Perceptions of Child Caregivers About Factors Influencing Childhood Corneal Blindness in a Rural Community in Southern Nigeria

Objectives: Corneal scarring secondary to measles keratopathy and vitamin A deficiency is the leading cause of childhood blindness in Nigeria and can be prevented by simple primary health care measures. Nutrition, health education and measles immunization are crucial components of preventive eye health services in the prevention of corneal blindness. This study explores the perceptions of child caregivers in a rural community in southern Nigeria to the uptake of preventive health services and child weaning practices which may influence corneal blindness.Methods: Qualitative methods were used to explore infant feeding practices and barriers to immunization services in a typical rural setting in southern Nigeria. The views of mothers, health workers and other  important members of the community were sought. Document study was used to assess the implementation of the World Health Organization (WHO) recommendation that vitamin A prophylaxis be administered to allmeasles patients to prevent vitamin A deficiency.Results: Traditional views had a strong influence on infant feeding practices and the utilization of immunization services. The interplay between nutrition and corneal blindness was unknown to mothers in this study. The strong influence of the views of members of the extended family on child rearing and health-seeking behaviour was also discovered.Conclusion: This study highlights the need for cultural sensitivity in designing and implementing health programmes and clearly demonstrates the importance of community support and participation to ensure theireffectiveness and sustainability. It was suggested that the target group of health education programmes be expanded to include influential members of the family and the community.Key words: corneal blindness, exclusive breastfeeding, measles keratopathy, vitamin A deficiency

A comparison of the NEIVFQ25 and GQL-15 questionnaires in Nigerian glaucoma patients

Chigozie A Mbadugha, Adeola O Onakoya, Olufisayo T Aribaba, Folashade B AkinsolaGuinness Eye Centre, Department of Ophthalmology, Lagos University Teaching Hospital, Lagos State, NigeriaAim: To compare two vision-specific quality of life (QOL) instruments – the disease-specific 15-item Glaucoma Quality of Life questionnaire (GQL-15) and the nonglaucoma-specific 25-item National Eye Institute Visual Function Questionnaire (NEIVFQ25).Methods: The QOL of 132 glaucoma patients being managed in Lagos University Teaching Hospital and an equal number of controls matched for age and sex was assessed using two vision-specific instruments: GQL-15 and the NEIVFQ25. The categorization of the severity of glaucoma into mild, moderate, and severe disease was determined using the degree of visual field loss. The Statistical Package for the Social Sciences (version 15; SPSS Inc, Chicago, IL) software program was used for analyzing the data obtained. Spearman’s correlation coefficients were used to assess the correlation between the scores from the two questionnaires.Results: Patients had the greatest difficulty with activities affected by glare and dark adaptation in the GQL-15. Driving and general vision were the factors most affected in the NEIVFQ25. The Spearman rho values showed strong correlations (rho > 0.55) between the NEIVFQ25 and GQL-15 QOL scores for the total number of participants (rho: –0.75), total number of cases (rho: –0.83), and the mild (rho: –0.76), moderate (rho: –0.75), and severe (rho: –0.84) cases. There was a moderate correlation (rho: –0.38) for QOL scores of controls. Cronbach’s alpha was 0.94 for the GQL-15 and 0.93 for the NEIVFQ25, showing high internal consistency for both questionnaires.Conclusion: The GQL-15 and the NEIVFQ25 questionnaires showed high internal consistency, correlated strongly with each other, and were reliable in the assessment of glaucoma patients in this study.Keywords: primary open-angle glaucoma, quality of life questionnaires, GQL-15, NEIVFQ2

Pattern of Conjunctival Masses Seen At Guinness Eye Centre Luth Idi-Araba

Background: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations.Objective: To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995- Dec 2007).Method: A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded.Results: Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85years with a male to female ratio of 1.26: 1. Three hundred and eightyeight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients.Conclusion: Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.Key words: Conjunctival masses, pterygium, pingueculu