Blindness Secondary to Noma Destruction of Orbital Bone: Case Series from Noma Children Hospital Sokoto, Northwest Nigeria

Abstract

Background: Noma is an infectious disease that rapidly destroys orofacial tissues and neighboring structures in its fulminating course. This study aimed to present a case series of blindness as a result of Noma destruction of the orbital bone and highlight the important aspect of its management.

Patients and Methods: This was a case series of 12 patients seen and managed for Noma with associated blindness over 2 years study period at Noma Children Hospital Sokoto, Northwest Nigeria. Sociodemographic variables, presenting complaints, presenting visual acuity, investigations, and, the treatment done was recorded. Data were analyzed using IBM SPSS version 25.

Result: There were 4 (33.3%) males and, 8 (66.7%) females in the age range of 4-15 years with a mean±SD of 7.5±3.3years. The time range of onset before presentation to our facility was 2 weeks to 4 months. Ophthalmic examination revealed a destroyed globe and purulent discharge with no light perception in all the patients. Anemia and malnutrition were present and, microbiological culture and sensitivity (MCS) yielded no growth in all the patients. Patients were optimized, then later had sequestrectomy and, teeth extraction. Monitoring of patients was done until symptoms resolution.

Conclusion: Noma is capable of spreading rapidly to the orbit, causing loss of vision as a complication. However, aggressive medical and surgical intervention in consultation with an ophthalmologist can result in early resolution of symptoms and prevent further spread that may lead to blindness.