African
Journals Online
Nigerian Journal of
Ophthalmology
Volume 10, No. 1, August, 2002
ISSN 0189-9171
ABSTRACTS
Analysis
of Eye Disease in Private Practice
Adeoye A.O.
Department of surgery, College of Health Sciences,
Obafemi Awolowo University, Ile-Ife, Nigeria
SUMMARY
The
pattern of eye disorders of 1,584 consecutive new patients presenting at a
private hospital in a sub-urban area of South-western Nigeria was analysed.
Nine hundred and twenty-seven were males (58.5%) and 657 females (41.5%);
(25.8%) of patients were under 20 years of age, while (45.5%) were over 40
years. Common ocular presentations were refractive error (16.9%), allergic
conjunctivitis (15.9%), trauma (12.0%) and glaucoma (7.3%). One hundred and
fifty-eight patients (10.5%) were blind i.e visual acuity (VA) less than 3/60
in the better eye; 315 (21.0%) were unilaterally blind and 178 (11.9%) had low
vision (VA,6/18 but .3/60). Eye care needs of patients presenting to private
practice in suburban Nigerian town can be met by the provision of inexpensive
optical correction, large volume cheap cataract surgery, health education and
maintenance of peace.
KEY WORDS: Eye
Disease, private practice, Nigeria, blindness
Intraocular Lens Implantation Surgery In
Onitsha, Nigeria
Nwosu S.N.N. Onyekwe L.O.
Department of Ophthalmology, Nnamidi Azikiwe
University Nnewi Campus Nnewi, Nigeria
SUMMARY
Objective: to evaluate the outcome of
cataract extraction with intraocular lens implantation surgery at the Guinness
Eye Centre, Onitsha, Nigeria.
Design: Retrospective cases series.
Main outcome Measures: Visual acuity;
post-operative complications.
Materials and Methods: Consecutive patients who had
cataract extraction with intraocular lens implant between January 2001 at the
Guinness Eye Centre, Onitsha and follow up for at least 2 months post-surgery
were studied. Information on age, sex, ocular and systemic co-morbidities; type
of cataract; pre- and post-operative visual acuity and surgical complications
were analyzed.
Results: 30 patients (41eyes) were
studied; mean age – 66.1 years (range – 10-90 years); M:F = 1:1. Eleven
patients (36.7%) had bilateral surgery. Follow up was 5-18 months. 35 eyes
(85.4%) had senile cataract; traumatic cataract and couched eyes, 2 eyes each;
post-uveitic cataract and secondary lens implant, 1 eye each. Systemic
co-morbidities were diabetes melitus and hypertension, 6 patients each;
cardiovascular disease (2 patients); arthritis and bronchitis (1 patient each).
Pre-operative
acuity in all eyes was <6/36. At 2 months post-surgery, 24.3% had presenting
acuity >6/18; 46.1% had corrected acuity >6/18; 16.9% had acuity >6/9.
At the last visit, 43.6% and presenting acuity >6/18 or better, 75.4% had
corrected acuity >6/18; 29.1% had corrected acuity >6/9. Optimal
post-operative acuity occurred in 2-5 months; means – 3.5 months.
Surgical
complications were recurrent uveitis, 20 eyes (48.8%) astigmatism, 14 eyes
(34.1%); high intraocular pressure, 3 eyes (7.3%); posterior capsule opacity, 3
eyes (7.3%) posterior castle tear, 2 eyes (4.9%). Poor post-operative acuity
were due to posterior capsule opacity and macular scar, 3 eyes each; leukoma, 2
eyes; diabetic retinopathy, 1 eye.
Conclusion: In spite of lacking some
facilities for ocular microsurgery, cataract surgery with IOL implantation is safe and ensures better visual rehabilitation in
Nigerians. Use of A-mode ultrasound scan, keratometer, YAG laser and newer lens
designs will improve our results. But ophthalmic surgeons should promptly
attend to such vision threatening complications as post-operative uveitis.
KEY WORDS: Cataract; intraocular lens; visual acuity; surgical
complications.
Comparative
Evaluation of Oculokinetic Perimetry and Henson CFS 2000 in Detecting
Glaucomatous Field Detects.
Onakoya.
A. O.
Ophthalmology
Unit, Dept. of Surgery, College of Medicine University of Lagos.
SUMMARY
OculoKinetic perimetry (OKP) is a visual field test
developed for use in situations where conventional perimetry is not convenient
or readily available. The test is inexpensive fully portable and simple to
perform and can therefore supplement conventional perimeter in non-ophthalmic
clinics, the community, by the bedsides and in the patient’s home. OKP uses
controlled movements of the patient’s eye to position a static test stimulus in
the visual field. The test chart consists of a white tangent screen with 26
numbered fixation points located eccentrically at strategic points in relation
to a central black spot, which is the test stimulus. As the patient looks at
each number in turn, the central stimulus automatically moves through
corresponding points in the visual field.
