Visual Outcome Of Traumatic Cataract Surgery In Ibadan, Nigeria

To review the visual outcome of traumatic cataracts operated at the University College Hospital, Ibadanwith the view to making recommendations for improved outcome. All patients operated at the University College Hospital Ibadan, Nigeria between May 1999 and April 2004with traumatic cataractwere reviewed retrospectively to determine visual outcome andmain causes of poor visual outcome 6/18, 10 (32.2%) < 6/18-3/60,while 32.2%of the cases reviewed remained blind or had visio

Cystercercus Larva in the Anterior Chamber of the Eye of a 7- year-old Nigerian Girl

The case of a 7 year old Nigerian girl with features of traumatic uveitis which was later found to have anterior chamber cestode larva infestation is presented. Though uncommon, ocular cestode larva infestation should be considered when children present with features of ocular inflammation

Suppurative Keratitis in a Nigerian Tertiary Hospital

Purpose: Microbial keratitis is a potentially vision threatening condition that requires prompt diagnosis and treatment to prevent untoward outcome. This study describes the demographic characteristics, clinical presentation, and microbiological features of patients diagnosed with suppurative keratitis between April 2005 and May 2006 in the University College Hospital lbadan, Nigeria. Methods: A retrospective review of case notes of patients who presented with suppurative keratitis between April 2005 and May 2006 was done. The outcome measures were: interval between onset and presentation, aetiology of keratitis, extent of corneal involvement and final visual acuity. Results: There were 23 (65.7%) males and 12 (34.3%) females. The mean age was 32.8&plusmn;18.64. A positive history of trauma was present in 48% of patients. In 6% of the patients, the predisposing factor was severe allergic conjunctivitis. The presenting visual acuity was &lt;6/60 in 66% of the patients, &lt;6/18&mdash;6/60 in 14%, and 6/6-6/18 in 17% of the patients. At discharge, 40% had a visual acuity of 6/6-6/18, 15% had borderline vision (&lt;6/18-6/60), 40% had severe visual impairment (&lt;6/60), while 5% had no light perception. The most common organisms isolated microbiologically were Staphylococcus aureus in 28.6%, Streptococus pneumoniae in 8.6%, and Pseudomonas aeruginosa in 2.9%. The risk factors for poor visual outcome were late presentation, farming, stromal thinning and large corneal involvement. Conclusion: Bacteria is responsible for most cases of suppurative keratitis in a developing country like Nigeria and the risk for poor visual outcome includes late presentation, farming, stromal thinning and large corneal involvement.Key words: cornea, suppurative keratitis, visual outcom

Visual Outcome after Small Incision Cataract Surgery in Southwestern Nigeria

Objective: The aim of this study was to determine the visual outcome of patients who had manual small incision cataract surgery in a high volume secondary eye hospital in southwestern Nigeria, and to identify reasons for poor outcome. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at St Mary&rsquo;s Catholic Eye Hospital, Ago Iwoye (SMEH) Nigeria conducted between May and October 2007. A total of 146 patients who presented to the hospital and met the inclusion criteria were recruited for the study. Patients were examined preoperatively, 1st day and 8th week post-operatively. Results were analyzed using the SPSS statistical software. Significant association was taken at 95% confidence interval i.e. &lt; 0.05. Results: A total of 146 patients who met the inclusion criteria were studied. The mean age was 65.3&plusmn;10.04 years; and the male to female ratio was 1.4:1. Preoperatively, 110 patients (75.3%) were blind in the operated eye, while 33 patients (22.6%) were blind in both eyes at presentation. At 1st day post-operatively, 17 patients (11.6%) had pinhole visual acuity of 6/6-6/18. Out of 137 patients that had refraction, 114 patients (83.2%) had a visual acuity of 6/6-6/18. The number of blind patients also reduced from 33 (22.6%) to 1(0.7%). Uncorrected refractive error was the commonest cause of poor vision post-operatively. Conclusion: This study demonstrates that good results can be obtained with small incision cataract surgery with intraocular lens implantation in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery.Key words: cataract, cataract surgery, visual outcom

Visual outcome after cataract surgery at the University College Hospital, Ibadan

Aim: The aim of this study was to determine the visual outcome of patients who had cataract surgery in the University College Hospital Ibadan. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at the University College Hospital conducted between May and October 2007. A total of 184 patients who presented to the hospital and met the inclusion criteria were recruited into the study. Patients were examined preoperatively, 1st day postoperatively and 8th week postoperatively. Results: The mean age was 66.5 years; and the male to female ratio was 1.2:1. Preoperatively, 137 patients (74.5%) were blind in the operated eye, while 39 patients (23.6%) were blind in both eyes at presentation. At 1st day postoperatively, 87 patients (47.3%) had pinhole visual acuity of 6/6-6/18. Best corrected vision after refraction eight weeks postoperatively showed that 127 patients out of 161 patients (78.8%) had good vision while 28 patients (17.4%) had borderline vision, and six patients (3.8%) had severe visual impairment after refraction. The number of bilaterally blind patients also reduced from 39 (23.6%) to one (0.6%). Uncorrected refractive error was the commonest cause of poor vision prior to refraction. Glaucoma was the commonest ocular co-morbidity accounting for poor vision in 9.1% of patients eight weeks after cataract surgery. Conclusion: This study demonstrates that good results can be obtained with cataract surgery and intraocular lens implantation in the developing world. More attention should be directed towards ensuring that successful outcomes are indeed being realized by continued monitoring of postoperative visual outcomes and prompt refraction for all patients.Keywords: Cataract, Visual outcome, Cataract surger

