Eye health myths, misconceptions and facts: results of a cross-sectional survey among Nigerian school children

Background. Vision is critical in the development and performance of children. Factual knowledge of eye health is important for preventive and promotive eye health. Objectives. To identify eye health myths and misconceptions that are considered true in a population of Nigerian school children, with the aim of prioritizing eye health messages. Material and methods. In a cross-sectional survey, self-administered questionnaires were used to obtain pupils’ views, which were elicited using statements presented as 22 ocular health myths/misconceptions and three facts in two selected secondary schools in Enugu state, Nigeria in October 2014. Frequency counts and percentages were generated using SPSS v18. A p-value of <0.05 was considered statistically significant. Results. The sample comprised 404 males (48.5%) and 429 females (51.5%), age range 10–17 years, median 13–14 years; IQR –6). More pupils in the senior classes had previously listened to eye health talks. The most common beliefs concerned the statements “staying close to the television set will damage vision” 782 (93.9%), and “reading in dim light will damage vision” 758 (90.8%). The least commonly-held misconception was “children do not need regular eye checks” 119 (14.3%). The greatest amount of uncertainty concerned the statements “short-sightedness is worse than long-sightedness” 421 (51%), and “crossed-eye disorders cannot be corrected in children” 383 (46%). Conclusions. The majority of the children do not have information on eye health. Despite the persistence of these myths and misconceptions, this study has demonstrated that the children had a reasonable level of knowledge in terms of safe eye care practices. However, appropriate eye health messages still need to be provided

Rural eye care practice-survey of ophthalmology resident doctors in Nigeria

AIM:To determine the factors affecting the uptake of rural practice by trainee ophthalmologists in Nigeria.METHODS: This cross sectional survey was conducted among Nigerian Ophthalmology resident doctors attending an annual Neuro-ophthalmology course jointly organized by the West African College of Surgeons and the Ophthalmological Society of Nigeria Southeast-South south zone(OSN SESS), preparatory to the part 1 and 2 fellowship examination from 15th to 21st June 2015. A pre-tested closed-ended questionnaire adapted and modified for this study was self-administered at the end of the course to all consenting participants. Data on respondent's socio-demographics and views about rural eye care services were collected. In addition, information was collected on the respondents' perception of rural practice, willingness to practice in the rural area, benefits and barriers to working in the rural area. Data were analyzed using the statistical package for social sciences(SPSS), version 19(SPSS Inc., Chicago, Illinois, USA). Descriptive analysis yielded measures of central tendency while comparative statistical tests for significance of observed inter-group differences was performed using Chi-square. In all comparisons, the P- value for statistical significance was set at PRESULTS: The total number of respondents was 44 aged 32.9±0.56y, comprising of 24(54.5%)males and 20 females with a male to female ratio of 1:0.8. All the respondents viewed the current state of rural service in Nigeria as unsatisfactory. Majority(75.0%)of the respondents were unwilling to practice Ophthalmology in rural areas. More females than males indicated willingness to work in the rural area. The commonest potential benefit of working in a rural area mentioned by the respondents was “health services for the poor/serving the country”(37; 84%)while all the respondents(44; 100%), noted absence of infrastructure/facilities as drawback to rural ophthalmic practice.CONCLUSION: All the respondents in our survey had an unsatisfactory perception of Nigeria's rural eye-care service and majority were unwilling to work in a rural area

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

Causes and emerging trends of childhood blindness: findings from schools for the blind in Southeast Nigeria.

