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Since the 1950s, the Kingdom of Morocco has been and remains one of the pioneers in the fight against trachoma, a disease that has completely disappeared in the majority of its national territory, but some endemic pockets have persisted and pose a health risk, particularly for children and women. Morocco finds itself today, thanks to years of joint efforts, at the forefront of the world stage of the fight against trachoma. The country has demonstrated through its experience the effectiveness and relevance of the "SAFE" strategy - an extensive programme designed to tackle trachoma and its complications. The strategy is complex in its implementation and requires the synergy of a set of actors dedicated to specific activities, whether medico-surgical management activities aimed at setting up a physical project for local development, or information and awareness-raising activities. The key to the long-term success of eliminating blinding trachoma was not only to link distribution of drugs to the entire project area for several years to reduce substantially the reservoir of human- to-human transmission, but also to ensure permanence. In addition, services that provide quality palpebral surgery and especially repeat treatment campaigns with antibiotics, as well as health education campaigns and the promotion of personal and collective hygiene have generated sustainable changes in the living environment of receiving populations.القضاء على التراكوما في المغرب: استعراض تاريخي.جواد حمو، مجدولين أوبطيل، رشيد رزين، أمينة برحو، محمد بلمكي.منذ خمسينات القرن الماضي، واصلت المملكة المغربية دورها كرائدة لجهود مكافحة التراكوما، وهو المرض الذي اختفى كلية من معظم ترابها الوطني، غير أن بعض الجيوب المستوطنة بالمرض ما زالت موجودة وتمثل خطراً صحياً، لا سيما بالنسبة للنساء والأطفال.ويتبوأ المغرب اليوم، بفضل سنوات من الجهود المشتركة، مكان الصدارة على ساحة الجهود العالمية المبذولة للقضاء على التراكوما. وأوضح البلد من خلال ما يمتلكه من خبرة فعالية استراتيجية جراحة الأهداب والمضادات الحيوية ونظافة الوجه وتحسين البيئة ومدى ملاءمتها - وهي عبارة عن برنامج ممتد صُمِّم للتصدي للتراكوما ومضاعفاتها. وتتسم الاستراتيجية بالتعقيد في تنفيذها وتتطلب تحقيق تآزر بين مجموعة من الجهات الفاعلة المُكرّسة لأنشطة محددة، سواء كانت أنشطة تدبير علاجي طبي وجراحي تهدف إلى إنشاء مشروع فعلي للتنمية المحلية، أو أنشطة إعلامية ومُذكية للوعي.ولم يكن السر وراء النجاح الممتد لجهود القضاء على التراكوما المسببة للعمى متمثلاً وحسب في ربط توزيع الأدوية بكامل منطقة المشروع للحد بصورة جوهرية من مستودع انتقال العدوى بين البشر، بل وتمثل أيضا في العمل على ضمان استدامة المشروع. وعلاوة على ذلك، فقد أدت الخدمات التي تُقدَّم من خلالها جراحة أهداب جيدة، وتكرِّر حملات العلاج بالمضادات الحيوية على وجه خاص، إلى جانب حملات التثقيف الصحي وتعزيز النظافة الشخصية والجماعية، إلى إحداث تغييرات مستدامة في البيئة المعيشية للفئات السكانية المتلقية لتلك الخدمات.Élimination du trachome au Maroc : une revue historique.Depuis les années 1950, le Royaume du Maroc est l’un des pionniers de la lutte contre le trachome. Cette maladie a complètement disparu de la majeure partie de son territoire national, mais elle demeurait endémique dans certaines poches, représentant un risque pour la santé, en particulier pour les enfants et les femmes.Aujourd’hui, grâce à des années d’efforts conjoints, le Maroc se trouve à l’avant-scène de la lutte mondiale contre le trachome. À travers son expérience, le pays a démontré l’efficacité et la pertinence de la stratégie « CHANCE », programme à grande échelle conçu pour s’attaquer au trachome et à ses complications. La mise en oeuvre de cette stratégie est complexe. Elle nécessite la participation conjointe d’un ensemble d’acteurs se consacrant à des activités spécifiques, qu’il s’agisse d’activités de prise en charge médico-chirurgicale visant à mettre en place un projet physique de développement local ou d’activités d’information et de sensibilisation.Pour réussir à éliminer durablement le trachome cécitant, la solution a consisté non seulement à étendre la distribution de médicaments à toute la zone du projet pendant plusieurs années afin de réduire considérablement le réservoir de transmission interhumaine, mais également à assurer la permanence de cette distribution. De plus, les services qui assurent une chirurgie palpébrale de qualité et surtout des campagnes régulières de traitement par antibiotiques, ainsi que des campagnes d’éducation sanitaire et la promotion de l’hygiène personnelle et collective, ont généré des changements durables dans l’environnement de vie des populations qui en bénéficient.

Background: Iris cysts are rare lesions of the anterior segment of the eye, they can be congenital or acquired. The management of acquired post-traumatic iris cysts remains difficult. Case report: We report the case of a 24-year-old girl who presented with a progressive decrease in vision in the left eye with pain and redness for the past few months. She had a history of penetrating injury in the same eye 14 years ago. The slit lamp examination identified a corneal scar at 7’ o’clock and a large iris cyst deforming the pupillary area. Ultrasound biomicroscopy (UBM) has confirmed the benign nature of the cyst. Anterior segment optical coherence tomography (AS-OCT) has shown the contact of the external layer of the cyst with the corneal endothelium. Surgical management consisted of soft viscodissection to separate the cyst from the corneal endothelium followed by complete excision of the external layer of the cyst. Conclusion: The postoperative course was simple with good visual outcome.

