Impact of congenital color vision defect on color‑related tasks among Secondary School Students in Ibadan, Southwest Nigeria

Aim: To assess the difficulties encountered by students with congenital color vision defects in daily living and school activities.Methods: A cross‑sectional descriptive study conducted among students of public secondary schools in Ibadan, Nigeria. Structured questionnaires were administered to all consenting students to determine difficulties encountered in aspects of color matching and color recognition.Results: A total of 1635 students (male:female 1:1.1) were screened of whom 37 (2.3%) had congenital color vision defect. A statistically significant proportion (P < 0.0001) of them reported difficulties with color‑related school work and day‑to‑day activities.Conclusion: Congenital color vision deficient students encounter some difficulty with school work and daily living activities, hence a need to identify them early and give appropriate career guidance.Keywords: Color vision, color vision defect, congenita

Students' perceptions of the learning environment in two Nigerian medical schools offering different curricula

Objective: Compare the results of administering the DREEM questionnaire in two Nigerian medical schools offering traditional and student-centred curricular respectively, to identify any differences in the learning environment and appreciate advantages of the more modern curriculum.Methods: A survey design was used. Data was analysed using the DREEM scoring rubric. The independent t-test was used to compare results. Setting: The DREEM questionnaire was administered to final year medical students at two participating centres. Participants: Final year students of a teacher-centred and a student-centred medical school. Results: There were 138 respondents – 50 (96.2% of the final year students) from the teacher centred school and 88 (59.1% of the final year students) from the student-centred school. The mean total DREEM score was 117+22.3 in the former and 119 +23.6 in the latter (p = 0.798). Mean age of students in the teacher centred school was 28 ± 5.28 years, while that of the student-centred school was 23 ± 1.83 years (p < 0.05). Conclusion: The mean total DREEM score proximity between the schools suggests that the younger students using a more student-centred curriculum have less of an appreciation of their improved learning environment than is expected. Thus, the hidden curriculum could be lagging behind the written one. The older students in the teacher centred environment have a more mature appreciation of their learning climate.  Funding: Personal sourcesKeywords: medical education, Nigeria, curriculum, DREE

Congenital orbital teratoma: a case report and challenges of its management in a resource limited setting

We report a case of congenital immature teratoma of the orbit in a female neonate who presented on the second day of life. She was successfully managed by modified exenteration. The patient was lost to follow-up intermittently over a 24-month period without recurrence of the tumour. However the patient could not be traced again after 24 months of follow up. This happened despite concerted efforts to educate the parents. The possible implications of this and other social factors, in a challenging and resource limited setting, on the prognosis of the disease and cosmetic outcome are considered.Pan African Medical Journal 2012; 12:

Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study

Introduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. Methods: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. Results: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. Conclusion: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical services.Pan African Medical Journal 2016; 2

Economic Constraints in Managing Complicated Cataracts

Practicing in a low‑resource environment presents unusual challenges with the management of even the simplest conditions when physicians must choose between investigating their patients and proceeding to intervention with patients’ limited resources. Failure to perceive light, inaccurate light projection, or sonographic evidence of retinal detachment are all reasons to avoid cataract surgery, as there is no hope of visual recovery. However, when a patient already accepts a blind eye, but wants cataract surgery to remove the cosmetic blemish of leukocoria, they may question the necessity of preoperative ultrasonography because of the additional expense involved. Market forces can be defined as the economic factors affecting the price, demand, and availability of a commodity. In recent times, market forces have played increasingly significant role in the accessibility of standard healthcare in Nigeria; as Medical Services in Public Hospitals are no longer free, and the majority of Nigerians fund their healthcare through out‑of‑pocket expenditure, which places a burden on the economically challenged and uninsured. The main objective is to emphasize the importance of ultrasonography in a blind eye for the purpose of determining the position of a suspected retinal detachment, and to introduce the black occlusive intraocular lens (IOL). This is a report of cosmetic cataract surgery performed in a blind eye, with failure to achieve desired results, due to anteriorly displaced retinal detachment. This case describes the difficulties encountered with cosmetic cataract surgery in a low resource setting and discusses the use of occlusive IOL to improve cosmetic outcome. Cataract surgery is to be avoided in the presence of total retinal detachment. However, black occlusive IOL implantation may provide a cosmetically acceptable outcome.Keywords: Cosmetic cataract extraction, leukocoria, occlusive intraocular lens, retinal detachment traumatic catarac

