Management of Mooren\'s Ulcer and Visual Outcome in Jos University teaching Hospital- Central Nigeria

Abstract

Background Mooren's Ulcer is a chronic painful Ulceration of the cornea, with a steep overhanging edge and may progress centrally or circumferentially to involve the whole cornea, often resulting in blindness. Aim: To review the visual outcome of Mooren's ulcer patients managed using conjunctivectomy with systemic and topical steroids in Jos University Teaching Hospital with the aim of optimizing management. Methods Case notes of patients managed in the last 5 years in Jos University teaching hospital were reviewed to ascertain the visual outcome. The folders of 19 of the 26 patients who attended the clinic were reviewed. Information on age, sex, presenting complaints, drugs used before and after presentation, examination, treatment given in JUTH and visual outcome Results The mean age at presentation was 27.7 years. Both sexes were found to be equally affected. Four (21.1%) patients had both eyes affected, 16 (66.3%) patients had used traditional eye medicines before and after presentation. Fifteen (65.2%) eyes had both medical and surgical interventions, while 8(34.8%) eyes were treated with topical and systemic steroids only. Five (21.7%) eyes had visual acuity between 6/6 to 6/18, while 3 (13.0%) eyes had visual acuity of 6/24 to 6/60. Two (8.7%) eyes had visual acuity of worse than 6/60. The final visual acuity of 13 (56.5%) eyes could not be tested after treatment because the patients were lost to follow up. Conclusion Though several studies have shown that systemic immunosuppressive chemotherapy has been found to be superior to local ocular care, such as conjunctivectomy and topical steroids, we have found that patients who did not use traditional eye medicines or indulge in self medication did well on conjunctivectomy with systemic and topical steroids. Keywords: Mooren's Ulcer, Management, and Visual OutcomeHighland Medical Research Journal Vol. 4 (2) 2006 pp. 44-48