Background Corneal dystrophies (CDs) are a heterogeneous group of bilateral, genetically determined, noninflammatory bilateral corneal diseases that are usually limited to the cornea. CD is characterized by a large variability in the age of onset, evolution and visual impact and the accumulation of insoluble deposits at different depths in the cornea. Clinical symptoms revealed bilateral multiple superficial, epithelial, and stromal anterior granular opacities in different stages of severity among three patients of this family. A total of 99 genes are involved in CDs. The aim of this study was to identify pathogenic variants causing atypical corneal dystrophy in a large Moroccan family and to describe the clinical phenotype with severely different stages of evolution. Case presentation In this study, we report a large Moroccan family with CD. Whole-exome sequencing (WES) was performed in the three affected members who shared a phenotype of corneal dystrophy in different stages of severity. Variant validation and familial segregation were performed by Sanger sequencing in affected sisters and mothers and in two unaffected brothers. Whole-exome sequencing showed a novel heterozygous mutation (c.1772C > A; p.Ser591Tyr) in the TGFBI gene. Clinical examinations demonstrated bilaterally multiple superficial, epithelial and stromal anterior granular opacities in different stages of severity among three patients in this family. Conclusions This report describes a novel mutation in the TGFBI gene found in three family members affected by different phenotypic aspects. This mutation is associated with Thiel-Behnke corneal dystrophy; therefore, it could be considered a novel phenotype genotype correlation, which will help in genetic counselling for this family.

Although knowledge on medicine acceptability remains fragmented, this multi-faceted concept has emerged as a key factor for compliance in pediatrics. In order to investigate the acceptability of medicines used in the University Medical Centre Ibn Sina (CHIS) of Rabat, Morocco, an observational study was conducted. Using a multivariate approach integrating the many aspects of acceptability, standardized observer reports were collected for 570 medicine intakes in patients up to the age of 16, then analyzed on a reference framework. Tablets appeared to be well accepted in children greater than 6 years old, but were crushed/dissolved for 90% of the 40 children aged from 3 to 5, and 100% of the 38 patients younger than 3. Moreover, the prescribed dose was fully taken for only 52% and 16% of these younger children, respectively. Despite this, tablets represented 24% of evaluations in children from 3 to 5 and 20% in infants and toddlers. Oral liquid preparations appeared to be better accepted than tablets in preschoolers, but not for those under 3. Overall, these findings highlight the lack of suitable alternatives for the younger children, especially for formulations of antiepileptics, antithrombotic, and psycholeptic agents in the local context.

Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.

Heimler syndrome (HS) is a rare recessive disorder characterized by sensorineural hearing loss (SNHL), amelogenesis imperfecta, nail abnormalities, and occasional or late-onset retinal pigmentation. It is the mildest form known to date of peroxisome biogenesis disorder caused by hypomorphic mutations of PEX1 and PEX6 genes. We report on a second Moroccan family with Heimler syndrome with early onset, severe visual impairment and important phenotypic overlap with Usher syndrome. The patient carried a novel homozygous missense variant c.3140T > C (p.Leu1047Pro) of PEX1 gene. As standard biochemical screening of blood for evidence of a peroxisomal disorder did not provide a diagnosis in the individuals with HS, patients with SNHL and retinal pigmentation should have mutation analysis of PEX1 and PEX6 genes.

Pathomimia is an unconscious falsification of physical manifestations. The eyelids and ocular surface are almost always affected because of the easy accessibility to these structures for the purpose of attracting attention from one's entourage as well as the medical community. We report four cases of lid and conjunctival pathomimia. The diagnosis was made after a long follow-up and numerous ancillary tests.

Introduction: The ophthalmological manifestation of tuberculosis varies significantly, and almost all the elements of the globe and orbit can be reached. Methods and Results: The aim of this work was to report a clinical aspect of ocular tuberculosis in a young woman who has a notion of tuberculous contagion and who was presented at the fundus of a macular papillary membrane with a tubercle of Bouchut or papillary tubercle. The diagnosis was retained on a bundle of clinical, biological, and radiological arguments. The evolution under treatment was favorable with an improvement of its visual acuity. Conclusion: It is necessary to know how to evoke the tuberculous etiology in view of all ocular inflammation, even atypical. This is required considering the great polymorphism of its clinical characteristics.

International audience; Autosomal dominant cerulean cataracts (ADCC) have previously been mapped to two loci: one on chromosome 17q24 and the other on chromosome 22q11.2-q12.2, which includes the b-B2 crystallin (CRYBB2) candidate gene. Using polymorphic markers in these regions (D17S802, D17S836, D17S1806 and CRYBB2, D22S258) for linkage analysis, we excluded these loci in a large Moroccan family presenting with an unusual form of ADCC with early onset of lens opacities and rapid evolution. This finding confirms the clinical and genetic heterogeneity of autosomal dominant congenital cerulean cataracts.