African Journals Online
Nigerian Journal of Ophthalmology

Volume 9, No. 1, August, 2001 
ISSN 0189-9171
ABSTRACTS

 Vision Screening in Nigeria School Children

Abubakar S. and *Ajaiyeoba A.I.

Guinness Eye Centre, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria.

*Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

SUMMARY

The study was conducted to establish the ability of simple screening tests conducted by readily available non-ophthalmic personnel (such as teachers rather than ophthalmologists, the gold standard) to detect cases of reduced visual acuity in school children. Trained schoolteachers assessed the ability of pupils to read the E-chart at the 6/12 line. A total of 1618 students comprising 525 pupils from one government owned public primary school (mixed boys and girls) and 1093 from another private secondary school (boys only) school located in the metropolis were screened by the teachers. The trained schoolteachers were able to attain a sensitivity of 78.3% and specificity of 92.1% for the visual acuity testing. The trained schoolteachers were able to achieve reasonably high levels of specificity and modest levels of sensitivity in carrying out screening using visual acuity testing. Schoolteachers can reduce the workload of ophthalmic personnel who at the moment are few and are overworked. They can also play a vital role in vision testing exercises in school children especially in developing countries where there is little or no provision for school health services in school attended by those from a poor background.

KEY WORDS: Vision screening, school children

Screening for Eye Disease in Nigeria School Children

Abubakar S. And *Ajaiyeoba A.I.

Guinness Eye Centre, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria.

*Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

SUMMARY

The study aimed to establish the validity of simple screening test conducted by readily available non-ophthalmic personnel (such as teachers rather than ophthalmologists who may be regarded as the gold standard) to detect cases of common eye problems in school children. Trained school teachers conducted screening using a simple pen torch eye examination to recognise common eye conditions like red eyes, squint, corneal scar and Bitot’s spots. A total of 1585 students from a government owned public primary school (mixed boys and girls) and a private secondary (boys only) school located in Kaduna metropolis were screened by the teachers. The trained schoolteachers were able to attain a sensitivity of 59.1% and specificity of 85.1% for the sample eye examination. After just one day training, the trained schoolteachers were able to achieve reasonably high levels of specificity and modest levels of sensitivity in carrying out simple eye examination. Trained teachers can reduce the workload of ophthalmic personnel by as much as a factor of twenty. They can also play a vital role in promoting ocular health of school children especially in developing countries where there is little or no provision for school health services in schools attended by those from a poor background.

KEY WORDS: screening, Eye diseases, school children

Refractive Errors in Primary School Children in Nigeria

M.A. Faderin And *A.I. Ajaiyeoba

Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

*Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

SUMMARY

The study was carried out to determine the prevalence of refractive errors in primary school children in the Nigerian Army children school. Bonny Camp, Lagos, Nigeria. A total of 919 pupils from two primary schools (one private school and one public school) were screened. The schools and classes were selected using stratified random sampling methods. Refractive error was defined for this study as visual acuity of less than 6/9, or any visual acuity correctable with minimum of plus or minus 1.0 dioptre sphere, with or without minimum of plus or minus 0.5 dioptre cylinder to normal (6/5) vision. The prevalence of refractive error was 7.3% (95% CI = 5.5% - 9.1%). Hypermetropia predominated with 52.2 % of all errors and was common betwwen 6 and 15 years of age. Myopia was found in only 9% of children and was common in children less than 8 years of age. However, astigmatism was seen in 38.8% of children who above 13 years of age. More girls (56%) presented with refractive errors than boys (44%). It is advisable that pupils be tested whilst at primary school so that they can maximally utilize their visual endowment during learning processes at this rather formative stage of life.

KEY WORDS: Refractive errors, primary school children.

Barriers to Wearing Glasses Among Primary School Children in Lagos, Nigeria

Faderin M.A. And * Ajaiyeoba A.I.

