinal diagnostic and treatment capabilities and integration of posterior-segment disease management into routine eye-care services. Strengthening referral systems and public awareness initiatives are critical to reducing the burden of avoidable blindness in this population.
Background: Ocular injuries are an under-recognized cause of vision loss, leading to blindness, disability, and significant socioeconomic burden, especially in resource-limited settings. They commonly occur alongside traumatic brain injury, but their incidence and patterns vary widely, and the relationship between ocular injuries and injury severity (such as Glasgow Coma Scale) remains unclear and insufficiently studied. Aims: To assess the prevalence and patterns of ocular injuries among traumatic brain injury patients and relate them to the Glasgow Coma Scale. Study Design: Cross-sectional study. Place and Duration of Study: University Teaching Hospitals – Adult Hospital, from July 2024 to December 2024. Methodology: A total of 129 traumatic brain injury patients were recruited into the study by means of consecutive sampling. A data collection tool was used to capture sociodemographic details, the patient’s history, the Glasgow Coma Scale (GCS), and ocular examination findings. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS) software version 28. Multiple logistical regression was used to determine predictor variables. Results: The prevalence of ocular injuries among study participants with traumatic brain injury was found to be 58.14% (95% CI: [49.13% - 66.76%]). The eyelid was the most affected ocular structure in 67 participants (89.33%), followed by the conjunctiva 49 (65.33%). The occurrence of structural ocular findings and neuro-ophthalmic manifestations were associated with vision impairment (P < .001 and P = .006 respectively), and conjunctival injury and neuro-ophthalmic manifestations were associated with moderate to severe cases of traumatic brain injury (P = .024 and P = .015 respectively). Participants with scalp and/or facial haematoma (AOR = 4.50; 95% CI: [1.11–18.17], P = 0.035) and facial asymmetry (AOR = 12.11; 95% CI: [1.49–98.81], P = .02) were significantly more likely to sustain ocular injuries. Conclusion: The findings of this study highlight the burden of ocular injuries among traumatic brain injury patients and underscores the need for timely comprehensive ocular examinations in traumatic brain injury patients. This is to identify ocular injuries that have potential to cause disabilities like physical disfigurement or vision impairment.
Background: Eyelid eczema includes a heterogeneous group of inflammatory dermatologic conditions affecting the periocular region. Although these disorders often present with similar clinical features, their etiologies are distinct. Aim: We aimed to establish demodex infestation as a cause of eye lid eczema. Methodology: Patients diagnosed with eyelid eczema were enrolled in the study from April 2024 to December 2024. An age and gender matched control group was formed from healthy volunteers. Each patient had a detailed ophthalmic evaluation, and two lashes were removed from each eye, then eyelashes were examined directly under light microscopy for the presence of Demodex mites. Results: A total of 58 patients with eyelid eczema and 46 healty controls were enrolled the study. Demographics were similar between groups. Demodex infestation was found more prevalent in patients with eyelid eczema compared to the control group (31% in the eczema group, 13% in the control group, p-value= 0.03 Participants with demodex infestation had a threefold higher likelihood of having eyelid eczema compared to the control group. Conclusion: When evaluating eyelid eczema, Demodex infestation should not be overlooked.
Vogt–Koyanagi–Harada Disease is an uncommon systemic autoimmune disorder that predominantly affects young adults. Its diagnosis relies on a combination of clinical and paraclinical findings, but may be delayed because of atypical presentations. We report the case of a 26-year-old woman initially managed for idiopathic intracranial hypertension, in whom the subsequent development of bilateral granulomatous panuveitis associated with exudative retinal detachment led to the diagnosis of incomplete VKH disease. Early initiation of high-dose corticosteroid therapy combined with immunosuppressive treatment resulted in complete visual recovery. This case highlights the importance of early diagnosis in improving visual prognosis and preventing progressive complications.
