TRAUMATIC CORNEAL LACERATION IN NORTHWESTERN NIGERIA.

Background: Corneal laceration is a partial or full thickness corneal injury resulting from direct or indirect ocular trauma. Cornea laceration generally leads to the development of corneal opacity which is a significant cause of blindness worldwide, particularly in developing countries where facility for corneal transplant is not readily available. Clinical outcomes depend on causes, the part of cornea involved, and availability of skilled human resource and presence of corneal transplant services.

Aim: To assess the presentation, causes, and outcome of management of traumatic cornea laceration among patients at Federal Medical Centre (FMC), Birnin Kebbi, Kebbi, Nigeria.

Methodology: A one-year, retrospective review of all patients with traumatic corneal laceration who presented to eye clinic of Federal Medical Centre (FMC) Birnin Kebbi, Nigeria between November 2013 and October 2014. Information retrieved from the patient records included patient's bio data, clinical features, presenting visual acuity (VA), agents of injury, surgical intervention and visual outcome after treatment. The data obtained were analyzed with SPSS version 16.

Results: Thirty two cases of traumatic corneal laceration presented during the study period. The age of study participants ranged from 2 years to 47 years with a mean of 15.28+12.46. 16 (50%) were children less than ten years old. There were 21(65.6%) males and 11(34.4%) females with male/female ratio of 1.9:1 and 20 (62%) cases of corneal lacerations occurred at home. Majority of injuries were inflicted with sticks in 9 (28.1%) cases followed by motor bike accidents in 6(18.8%). The left eye was mostly affected 18 (56.2%). Thirteen patients (40%) presented within 24 hours of injury while 16 (50%) presented within a week while one (3.1%) reported after two weeks. Presenting visual acuities in 28(90.6%) ranged from 6/12 to hand movement and no light perception in 3(9.4%). Associated injuries included uveal prolapsed 28(87.5), cataract 15(46.9%), vitreous haemorrhage 6(18.8%) and retinal detachment 1(3.1%). All the patients had examination under anesthesia and cornea repair carried out within 36-48 hours of admission in 28(87.5%) cases and within 7 days in the remaining 4 (12.5%) patients. One (3.2%) patient developed endophthalmitis. After 6weeks follow up, visual accuity of 6/60 and better were achieved in 9 eyes. There was a statistically significant correlation between the presenting visual acuity and visual outcome. However, no relationships exist statistically between age, sex, and agent of injury. The site of injury also shows statistical association with the visual acuity at six weeks follow up.

Conclusion: from this study, we observed that traumatic corneal lacerations were significant causes of ocular morbidity especially in children; public eye-health education is recommended as a preventive measure.