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RESUMEN Introducción: la inflamación unilateral de un párpado supone un motivo de consulta pediátrica relativamente frecuente. Este signo puede deberse a múltiples causas entre las que se encuentran la celulitis preseptal y la celulitis orbitaria. Presentación de caso: se presenta un caso de una lactante femenina, de 3 meses de edad, con ingreso en el hospital pediátrico Luis A Milanés, por síndrome febril, posterior a vacunación con AM-BC y antipolio oral, asociado a irritabilidad y rechazo al alimento, con tratamiento endovenoso (cefuroxima), sin antecedentes de enfermedad respiratoria. Se valoró al tercer día por oftalmología debido a un aumento de volumen periorbitario izquierdo y rubor, secreciones amarillentas y se constató en al examen lesión en piel del párpado superior hacia canto interno, con salida de pus. Se diagnosticó celulitis preseptal ojo izquierdo, se puso tratamiento con metronidazol, ceftriaxona y vancomicina endovenosos. Se ingresó en sala de cuidados intensivos, se tomó muestra de las secreciones en ojo izquierdo con resultados negativos, y se indicaron complementarios: Hb 7.6 g/l, PCR 48mg/dl, eritrosedimentación 57mm/h, hemocultivo positivo a Staphylococus aureus resistente a meticilina. Al séptimo día se suspendió tratamiento anterior por empeoramiento y se comienza con meropenem y linezolid. En la tomografía computarizada y resonancia magnética se observó etmoiditis izquierda. Se valoró por otorrinolaringología y oftalmología. Se planteó tratamiento quirúrgico: incisión y drenaje palpebral. Conclusiones: la celulitis orbitaria y los abscesos orbitarios se asocian comúnmente a diseminación de una infección de los senos paranasales (sinusitis), se debe valorar la observación hospitalaria y el tratamiento intravenoso en niños menores de un año. El tratamiento debe ser precoz y multidisciplinario para evitar complicaciones. ABSTRACT Introduction: unilateral inflammation of an eyelid is a reason for a relatively frequent pediatric consultation. This sign may be due to multiple causes including preseptal cellulitis and orbital cellulitis. Case report: a case of a 3-month-old female infant with admission to the Luis A Milanés pediatric hospital due to febrile syndrome, after vaccination with AM-BC and oral antipoly, associated with irritability and rejection Food, with intravenous treatment (cefuroxima), with no history of respiratory disease. It was assessed on the third day by ophthalmology due to an increase in left periorbital volume and flushing, yellowish secretions and it was found in the examination skin lesion of the upper eyelid towards inner edge, with outlet of pus. Preseptal cellulitis was diagnosed in the left eye, treatment with intravenous metronidazole, ceftriaxone and vancomycin. The patient was admitted to the intensive care unit and the patient was shown to have left-sided secretions with negative results, and the following were indicated: Hb 7.6 g / l, PCR 48mg / dl, erythrocyte sedimentation 57mm / h, methicillin-resistant Staphylococcus aureus positive hemoculture. On the seventh day, previous treatment for worsening was discontinued and meropenem and linezolid were started. Left ethmoiditis was observed on computed tomography and magnetic resonance imaging. It was evaluated by otorhinolaryngology and ophthalmology. Surgical treatment: incision and eyelid drainage. Conclusions: Orbital cellulitis and orbital abscesses are commonly associated with dissemination of a sinus infection (sinusitis), hospital observation and intravenous treatment should be assessed in children younger than one year. Treatment should be precocious and multidisciplinary to avoid complications.

OBJECTIVE: We aimed to summarize and map the existing global population-based data on active trachoma and trichiasis. Detailed distribution maps of various infectious diseases have proved a valuable tool in their control. Such maps play an important role in assessing the magnitude of the problem, defining priority areas for control, monitoring changes, and advocacy. Until now, information on trachoma prevalence at within country levels has not been systematically collated, analysed and reported. METHODS: We gathered the last 18 years' worth of reported data on active trachoma in children aged less than 10 years, and the last 25 years of reported trichiasis in adults aged 15 years and over from 139 population-based surveys in 33 countries. We collated these data into one database using the "district" (second administrative level) as the standard unit of reporting. We used Geographical Information Systems as a database and cartographic tool to generate a global map of the prevalence of trachoma and trichiasis. FINDINGS: We obtained data on active trachoma and trichiasis from 18 countries in the WHO African Region, 6 in the Eastern Mediterranean Region, 3 in the South-East Asia Region, 3 in the Western Pacific Region and 2 in the Region of the Americas. In 23 countries suspected of having endemic trachoma no reliable district-level population-based data were available. In China and India, data were limited to a few districts. The data highlighted important regional differences and marked national variations in prevalence of active trachoma and trichiasis. CONCLUSION: This is the first attempt to summarize and map the existing population-based data on active trachoma and trichiasis. The lack of data in many countries remains an important obstacle to trachoma control efforts.