Contact lenses represent one of the most widely used biomedical devices globally, with well over 140 million wearers correcting refractive errors and managing various ocular conditions. Over the past six decades, the field has undergone a remarkable transformation—from rigid poly (methyl methacrylate) lenses to sophisticated silicone hydrogel materials capable of delivering clinically adequate levels of oxygen to the corneal surface. This narrative review synthesises contemporary knowledge on advances in contact lens design and materials, with emphasis on the development of silicone hydrogel platforms, surface wettability and modification technologies, drug-eluting and smart lens systems, orthokeratology and myopia control, as well as emerging nanotechnology-enabled materials. The review traces the historical evolution of contact lens materials, critically examines the physicochemical properties that govern ocular compatibility and wearer comfort, and evaluates the clinical evidence underpinning current and next-generation lens technologies. Special attention is given to the intersection of materials science, ocular physiology, and digital health in shaping the future of wearable ophthalmic devices. Key challenges including lens-induced dry eye, mechanical complications from high-modulus silicone hydrogels, and regulatory hurdles for smart lens commercialisation are discussed. The review underscores that despite significant progress, optimising the balance between oxygen permeability, water content, modulus, wettability, and biocompatibility remains an active and clinically important area of research.
Background: Thyroid eye disease is an immune-mediated orbital disorder that may cause proptosis, eyelid oedema, chemosis, and restricted ocular motility. Acute, markedly asymmetric presentations can closely resemble orbital cellulitis, making prompt clinical assessment and orbital imaging essential for accurate diagnosis. Aims: The study aims to describe an acute, highly asymmetric presentation of thyroid eye disease (TED) in an elderly woman with treated hyperthyroidism and to emphasise the role of emergency orbital imaging in differentiating TED from orbital cellulitis. Presentation of Case: A woman in her late seventies who was receiving thiamazole 10 mg twice daily and propranolol 20 mg daily for hyperthyroidism presented with painful bilateral proptosis that was markedly more pronounced in the left eye. The left eye showed eyelid oedema, conjunctival hyperaemia, chemosis, and limited ocular motility. The anterior segment was quiet, and fundus examination was normal. No fever was documented in the emergency record, and the complete blood count and C-reactive protein level were normal. Urgent orbito-cerebral computed tomography demonstrated bilateral grade 1 proptosis and bilateral enlargement of the extraocular muscle bellies, with relative sparing of the anterior tendinous insertions and no reported orbital collection. These findings supported active, left-predominant TED rather than infectious orbital cellulitis. Antithyroid therapy was continued, and systemic corticosteroids were administered, resulting in improvement in pain, chemosis, conjunctival inflammation, and eyelid oedema. Discussion: Asymmetric, painful proptosis may mimic infectious orbital disease. In this case, the thyroid history, bilateral CT involvement, tendon-sparing myopathy, normal inflammatory markers, and absence of an orbital collection were decisive diagnostic clues. Conclusion: TED should be considered in patients with thyroid dysfunction who present with painful or asymmetric proptosis. Prompt imaging and multidisciplinary care are essential to exclude vision-threatening and infectious conditions.
Aim: To compare the efficacy and safety of phacoemulsification (PHACOE) versus manual small-incision cataract surgery (PHACOA) at the Chad–China Friendship University Hospital Centre (CHU‑ATC) in N’Djamena, Chad. Study Design: A prospective, descriptive, cross-sectional study conducted over 6 months, from 1 February to 31 July 2025, at the CHU‑ATC. Methods: All patients aged ≥40 years with preoperative visual acuity <3/10 who underwent either PHACOE or PHACOA, were followed for at least 30 days postoperatively, and provided informed consent were included. Traumatic, congenital and pathological cataracts, as well as cases with detectable ocular pathology (corneal opacity), were excluded from the study. Results: Among 332 cataract surgeries, 279 eyes from 261 patients (mean age 58.8 ± 16.4 years) met the inclusion criteria. Of these, 53.7% (n = 150) underwent PHACOE and 46.3% (n = 129) underwent PHACOA. Intraoperative complications occurred in 8.5% of PHACOE procedures versus 8.0% of PHACOA procedures (p = 0.420), with capsular rupture being the most frequent (8.5% vs 6.0%, respectively). On postoperative day 30, uncorrected visual acuity ≥3/10 was achieved in 86.0% of PHACOE eyes versus 77.3% of PHACOA eyes (p = 0.101). With optical correction, visual acuity ≥3/10 was obtained in 87.6% of PHACOE eyes versus 79.3% of PHACOA eyes (p = 0.086). The mean gain in visual acuity was 11.8 lines for PHACOE compared with 9.6 lines for PHACOA (p = 0.10). Conclusion: Phacoemulsification provided better visual recovery than manual small-incision cataract surgery, while both techniques showed low perioperative complication rates. PHACOE outcomes met WHO standards for postoperative visual results, and PHACOA outcomes approached these standards. Given its lower cost, PHACOA represents a viable alternative in resource-limited settings such as Chad.
