Bilateral Iris Coloboma Revealed by a Decreased Vision: About the First Case in Togo Observed in Kara University Teaching Hospital

Background: Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation [1]. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births [1]. The aim of this observation is to present the first case of bilateral coloboma of the iris [1]. This case was associated with an ametropia causing a decrease in visual acuity. Case Presentation: This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. Conclusion: A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.

Diagnosis of Large Papillary Excavations in Developing Countries: From Automated Visual Field to OCT of the Ganglion Complex. About a Case

Background: Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. Aim: To present a clinical case of large papillary excavation simulating glaucomatous optic neuropathy in a young subject. Case Presentation: The ophthalmologic examination made it possible to note a visual acuity of LogMar 0.00, ocular hypertonia and a large papillary excavation in both eyes. The visual field noted bilateral perimetric involvement suggesting optic neuropathy. Optical coherence tomography (OCT) of the ganglion complex revealed an absence of involvement of the ganglion complex and the ganglion ridge essential to evoke optic neuropathy. An ocular hypotonizing treatment made it possible to normalize the intraocular pressure. Conclusion: The particularity of this observation lies in the fact that the perimeter involvement that preceded any involvement can simulate a glaucomatous involvement. Functional damage to the visual field must be correlated with structural damage to suggest glaucomatous damage in our ophthalmic patients.

Place of Ocular Ultrasound in the Diagnosis of Optic Disc Druses in Developing Countries: About a Case and Review of the Literature

Background: Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. Aim: The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. Case Presentation: Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. Conclusion: Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.