Browsing by Author "Hu, V. H."

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    Factors associated with poor presenting vision among patients with microbial keratitis In Uganda
    (The Journal of Ophthalmology of Eastern, Central and Southern Africa, 2020) Arunga, S.; Atto, G.; Ayebazibwe, B.; Onyango, J.; Macleod, D.; Hu, V. H.; Burton, M. J.
    To determine factors associated with poor presenting vision among patients with microbial keratitis in Uganda. Design: Retrospective audit study. Methods: This was a study of patients presenting with microbial keratitis at the two main eye units in Southern Uganda in the year 2015. Information on time to presentation, treatment history, use of traditional eye medicine, trauma and presenting final visual acuity was collected. Factors associated with a poor presenting vision in a regression model were analysed. Results: There were 273 cases during the year 2015. The median presentation time was 7 days from onset (IQR 2-21, total range 0-366 days). Trauma was reported in 59/88 (67%) patients and 69/162 (43%) reported using traditional eye medicine. Visual acuity was reported in only 216/273 cases at presention. Visual acuity at presentation of less than 6/60 (severe visual impairment) was strongly associated with the use of traditional eye medicine (OR 5.13, 95%CI 2.17–12.1, p=0.001) and distance from the eye hospital (OR 1.02, 95% CI 1.01-1.03, p=0.002). Conclusion: This audit highlighted the role of use of traditional eye medicine and long distance from the eye hospital in contributing to poor presentation among patients with microbial keratitis in Uganda.
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    Mooren’s ulcer in Uganda: A prospective observational case series
    (The Journal of Ophthalmology of Eastern, Central and Southern Africa, 2020) Kavuma, D.; Arunga, S.; Onyango, J.; Leck, A.; Hoffman, J. J.; Hu, V. H.; Burton, M.
    Mooren’s ulcer is a progressive, chronic, and painful peripheral ulceration of the cornea, commonly seen in adult men. In our set up, it has been observed to be aggressive and difficult to treat, often resulting in poor visual outcomes. There is limited published evidence on its management. Objective: Our aim was to describe the presentation, treatment and outcomes of patients presenting with Mooren’s ulcer in Mbarara, Uganda over a defined time period. Methods: A prospective case series conducted over 3 months from August 2017 to November 2017, with scheduled reviews up to 3 months. Participants’ history, presentation, management and clinical course were captured. Laboratory investigations for underlying systemic diseases were performed, in addition to corneal microbiology testing. Results: A total of eight patients (6 males and 2 females) were enrolled. The median age was 26 years (IQR 22- 27.5, full range 16-32). A history of trauma was present in 3 (38%) of cases. The earliest presenting time was one month after start of symptoms. At presentation, 2 (25%) patients had normal vision, 3 (38%) had moderate vision impairment (VI), 1 (12%) had severe VI, and 2 (25%) were blind. There was no systemic disease diagnosed on investigation, but corneal microbiology revealed 3 (38%) ulcers had fungal co-infections. At 3 months, 4 (50%) patients had normal vision, 1 (12%) had moderate VI, and 3 (38%) were blind. No patients required evisceration or enucleation. Conclusion: Most patients were below 30 years and presented late to the hospital, with advanced ulcers, leading to outcomes ranging from good to poor. Mooren’s ulcer is difficult to treat and further studies to assess risk factors would be beneficial in providing evidence for better management of this condition, particularly in resource limited settings.