Background: Demodex mites are common commensals of human skin and eyelids but may become pathogenic in immunocompromised individuals. Increased mite density has been associated with ocular surface disease, blepharitis, and dermatological manifestations, particularly in patients receiving long-term immunosuppressive therapy. Case Presentation: We report a woman in her late 60s with lupus nephritis on immunosuppressive therapy who presented with persistent facial dryness, erythema, scaly patches, and chronic eyelid itching unresponsive to topical antibiotic ointment, which was used only as adjunctive therapy to reduce secondary bacterial colonization. Dermatological assessment with Standardized Skin Surface Biopsy revealed a high density of Demodex mites (>5 mites/cm²). Ophthalmological examination demonstrated cylindrical dandruff, and eyelash epilation according to the Gao method, confirmed Demodex infestation. A combined treatment regimen of topical ivermectin 1% cream, tea tree oil–based eyelid wipes, and adjunctive antibiotic ointment led to significant clinical improvement within six weeks. By three months, both dermatological and ocular symptoms had resolved completely, and follow-up testing confirmed normalized mite density. No recurrence occurred during 12 months of follow-up. Conclusion: This case highlights a possible association between immunosuppression and Demodex overgrowth, underscoring the importance of considering demodicosis in patients with refractory blepharitis and dermatitis. Early recognition, interdisciplinary collaboration, and targeted acaricidal therapy can achieve full remission and prevent chronic ocular surface inflammation in immunocompromised individuals.
Introduction: Necrotising fasciitis is a severe infection of the subcutaneous tissue and superficial fascia, associated with necrosis of the overlying skin tissue. Periorbital involvement is rare. It can be responsible for multiple early deleterious complications and late cicatricial ones, such as ectropion. Case Presentation: We report the case of a 69-year-old patient, hypertensive and poorly controlled diabetic, with a history of hospitalisation for bilateral palpebrojugal Necrotising fasciitis on maxillary sinusitis. The examination found visual acuity at 6/10 in ODG, with severe bilateral ectropion, associated with adhesions, a more marked KPS in the inferior, a good anterior chamber, a round and regular pupil, and a posterior cortical and subcapsular cataract. The posterior segment was normal. Discussion: Ectropion is the most common eyelid malposition; it is an eyelid eversion associated with conjunctival and corneal exposure, more frequently affecting the lower eyelid. It can be congenital or acquired; the latter is classified according to the causal mechanism as involutional, paralytic, cicatricial, or mechanical. Management depends on the type of damage, with focal damage treated by excision of scar tissue and severe damage requiring transposition flaps or full skin grafts. Conclusion: Several conditions can cause cicatricial ectropion; periorbital Necrotising fasciitis is one of them, requiring protective medical and restorative surgical management.
Aims: To evaluate the proportions and assess factors associated with pre-operative anxiety among patients undergoing elective eye surgeries at KCMC. Study Design: This was a hospital based cross-sectional study. Place and Duration of Study: Department of Ophthalmology at Kilimanjaro Christian Medical Center, Tanzania, between November 2024 and May 2025. Methodology: A total of 220 participants scheduled for ophthalmic surgery were enrolled into the study. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used to detect preoperative anxiety along with a data collection sheet for surgical and patient information. The overall prevalence of pre-operative anxiety was determined using a binary variable derived from patients who scored above 10 on the total APAIS score. Bivariate analysis comparing categorized variables and multivariate analysis were performed. Results: The proportion of high preoperative anxiety was 26.4% (95% CI: 20.7–32.4%). Surgery-related anxiety (31.8%; mean score 4.44 ± 2.22) was more prevalent than anesthesia-related anxiety (23.2%; mean score 3.87 ± 2.25). Younger age(P = 0.15), high information desire (P < 0.001), and diagnostic surgical indication(P = 0.001). were independently associated with high preoperative anxiety. Conclusion: A substantial proportion of ophthalmic patients at KCMC experience high preoperative anxiety, predominantly driven by surgery-related concerns. Targeted preoperative counseling and patient-centered information delivery may reduce anxiety levels.