Defects are recorded on a miniature chart by crossing
out the numbers that are associated with the disappearance of the test
stimulus. In this study we have shown that in 80 eyes of 43 glaucomatous patients,
the test is efficient and reliable when compared with Henson CFS2000 field
test. The results were comparable in 88.75% of the eyes and the specificity
relatively high at 95%. OKP appears to be a useful tool for glaucoma screening
in the community.
KEYWORDS: Oculokinetic Perimetry,
Glaucoma, Screening, Henson CFS2002, Visual field.
Beliefs and Attitude to Eye
Disease and Blindness in Rural Anambra State, Nigeria
Nwosu
S.N.N.
Department
of Ophthalmology, Nnamidi Azikiwe Unversity Hospital, Nnwei, Nigeria
SUMMARY
Objectives:
To determine (a) the beliefs and knowledge of the eye diseases/blindness; (b)
the actions taken to alleviate eye diseases/blindness; (c) the disposition
towards optical aids and surgery among adults in rural Anambra State, Nigeria.
Materials and Methods: three villages in the onchocercal endemic area of
Anambra States were randomly selected for ophthalmic surgery. The study
instruments included using interviewer administered pre- tested structured
questionnairie to obtain from all persons aged 20 and above, information on
beliefs, knowledge and attitude to eye diseases/blindness, eyeglasses and eye
surgery.
Results:
The 954 persons interviewed thought eye diseases/blindness were caused by
filariasis, germs, enemy poison, heredity, entering bad bush, evil spirit and
swearing to false oath. Self-medication was common but ophthalmologist,
chemists, general practitioners, opticians, nurses and herbalist wee also
consulted. Unorthodox ocular preparations in common use were holy water, sugar
solution, salt solution and herbs.
Most respondents (94.6%)
would advise a relation with eye disease/blindness to go to hospital and
kinsmen were likely to contribute to treat the blind (93.3%) and exclude him
from tax and levies (58.7%). But recommending herbs, consulting herbalists and
or seer and offering sacrifice to the gods were other options. While 830
(87.0%) persons would accept eyeglasses, only 570 (59.7%) would submit to eye
surgery if necessary, 176 (18.4%) persons saw eye surgery as frightening and 82
(8.6%) viewed it as useless.
Conclusion:
While the views and attitude of most respondents agree with modern scientific
knowledge and approach to ophthalmic problems, a good proportion had negative
attitude. The supportive role of kinsmen and close relation of the ophthalmic
patients is conspicuous. These finding deserve serious consideration when
planning eye health services for these and similar communities.
KEY WORDS: Beliefs; attitude; eye
disease; blindness; Nigeria.
Indications for Enucleation
of the Eyes of Children in Eastern Nigeria
*Ezegwui
I. R., Ezepue U.F., Umeh R.E., **Onuigbo W.I.B.
*Dept.
of Ophthalmology, UNTH, Enugu,
**Medical
Foundation and Clinic, Enugu
SUMMARY
Objective:
To determine the reason for enuleation of the eyes among children in eastern
Nigeria as this should serve as a guide for initiating appropriate prevention
measures where possible.
Materials and Methods: A retrospective study of records of enucleated eyes
from children aged 15 years or less received in a central laboratory service
situation in Enugu, eastern Nigeria, over a 29-year period (20/2/70-19/2/99)
was undertaken.
Results:
A total of 82 enucleated eyes were received. Retinoblastoma accounted for 36
(56.1%) enucleations, both sex being equally affected. Avoidable ocular
problems resulting in enucleations such as panophthalmitis, endopphthalmitis,
some staphyloma and others were noted in as high as 42.7% Trauma, measles and
corneal ulcers of unknown aetiology preceded most of these.
Conclusions: A significant proportion of enucleation among children
in eastern Nigeria is due to avoidable causes, Health education and other
positive measures to reduce the incidence of avoidable enucleations are
advocated.
KEY WORDS: Eye Enucleations, Children,
retinoblastoma, Avoidable Enucleations
Sympathetic
Ophthalmitis in Nigerians - Case Reports
Samaila
E. and Olali C. A
Department
of Ophthalmology (Guinness Eye Clinic) Ahmadu Bello University Teaching
Hospital P.M.B. 2016, Kaduna. Nigeria
SUMMARY:
We describe two cases of sympathetic uveitis in two
Nigerian patients. The first case occurred after a penetrating injury while the
second was after surgery in a painful blind eye. The aetiopathogenesis as well
as the management of the condition in Nigeria are discussed.
