Prevalence of blindness and visual impairement in Atakunmosa west local government area of southwestern Nigeria

No Abstract.Tanzania Health Research Bulletin Vol. 9(2) 2007: pp.126-13

A comparison of the NEIVFQ25 and GQL-15 questionnaires in Nigerian glaucoma patients

Chigozie A Mbadugha, Adeola O Onakoya, Olufisayo T Aribaba, Folashade B AkinsolaGuinness Eye Centre, Department of Ophthalmology, Lagos University Teaching Hospital, Lagos State, NigeriaAim: To compare two vision-specific quality of life (QOL) instruments – the disease-specific 15-item Glaucoma Quality of Life questionnaire (GQL-15) and the nonglaucoma-specific 25-item National Eye Institute Visual Function Questionnaire (NEIVFQ25).Methods: The QOL of 132 glaucoma patients being managed in Lagos University Teaching Hospital and an equal number of controls matched for age and sex was assessed using two vision-specific instruments: GQL-15 and the NEIVFQ25. The categorization of the severity of glaucoma into mild, moderate, and severe disease was determined using the degree of visual field loss. The Statistical Package for the Social Sciences (version 15; SPSS Inc, Chicago, IL) software program was used for analyzing the data obtained. Spearman’s correlation coefficients were used to assess the correlation between the scores from the two questionnaires.Results: Patients had the greatest difficulty with activities affected by glare and dark adaptation in the GQL-15. Driving and general vision were the factors most affected in the NEIVFQ25. The Spearman rho values showed strong correlations (rho > 0.55) between the NEIVFQ25 and GQL-15 QOL scores for the total number of participants (rho: –0.75), total number of cases (rho: –0.83), and the mild (rho: –0.76), moderate (rho: –0.75), and severe (rho: –0.84) cases. There was a moderate correlation (rho: –0.38) for QOL scores of controls. Cronbach’s alpha was 0.94 for the GQL-15 and 0.93 for the NEIVFQ25, showing high internal consistency for both questionnaires.Conclusion: The GQL-15 and the NEIVFQ25 questionnaires showed high internal consistency, correlated strongly with each other, and were reliable in the assessment of glaucoma patients in this study.Keywords: primary open-angle glaucoma, quality of life questionnaires, GQL-15, NEIVFQ2

Ocular Findings in Acquired Immunodeficiency Syndrome Patients in Lagos, Nigeria.

Background: There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized countries and are not representative of the spectrum of ocular complication of HIV and it's prevalence in developing countries.Objective: To determine the prevalence of ocular disorders in adult (>15 years ) AIDS patients at PEPFAR clinic in Lagos, Nigeria.Material and Methods: All consecutive adult Seropositive HIV/AIDS patients of PEPFAR Clinic at the Lagos University Teaching Hospital between February 1st - March 15th 2008 were enrolled into the study Cross sectional and non randomized, convenient study was used. Biodata and medical history were recorded on interviewer administered questionnaire. Participants were examined according to standard protocol comprising visual acuity, intraocular pressure, anterior segment examination with slit lamp biomicroscopy, dilated fundoscopy and fundus photograph where necessary. PCV, CD4+ count, viral load at diagnosis, stage of HIV disease were extracted from patients' records. Details of drug were regimen also recorded. Data analysis was performed with EPI-Info 6.04 version; Chi square and student t test used to describe statistical association.Results: A total of 400 patients were studied. Male:female ratio was 1.7 and mean age was 40 years (S.D.+ 9.12). Ocular disorders seen in 78.5% of patients; HIV related ocular disorders occurred in 45 (11.3) patients. Conjunctival microvasculopathy 166 patients (41.5%), pingueculum in 114 (28.5%), pterygium in 76 (19.0%), refractive error in 93 (23.3%), cataract in 12 (3.0%), and 22 (5.5%) Glaucoma suspects. HIV retinopathy and allergic eye disease in one patient each (0.3%). Presumed Cytomegalovirus retinitis 7 (1.8%), 14 (3.5%) Toxoplasmosis, 8 (2.0%) HZO, and 15 (3.8%) Presumed Squamous cell carcinoma. Eighty six (21.5%) of the patients had no abnormality. 91.4% of eyes examined had visual acuity with best correction of > 6/18. CD4+ in 79.3% of the patients was >200cells/ul and <5% had counts<50cells with an overall mean of 406cell/ul. 375 (93.8%) patients were on Highly Active Antiretroviral therapy (HAART), and 25 (6.2%) were not.Conclusion: Study revealed low prevalence of HIV related ocular disorders. This could be due to few patients at low level of immunosuppresion where the infections occur.Keywords: Aids, Ocular Manifestation, Prevalenc

Pattern Of Refractive Errors At Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria

Objective: The objective of this paper is to determine the prevalence and pattern of cases of refractive error reported at the eye clinic of the Obafemi Awolowo University Teaching Hospital, Ile-Ife (OAUTH). Methodology: All consecutive new patients seen at the eye clinic of the OAU Teaching Hospital, Ile-Ife, between October 1997 and September 1998 were examined. Those patients who complained of difficulty in seeing near or far objects, whose vision improved with the pinhole or those who had difficulty doing close work like reading or threading needles were refracted by the author. Results: Out of the 1,550 new patients seen within the period of study, eight- hundred and sixty eight (54.9%) had refractive errors. Refractive errors were twice as common among the females than the males in this study. Myopia was the commonest spherical error (22.7%). The highest degree was -12.0DS. Presbyopia was present in 31.8% of the patients. The youngest age of presentation for presbyopia was 36 years. Astigmatism occurred in 55.8% of the patients seen. Most of the patients (68.3%) had myopic astigmatism. One of the two patients who had anisometropia had developed amblyopia in the more hypermetropic eye. Conclusion: Since refractive errors were found to be very common in this study increased health education and provision of adequate, affordable and modern facilities for correction of refractive errors are highly recommended. Nigerian Journal of Ophthalmology Vol. 11(2) 2003: 76-7

