Corneal Diseases in Children in The Gambia

Abstract

Background: Blindness surveys carried out in The Gambia in 1986 reported childhood blindness from non-trachomatous corneal diseases as the commonest cause of blindness in children. The major causes were, post measles keratopathy, vitamin A deficiency and ophthalmia neonatorum.Aim: This study aims to find out what impact the ExpandedProgramme on Immunization and the development of humanresources have had on the causes/pattern of corneal eyediseases in children in The Gambia.Design: A prospective six-month hospital-based study.Method: The eyes of all children aged 0-16 years presenting at theRoyal Victoria Teaching Hospital (RVTH) in Banjul, TheGambia, from December 2005 to May 2006, were examinedfor aetiology of corneal eye diseases. All the children weretreated according to the diagnosis.Result: A total of 169 children aged 0-16 years were seen duringthe study period. Seventy-one (42%) had corneal diseases.Their ages ranged from 2 weeks to 16 years; mean 7.5 yearsand SD 3.1 years. The aetiology of corneal diseases weretrauma in 23 (32.4%) vernal kerato-conjunctivitis in 16 (22.54%), congenital eye diseases in 12 (16.9%), corneal infections in 12 (16.9%), corneal scarring from unknown causes in 5 (7.04%) and corneal dystrophy/degenerations in 3 patients. Ten patients (14%) became bilaterally blind while 22 patients (31%) suffered unilateral blindness, withcongenital diseases and trauma being the causes respectively.Vernal kerato-conjunctivitis was a major cause of ocularmorbidity. Conclusion: Bilateral blindness is no longer due to preventablecauses like measles, ophthalmia neonatorum and keratomalacia. The use of harmful traditional eye medication is a contributory factor to the severity of vernal keratoconjunctivitis.