Eye injury requiring hospitalisation in Enugu Nigeria: A one-year survey

BACKGROUND: - Eye injuries are becoming relatively important, not only as a cause of presentation but also a cause for admission at health centres in Nigeria. In view of this trend being observed and the factthat most eye injuries requiring hospital admission may give rise to grave ocular consequences. This study set out to highlight the pattern of eye injuries admitted into the eye ward of a Nigerian TeachingHospital over one year. This is with a view to providing suitable protocols in the management and prevention of such injuries and their attendant ocular complications.MATERIALS AND METHODS: - A retrospective study of all cases of eye injury admitted into the eye ward of the University of Nigeria Teaching Hospital, Enugu, Nigeria in the year 2003 was conducted. All thehospital records of such cases were studied.RESULTS: - Eye trauma constituted 15.95% of 257 admissions. Males comprised 78%, and children comprised 22%. The commonest agents of injury were gunshot pellets, glass, metal and wood pieces.Activities implicated commonly were assault/combat,  agricultural/artisan work-related accidents and road traffic accidents. A variety of sight threatening complications were noted in these subjects. Visual acuity on presentation ranged between 6/12 and no light perception (NPL). After treatment, approximately 80% of the injured eyes were blind.CONCLUSION: - Eye injuries requiring hospitalisation in Nigeria are not only common, but also severe. Safety measures and health education campaigns should help reduce this public health problem

Surgical Indications for Eye Removal in Enugu, South Eastern Nigeria

Objective: To determine the surgical indications for removal of the eye in Enugu in south eastern Nigeria. Method: Retrospective case series review. Results: At the University of Nigeria Teaching Hospital Enugu, between 1st January 1994 and 31st December 2003, 106 eyes of 106 patients, comprising 71 (67.0%) males and 35 (33.0%) females, aged 6-72 years (mean 31.8), were removed by evisceration (59; 55.7%), enucleation (35; 33.0%), and exenteration (12; 11.3%). Severe open globe injury (49; 46.2%), infection (29; 27.4%), malignant tumour (15; 14.2%) and blind painful eye (14; 13.2%) were the indications for eye removal. Eye removal was more frequent in males (67.0%), among farmers (21.7%), and among the 21-40 year age group (41.5%). Patients who had their eyes removed constituted 0.42% of new outpatients, 4.63% of inpatients and 7.83% of patients who had eye operations during the study period. Conclusion: The indications for eye removal were mainly for preventable/curable causes. There is, therefore, a need to improve promotive, preventive and curative eye care delivery to reverse this trend. Keywords:eye, removal, indications, Enugu, NigeriaNigerian Journal of Opthalmology Vol. 15 (2) 2007: pp. 44-4

Patients’ satisfaction with eye care services in a Nigerian Teaching Hospital

Background: Understanding the patientsf perception of services received is essential as the parameters important to the patient may be quite  different from that to the eye health provider.Aim: This study aims to evaluate patientsf satisfaction with the care received from the pioneer teaching hospital in south.eastern Nigeria and use it to audit services.Materials and Methods: This was a descriptive cross.sectional study. An interviewer.administered questionnaire was administered to 307 consecutive consenting patients seen at the eye clinic of the University of Nigeria Teaching Hospital Enugu in April 2013. The questionnaire asked questions regarding satisfaction with the time spent in the clinic, attitudeof various categories of staff, physical facilities, cleanliness of the clinic and willingness to come again to the clinic or recommend it to others.Results: The respondents were more satisfied with the attitude of the doctors and nurses than that of revenue and medical records clerks (P = 0.001). Most patients, 288 (93.8%) expressed satisfaction with the overall cleanliness of the eye clinic; 220 (71.7%) and 288 (93.8%) were not satisfied with the toilet facilities and cost of services, respectively. Only 140 (45.6%) participants will recommend the hospital to others strongly, 145 (47.2%) will do so hesitantly.Conclusion: Majority of the patients were satisfied with the services  received. The major dissatisfaction points were cost of services and inadequate toilet facilities.Key words: Developing country, eye care services, patient satisfactio

Refractive errors in children with autism in a developing country

Background: In a resource.limited country visual problems of mentally challenged individuals are often neglected.Aim: The present study aims to study refractive errors in children diagnosed with autism in a developing country.Materials and Methods: Ophthalmic examination was carried out on children diagnosed with autism attending a school for the mentally  challenged in Enugu, Nigeria between December 2009 and May 2010. Visual acuity was assessed using Lea symbols. Anterior and posterior segments were examined. Cycloplegic refraction was performed. Datawas entered on the protocol prepared for the study and analyzed using Statistical Package for the Social Sciences version 17 (Chicago IL, USA).Results: A total of 21 children with autism were enrolled in the school; 18 of whom were examined giving coverage of 85.7%. The age range was 5.15 years, with a mean of 10.28 years (standard deviation } 3.20). There were 13 boys and 5 girls. One child had bilateral temporal pallor of the disc and one had bilateral maculopathy with diffuse chorioretinal atrophy.  Refraction revealed 4 children (22.2%) had astigmatism and 2 children (11.1%) had hypermetropia.Conclusion: Significant refractive error mainly astigmatism was noted in the children with autism. Identifying refractive errors in these children early and providing appropriate corrective lenses may help optimize their visual functioning and impact their activities of daily life in a positive way.Key words: Autism, developing country, refractive erro

Awareness regarding eye donation among stakeholders in Srikakulam district in South India