Aims: This study reports a case of localized ocular surface squamous neoplasia (OSSN) and highlights the role of anterior segment optical coherence tomography (AS-OCT) in diagnosis, surgical planning, and postoperative surveillance. Presentation of Case: A 60-year-old male farmer presented with a small, well-defined greyish-white lesion measuring 3 × 3 mm at the nasal limbus of the right eye. Anterior segment optical coherence tomography revealed a thickened, hyperreflective epithelial lesion with an abrupt transition from normal epithelium and preservation of Bowman’s layer, suggestive of pre-invasive OSSN. The lesion was managed with wide local excision using the no-touch technique with 4 mm margins, double freeze–thaw cryotherapy, intraoperative mitomycin C (0.04%), and amniotic membrane grafting. Histopathological examination confirmed carcinoma in situ. Postoperatively, topical 5-fluorouracil 1% was administered for four weeks. Discussion: AS-OCT provided a reliable, non-invasive assessment of lesion depth and extent, which assisted in confirming epithelial confinement and guiding surgical management. The combined use of surgical excision and adjuvant chemotherapy helped reduce recurrence risk while maintaining ocular surface integrity. Conclusion: Early diagnosis supported by AS-OCT and a multimodal therapeutic approach can achieve favorable anatomical and oncological outcomes in localized OSSN.
Introduction: Nodular fasciitis (NF) is a benign, rapidly growing proliferation of fibroblasts and myofibroblasts that can mimic malignant soft-tissue tumors both clinically and histologically. Although commonly found in adults, NF is rare in the pediatric population, especially in the periorbital region. Prompt diagnosis is essential to guide appropriate management. Case Report: We report the case of a 10-month-old infant presenting with a painless, firm, and mobile mass at the medial canthus of the right eye, progressively enlarging over two months. Orbito-ocular computed tomography revealed a well-defined, ovoid soft-tissue lesion with peripheral contrast enhancement. Excisional biopsy showed a spindle-cell proliferation arranged in a storiform pattern, with cells positive for smooth muscle actin and negative for desmin and S100. The Ki-67 proliferation index was 3%, confirming the diagnosis of nodular fasciitis. Postoperative recovery was uneventful, and no recurrence was observed over one-year follow-up. Discussion: Periorbital NF is rare in children and may clinically mimic aggressive malignancies such as rhabdomyosarcoma. Imaging modalities such as CT and MRI help define the lesion, but definitive diagnosis relies on histopathology and immunohistochemistry. Surgical excision is the treatment of choice, with recurrence being uncommon. Rapid excision is particularly important in pediatric patients to prevent functional complications such as amblyopia, strabismus, or mechanical ptosis. Conclusion: This case highlights the diagnostic and therapeutic challenges of periorbital nodular fasciitis in infants. Awareness of this rare entity is essential to differentiate it from malignant tumors and to guide timely and appropriate surgical management, ensuring favorable outcomes.
Vogt-Koyanagi-Harada disease(VKH) is an idiopathic multisystem autoimmune disease affecting the melanocyte-containing tissues such as Uvea, inner ear, meninges and skin. Cases of Probable vogt-koyanagi-harada disease are rarely encountered in clinical practice. Here we report case series of Probable VKH disease diagnosed with use of multimodal imaging techniques and treated with combination of Systemic corticosteroids and Immunosuppressive .