Nigerian Army Eye Centre, Bonny Camp, Lagos, Nigeria

*Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

SUMMARY

The study was carried out to investigate barriers to uptake of wearing glasses amongst primary school children. A total of 919 pupils from two primary schools (one private school and one public school) were screened. The schools were selected using a stratified random sampling technique. All pupils whose visual acuity was equal to or less than 6/9 were refracted by the optometrist. These pupils were given referral letters inviting their parents to attend the eye clinic with them. The researcher using structured and open-ended questionnaires interviewed the pupils, parents and teachers. Focus group discussions were held with the pupils and teachers. Pupils were more aware of issues surrounding wearing of glasses than their parents. The main constraint preventing children from wearing glasses was the poor economic status of the parents. If glasses were made available to school children at a highly subsidized rate, or better still free, most of the excuses parents gave for not providing glasses for their children or allowing them to wear glasses would not be tenable. For those that genuinely had deep-rooted beliefs against wearing glasses, health education by teaching the benefits of wearing glasses could be of great help. We appeal to private eye care service deliverers to accommodate school children and to offer services to them at affordable costs including provision of glasses. It is recommended that funding for this exercise should be from non-governmental organisations, philanthropists, pharmaceutical companies and well-meaning individuals.

KEY WORDS: Barriers, wearing glasses, primary school children

The Problem of Educating Blind Children in Benin City

*O.A. Dawodu And **F.N. Ejegi

*University of Benin Teaching Hospital, Department of Ophthalmology, Benin City.

**University of Benin Teaching Hospital, Benin City.

SUMMARY

All the institutions available for formal education of blind children in Benin City were studied. The total number of children in these schools were 14 (eleven in the primary school exclusively for blind children and three were attending normal secondary schools with facilities for blind education). The number reflects the gross under utilisation for the facilities available. The commonest cause of blindness amongst these children was opacities in the media which occurred in 8 out of 14 (57%) (6 in the cornea and 2 in the lens). This was closely followed by congenital anomalies, 7 out of 14 (50%) (micro-cornea 4, micro-ophthalmos 2, congenital glaucoma 1). Some of the factors militating against a better uptake of the available facilities are discussed.

KEY WORDS: Blindness, Educating blind children.

Cryotherapy in Dendritic Keratitis.

C.D. Mpyet And Ron. Ghosh Do

University of Jos Teaching Hospital, Nigeria

SUMMARY

This study evaluates the effectiveness of cryotherapy in the treatment of Dendritic Keratitis where antiviral agents are not available. The result show some improvement in visual acuity while one patient has a drop in vision. The extent of corneal scarring appears to depend on the duration of the disease and extent of stroma involvement. A coparative study with antiviral agents is recommended. To evaluate the effectiveness of cryotherapy in the treatment of Dendritic Keratitis where antiviral agents are not available. Ten patients with Dendritic Keratitis underwent cryotherapy by a freeze thaw technique at a temperature of between –40^oC to –60^oC. Six patient records were reviewed while the remaining four were prospectively followed up. Patients had Gutt atropine sulphate 1.0% and Oc. Chloramphenicol 1.0% in addition to their treatment. There was an improvement in the visual outcome of most patients with complete epithelial healing within ten days of the procedure. We recommended a comparative study with antiviral agents though cryotherapy can be considered where antiviral agents are not available.

KEY WORDS: Dendritic keratitis, cryotherapy, antiviral agents.

The Problem of Educating Blind Children in Benin City

M.J.M. Waziri-Erameh and A.E. Omoti

University of Benin Teaching Hospital, Department of Ophthalmology,

SUMMARY

This is a preliminary report on 5 Nigerians who were blind from supposedly hopeless corneal conditions where Keratoplasty stood no chance of survival. They all had light perception vision. After the surgery, three of the five patients had a best corrected vision of 6/36, one had 6/48 and another 6/9. Complications encountered were uveitis and retroprosthetic membranes of which the later was one significant.

KEY WORDS: Keratoprosthesis, corneal opacities, retroprosthetic membranes.

Evaluation of the Outcome of ECCE Surgery with PC-IOL at Ago-Iwoye, Ogun State, Nigeria

Bekibele C.O.

