Visual outcome following optic neuritis: A 5‑year review

Background: Optic neuritis is a demyelinating inflammatory disease of the optic nerve that typically affects young adults especially females, and is usually associated with multiple sclerosis especially in Caucasians. The prognosis for visual recovery is usually good but with poor quality.Objective: The objective was to determine the level of improvement of vision after an attack of optic neuritis in Port Harcourt, Nigeria.Design: A retrospective hospital‑based study was performed.Setting: Eye Clinic, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.Data Extraction: Medical records of all cases of optic neuritis seen at the Eye Clinic of UPTH over a 5‑year period (January 2006–December 2010) were retrieved and relevant data including age, sex, presenting symptom, and visual acuity (VA) were extracted. The VA at discharge 12 weeks later was noted. Our diagnosis of optic neuritis was based on the presence of low vision, dyschromatopsia, and peri‑ocular pain.Results: Over 24,000 patients were seen during this period, and 27 cases were optic neuritis (0.1%). Of the 27 cases of optic neuritis, 20 cases were retro‑bulbar neuritis (74.1%), while seven (25.9%) were papillitis. There were 16 females and 11 males giving a female to male ratio of 3:2. Most cases (75%) at presentation had VAs<6/24. By the 12th week, most visual acuities (77.1%) had improved to 6/12 or better.Conclusion: This study confirms widely documented evidence that there is improvement in visual acuity after an attack of optic neuritis. Even though the risk of developing multiple sclerosis following optic neuritis is said to be low in blacks, these patients should still be followed up for sometime especially as some may go on to develop other complications of demyelination

Screening for Uncorrected Refractive Error Among Primary School Children In South-South Nigeria

A study on screening for uncorrected refractive error in primary school children has not been done in Bayelsa State, South-South Nigeria. This study aims to screen for uncorrected refractive error among primary school children in Bayelsa State and use the data to plan for an effective school Eye Health Program. A cross sectional study on screening for uncorrected refractive error in school children was carried out in Yenagoa Local Government Area of Bayelsa State, South-South Nigeria in June 2009. A multistage sampling technique was used to select the study population (pupils aged between 5-15 years). Visual acuity for each eye was assessed by an optometrist and a community ophthalmic nurseoutside the classroom, at a distance of 6 meters. Unaided distant visual acuity of 6/12 or less which improved with pin hole,in a child not currently using corrective glasses, was considered an uncorrected refractive error. Funduscopy was done inside a poorly lit classroom. Data was analyzed with EPI INFO version 6 and scientific calculator. A total of 1,242 school children consisting of 658 females and 584 males were examined.About 97.7% of pupils had normal vision of 6/6 while 26 eyes (1%) had visual acuity of 6/12 or less. Of the 26 eyes with visual acuityof 6/12 or less, 22improved when presented with pin-hole. A total of 12 pupils had uncorrected refractive error, giving a population prevalence of 0.97%.The 8-10 yearage-range had the highest proportion (41.7%) of cases of uncorrected refractive error. The prevalence of uncorrected refractive error in primary school children in Bayelsa State, South-South Nigeria was 0.97% and most eyes (97.7%) had normal vision.Keywords: Uncorrected refractive error, Screening, School children

The relationship between vertical cup‑disc ratio and body mass index in Port Harcourt, Nigeria

Background: Glaucoma is the leading cause of irreversible blindness in the world and risk factors to developing glaucoma must be determined early to prevent blindness from the disease. Aim: To determine the relationship between vertical cup disc ratio (VCDR) and body mass index (BMI) in a population screened for glaucoma in Port Harcourt, NigeriaMaterials and Method: This study was part of a one-day screening exercise for glaucoma at the University of Port Harcourt. Demographic data included age, sex, race and occupation. Height was measured with a wall-mounted tape and weight with a bathroom scale. Intraocular pressure was measured with Perkins applanation tonometer and funduscopy was with direct ophthalmoscope. BMI was calculated as weight in kilograms divided by the square of height in meters (Weight/Height2).Results: A total of 491 subjects were screened; consisting of 230 males (46.8%) and 261 females (53.2%). The mean age was 35±13.29 years. About 28%(n=141) of the participants were overweight while 17.7%(n=87) were obese. The mean BMI was 25.39 ± 4.82 kg/m2 and the mean VCDR for both eyes was 0.38±0.13mmHgratios have no units. Most participants (n=864; 89.4%) had normal VCDR. Only 102 (10.6%) had cupped discs. There was no statistically significant relationship between BMI and VCDR (P= 0.947; R2 = 0.01).Conclusion: Obesity was not associated with a larger VCDR.Keywords: Body mass index, relationship, vertical cup/disc ratioNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Prevalence and Causes of Blindness in Ikwerre Local Government Area of Rivers State, Nigeria