Squamous papillomas of the conjunctiva: A retrospective clinicopathological study

Background: There is very limited literature on squamous papillomas of the conjunctiva from Nigeria and sub-Saharan Africa. In an attempt to contribute to the literature on the subject, we studied the clinicopathological characteristics of patients histologically diagnosed with squamous papilloma of the conjunctiva in Ibadan, Nigeria. Materials and Methods: Clinical and pathological records of patients with histological diagnosis of squamous papilloma of the conjunctiva made in the Department of Pathology, University College Hospital, Ibadan, between January 1985 and December 2004, were reviewed. Results: There were totally 26 cases. Patients&rsquo; ages ranged from 2 to 58 years with a mean age of 32 years. Male to female ratio was 1.4:1. Size of tumors ranged from 2 to 10 mm. Duration of presenting complaints was from 2 months to 10 years. The lesions in 10 cases were located in the medial canthus, at or close to the limbus in another 10 cases, and in the tarsal conjunctiva in a single case. Five cases had no documentation of location. Sixteen cases (61.5%) had multiple papillomas. Four cases had a history of chemical injury (alkaline based &ndash; hair relaxer in a single case, acid based &ndash; wet cell car battery fluid in two cases, and unknown chemical in a single case) preceding the lesion by at least 6 weeks. Fourteen cases had koilocytosis on histology suggestive of Human Papilloma Virus (HPV) etiology. HIV screening test was negative in the three patients who had the screening done. Preoperative clinical diagnosis was squamous papilloma in 16 cases, pterygium in 6 cases and squamous cell carcinoma in 2 cases. Conclusion: In the environment where we practice, conjunctival squamous papilloma occurs most commonly in the fourth decade of life. Only very few cases are submitted for histological diagnosis. HPV infection and chemical injury are the main etiology. We strongly advocate that all excisions of the conjunctiva, irrespective of the clinical impression, should be submitted routinely for histological assessment.Keywords: Squamous, papillomas, conjunctivaNigerian Journal of Clinical Practice &bull; Jan-Mar 2012 &bull; Vol 15 &bull; Issue

Cataract surgery in Ibadan, Nigeria: Visual outcome and post-operative refractive error

Background: Cataract is the leading cause of blindness worldwide and can be treated by various surgical techniques with good visual outcome. Objective: To describe the visual outcome and post-operative refractive status among patients who had cataract surgery in a tertiary centre. Methods: In a retrospective study, the demographic data, type of cataract, surgical procedure and complications, visual outcome and post-operative refractive status of the treated eye were retrieved from the hospital records of all adult patients who had cataract surgery. Results: Four hundred and sixty eyes of 456 patients (mean age 61.2 ± 17.3 years, Male: Female = 1.1: 1) had cataract surgery during the study period January 2012 and December 2014. The pre-operative visual acuity was < 3/60 in 415 (90.2%) eyes. All the surgeries were performed under local anaesthesia with 331 (72%) eyes undergoing extracapsular cataract extraction while 129 (28%) had small incision cataract surgery. Visual outcome in those who had a minimum of six weeks follow-up revealed unaided visual acuity of ≥ 6/18 in 185 (56.9%) eyes. Following refraction, 237 (72.9%) eyes had acuity of ≥ 6/18. Post-operative spherical refractive error ranged from ­6.75D to +4.50D (mean -1.61 ± 1.41D) while cylindrical error ranged from 0.00DC to 6.00DC (mean 2.33 ± 1.80DC). Pre-existing ocular problems contributing to poor post-operative visual outcome included glaucoma (50; 15.4%), and age-related macular degeneration (10; 3.1%). Conclusion: Extracapsular cataract extraction gave better visual outcome compared with small incision cataract surgery, but a higher incidence of post-operative cylindrical error was observed

Risk factors for falls in older adults in a South African Urban Community

Background: Studies on falls in older adults have mainly been conducted in high income countries. Scant, if any, information exists on risk factors for falls in the older population of sub-Saharan African countries. Methods: A cross-sectional survey and a 12-month follow-up study were conducted to determine risk factors for falls in a representative multi-ethnic sample of 837 randomly selected ambulant community-dwelling subjects aged ≥65 years in three suburbs of Cape Town, South Africa. Logistic regression models were fitted to determine the association between (1) falls and (2) recurrent falls occurring during follow-up and their potential socio-demographic, self-reported medical conditions and physical assessment predictors. Results: Prevalence rates of 26.4 % for falls and 11 % for recurrent falls at baseline and 21.9 % for falls and 6.3 % for recurrent falls during follow-up. In both prospective analyses of falls and recurrent falls, history of previous falls, dizziness/vertigo, ethnicity (white or mixed ancestry vs black African) were significant predictors. However, poor cognitive score was a significant predictor in the falls analysis, and marital status (unmarried vs married) and increased time to perform the timed Up and Go test in the recurrent fall analysis but not in both. Other than the timed Up and Go test in recurrent falls analysis, physical assessment test outcomes were not significant predictors of falls. Conclusion: Our study provides simple criteria based on demographic characteristics, medical and physical assessments to identify older persons at increased risk of falls. History taking remains an important part of medical practice in the determination of a risk of falls in older patients. Physical assessment using tools validated in developed country populations may not produce results needed to predict a risk of falls in a different setting