Background There is a huge need for the availability of transplantable donor corneas worldwide to reduce the burden of corneal blindness due to corneal opacity. Voluntary eye donation depends on the awareness levels of various stakeholders in the community. This study aimed to assess the awareness level regarding eye donation among various stakeholders in Srikakulam district in the state of Andhra Pradesh, India. Methods 355 subjects were selected from the district using multi stage random sampling. A pre tested semi structured questionnaire was used to collect information regarding each individual’s awareness, knowledge, and perception regarding eye donation. Each response was scored individually and a total score was calculated. Univariate and multivariate regression analysis was used to determine the factors associated with willingness towards eye donation and increased awareness levels. Results Of the 355 subjects interviewed, 192 (54%) were male and 163 (46%) were female. The mean age of the stakeholders was 35.9 years (SD ±16.1) and all the study subjects were literate. Ninety-three percent of subjects were aware of the concept of eye donation. Knowledge levels were similar among the teaching community and persons engaged in social service, but lower among students (p < 0.05). Among the stakeholders, there was considerable ambiguity regarding whether persons currently wearing spectacles or suffering from a chronic illnesses could donate their eyes. Older age group (p < 0.001), female gender (p < 0.001) and education (p < 0.001) were associated with increased knowledge levels. 82% of the subjects were willing to donate their eyes and this was unaffected by gender or geographical location (rural vs urban). Conclusions Awareness levels and willingness to donate eyes are high among the stakeholders in Srikakulam district in India. The services of stakeholders could be utilized, in conjunction with other community based eye donation counselors, to promote awareness regarding eye donation among the general population

Medical doctors’ strike actions – ethical reflections

Medical Doctors’ strike actions had been relatively rare events in medical history. However, in recent times over the past two decades, they have become commonplace in most developing countries, including Nigeria. Most strike actions have been called over issues bordering onwelfare/pay packages, quality of health infrastructures and patient care. The outcomesof these strike actions have either been favourable or unfavourable, depending onwhich side of the divide you belong to. Doctors’ strike actionsmay be explicable due to various reasons, but they are not ethically entirely justifiable beyond any doubt, apart from when the utilitarian viewpoint (bringing the greatest good to the greatest number of people) is adopted. Strike actions are better prevented by all the stakeholders in the health sector. The medical profession should be prepared to give up strikes as industrial pressure tools, and rather look for equally effective methods consistent with their unique roles as caregivers.Niger Med J. Vol. 48, No. 3, Oct. – Dec., 2007: 105 –109 .Keywords: Doctors, strike actions, ethical, reflections

Relationship between Corneal Biomechanical Properties among Pregnant Women in a Tertiary Hospital in Nigeria

Objective: In Nigeria, many pregnant women as well as health‑care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them. Materials and Methods: A prospective longitudinal study was used. One hundred and thirty‑four pregnant women attending the Obstetric Clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. Changes in CCT, CS, and IOP were monitored at the second and third trimesters and 6‑week postpartum. Data obtained were analyzed using Statistical Package for the Social Sciences version 20. The effect of duration of pregnancy on these variables was determined using simple linear regression and further analysis was done using Bonferroni’s post hoc test. Results: The women were aged 18–48 years, with a mean age of 30.81(±5.49) years and majority of them (61.2%) were multigravida. The duration of pregnancy varied inversely and significantly with CS (P &lt; 0.05) and IOP (P &lt; 0.000) with the least values recorded in the third trimester, while it varied directly and also significantly with CCT (P &lt; 0.000) with the highest value obtained in the third trimester. A negative correlation that was significant only in third trimester was found between CCT and IOP (P &lt; 0.02) and CS (P &lt; 0.03). Conclusion: There was a progressive increase in CCT with a corresponding decrease in CS and IOP across the trimesters of pregnancy, but these changes reversed 6‑week postpartum.Keywords: Central corneal thickness, cornea sensitivity, intraocular pressure, pregnanc

Post operative diploid after cataract surgery 6 years review in a teaching hospital

No Abstract.Ebonyi Medical Journal Vol. 4 (1&2) 2005 pp. 16-1

Topical‑intracameral anesthesia in manual small incision cataract surgery: A pilot study in a Tertiary Eye Care Center in Africa

Background: Cataract remains a leading cause of blindness worldwide. Manual small incision cataract surgery (MSICS) is currently practiced as the technique of choice in Sub‑Saharan Africa to reduce the backlog of cataract blindness. Optimal pain control during surgery remains a challenge to cataract surgeons.Aim: To evaluate the efficacy and safety profile of the use of aqueous topical/intracameral anesthesia in MSICS.Materials and Methods: In this hospital‑based case series, consecutive patients presenting at the eye clinic with operable cataract and willing to have surgery were enrolled. Baseline sociodemographics (age, sex, and occupation), type of cataract by morphology, pain perception, and surgeons experience were recorded. Descriptive and comparative statistical analyses were performed. A P &lt; 0.05 was considered statistically significant.Results: The surgeries were performed on 30 eyes of 16 (53.3%) males, and 14 (46.7%) females (sex ratio, 1:0.9) who were aged 60.3 ± 16.32 standard deviation (SD) (95% confidence interval [CI] of mean; 53.94–66.13) (range; 20–98 years). Using the visual analog scale, the mean pain score was 2.7 SD ± 2.215 (1.87–3.53 95% CI). There was no correlation between degree of pain perception and gender (P = 0.806) or age (P = 0.388). Patient’s cooperation was excellent in 22 (73.3%) of patients. Intraoperative complications occurred in 3 (10%) of patients.Conclusion: The mean pain score in this study is low. There is no correlation between perception of pain with gender or age. Surgeons experience is excellent in most of the cases. This method of anesthesia in MSCIS is adequate for patient’s comfort and safe cataract surgery.Key words: Anesthesia, cataract surgery, intracameral, topica

Visual loss in a school for the blind in Nigeria

No Abstract