Traumatic ocular emergencies: the difficulties associated with their care at the university hospital of Brazzaville

Abstract

Background: In black Africa, the severity of traumatic ocular emergencies (TOE) is increased by a lack of ophthalmologists and often inadequate or even the inexistence of surgical equipment.
Objective: To make an inventory of the difficulties associated with the management of TOE at the ophthalmology department of the University Hospital of Brazzaville (UHB).
Design: A retrospective study.
Setting: The University Hospital of Brazzaville.
Subjects: Records selected were those of patients seen for traumatic pathologies that could compromise the visual prognosis and require immediate surgical treatment. The patients seen for injuries of related structures of the eye were excluded. Types of lesion, consultation period, time of surgical treatment, clinical appearance of the eye and visual acuity (VA) at three months were analysed.
Results: The frequency of TOE was 1.8%. The average age was 35 ± 4 years old. The average time for consultation and treatment were 35 ± 10 days and 74 ± 5.5 hours. These TOE were: corneoscleral rupture (63.2%), vitreoretinal iron foreign body (16.8%), retinal detachment (15%), and macula hole (5%). At three months 73.2% of eyes did not see the light, 19.2% had a VA waving from light perception and counting fingers, and for 7.6% the best VA did not exceed three out of ten.
Conclusion: In the UHB, the rate of blindness associated with TOE is high. Training of ophthalmologists and adapted surgical equipment should be a priority.

Background: In black Africa, the severity of traumatic ocular emergencies (TOE) isincreased by a lack of ophthalmologists and often inadequate or even the inexistenceof surgical equipment.Objective: To make an inventory of the difficulties associated with the management ofTOE at the ophthalmology department of the University Hospital of Brazzaville (UHB).Design: A retrospective study.Setting: The University Hospital of Brazzaville.Subjects: Records selected were those of patients seen for traumatic pathologies thatcould compromise the visual prognosis and require immediate surgical treatment.The patients seen for injuries of related structures of the eye were excluded. Types oflesion, consultation period, time of surgical treatment, clinical appearance of the eyeand visual acuity (VA) at three months were analysed.Results: The frequency of TOE was 1.8%. The average age was 35 ± 4 years old. Theaverage time for consultation and treatment were 35 ± 10 days and 74 ± 5.5 hours. TheseTOE were: corneoscleral rupture (63.2%), vitreoretinal iron foreign body (16.8%), retinaldetachment (15%), and macula hole (5%). At three months 73.2% of eyes did not seethe light, 19.2% had a VA waving from light perception and counting fingers, and for7.6% the best VA did not exceed three out of ten.Conclusion: In the UHB, the rate of blindness associated with TOE is high. Trainingof ophthalmologists and adapted surgical equipment should be a priority.