AIM: To ascertain the causes severe visual impairment and blindness (SVI/BL) in schools for the blind in southeast Nigeria and to evaluate temporal trends. METHODS: All children who developed blindness at 15 years) children were compared with younger (≤15 years) children. RESULTS: 124 children were identified with SVI/BL. The most common anatomical site of blindness was the lens (33.9%). Overall, avoidable blindness accounted for 73.4% of all blindness. Exploring trends in SVI/BL between children ≤15 years of age and those >15 years old, this study shows a reduction in avoidable blindness but an increase in cortical visual impairment in the younger age group. CONCLUSIONS: The results from this study show a statistically significant decrease in avoidable blindness in children ≤15 years old. Corneal blindness appears to be decreasing but cortical visual impairment seems to be emerging in the younger age group. Appropriate strategies for the prevention of avoidable childhood blindness in Nigeria need to be developed and implemented

Amblyopia in rural Nigerian school children

Purpose: Globally, amblyopia remains a common cause of visual impairment in children. Early screening and treatment is necessary to prevent permanent visual loss. This study aimed to evaluate the prevalence, etiologic factors, and characteristics of amblyopia among rural, public primary school children in Ijebu East Local Government Area (IELGA) of Ogun state, southwest Nigeria.Materials and Methods: The study was a cross-sectional descriptive study conducted among pupils of randomly selected public primary schools in IELGA from 27th October to 7th November 2014. Data on sociodemographics, ocular history, and ocular examination were collected. Descriptive and comparative analyses were performed. Values of P 0.05 were considered statistically significant.Results: There were 1180 public primary school pupils enrolled for the study. The data of 1153 pupils were analyzed giving a 97.7% response rate. The mean age was 9.2 ± 2.8 years with age range from 4 years to 16 years. There were more female students (586; 50.8%) with a male-to-female ratio of 1:1.03. Majority of the pupils were from the Yoruba ethnic group (819; 71.0%) and from basic one academic class (236; 20.5%). Six of the examined pupils were found to have amblyopia, giving a prevalence of 0.5%. The following three types of amblyopia were seen in this study: anisometric amblyopia (2; 0.17%), ametropic amblyopia (2; 0.17%), and strabismic amblyopia (2; 0.17%). Three pupils had unilateral amblyopia while three had bilateral amblyopia. All amblyopias were classified as mild-to-moderate amblyopia.Conclusion: The prevalence of amblyopia among these rural school children was low. However, because children with amblyopia could have a lifetime of blindness ahead of them, the number of “blind person years” in those whose blindness started in childhood is enormous. Early screening is required to prevent the attendant consequences of socioeconomic burden following visual impairment in this vulnerable subsection of the Nigerian rural populace.Keywords: Amblyopia, children, nigeria, rural, visual impairmen

Microbial Keratitis—A Review of Epidemiology, Pathogenesis, Ocular Manifestations, and Management

Purpose: To review updated knowledge on the epidemiology, pathogenesis, clinical features, and treatment of microbial keratitis (MK).Source of Data: International and local journals containing current literature on MK were sourced through the Internet.Study Selection: Findings consistent with our objectives were compiled and reviewed. Data Extraction: Data were extracted using endnotes. Results: MKis a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. The pathogenesis comprises molecular mechanismsdescribing microbial activities which involve virulence and host factors  responsible for ocular tissue damage and progression in keratitis. Clinical features include redness, pain, tearing, blurred vision, and inflammation, but symptoms vary depending on the causative agent. The primary treatment goal is the elimination of causative organism in addition to neutralization of virulence factors and healing of damaged host tissue. A timely review of our current understanding of MK with the recent advances in its treatment will ensure improved management outcomes. Conclusion: Optimal outcome from management of MK will require an  updated knowledge of its pathogenesis, clinical features, and treatment protocols, especially in sub-Saharan Africa where its prevalence is on the increase.Keywords: Epidemiology, management, microbial keratitis, ocular manifestations, pathogenesi

Challenges in horizontal integration of eye care services into the pre-existing rural primary care structure: an operations research perspective from Nigeria