KEY WORDS: Sympathetic Ophthalmitis (Uveitis), Management,
Nigeria
Carcinoma of
the Breast with Orbital Metastasis in a Young Nigerian - A case Report
*Ashaye
A. O., Osuntokun O.
*Department
of Ophthalmology University College Hospital Ibadan, Nigeria.
SUMMARY
Orbital metastasis is rarely the first sign of a
malignant process. Most cases of metastatcis orbital tumours are diagnosed in
patients with known primaries elsewhere.
The patient presented is one of the unusual cases of
breast carcinoma in a young person. Her primary presentation to the eye clinic
with “orbital inflammatory disease” (which turned out to be a metastasis into
the orbit) prior to the diagnosis of the primary disease makes her even more
unusual. All cases of “inflammatory orbital disease” require a full and
thorough physical examination.
KEY WORDS:
Breast
Cancer, Young, Meratasis.
Waardenburg’s Syndrome in a Nigerian
Family
Onabolu O.O
Dept
of Ophthalmology, Obafemi Awolowo College of Health Sciences, OSUTH, Sagamu.
SUMMARY:
Waardenburg’s Syndrome {WS} is described in two girls of
a Nigerian family. Both girls presented with white forelock, heterochromia
irides and sensorineural deafness. WS is inherited as an autosomal dominant
gene with variable penetrance and phenotypic expression. It is divided into
four clinical sub types according to mutations in the genes responsible for
melanocyte proliferation and differentiation. There is no history suggestive of
Waardenburgs syndrome in this family. The wide difference between the ages of
the father and the mother {30years}, and the old age of the father {65 years}
is believed to be responsible for a new mutant gene in the family. Deafness,
which is the most disabling feature of this syndrome should be identified early
to prepare the child for proper education.
KEY WORDS: Waardenburg’s Syndrome, genetic mutation,
deafness.
Urinary Excretion of Renal Stone
Following Prolonged Acetazolamide Therapy: A Case Report
Onakoya
A. C. and Adefule- Ositelu A.O.
Dept.
of Surgery, College of Medicine, University of Lagos.
SUMMARY:
This article reports a case of urinary excretion of
renal stone following prolonged acetazolamide therapy in otherwise healthy
patient with Primary Open Angle Glaucoma (POAG).
KEYWORDS: Acetazolamide, POAG, Renal stone
Initial Experience
with the Utility of Infrared Diode Laser in Kaduna, Nigeria
Mahmoud
A.O., Kyari F., Ologunsua Y.
National
Eye Centre, P.M.B. 2267, Kaduna, Nigeria
SUMMARY
Our initial clinical
experience with the use of a diode laser in the treatment of some
retinovascular conditions and refractory glaucoma in some black patients in
Kaduna, Nigeria.
Methods:
All the 32 eyes of 26 patients treated with diode laser photocoagulation
between September 1997 and September 1999, were studied retrospectively. Patient’s
eye, sex, eye diagnosis. laser treatment parameters and the intra-operative and
post-operative observations were tabulated.
Results:
All patients tolerated the laser treatment sessions, although complaints of
pain were universal. The follow up observation period ranged from none to one
year in this initial study. Eight of 6 patients were treated for proliferative
sickle cell retinopathy. Regression of sea fans was observed in all the four
eyes (100%) of three patients that were available for follow-up observation.
However, a fresh sea-fan neo-vascularisation developed elsewhere in the same
retina of one of the treated eyes. Of the 12 eyes of 9 patients with diabetic
retinopathy, 6 patients (8eyes) were available for follow up.
Among the later group,
all eyes but one (87.5%) had their retinopathy changes stabilised following
laser treatment. Two patients with central retina vein occlusion were treated.
The only one that was available for follow up was stabilized following
treatment. Of the 3 eyes (3 patients) that had retinopexy for flat retina
breaks, 2 reported for follow up. Both retina remained attached.
All the 6 patients (7
eyes) with refractory glaucoma who contact diode laser treatment did not have
the initial reduction in the intra-ocular pressures sustained subsequently.
Conclusion:
Diode laser has been found to be useful in treating a number of retinovascular
conditions among the black patients studied. Its initial intra-ocular pressure
lowering effect was not sustained in refractory glaucoma. However, the small
pool of patients and the limited period of follow up examination in this study
call for caution with these conclusion.
KEY WORDS: Diode
laser treatment, sickle cell retinopathy, diabetic retinopathy, retinopexy
refractory glaucoma
|