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1.
J West Afr Coll Surg ; 14(3): 352-354, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38988417

RESUMEN

Corneal opacities are a major source of corneal morbidity in Africa and many resource-limited parts of the world. Unfortunately, there is a dearth of specialist corneal services either from lack of manpower or non-availability of materials and tools. This makes penetrating keratoplasty inaccessible from prohibitive cost or lack of donors. The index case was a 45-year-old indigent female farmer who presented with a right atrophic eye and defective vision on the left eye due to stick injury from farm work. Examination revealed a 2/60 eccentric vision and extensive adherent leukoma on the left eye. Superonasal optical iridectomy was done and vision improved to 6/18 with correction at sixth postoperative week. In conclusion, optical iridectomy, in selected patients, can restore useful vision.

2.
Trop Med Health ; 52(1): 24, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38486241

RESUMEN

BACKGROUND: The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre. The current study attempts to quantify the impact on a larger scale, namely that of sub-Saharan Africa, and to include all ophthalmic subspecialties. METHODS: This is a retrospective analysis of the surgical records from 17 ophthalmology centres in seven countries located in East, Central, West and Southern Africa. The date of declaration of the first lockdown was used as the beginning of the pandemic and the pivot point to compare theatre records one year prior to the pandemic and the first year of the pandemic. We examined the total number of surgical procedures over the two year period and categorized them according to ophthalmic subspecialty and type of procedure performed. We then compared the pre-pandemic and pandemic surgical numbers over the two year period. RESULTS: There were 26,357 ophthalmic surgical procedures performed with a significant decrease in the first year of the pandemic (n = 8942) compared to the year prior to the pandemic (n = 17,415). The number of surgical procedures performed was lower in the first year of the pandemic compared to the year prior to the pandemic by 49% [Incidence rate ratio (IRR) 0.51, 95% CI 0.41-0.64), 27% (0.73, 0.55-0.99), 46% (0.54, 0.30-0.99), 40% (0.60, 0.39-0.92) and 59% (0.41, 0.29-0.57) in sub-Saharan Africa (4 regions combined), West, Central, East and Southern Africa, respectively]. The number of surgical procedures in the different sub-specialty categories in sub-Saharan Africa (4 regions combined) was significantly lower in the first year of the pandemic compared to the year prior to the pandemic, except for glaucoma (IRR 0.72, 95% CI 0.52-1.01), oncology (0.71, 0.48-1.05), trauma (0.90, 0.63-1.28) and vitreoretinal (0.67, 0.42-1.08) categories. CONCLUSION: This study provides insight into the impact of the COVID-19 pandemic in multiple regions and countries on the African continent. The identification of which surgical subspecialty was most affected by the COVID-19 pandemic in each region allows for better planning and resource allocation to address these backlogs.

3.
J West Afr Coll Surg ; 12(3): 79-83, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36388747

RESUMEN

Background: The access to universal eye health is still poor in many developing countries. There are various initiatives to address this problem, but the initiatives are majorly under the support of external funding. This study reports community outreaches supported by community-based organisations over a 7-year period in resource-poor settings in Ilorin, Kwara State, Nigeria. Aims and Objectives: This study aims to describe the processes/procedures, output, and funding of eye care services provided in the rural communities over a 7-year period. The study seeks to present the process, demographical profiles, disease pattern, challenges, and recommendation in finding the core area of development to improving eye care services for these communities as well. The setting of this research work is 65 rural communities around the Ilorin metropolis of Kwara State, Nigeria. The design of the study is a retrospective review. Materials and Methods: This is a descriptive study of 7-year community eye outreaches in Ilorin, Nigeria. Data were analysed with IBM-Statistical Package for Social Sciences (SPSS-20). Results: A total of 65 communities with 235 visits were carried out between the years 2013 and 2019, with a total of 13,661 persons screened. The major eye diseases seen were refractive errors, allergic conjunctivitis, cataract, and pterygium. Common surgical eye problems were cataract, pterygium, and glaucoma. Community-based organisation direct financial support built up from USD 855 in 2013 and totalled USD 27,250 in 2019. Community-based organisation funding is an alternative and useful means of meeting the unmet needs of eye care in resource-poor communities. Subsidised care was provided to community-sourced patients due to support by local community-based organisations. This subsidy assisted in reaching the outreach numerical goal. However, it was still inadequate to meet the total needs as seen by the lower number of clinical care and surgeries rendered against the total numbers identified. Conclusion: To achieve sustainable and wider coverage of care, a combination of local source and external funding is required. This study shows that community eye care programme can be supported by local or indigenous sponsors in a sustainable manner, thereby contributing considerably to addressing prevalent cases of avoidable blindness.

