title: [Treatment of ocular lesions due to Elapidae venom spitting in Central African Republic: epidemiological and clinical aspects].
abstract: This survey concerns 16 patients admitted to Bangui teaching national hospital center, coming from Ngakobo health center 450 km from the South East of Bangui, between September 2001 and May 2002. All of them have undergone a basic ophthalmological examination 16 patients have been hospitalised in the service of ophthalmology among them, 11 didn't go to the consultation. All the 16 patients were males, 18 to 46 years old. Five of them had bilateral corneal lesions and eleven patients presented unilateral lesions. Two patients had a corneal perforation at admission. The initial visual acuity of the concerned eye was estimated between LP(-) and 3/10th. The visual acuity valued after exit was LP(-) to 6/10. Four patients out of sixteen (two eyes with bilateral lesions and two with unilateral lesion) (six eyes) received as initial treatment, water rinse on the spot of the accident, then a local treatment by antibiotics administrated in the dispensary of the Ngakobo Province. Eight patients (two bilateral and six unilateral lesions) received a traditional treatment while five of them received it before their transfer to Bangui and 3 patients just before their arrival in Bangui. Four patients (five eyes) had no treatment at all. The nature of this traditional treatment, often of mineral and vegetal origin has not been specified. The main after-effects are corneal opacities, varying according to size, localization and gravity. At the beginning, 9 cases out 16 are generally diffused and superficial keratitis. After some days of treatment, 8 cases developed into corneal opacity freeing thus the visual axis. 3 cases of keratitis developed into a purulent melting then to a corneal perforation. Elapidae's spits on the eye are frequent in sugar cane cultivation areas. They can provoke some severe erosive corneal lesions, in absence of adequate and early management. The administration of traditional treatment most often complicates the clinical issue. Nursing staff, medical personnel and family should pay attention to the ocular toxicity of these septic matters and to the first cares provided to the patient before his early transfer to hospital.
authors.affiliation: Service d'Ophtalmologie, Centre National Hospitalier Universitaire de Bangui, République Centrafricaine. geya_ophtalmo@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Yaya
authors.forename: A
authors.initials: A
authors.lastname: Danaï
mesh_terms: D000293:Adolescent; D000328:Adult; D002488:Central African Republic; D065306:Corneal Injuries; D004546:Elapid Venoms; D005131:Eye Injuries / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D004546:Elapid Venoms