Corneal Ulcers in a Tertiary Hospital in Africa

Purpose: To study the clinical features of corneal ulcers in a tertiary hospital in Africa. Methods: This is a retrospective review of the medical records of 82 consecutive corneal ulcer patients who presented to the eye clinic of Enugu State University of Science and Technology (ESUT) Teaching Hospital Parklane, Enugu, Nigeria, in 2008. Data entry and analysis was done using SPSS version 15.0. Results: The 82 consecutive patients comprised 38 males (36.3%) and 44 females (53.7%). Fifty-five (71.4%) presented with visual acuity in the affected eye of less than 3/60. After treatment, the vision improved in 21 eyes (32.3% of the total), remained the same in 34 eyes (52.3%), and deteriorated in 4 eyes (6.2%); 6 eyes (9.2%) had to be eviscerated. Forty-three eyes (52.4%) had antecedent trauma. Only 5 patients (6.1%) presented to the hospital within 24 hours of trauma or onset of symptoms. Thirty-eight patients (47.6%) sought treatment from patent medicine dealers prior to coming to the hospital, while 16 (19.5%) admitted use of traditional eye medication. Conclusion: Trauma is a major risk factor for corneal ulcer in developing countries. Vision is often poor after treatment, making corneal ulcer a major cause of corneal blindness. Patients commonly seek help from the wrong source and only present to the hospital when these have failed.