4.
Ghana Med J ; 54(4): 231-237, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33883771

RESUMEN

INTRODUCTION: Long waiting time in the out-patient clinic is a major cause of dissatisfaction in Eye care services. This study aimed to assess patients' waiting and service times in the out-patient Ophthalmology clinic of UITH. METHODS: This was a descriptive cross-sectional study conducted in March and April 2019. A multi-staged sampling technique was used. A timing chart was used to record the time in and out of each service station. An experiencebased exit survey form was used to assess patients' experience at the clinic. The frequency and mean of variables were generated. Student t-test and Pearson's correlation were used to establish the association and relationship between the total clinic, service, waiting, and clinic arrival times. Ethical approval was granted by the Ethical Review Board of the UITH. RESULT: Two hundred and twenty-six patients were sampled. The mean total waiting time was 180.3± 84.3 minutes, while the mean total service time was 63.3±52.0 minutes. Patient's average total clinic time was 243.7±93.6 minutes. Patients' total clinic time was determined by the patients' clinic status and clinic arrival time. Majority of the patients (46.5%) described the time spent in the clinic as long but more than half (53.0%) expressed satisfaction at the total time spent at the clinic. CONCLUSION: Patients' clinic and waiting times were long, however, patients expressed satisfaction with the clinic times. FUNDING: Self-funded.


Asunto(s)
Atención a la Salud/organización & administración , Oftalmología , Satisfacción del Paciente , Calidad de la Atención de Salud , Listas de Espera , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Encuestas y Cuestionarios , Centros de Atención Terciaria
5.
Saudi J Ophthalmol ; 30(3): 185-188, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28210180

RESUMEN

PURPOSE: To determine the normative range of intraocular pressure (IOP) in full-term newborns and possible association with birth parameters during the first week of life. METHODS: This was an observational cross sectional study in which IOP was measured in 1000 eyes of 500 normal full-term newborns using the Perkins applanation tonometer under topical anesthesia. An average of three readings was taken as the IOP value. The relationship between IOP and birth parameters was analyzed. RESULTS: The male to female ratio was 1:1 with 254 (50.8%) male and 246 (49.2%) female babies. The (mean ± SD) value of IOP in the right eyes was 11.93 ± 1.80 mmHg, ranging between 9.00 and 16 mmHg. In the left eyes, the mean value of IOP was 11.84 ± 1.77 mmHg with a range of 8.00-15.00 mmHg. IOP in males (12.02 ± 1.84 mmHg) was not significantly different from that in females (11.89 ± 1.75 mmHg). There was no significant difference between right and left eyes (p = 0.42). The 95% range (mean ± 2 SD) was 15.53 mmHg for the right eye and 15.38 mmHg for the left. Correlational analysis showed that birth weight and gestational age were positively correlated with IOP. CONCLUSION: This study provides useful normative data on IOP among Nigerian full-term newborns. Further studies on possible ethnic/geographic variations of IOP in children may be beneficial.

6.
Middle East Afr J Ophthalmol ; 22(4): 508-13, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26692726

RESUMEN

AIM: To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. METHODS: A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. RESULTS: A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. CONCLUSION: This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.


Asunto(s)
Actitud Frente a la Salud , Ceguera/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Servicios de Salud Rural/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Percepción Social , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud/etnología , Ceguera/prevención & control , Ceguera/cirugía , Servicios de Salud Comunitaria/estadística & datos numéricos , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Encuestas y Cuestionarios
7.
J Glaucoma ; 23(1): 41-5, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22828000

RESUMEN

PURPOSE: To estimate the outpatient clinic burden and surgical workload related to glaucoma in Lagos, Nigeria. METHODS: A multicentre study involving the 2 tertiary eye institutions, 7 secondary eye centers with eye care facilities, and the largest private eye hospital in Lagos state, Nigeria. Data on outpatient department (OPD) visits were collected over a 4-week period, using a specially designed tally sheet. Theater records were examined in each hospital over a 1-year period (2009) for the number and types of glaucoma surgeries performed. RESULTS: A total of 6240 patients visited the OPD over the 4-week period, out of which 1577 (25.3%) were glaucoma patients. OPD visit per ophthalmologist were 274, 323, and 61, whereas glaucoma visits per ophthalmologist were 75, 70, and 23 in the tertiary, secondary, and private centers, respectively. Glaucoma surgeries constituted 8.6% of total surgeries (n=4050). Trabeculectomy with intraoperative 5-fluorouracil was the most common procedure (81.0%). Number of glaucoma surgeries per ophthalmologist per month in the tertiary, secondary, and private centers were 0.5, 0.9, and 1.4, respectively. Overall number of glaucoma surgery per ophthalmologist per month was 1. CONCLUSIONS: Glaucoma visits constitute a significant proportion of eye clinic visits in Lagos state, Nigeria, and therefore, necessary manpower, infrastructure, and equipments should be mobilized for its optimal management. Also, there is a relatively low output of glaucoma surgeries that needs to be further investigated and appropriate measures taken to manage it.