Red flags in neuro-ophthalmology

Some diseases of the brain presenting with visual symptoms are life threatening and need urgent management. This article discusses possible causes of double vision, vision loss with headache, and non-ocular vision loss

Encouraging Subspecialty Practice by Constructively Influencing Trainees Early in their Careers Will Improve Advocacy for Neuro-Ophthalmology among Nigerian Ophthalmologists

This study was conducted to assess the current knowledge, attitude, and perception of Nigerian ophthalmologists toward neuro-ophthalmology; identify barriers to the uptake of neuro-ophthalmology as a desired subspecialty; and make recommendations to improve interest in neuro-ophthalmology training. This was a cross-sectional survey of ophthalmology consultants and trainees from the six geopolitical zones of Nigeria, who were attending a national ophthalmology conference. All consenting respondents voluntarily completed a validated self-administered questionnaire. There were 107 respondents comprising 56 males and 51 females. Majority (54.2%) of respondents were aged 40 years and younger. Almost half (47.8%) worked at tertiary level, public health institutions. Only 10.3% worked in private practice. Neuro-ophthalmology exposure was short and occurred mainly during residency (65.7%), while 15% had no exposure at all. Most (80.4%) indicated only nominal interest in neuro-ophthalmology, while only 4.6% indicated a desire to specialize in the field. Financial constraint was the main obstacle to the pursuit of subspecialty training. A total of 86% of respondents admitted that full (34%) or partial (52%) Funding would motivate them to pursue the training. Among respondents desiring part sponsorship, more than half were willing to augment such sponsorship with personal funds. In conclusion, career interest in neuro-ophthalmology is very low among Nigerian ophthalmologists. Late and limited exposure to neuro-ophthalmology during medical training may be contributing factors. Early exposure to neuro-ophthalmology during medical school rotations, coupled with the provision of sponsored subspecialty training opportunities, will serve to increase enrollment in the field

Iridescent anterior chamber crystals following minor ocular trauma

Anterior chamber crystals occur due to severe ocular trauma or chronic inflammation. The affected eye has often suffered irreversible visual loss. Iridescent crystals are rare and they have interesting clinical features which have been reported commonly among Caucasian populations. This condition has never been reported in an African patient. A 21-year-old Nigerian woman presented with a history of trauma to the left eye and subsequent progressive loss of vision. Polychromatic crystals were observed incidentally in the anterior chamber. This is the first report of this unusual clinical condition in an African patient

Severe Ophthalmological Complications of Thyroid Disease are Rare in Ibadan, Southwestern Nigeria: Results of a Pilot Study

Background Ocular manifestations of thyroid dysfunction constitute a wide clinical spectrum ranging from minor ocular discomfort, lid retraction, lid lag and ocular injection, to sight threatening eyeball protusion and optic nerve compression. Thyroid-related eye disorders are most commonly associated with Graves' disease, and this most frequently occurs in the setting of hyperthyroidism. However, in 10% of cases, typical eye signs have also been reported in euthyroid and hypothyroid states. The severity of thyroid eye disease has been linked to cigarette smoking. There is very little data specifically reporting the ocular manifestations of thyroid disease among black African patients and there is no known report from Nigeria. This pilot study therefore focused on documenting the ocular signs accompanying thyroid dysfunction in a black African population. Aim To evaluate the pattern of ocular complications, among patients treated for thyroid disorders, in a major Nigerian teaching hospital. Results A total of 75 patients with thyroid dysfunction, were evaluated, comprising 63 females and 12 males. There was a very low prevalence of smoking among patients (<5%). Graves' disease was the commonest thyroid disorder, representing 70% of cases. Seventy-eight percent of patients were hyperthyroid, 11.8% were euthyroid and only 9.8% of patients were hypothyroid. Commonest systemic symptoms were neck swelling (68.6%), weight loss (63.8%), tremors (60.9%) and palpitations (59.4%). Two-thirds of patients reported ocular symptoms consisting mainly of painless eye swelling (66.7%) and ocular irritation (58%). Conjunctival injection, lid lag and lid retraction were the commonest ocular signs. Chemosis, severe proptosis and ocular motility disorder were very rare. Optic neuropathy was found in 4 patients but was related to pre-existing glaucoma. Majority of patients required only ocular emollients and tear supplements. Conclusion Severe ocular complications of thyroid disorders were uncommon in this cross-section of Nigerian patients. This may be linked to the very low prevalence of cigarette smoking among Nigerians or genetic and environmental factors linked to their African heritage