Background: The target of the world Health organization (WHO) to reduce blindness to less than 0.5% in all countries and <1% in individual countries is only possible if all major blinding eye diseases are detected early and treated or even prevented from occurring. Unfortunately, this target is frequently hampered by the problem of access to effective eye care in developing countries. The aim of this study is to determine the prevalence and causes of blindness in Ikwerre Local Government Area of River State, NigeriaMethods: A population based, multistage random sampling survey on the causes of blindness was carried out between the 8th of September and  20th of October 2007. Various household in Seven villages picked from seven communities in the LGA were involved in the survey. Basic eye examination involving visual acuity measurement, pen torch assessment, funduscopy and intra-ocular pressure measurement were done. Data was recorded with WHO / PBL form.Results: A total of 1513 persons were examined consisting of 754 males and 759 females. The prevalence of bilateral blindness was 1.26%; the commonest causes of bilateral blindness were cataract (37), glaucoma (31.5%) and optic atrophy (15.7%). There were more bilaterally blind females (68%) compared to males (32%). They were all above 50 years old. The main causes of unilateral blindness were cataract (42.3%), glaucoma (15.4%) optic atrophy (11.5%) and corneal opacity (11.5%).Conclusion: The burden of blindness can be reduced through effective planning and implementation of programmes for making cataract surgeries affordable, training of health personnel on basic eye care and establishment of a functional state programme for prevention of blindness.Key words: Blindness; Prevalence; Causes; Ikwere Nigeri

Causes of Vitreous Haemorrhage In Port Harcourt; A 3 Year Review.

Background: Vitreous haemorrhage is one of the causes of visual loss and arises from a number of risk factors. This study aims to expose the causes of vitreous haemorrhage in our environment and evaluate the pattern of visual loss.Methods: A 3 year retrospective review of medical records of patients presenting in the outpatient clinic of the eye department in University of Port Harcourt Teaching Hospital was carried out between 2007 and 2009.Demographic data and causative factors of vitreous hemorrhage were amongst the information culled from the records and analysed.Results: Twenty-six patients were seen over the period under review out of which 18 of them were males. The age range was 12-70 years. Trauma accounted for 73.1% of all the causes of vitreous haemorrhage.Conclusion: Trauma is a significant cause of vitreous haemorrhage in our environment affecting the younger age group. The poor presenting visual acuity reflects the severity of causes of vitreous haemorrhage in our environment. Awareness needs to be increased on the causes and risk factors of vitreous haemorrhage.Keywords: Vitreous haemorrhage;Aetiology; Vision loss; Nigeria

Subjective Optic Disc Assessment and Single Measurement Intraocular Pressure to Screen a Cohort of Pensioners in Port Harcourt

Background: There is good evidence that screening can detect primary open-angle glaucoma (POAG) in adults and that early treatment of adults reduces the number of persons who develop visual field defects or those whose visual field defects progress.1 Aim: To screen and identify persons with glaucoma among pensioners in Port Harcourt. Materials and Method: The study was carried out among retirees in Rivers State. Verbal consent was obtained from the Treasury Department of the Rivers State Ministry of Finance and also from all individuals who participated in the study. Demographic data including age and sex were recorded in the WHO/PBL eye examination form. Ocular examination consisted of uncorrected VA measured with Snellen’s chart and then pin-hole presented when VA < 6/18. Intraocular pressure was measured with Perkin’s applanation tonometer. The external eye was examined with a pen torch and funduscopy with the direct ophthalmoscope. Glaucoma was diagnosed based on an IOP>21mmHg and VCDR >0.5 or VCDR = 0.8 with normal intraocular pressure. Results: A total of 176 subjects (351 eyes) were examined; 135(76.7%) male and 41(23.3%) female patients. The mean age of respondents was 62.33 (±±8.58) years. Of the 176 subjects examined, 14 had glaucoma (based on the defined criteria of VCDR > 0.5 and IOP above 21mmHg or VCDR = 0.8 with normal IOP) giving a relative frequency of 7.95%. Ten subjects had ocular hypertension. Conclusion: There is a need to screen at-risk people for glaucoma especially the aged. In doing this, sufferers will be identified early and appropriate treatment instituted to prevent visual loss.Key words: glaucoma screening, cohort, pensioners, Port Harcour