Asunto(s)
Cirugía Filtrante/estadística & datos numéricos , Glaucoma/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Anciano , Femenino , Glaucoma/cirugía , Hospitales Especializados , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Oftalmología/estadística & datos numéricos , Servicio Ambulatorio en Hospital/estadística & datos numéricos
8.
Eur J Ophthalmol ; 21(6): 820-5, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21404218

RESUMEN

PURPOSE: To critically review the numbers, distribution, staff mix, and productivity of eye care workers (ECW) in Kwara State, north central Nigeria. METHODS: A cross-sectional descriptive survey of all ECW identified from all eye care facilities in July 2008 was carried out using a structured questionnaire. Output data on cataract surgery of each institution were also collected and data analyzed using SPSS 16. RESULTS: A total of 157 ECW comprising 8 ophthalmologists, 4 diplomates, 16 residents training ophthalmologists, 96 mid-level ophthalmic personnel (67 ophthalmic nurses, 3 optometrists, and 26 others), and 33 administrative and supporting staff were available to a population of 2.37 million. Ophthalmologist to population ratio was 1:300,000, optometrist 1:790,000, and ophthalmic nurses 1:35,000. Eighty percent of ECW and institutions are located in the state capital. There were no orthoptists, low vision specialists, counselors, or cataract finders, while optometrists, managers, and primary ECW were inadequate. The staff mix was 1 surgeon to 12 other ECW and an average of 182 cataract surgeries per surgeon per year. CONCLUSIONS: Emphasis should shift to team building and ensuring available workers perform optimally rather than meeting the absolute numbers of some cadre, which does not guarantee improved output. Issues of equitable distribution, appropriate staff mix, filling identified gaps in human resources, and addressing poor service uptake should be the focus to reach the goals of Vision 2020: The Right to Sight.


Asunto(s)
Países en Desarrollo , Personal de Salud/estadística & datos numéricos , Recursos en Salud/estadística & datos numéricos , Fuerza Laboral en Salud/estadística & datos numéricos , Oftalmología , Desarrollo de Personal , Estudios Transversales , Atención a la Salud , Fuerza Laboral en Salud/tendencias , Humanos , Nigeria , Oftalmología/educación , Oftalmología/estadística & datos numéricos , Optometría/educación , Optometría/estadística & datos numéricos , Desarrollo de Personal/estadística & datos numéricos , Encuestas y Cuestionarios
9.
Middle East Afr J Ophthalmol ; 17(1): 83-7, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20543943

RESUMEN

PURPOSE: To evaluate challenges, attitudes and practices among spectacle wearers to effect positive change when necessary, and determine positive change in a resource-limited economy. MATERIALS AND METHODS: A multi-hospital descriptive, cross sectional survey of spectacle wearers was conducted between May 2007 and December 2008 in Nigeria. RESULTS: A total of 214 wearers comprising 43.5% males and 56.5% females aged 18-84 years were surveyed. The majority of subjects (92.6%) had at least secondary education. The wearers' challenges included expensive spectacles (43.0%), falling/scratched/broken lenses (29.4%) and fear that spectacles would damage the eyes (23.8%). The wearers' attitudes were comprised of consultations with 'road side dispensers' (7%) and permitting other individuals to select spectacle frames for them (26%). Care and maintaince practices included use of handkerchief, tissue paper, fingers and water to clean spectacles (49.5%) and placing spectacles inside spectacle cases (30.4%). There were no associations (P > 0.05) between gender or literacy levels and who selected the frames for the subjects, caregivers consulted for spectacles, and cleaning materials for spectacles. The placement of spectacles when not in use was significantly associated (P < 0.05) with the wearers' gender and literacy levels but not with the length of spectacle wear. CONCLUSION: Attitudes and practices requiring positive change crossed gender and educational levels among spectacle wearers. The cost of spectacles should be regulated and availability of standard eye care practices would reduce challenges including lens-related defects and quackery. During consultation with a recognized eye care professional, counseling of wearers on positive attitudes/practices as well as allaying fear of spectacle wear is required.

10.
Ann Afr Med ; 8(4): 276-80, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-20139553

RESUMEN

OBJECTIVE: To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. METHODS: A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. RESULTS: Most trainees had a positive view about actions towards raising CSR: Structured ophthalmic training- 25 (92.6%), monthly cataract camps by eye departments in teaching hospitals- 21 (77.8%), rural allowance for ophthalmologists- 26 (96.3%) and welfare package for indigent cataract patients- 21 (77.8%). Other actions included local production of cataract consumables- 22 (81.5%), duty-free importation of ophthalmic materials- 23 (85.2%), employment of ophthalmologists in the services of the state governments- 24 (88.9%) and local governments- 20 (74.1%), effective primary eye care- 25 (92.6%) and marketing of cataract surgical services- 23 (85.2%). However, only 16 (59.3%) trainees wanted first ladies (wives of the president, governors and local government chairmen) to adopt cataract elimination as pet projects, and 24 (88.9%) opposed the introduction of cataract surgeons. CONCLUSION: Most trainees had positive perceptions about most actions that can raise CSR. However, top-priority actions to improve CSR were attractive rural allowance, structured training, resource availability, cost reduction and marketing of cataract surgical services. Multiple actions might be necessary to raise CSR.


Asunto(s)
Extracción de Catarata/educación , Educación Médica Continua/métodos , Procedimientos Quirúrgicos Oftalmológicos/educación , Oftalmología/educación , Adulto , Extracción de Catarata/estadística & datos numéricos , Competencia Clínica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Médicos , Encuestas y Cuestionarios , Recursos Humanos
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