OBJECTIVE: Limited surveys and anecdotal data indicate that trachoma is endemic in the states of Eastern Equatoria and Upper Nile in southern Sudan. However, its magnitude and geographical distribution are largely unknown. We conducted surveys to ascertain the prevalence and geographical distribution of trachoma, and to identify targets for control interventions. METHODS: Population-based cross-sectional surveys were conducted in nine sites in southern Sudan between September 2001 and June 2004. Two-stage random cluster sampling with probability proportional to size was used to select the sample. Trachoma grading was done using the WHO simplified grading system. FINDINGS: A total of 17 016 persons were examined, a response rate of 86.1% of the enumerated population. Prevalence of signs of active trachoma in children aged 1-9 years was: TF = 53.7% (95% confidence interval (CI) = 52.1-55.3); TI = 42.7% (95% CI = 41.2-44.2); TF and/or TI = 64.1% (95% CI = 62.5-65.5). Prevalence of trichiasis (TT) in children aged less than 15 years was 1.2% (95% CI = 0.9-1.4), while TT prevalence in persons aged 15 years and above was 9.2% (95% CI = 8.6-9.9). Women were more likely to have trichiasis compared to men (odds ratio (OR) = 1.57; 95% CI = 1.34-1.84). Tentative extrapolation to the states of Eastern Equatoria and Upper Nile estimates that there is a backlog of 178 250 (lower and upper bounds = 156 027-205 995) persons requiring surgery and the entire population, estimated to be over 3.9 million, is in need of the SAFE strategy to control blinding trachoma. CONCLUSION: Trachoma is a public health problem in all nine of the study sites surveyed. The unusually high prevalence of active trachoma and TT in children points to the severity of the problem. There is urgent need to implement trachoma control interventions in trachoma endemic regions of southern Sudan.

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Background and Objective: In 2013 we implemented an asynchronous telemedicine circuit for the diagnosis of eyelid diseases (tele-eyelid), connecting the outpatient primary healthcare with the hospital's specialists. The purpose of this study is to assess the use of telemedicine in the diagnosis of eyelid diseases by primary care teams, to evaluate its usefulness and to analyse the epidemiology of the pathological conditions referred to the tertiary level hospital, as well as the need for surgery., Materials and Methods: This study was carried out in the Spanish public health system, in a mainly rural area assisted by the Institut Català de la Salut (ICS) and Althaia Xarxa Assistencial Universitària de Manresa. This is a retrospective, descriptive analysis of the telematic consultations undertaken between 2013 and 2019. The consultations between 2018 and 2019 underwent a further descriptive retrospective-prospective analysis to assess the conditions referred to the hospital., Results: Unnecessary referrals were avoided in 72% of telematic consultations. More than 50% of primary care practitioners used tele-eyelid. Up to 68% of the referrals were due to eyelid tumours, 50% needed surgery and 18%, a biopsy. Moreover, we found a high reliability between telematic and face-to-face diagnosis., Conclusions: Teleophthalmology applied to eyelid pathology is a useful tool to improve access to specialized care and helps solving pathological conditions. It avoids unnecessary consultations and increases efficiency, both in primary and hospital care., (Copyright © 2022 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

De manera retrospectiva se revisaron las historias clínicas de 141 pacientes con diagnóstico histológico de lesiones pigmentadas, en el período comprendido entre enero de 1989 y diciembre de 1999. El 54 % de los pacientes fueron menores de 20 años. El 57 % eran del sexo femenino. El 57 % de estas lesiones se localizaron en la conjuntiva. El 73,8 % de las lesiones de los párpados eran nevus intradérmicos y en la conjuntiva el 53,8 % correspondieron a nevus compuestos. En nuestra serie encontramos que el grupo de mayor incidencia fue el de pacientes menores de 20 años de edad y el sexo femenino presentó el mayor número de casos. La conjuntiva constituyó la localización anatómica prevaleciente. El nevus intradérmico fue el diagnóstico más frecuente en los párpados y en la conjuntiva predominaron los nevus compuestos.A retrospective review of the medical histories of 141 patients with histological diagnosis of pigmented injuries from January, 1989, to December, 1999, was made. 54 % of the patients were under 20. 57 % were females. 57 % of these injuries were localized in the conjunctiva. 73.8 % of the eyelid injuries were intradermic nevus, whereas in the conjunctiva 53.8% corresponded to compound nevus. We found in our series that the group of patients under 20 had the highest incidence and that females presented a larger number of cases. The conjunctiva was the prevailing anatomical localization. The intradermic nevus was the most frequent diagnosis in the eyelids and the compound nevus predominated in the conjunctiva.