Department of Ophthalmology, University College Hospital, Ibadan.

SUMMARY

Objective: To evaluate all extracapsuler cataract extractions with PC-IOL done at St. Mary’s Catholic Eye Hospital between October 1998 and October 1999.

Materials and Methods: The case records of all patients who had extra-capsular cataract extraction (ECCE) with posterior chamber intra lens (PC-IOL) insertion between October 1998 and October1999 were reviewed retrospectively to determine complication rate and outcome of surgery.

Results: 61 ECCE with PC-IOL surgeries were done in 55 patients. 35 (63.6%) were males and 20 (36.4%) were females, 49 (89.1%) had unilateral surgery. The youngest age was 9 years and the oldest was 90years. Intra-operative complications occurred in 8 cases (13.1%) and consisted of posterior capsule rent 3 (4.9%), Iridodialysis, 1 (1.6%) Iris tear 2, (3.3%) and hyphema 3 (4.9%). The post-operative complications included striae Keratitis 6 (9.8%), posterior capsule opacity 2 (3.3%), raised intra-ocular pressure 10 (16.4%), uveitis 10, (16.4%) irregular pupil6, (9.8%) hyphema 4, (6.6%) and endophthalmitis 3 (4.9%). The uncorrected visual acuity improved to better than 6/18 in 28 (45.9%) of the operated eyes. There was improvement in visual acuity (better than 6/18) after refraction in 40 of 43 eyes that were refracted. Post-operative residual astigmatism was minimal in most cases.

Conclusion: ECCE with IOL is an excellent method of curing cataract Blindness but there is need for the use of A-scan biometry and Keratometry to determine the power of the inserted IOL as well as preventive measures against endophthalmitis for better results.

KEY WORDS: Cataract, intra-ocular lens, visual acuity, astigmatism.

Acute Retention of Urine Following Intraocular Surgery

S.N.N Nwosu

Guinness Eye Centre, P.M.B. 1534, Onitsha, Nigeria.

SUMMARY

Hyperosmolar agents and carbonic anhydrase inhibitors are used to lower the intraocular pressure and thus minimize the chances of vitreous loss during intraocular surgery. However, these agents could precipitate urinary retention. This is a report on two elderly men who had perioperative acute urinary retention following administration of oral glycerol and acetazolaminde, respectively. Ophthalmic using these agents must remember this compilation and should stock the instruments with which to promptly relieve the patient of the retention.

KEY WORDS: Acute retention, intraocular surgery.

Visual Field Measurement with Motion Sensitivity Screening Test in an Onchoendemic Area after Ivermectin Treatment

R.E. Umeh

Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

SUMMARY

Eye disease is a frequent complication of onchocerciasis in countrise where the disease is highly endemic. It has been shown that early ocular lesions which manifest as visual field defects or reduction in visual acuity can be reversed following treatment with ivermectin. At the community level, it is important to detect populations with eye disease early and also follow their progress during mass treatment. The Motion Sensitivity Screening Test (MSST) has been suggested as a potential useful method for monitoring visual field in onchocerciasis endemic communities. In this study the aim was to determine the usefulness of this test as a quick and simple method for monitoring visual field changes in an onchocerciasis endemic forest-savanna area following mass treatment with ivermectin. The method was evaluated in four villages over a two-year period. A total of 439 individuals had computerized visual field measurements yearly for up to two years after mass treatment with ivermectin and the results was compared with the pre-treatment values. The results showed an overall significant improvement in the motion sensitivity of the sample population after treatment with ivermectin. Lower percentages of the sample population than at baseline had abnormal teat within a year of treatment with ivermectin. By contrast the visual field tested by confrontation in all the subjects did not show any change over the same period. In conclusion, MSST was found to be a quick and easy-to-understand computer perimeter that could be useful in monitoring visual field changes in onchocerciasis endemic rural community during mass treatment with ivermectin.

KEY WORDS: Onchocerciasis, ivermectin, visual field, motion sensitivity screening test, monitory.