SUMMARY
Introduction:
Mansonellosis, is found in Brazil, in the Amazon Forest (states of Amazonas and Roraima) and in the state of Mato Grosso. Its pathogenicity is not clear and in ophthalmology it has been associated with conjunctivitis. Corneal changes associated with Mansonella have never been reported. The southwest of the state of Amazonas has no ophthalmic records related to the prevalence of the different diseases as well as their needs and priorities.
Purpose:
To report ophthalmic and vision conditions of the inhabitants of Pauini (located in the southwestern Amazonas state, on the Purus river, 915 km from Manaus), as well as corneal lesions possibly associated with Mansonella.
Patients and Methods:
In September 1997, 524 persons underwent ophthalmological exam ination. Prescribed spectacles were donated and delivered. Four patients underwent skin biopsy to evaluate onchocerciasis and another four underwent blood sampling to evaluate the presence of mansonellosis.
Results:
Ametropia was the most frequent ophthalmologic alteration. Glasses were prescribed for 178 (33.59%) patients. In 21 (4%) glasses were needed for far distance, in 104 (20%) only for near distance and in 53 (10%) for both. Forty-nine patients were affected by pterygium (9.35%) and 36 (6.90%) had severe visual loss due to cataract. Macular scars typical of Toxoplasma were present in at least 6 patients (1%). Twenty-two eyes of 20 patients (3.8%) presented peripheral corneal lesions. The lesions were round, measuring 0.5 to 1.0 mm in diameter, with clear cornea between them and the limbus. There was no neovascularization, nor decrease in visual acuity. Lesions were bilateral in two patients. Other conditions such as trachoma, cicatricial conjunctivitis, pupillary alterations or uveitis were not present. No skin biopsy was positive for onchocerciasis. Two of the patients who underwent blood sampling presented Mansonella spp.
Conclusions:
Refraction disorders with need for spectacles was the most important cause of decrease in visual acuity followed by cataract. The reported high prevalence of Mansonella and the exclusion of other known etiologies suggest it as the cause of the corneal opacities.
Keywords:
Pauini; Cornea; Mansonella; microfilariae Amazon; Spetacles