Assessment of Human and Material Resources Available for Primary Eye Care Delivery in Rural Communities of Southwestern Nigeria

Integration of primary eye care (PEC) into the existing primary healthcare (PHC) system is efficient in reaching rural communities. Baseline assessment of human and material resources for primary eye care delivery in a rural local government area of southwestern Nigeria with projected population of 126 625 was conducted. Data on number and cadre of all PHC facilities and health-workers were collected. All facilities were visited and materials required for basic PEC inspected. Forty-one (42.3%) community health extension workers, 42 (43.3%) health assistants, 3 (3.1%) community officers of health and 11 (11.2%) registered nurses administered PHC in 27 health facilities. No worker had training in PEC and none of the centres had all the materials for basic PEC delivery. Although procurement of materials and training of health-workers in basic PEC delivery is required, the healthcare facilities and workers currently available are adequate to commence integration of PEC into the PHC system

Vernal keratoconjunctivitis at Guinness eye centre, Luth (A five year study)

No Abstract

Pattern of Conjunctival Masses Seen At Guinness Eye Centre Luth Idi-Araba

Background: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations.Objective: To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995- Dec 2007).Method: A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded.Results: Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85years with a male to female ratio of 1.26: 1. Three hundred and eightyeight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients.Conclusion: Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.Key words: Conjunctival masses, pterygium, pingueculu

Central corneal thickness changes following manual small incision cataract surgery

Olufisayo Temitayo Aribaba,1 Olusesan Adetunji Adenekan,1 Adeola Olukorede Onakoya,1 Adekunle Rotimi-Samuel,1 John Olutola Olatosi,2 Kareem Olatunbosun Musa,1 Akinyele Oyedele Oyefeso,1 Folashade Bolanle Akinsola11Guinness Eye Centre, Lagos University Teaching Hospital, 2Department of Anaesthesia, College of Medicine, University of Lagos, Lagos, NigeriaAim: To determine changes in post-cataract surgery central corneal thickness (CCT) at Lagos University Teaching Hospital by assessing the time it takes for the cornea to return to its preoperative thickness value.Methods: This study is a prospective, hospital-based open within-patient controlled study with the unoperated eye controlling for the operated one.Results: Two hundred patients with 400 eyes were analyzed, with bilateral mature cataract in 47.0%. All the patients had manual small incision cataract surgery with posterior chamber intraocular lens implant. There is an increase in mean baseline CCT from 520.6±20.3 µm by 76.9 µm (597.9±30.4 µm) 24 hours after cataract surgery followed by relative reduction in the mean CCT to 555.2±24.7 µm and 525.1±19.7 µm at 2 weeks and 12 weeks, respectively. Increase in mean CCT in the unoperated and contralateral eyes were recorded in this study.Conclusion: There was a transient increase in corneal thickness following cataract surgery with subsequent decrease to preoperative thickness by 12th and fourth week in the operated and unoperated eyes, respectively. Corneal manipulations during cataract surgery must be minimal to reduce visual rehabilitation time to barest minimum. Postoperative refraction will be better at eighth week to 12th week considering the time it takes for the CCT to return to its stable preoperative values.Keywords: post-cataract surgery visual rehabilitation, pachymetry, recovery time, unoperated ey

Two cases of Vogt–Koyanagi–Harada’s disease in sub-Saharan Africa

Tunji S Oluleye,1 Adekunle O Rotimi-Samuel,2 Adetunji Adenekan,2 Olubanke T Ilo,2 Folashade B Akinsola,2 Adeola O Onakoya,2 Olufisayo T Aribaba,2 Adebukunola Adefule-Ositelu,2 Kareem O Musa,2 Yele Oyefeso2 1Retina and Vitreous Unit, Department of Ophthalmology, University College Hospital, Ibadan, 2Department of Ophthalmology, Guinness Eye Center, Lagos University Teaching Hospital, Lagos, Nigeria Abstract: Vogt–Koyanagi–Harada’s (VKH) disease has been reported to be rare in sub-Saharan Africa. Two Nigerians with the disease are presented in this report. The first patient, a 32-year-old pregnant Nigerian woman presented with a 1-month history of bilateral blurring of vision, persistent headache, and alopecia. Presenting visual acuity was 1 m counting fingers in both eyes. Examination revealed vitiligo and poliosis with bilateral panuveitis as well as bilateral exudative retinal detachment. A clinical assessment of complete VKH disease was made. The patient commenced systemic and topical steroids that resulted in remarkable recovery of vision and control of inflammation. The second patient, a 56-year-old Nigerian woman presented with severe headache, tinnitus, and visual loss in both eyes of 2 weeks duration. There was associated redness of both eyes and photophobia. Examination showed visual acuity of Hand motion (HM) and counting fingers at 1 meter (CF). in the right and left eye, respectively, with bilateral panuveitis and bilateral exudative retinal detachment. Subsequent follow-up showed poliosis, vitiligo, and sunsetting fundus appearance. The patient improved with systemic and topical corticosteroids. Developing a high index of suspicion is necessary in diagnosing VKH disease, even in sub-Saharan Africa. Prompt institution of appropriate treatment prevents blindness. Keywords: Vogt–Koyanagi–Harada’s disease, exudative retinal detachment, vitiligo, ­sub-Saharan Afric