Ocular Co-morbidity in Patients with Refractive Errors in Nigeria

Purpose: To d etermine the p attern and p revalence of other ocu lar p roblems seen in p atients with refractive errors in a Nigerian teaching hosp ital. Methods: A retrosp ective hosp ital-based review of all consecu tive p atients who p resented with signs and symp toms of refractive errors at the Obafemi Awolowo University Teaching Hosp itals Comp lex between 1st Janu ary 2007 and 31 Au gu st 2007. st Patients who had a d iagnosis of refractive error and su bsequ ently had d etailed eye examination were inclu d ed in this stu d y. Data was retrieved from the p atients’ clinical record s and analyzed with SPSS version 15. Results: Ou t of 724 new p atients seen within the stu d y p eriod , 235 had refractive errors (93 males and 142 females). Patients’ ages ranged between 7 and 74 years with a mean of 30.5+/ - 4.6 years. In more than half 54%) of the p atients, associated ocu lar co-morbid ities were d ocumented . The vision-imp airing d iseases d ocumented morbid ities in 56 (44.1) p atients were cataract 26 (20.5%), glau coma 20 (15.8%), d iabetic macu lop athy 3 (2.7%), amblyop ia, corneal op acities and CMV retinitis. Non vision-imp airing d isord ersd ocumented were conju nctivitis, 49 (38.6%); p terygium 6 (4.7%), chalazion 5 (3.9%), hypertensive retinop athy 4 (3.1%), d ry eyes and ep iscleritis. Immatu re cataract was responsible for abou t 2/ 3 of cases with p oor corrected visu al acu ity d ocumented in a large p rop ortion of the p atients 26 (11.1%). Conclusion: Patients with refractive errors need d etailed ocu lar examination for early d etection of other comorbid ities which may significantly affect vision and lead to avoid able blind ness and visu al imp airment.Key words: refractive errors, ocular co-morbid ity, glau coma, visu al imp airment, blind nes

Prevalence of blindness and visual impairement in Atakunmosa west local government area of southwestern Nigeria

No Abstract.Tanzania Health Research Bulletin Vol. 9(2) 2007: pp.126-13

Severity of Visual Field Loss at First Presentation to Glaucoma Clinics in England and Tanzania

Purpose: To compare severity of visual field (VF) loss at first presentation in glaucoma clinics in England and Tanzania. Methods: Large archives of VF records from automated perimetry were used to retrospectively examine vision loss at first presentation in glaucoma clinics in Tanzania (N = 1,502) and England (N = 9,264). Mean deviation (MD) of the worse eye at the first hospital visit was used as an estimate of detectable VF loss severity. Results: In Tanzania, 44.7% {CI95%: 42.2, 47.2} of patients presented with severe VF loss (< −20 dB), versus 4.6% {4.1, 5.0} in England. If we consider late presentation to also include cases of advanced loss (-12.01 dB to -20 dB), then the proportion of patients presenting late was 58.1% {55.6, 60.6} and 14.0% {13.3, 14.7}, respectively. The proportion of late presentations was greater in Tanzania at all ages, but the difference was particularly pronounced among working-age adults, with 50.3% {46.9, 53.7} of 18–65-year-olds presenting with advanced or severe VF loss, versus 10.2% {9.3, 11.3} in England. In both countries, men were more likely to present late than women. Conclusions: Late presentation of glaucoma is a problem in England, and an even greater challenge in Tanzania. Possible solutions are discussed, including increased community eye-care, and a more proactive approach to case finding through the use of disruptive new technologies, such as low-cost, portable diagnostic aids

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

<p>Abstract</p> <p>Background</p> <p>Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community.</p> <p>Methods</p> <p>A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007.</p> <p>Results</p> <p>A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%).</p> <p>Conclusions</p> <p>Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.</p

Conjunctivitis as seen in Ile-Ife

Objective: To survey the clinical pattern of conjunctivitis with the aim of identifying the etiologic agents of bacterial conjunctivitis and their antimicrobial sensitivity pattern.Method: Patients with clinical features of conjunctivitis form the cohort of this study. A retrospective study of 3,872 patients seen at the eye clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, between January 1997 and December 2000 was undertaken. Of these, 689 patients (17.8%) had conjunctivitis. Those diagnosed as having infective conjunctivitis had conjunctival swabs taken for microscopy, culture and sensitivity tests, and were investigated by standard microbiological methods.Results: Out of a total of 3,872 new patients seen over a 3-year period, 689 (17.8%) presented with conjunctivitis. Of these, allergic conjunctivitis was the most common type, seen in 580 patients (84.2%), followed by acute bacterial conjunctivitis in 98 patients (14.2%), while conjunctivitis secondary to physical trauma and toxic etiologies were seen in 8 (1.2%) and 3 (0.4%) patients respectively. Thirty-three patients (33.6%) with infective (acute bacterial) conjunctivitis had laboratory confirmed positive culture results. Thirteen patients (13.3%) developed complications such as corneal ulceration 9(9.2%) and perforation 4 (4.1%) before they presented at the hospital. Most of the bacterial isolates were sensitive to third generation cephalosporin, especially ciprofloxacin (89.8%-97.8% sensitivity).Conclusion: Conjunctivitis due to allergy and infective causes is a major cause of ocular morbidity. The high sensitivity of the isolates to ciprofloxacin (89.8-97.8%), chloramphenicol (68.9%), and gentamicin (84.9%), supports the appropriateness of using these drugs as first line drugs in the management of bacterial conjunctivitis. Corneal ulceration (9.2%) and perforation (4.1%) are major causes of ocular morbidity and blindness (6.1%), among patients with conjunctivitis as seen in Ile-Ife. There is a need for public eye health education and early referral of all cases of eye infections to an eye specialist to prevent blinding complications.Keywords: conjunctivitis, acute, aetiology and treatmentNigerian Journal of Ophthalmology Vol. 13 (1) 2005: 21-2