Prevalence of Refractive Error in a Rural Ogoni Community in Southern Nigeria

Background: Refractive error, though not life-threatening, can negatively affect the quality of the socio-economic life of an individual, especially in a poor-resource setting.Objective: To determine the prevalence and pattern of the distribution of refractive error in Kegbara-Dere community in Gokana local government area of Rivers State, Nigeria.Methods: This study forms part of a baseline ocular health survey among the residents of Kegbara Dere (K-Dere), a community designated for community eye outreach in Gokana local government area of Rivers State, Nigeria. Visual acuity was tested outdoors using the Snellen chart and near vision with a near vision chart. Objective refraction was done in a darkened area with a streak retinoscope, and subjectively refined to determine therefractive status of the subject. For this study, refractive error is defined aspresenting vision < 6/6 and improved by one or more lines on the Snellen chart when looking through the pinhole or with the aid of a minimum of 0.25D lens. Myopia was diagnosed when the correction of the eye was more than minus 0.25DS; hypermetropia, when the correction of the eye was > + 0.25DS. All astigmatic refractions were recorded at their spherical equivalent.Results: The prevalence of refractive error was 28.5%. Of this,  hypermetropia was seen in 19.2%, while myopia was seen in 9.3% of the cases. Most of the study population (71.5%) were emmetropic. The  highest number of emmetropes and hypermetropes occurred in the 20-29 year age group, while most myopes were seen in the 50-59 year age group.Conclusion: Refractive error constitutes a significant cause of ocular morbidity in Kegbara community.Key words: refractive error, rural communit

Evaluation of Teachers’ Performance of Vision Screening in Primary School Children in Port Harcourt

Objective: To evaluate the ability of primary school teachers toperform simple vision screening on their school pupils, so asto determine if they can provide the first level of school visionscreening services, and refer to the ophthalmologist for furtherevaluation when necessary.Methods: Using a multi-stage sampling technique, 130 teacherswere randomly selected from 13 schools in Port HarcourtLocal Government Area of Rivers State. They were trained forsix hours at a skills acquisition workshop on vision disordersin children and vision screening using Snellen visual acuitycharts. Subsequently, they screened 1,300 of their pupils, whowere all re-screened by the research team.Results: One hundred and ten female (84.6%) and 20 maleteachers (15.4%) participated in the study. Seventy (53.8%)were from public schools while 60 (46.2%) were from privateschools. The sensitivity of the teachers’ visual acuity test,compared to that of the research team, was 53.3%, with a highspecificity of 94.6%. The positive and negative predictivevalues of the teachers’ test were also high. The teachers’ visualacuity measurements showed moderate agreement with thatof the research team with a Kappa score of 0.604.Conclusion: The study concluded that trained primary schoolteachers can effectively perform vision screening in schoolchildren using Snellen visual acuity charts for early detectionand treatment of vision disorders in school pupils

Bilateral congenital microphthalmos

Background: Microphthalmos ia a rare congenital anormaly of the eye. Aim: To report a case of microphthalmos in an otherwise normal neonate Case report: A one-week-old full-term female neonate delivered by elective caesarian section to a mother who received ante-natal care in one of the choicest obstetric clinics in Port Harcourt is presented. The only congenital anomaly present was bilateral congenital microphthalmia. Conclusion: Microphthalmos is an uncommon condition whose management is very challenging. High motivation on the part of the parents can make the child live a fulfilled life and appear cosmetically acceptable. Keywords: Microphthalmos, Congenital, Female neonatePort Harcourt Medical Journal Vol. 2 (3) 2008: pp. 278-28

Cortical blindness in children in Port Harcourt, Nigeria

No Abstract