[50 millions people affected by onchocerciasis].
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Blindness↗
Biomedical subjects
A M Tønjum
Publications and source records attributed to A M Tønjum.
A three-year follow-up of ocular onchocerciasis in an area of vector control.
An evaluation of the effects on onchocerciasis of a 3-year period of vector control was undertaken during 1978 in the Onchocerciasis Control Programme area in West Africa. The results revealed that the overall prevalence of ocular onchocerciasis showed only a slight decrease at the follow-up in 1978, but that there was significantly less infection among children in the age group 5-14 years as compared with 1975. There was a total incidence of ocular signs of onchocerciasis of 8.6% over the 3 years, but also a disappearance of those signs in 11.7% of the sample examined. The incidence of severe onchocercal eye manifestations was low, compared with similar areas of uncontrolled transmission. The particularly low incidence of sclerosing keratitis may be associated with the finding of a significantly decreased microfilarial load in the cornea, whereas the number of living microfilariae in the anterior chamber of the eye was apparently unchanged. The incidence of blindness due to onchocerciasis was low and confined to individuals who already presented severe eye manifestations of the disease before the beginning of the vector control campaign.
Adolescent↗
Aspects of corneal changes in onchocerciasis.
The distribution of living and dead microfilariae in 160 cases of ocular onchocerciasis has been studied. A model for coding the densities in 9 different areas of the cornea has been used. The average numbers of microfilariae and onchocercal punctate opacities per square millimetre were assessed. The highest densities were found in the superficial one-third of the corneal stroma at the periphery of the nasal and temporal parts of the cornea. Sclerosing keratitis was also recorded, and the average age of the patients in this group was significantly higher than in the group with non-sclerosing onchocercal involvement. Corneal thickness measurement showed that the presence of microfilariae or onchocercal punctate opacities or a faint uveitis did not influence the values. In sclerosed areas the corneal thickness varied greatly and was dependent on the degree of the vascularisation. The routes of entry of microfilariae into the eye are discussed on the basis of the distribution patterns of microfilariae and onchocercal opacities.
Cornea↗
Visual field defects in onchocerciasis.
Lesions in the posterior segment of the eye in onchocerciasis may give visual field defects, but so far no detailed investigation has been done to determine the functional visual loss. Examination of the visual fields in 18 selected cases of onchocerciasis by means of a tangent screen test revealed important visual field defects associated with lesions in the posterior segment of the eye. Involvement of the optic nerve seemed to be important, giving rise to severely constricted visual fields. Cases of postneuritic optic atrophy showed a very uniform pattern of almost completely constricted visual fields, with only 5 to 10 degree central rest spared. Papillitis gave a similar severe constriction of the visual fields. The pattern of visual fields associated with optic neuropathy in onchocerciasis indicates that a progressive lesion of the optic nerve from the periphery may be responsible for the loss of vision. The visual field defects in onchocerciasis constitute a serious handicap, which must be taken into consideration when estimating the socioeconomic importance of the disease.
Adolescent↗