Background . The provision of population-wide, accessible, affordable, acceptable and evenly distributed qualitative eye care services remains a recurrent challenge to eye care organizations worldwide. Objectives . To report the challenges encountered in setting up eye care service in a pre-existing primary health care facility in rural Nigeria and also audit the common causes of eye disorders in rural setting southeast of Nigeria. Material and methods . The study was an operations research study conducted at Akpuoga-Nike between February and April 2011. Demographic and ophthalmic clinical data were collected. Health system-, community- and patient-determined challenges were catalogued and analyzed using Epi Info Statistical software for Windows, version 6. Univariate analysis was performed for data distribution testing. Analytical statistics were performed, with p < 0.05 considered statistically significant. Results . A total of 481 (males, 144 (29.9%); females, 377(70.1%)) patients aged 42.3 ± 20.2 SD years (range 4–80 years) were seen. The leading eye disorders were refractive error – 28.9%, and cataract – 16.4%. The operations challenges encountered included difficulties with community sensitization/advocacies, inadequate infrastructure and mobile equipment, as well as lack of eye care manpower, consumables and funding deficits. Conclusions . Health system-related issues were the main challenges encountered. Recruitment of an adequate number of rural eye care workforce, provision of needed material resources, adequate funding and engendering community participation in rural eye care delivery through grass roots advocacy and health service public education would overcome the challenges

Visual acuity and refractive changes among pregnant women in Enugu, Southeast Nigeria

Introduction: Pregnancy has been associated with changes in the eye which could be physiological, pathological, or exacerbation of pre-existing ocular conditions. Visual acuity (VA) and refractive error (RE) changes are part of the physiological changes that may occur during pregnancy. Objective: The objective of the present study was to investigate changes in VA and RE across two different trimesters and six weeks postpartum among pregnant women in Enugu, southeast, Nigeria. Materials and Methods: A longitudinal study was adopted and pregnant women in their second trimester attending antenatal clinic at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu were consecutively recruited. A questionnaire was used to obtain information on their sociodemographic and clinical characteristics. Visual acuity was measured and refractive error monitored in second and third trimesters and 6 weeks after delivery. Results: The mean age of women was 30.81 (±5.49) years and a majority of them were civil servants. There was a worsening of VA for distance in more women in the third trimesters compared to the second trimester. There was no significant change in VA for near throughout the study period. There was an increased myopic shift in more pregnant women during the third trimester (40; 40.0%) compared to second trimester (36; 36.0%). The most common refractive error found among the women was simple myopia. These changes resolved six weeks postpartum. Conclusion: Pregnancy worsened VA for distance and the most common RE in pregnant women was simple myopia. However, these changes resolved during the postpartum period

Challenges in horizontal integration of eye care services into the pre-existing rural primary care structure: an operations research perspective from Nigeria

Background . The provision of population-wide, accessible, affordable, acceptable and evenly distributed qualitative eye care services remains a recurrent challenge to eye care organizations worldwide. Objectives . To report the challenges encountered in setting up eye care service in a pre-existing primary health care facility in rural Nigeria and also audit the common causes of eye disorders in rural setting southeast of Nigeria. Material and methods . The study was an operations research study conducted at Akpuoga-Nike between February and April 2011. Demographic and ophthalmic clinical data were collected. Health system-, community- and patient-determined challenges were catalogued and analyzed using Epi Info Statistical software for Windows, version 6. Univariate analysis was performed for data distribution testing. Analytical statistics were performed, with p < 0.05 considered statistically significant. Results . A total of 481 (males, 144 (29.9%); females, 377(70.1%)) patients aged 42.3 ± 20.2 SD years (range 4–80 years) were seen. The leading eye disorders were refractive error – 28.9%, and cataract – 16.4%. The operations challenges encountered included difficulties with community sensitization/advocacies, inadequate infrastructure and mobile equipment, as well as lack of eye care manpower, consumables and funding deficits. Conclusions . Health system-related issues were the main challenges encountered. Recruitment of an adequate number of rural eye care workforce, provision of needed material resources, adequate funding and engendering community participation in rural eye care delivery through grass roots advocacy and health service public education would overcome the challenges