Isolated bileteral upper lid coloboma a case report

No Abstract. Nigerian Journal of Medicine Vol. 14(2) 2005: 224-22

Axial Length/Corneal Radius of Curvature Ratio and Refractive Status in an Adult Nigerian Population

Aim/Background: Associations between axial length (AL) to corneal radius of curvature (CR) ratio and refractive status in a healthy Nigerian adult population were studied. Materials and Methods: Healthy students and members of staff of Obafemi Awolowo Teaching Hospitals Complex, Ile‑Ife, South West Nigeria, free of obvious ocular diseases except possible refractive errors were recruited. Consecutive consenting volunteers were recruited by simple random sampling and a proportionate sample of each population based on its representative fraction in the hospital community was recruited. The study was conducted between June and August 2011. Noncycloplegic objective refraction was done and spherical equivalent refraction (SER) of the right eyes was used for calculation. The AL, CR, and keratometric readings were measured with the IOL Master. The AL/CR ratio was calculated. The data were analyzed with statistical software package STATA 13. Results: Three hundred and fifty volunteers aged 18–60 years were studied. The mean ± standard deviation of AL/CR and SER were 3.04 ± 0.10 and −0.38 ± 1.42D, respectively. AL in myopia was significantly higher than in emmetropia and hypermetropia. There were no significant differences between CR in the refraction groups. Myopes had significantly higher AL/CR than nonmyopes. On controlling for age and gender, 1 mm increase in AL increased SER by −0.77D (95% confidence interval [CI] −0.91–−0.64D) while a unit increase in AL/CR increased SER by −8.89D (95% CI −10.00–−7.78D). Whereas AL accounts for 39% of variability in SER (P &lt; 0.001), AL/CR accounts for 51% of the variability observed in SER (P &lt; 0.001). Conclusion: This study has further confirmed that the AL remains a strong determinant of refraction, but a derived factor AL/CR accounts for more variation in final refractive status than AL in isolation.Keywords: Axial length, axial length/corneal radius of curvature ratio, Nigerian adults, refractio

Pattern Of Refractive Errors At Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria

Objective: The objective of this paper is to determine the prevalence and pattern of cases of refractive error reported at the eye clinic of the Obafemi Awolowo University Teaching Hospital, Ile-Ife (OAUTH). Methodology: All consecutive new patients seen at the eye clinic of the OAU Teaching Hospital, Ile-Ife, between October 1997 and September 1998 were examined. Those patients who complained of difficulty in seeing near or far objects, whose vision improved with the pinhole or those who had difficulty doing close work like reading or threading needles were refracted by the author. Results: Out of the 1,550 new patients seen within the period of study, eight- hundred and sixty eight (54.9%) had refractive errors. Refractive errors were twice as common among the females than the males in this study. Myopia was the commonest spherical error (22.7%). The highest degree was -12.0DS. Presbyopia was present in 31.8% of the patients. The youngest age of presentation for presbyopia was 36 years. Astigmatism occurred in 55.8% of the patients seen. Most of the patients (68.3%) had myopic astigmatism. One of the two patients who had anisometropia had developed amblyopia in the more hypermetropic eye. Conclusion: Since refractive errors were found to be very common in this study increased health education and provision of adequate, affordable and modern facilities for correction of refractive errors are highly recommended. Nigerian Journal of Ophthalmology Vol. 11(2) 2003: 76-7

Assessment of Human and Material Resources Available for Primary Eye Care Delivery in Rural Communities of Southwestern Nigeria

Integration of primary eye care (PEC) into the existing primary healthcare (PHC) system is efficient in reaching rural communities. Baseline assessment of human and material resources for primary eye care delivery in a rural local government area of southwestern Nigeria with projected population of 126 625 was conducted. Data on number and cadre of all PHC facilities and health-workers were collected. All facilities were visited and materials required for basic PEC inspected. Forty-one (42.3%) community health extension workers, 42 (43.3%) health assistants, 3 (3.1%) community officers of health and 11 (11.2%) registered nurses administered PHC in 27 health facilities. No worker had training in PEC and none of the centres had all the materials for basic PEC delivery. Although procurement of materials and training of health-workers in basic PEC delivery is required, the healthcare facilities and workers currently available are adequate to commence integration of PEC into the PHC system