Presumed optic disc melanocytoma in a young Nigerian: a diagnostic challenge

Optic disc melanocytoma (ODM) is a rare, benign, deeply pigmented ocular tumor arising from melanocytes within the optic disc or from any part of the uvea. It occurs more in dark skinned individuals and females. We report a 17‑year‑old female who presented to our outpatient department with a history of poor distant vision from childhood, worse in the right eye. Ocular examination revealed visual acuity of 6/36 and 6/18 in the right and left eyes, respectively, which improved to 6/9 bilaterally with a pinhole. There was a relative afferent pupillary defect in the right eye, and a posterior segment examination of same eye showed a raised pigmented optic disc lesion occupying the inferior two-thirds of the optic disc and obscuring the lower disc margin. Both the anterior and posterior segments of the left eye were normal. A diagnosis of presumed ODM was made. Spectacles were prescribed, and the patient was counseled on regular follow‑up to monitor progression. ODM should be considered in patients presenting with a pigmented optic disc lesion. Regular follow‑up with fundus photography is advocated.Keywords: Melanocytoma, optic disc, pigmented ocular tumo

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.

OBJECTIVES: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. DESIGN: Descriptive case study. SETTING: Neonatal intensive care units in Nigeria. PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential

Pattern of ocular abnormalities among students attending schools for the hearing impaired in Ibadan, South-West Nigeria

Objective: To describe the pattern of ocular abnormalities among students attending schools for the hearing impaired in Ibadan, Oyo State, Nigeria. Materials and Methods: This was a descriptive cross-sectional study  conducted from February to March 2016 among hearingimpaired students who were older than 10 years. Students were selected from four schools using systematic random sampling. The students’ sociodemographic characteristics, visual complaints, ocular, and family history were recorded using an interviewer-administered semistructured questionnaire. Ocular examination and refraction was conducted on each student. Data were analyzed using IBM-SPSS Statistics for Windows 22 (IBM Corp., Armonk, NY, USA) with the test of association performed using the chi-square test and level of statistical significance set at P-value &lt;0.05.Results: A total of 335 students participated in the study. Mean age was 17 ± 2.9 years (range 11–39 years). The prevalence of ocular abnormalities among the  participants was 56.1%. These included allergic conjunctivitis 8 (2.4%), retinitis pigmentosa 3 (0.9%), phthisis bulbi 3 (0.9%), cataract 2 (0.6%), and Wardenburg syndrome 2 (0.6%). Seventy-five (22.4%) respondents were with coexisting ocular abnormalities. Conclusion: The prevalence of ocular abnormalities was found to be high among the hearing impaired, with refractive error being the most common. It is necessary for the eye care providers and other stakeholders to provide eye health education as well as affordable and accessible eye care services for hearing-impaired students so as to improve their overall quality of life.Keywords: children, hearing impaired, ocular abnormalities, students, visual impairmen

Prevalence and determinants of corneal blindness in a Semi-Urban population of southwest Nigeria

Purpose: To determine the prevalence and determinants of corneal blindness in a semi-urban population of Southwest Nigeria.Materials and Methods: This population-based, cross-sectional study was conducted over a period of two months from 3rd March to 30th April 2014. A multi-stage sampling method with probability proportional to size procedure was used to select 1002 participants. The study involved obtaining information from the participants on demographic data and ocular history suggestive of the causes of corneal blindness using interviewer-administered questionnaires. Ocular examinations of the anterior and posterior segments of the participants were performed using pen touch, magnifying loupe, slit lamp and direct ophthalmoscope. The data collected were analyzed using the Statistical Package for Social Sciences software version 22. Summary statistics was presented using frequency tables, charts, means and rates. The level of statistical significance was set at 5%.Results: There were 1002 participants (410 males and 592 females). Their age range was 5–92 years with a mean age of 43 (±17) years. Eleven participants (13 eyes) had corneal blindness with a prevalence of 1.1% (95% confidence interval: 0.5–1.7). Corneal blindness accounted for 9.6 and 20.4% of bilateral and unilateral blindness, respectively. The prevalence of corneal blindness in the communities was greater among the male respondents, the older age groups, the farmers and the participants with lower educational status. The major causes of corneal blindness in the study were post-microbial keratitis (36.4%) and trauma (27.2%).Conclusion: Corneal blindness is still a major cause of both unilateral and bilateral blindness. Preventive measures for corneal blindness need to be further strengthened. In addition, affordable and accessible corneal surgery facilities should be established.Keywords: Corneal blindness, developing countries, prevalence, semi-urban populatio