Keratoconjunctivitis sicca in a Tertiary Hospital in Lagos Nigeria

Background: Keratoconjunctivitis sicca is a growing public health problem and a common cause of ocular morbidity, which is often  unrecognized by eye care practitioners. It is also a cause of visual impairment and ocular discomfort. Recent changes in global climate may have contributed to the increased incidence and severity of the disease Objective: To determine the prevalence and identify risk factors for Keratoconjunctivitis sicca (KCS) in patients presenting at a tertiary ophthalmic center. Methods: The study was a cross-sectional descriptive hospital-based survey conducted at the Guinness Eye Centre of the Lagos  University Teaching Hospital (LUTH) between a one year period of November 2015 and October 2016. A total population sampling method was used. All new patients 16 years and above, that presented to the Eye Clinic during the study period who met the inclusion criteria and gave consent were included in the study. The participant's socio-demographic data were obtained and Keratoconjunctivitis Sicca was assessed using the Ocular Surface Disease Index (OSDI), Shirmer's Test and Tear Film Break Up Time (TFBUT). An OSDI score of ≥50 with a TFBUT of <10 seconds or Shirmer's Test reading of <10mm was considered diagnostic of KCS. In all data analysis and comparisons, a p value <0.05 was considered statistically significant. Results: A total of 300 eyes in 150 patients comprising 65 males and 85 females were analyzed. The average age was 47.4 ± 18.2 years and age range was 16-84 years. The prevalence of KCS was 54.3%. KCS was significantly associated with increasing age with a mean age of 50.3 years (p value= 0.031). The prevalence of KCS increased per decade of life and was seen in 72.2% of patients above the age of 70 years, was seen more in the female gender (prevalence of 56.5%), use of computer screen based technologies (55.7%) and cigarette smoking (odds ratio of 3.53). The positive predictive value of the OSDI was 53.2%. Conclusion: The prevalence of Keratoconjunctivitis Sicca is high especially in our evolving technological world today. There should be a high index of suspicion in patients who fit into the demographic of individuals with KCS. Therefore, screening should be done for such patients with the risk factors irrespective of their symptoms so that appropriate care may be rendered. Keywords: Keratoconjunctivitis Sicca, prevalence, risk factors&nbsp

Prevalence And Pattern Of Refractive Errors In Secondary School Students In Lagos State, Nigeria: The Need For A National School Eye Health Screening Programme

Aim: The purpose of this study was to determine the frequency, types and distribution of refractive errors among public secondary students in Lagos State, Nigeria. Methods: This was a descriptive cross -sectional study conducted from October 2005 to January 2007. Randomly selected students in 19 public secondary schools within the 6 education districts in Lagos State constituted the sample. The study in all the schools was preceded by ocular health education. Detailed ocular examination carried out included visual acuity measurements with multiple alphabetical Snellen's chart. Significant refractive error was defined as a visual acuity of 6/12 or worse, or any error correctable with spherical equivalent of at least -0.500DS or +2.00DS, according to the guidelines of Refractive Error Study in Children (RESC) Result: A total of 1,987 students which comprised of 1019 (51.3%) males and 968 (48.7%) females were examined. Their age range was 9-24years, mean age, 14.8 years (95% CI, 12.4-17.2). Using spherical equivalence (SE) of findings, 564 students accounting for 28.4% (95% CI, 26.4 – 30.4) had significant refractive errors. Myopia (SE of at least - 0.50 DS in one or both eyes) accounted for 26.2% (95% CI, 24.2 – 28.2) and hypermetropia, (SE of > + 2.00DS in either eye) constituted 2.2% (95% CI, 1.54 – 2.36). Most of the errors were of low degree and amblyopia was present in 16 participants (0.8%). One hundred and twenty seven students (6.4%) with significant refractive errors however had associated astigmatism. Forty five cases out of these (35.4%) were > 0.75DC. Conclusion: The prevalence rate of 28.4% for refractive errors in the study was higher than previous findings among secondary school  students in Nigeria. Although most students with low degree of myopia were asymptomatic, they are at high risk of further increase due to increasing near work and changes in diet associated with westernization. The need for a sustainable National School Eye HealthScreening Programme cannot be overemphasized. Keywords: Uncorrected Refractive Errors, Amblyopia, Screening, Secondary Schools

Indications for intravitreal injections in Lagos University Teaching Hospital, Lagos, Nigeria

Background: The influence and contribution of angiogenesis in retinal diseases has been documented in many literature emphasizing the role of Vascular Endothelial Growth Factor (VEGF) as a major factor in proliferative retinopathies. The use of Anti-Vascular Endothelial Growth Factors (AntiVEGF) is now employed in the treatment of these diseases. With the objective of reviewing the indications of all intravitreal AntiVEGF given in Lagos, this study aimed to describe the common ones and re-emphasizing the need for more awareness.Methods: The ophthalmic surgical records of patients (n=104) who had intravitreal AntiVEGF at the Guinness Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria from November 2013 to November 2015 were reviewed in a retrospective manner after obtaining ethical approval.Results: A total of one hundred and four AntiVEGF injections were given in the study period. The commonest indication was clinically significant macular edema from Diabetic Maculopathy, 32 (30.7%) followed by Wet Age Related Maculopathy, 21 (20.2%) and retinal vein occlusion, 18 (17.3%). Newer indication included idiopathic Polypoidal Choroidal Vasculopathy 7, (6.7%).Conclusion: Diabetic maculopathy and wet age related macular degeneration are the major indications for intravitreal antiVEGF injection in Lagos.Keywords: Diabetic maculopathy; intravitreal AntiVEGF; idiopathic polypoidal choroidal vasculopath

Prevalence and causes of low vision in Kosofe Local Government, south western Nigeria

Background: Low vision is a very important area in Ophthalmology, however, some Ophthalmologists and eye health  practitioners are not paying enogh attention to this area of ophthalmic practice. Hence, this determination of prevalence and causes of Low Vision in Kosofe Local Government Area of Lagos, South Western Nigeria.Objective: To determine the prevalence and pattern of Low Vision in Kosofe Local Government in Nigerians over 16 years of age with a view to increase awareness of low vision and to provide data to facilitate the establishment of low vision services in Kosofe Local Government Area of Lagos.Methods: A descriptive, cross-sectional study where eligible subjects filled structured interviewer administered questionnaires, after which they underwent full ophthalmological examination including visual acuity and full refraction. Low vision was defined as best corrected visual acuity equal to/worse than 6/18 to light perception in the better eye. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 17 and a p value <0.05 considered statistically significant.Results: Of the three hundred subjects examined, the female : male was 1.3:1 with the age range of 16 and 74years.Low vision was found in 31 (10.3%) Subjects. Cataract was the leading cause of low vision in 14 (45.16%) respondents, followed by glaucoma 8 (25.8%) and refractive errors 3 (9.68%). There was a statistically significant association between low vision and these risk factors -advanced age, low educational level, poor income and past ocular trauma (p<0.05), with ocular trauma having the strongest association with low vision.Conclusion: Low vision is prevalent in Kosofe Local Government Area of Lagos State and the main causes are avoidable. There is a need for enlightenment to reduce the burden of low vision.Keywords: Low Vision; Prevalence; Causes; Lagos; South Western Nigeri