Background and Aims: Goldenhar syndrome is a rare condition that causes a defect in the development of structures derived from the first and second branchial arches, manifesting with a wide range of symptoms, including ocular, auricular, and vertebral abnormalities. The objective of this case presentation is to disseminate knowledge about Goldenhar syndrome, to promote timely diagnosis and surgical intervention in order to improve functional and cosmetic outcomes in these patients. Case Report: We report the case of a four-year-old girl whose parents complained primarily of a growth on her left eye, present since birth and which, according to them, had progressively increased in size over the years. On examination, we observed a large, rounded mass straddling the temporal limbus of the left eye, with a few fine hair follicles, consistent with a limbal dermoid cyst. The lesion was further characterized by B-mode ultrasound, which revealed a mass with a hyperechoic anterior wall and a hypoechoic core, resting on the cornea without invasion of Descemet's membrane or the anterior chamber. An oculo orbital Magnetic Resonance Imaging was also performed, showing a well-defined prelimbic lesion in the left eye, measuring 8.5 x 4.8 x 14 mm, hyperintense on T1- and T2 sequences, without enhancement after contrast injection. The evaluation of systemic malformations revealed the bilateral presence of multiple preauricular appendages. The overall clinical presentation was consistent with an epibulbar dermoid cyst within the context of Goldenhar syndrome. Regarding the management of the dermoid cyst, we opted for complete excision, combined with a multilayer amniotic membrane graft secured with 7-0 Vicryl to cover the wound. Histopathological examination confirmed the dermoid nature of the cyst. The patient then benefited from regular follow-up, with very satisfactory postoperative results and good healing. Conclusion: Goldenhar syndrome is a rare congenital disorder with highly variable clinical manifestations. Epibulbar dermoid cysts are the characteristic ocular manifestation, and their treatment aims for a dual objective: preserving visual function and improving cosmetic appearance. Management can range from a conservative approach with optical correction and simple monitoring to more invasive surgical excision, combined with various techniques for reconstructing the resulting defect.
Background: Diabetic macular edema being a foremost cause of visual loss in the diabetic population, is typically managed with intra-vitreal anti-VEGF therapy. The unilateral intra-vitreal bevacizumab (IVB) injections are standard, but the possible bilateral effect on the un-injected eye remains unclear, specifically in the African population. Aims: This study intended to evaluate the anatomical and visual outcomes in the un-injected eye after a single dose intra-vitreal bevacizumab injection and to identify systemic and ocular factors associated with these outcomes in patients with Diabetic Macular edema (DME). Study Design: A hospital-based prospective cohort study. Place and Duration of Study: Department of Ophthalmology, Kilimanjaro Christian Medical Centre (KCMC), between Jun 2024 and July 2025. Methodology: We included 105 patients (53 male, 52 female, mean age 64.1(±9.06) years) with diabetic macular edema (DME). Each patient received a single intra-vitreal bevacizumab injection in the eye with worse baseline Central Subfield Macular Thickness (CSMT). The un-injected eye was assessed for changes in CSMT and Best Corrected Visual Acuity (BCVA) after 4 weeks post injection. Paired t-tests and Wilcoxon signed-rank tests were applied for within-eye assessments. Pearson and Spearman correlations evaluated inter-eye associations. Generalized linear models (GLM) with a gamma distribution and log link were used to identify factors associated with anatomical and visual outcomes. Results: The mean CSMT of un-injected eye changed from (300.9 ± 31.5 μm) to 304.7 ± 36.9 μm), p = 0.1472, and median BCVA remained unchanged (LogMAR 0.3 at baseline and follow-up), p = 0.1154). Nevertheless, significant associations were observed between increased CSMT and systemic hypertension (ARR = 1.07; p = 0.021), elevated serum creatinine (ARR = 1.002; p = 0.038), and history of prior bevacizumab use (ARR = 1.09; p = 0.001). The history of PRP was associated with decrease in mean CSMT (ARR = 0.94; p = 0.021). Conclusion: A single unilateral IVB injection did not produce significant anatomical or visual improvements in the contralateral eye after 4 weeks. Though, systemic comorbidities such as hypertension and good renal function significantly influenced anatomical outcome, highlighting the need for integrated systemic and ocular management in DME treatment.
