Refractive errors in Aminu Kano Teaching Hospital, Kano Nigeria.

AIMS AND OBJECTIVES: The aim of the study is to retrospectively determine the pattern of refractive errors seen in the eye clinic of Aminu Kano Teaching Hospital, Kano-Nigeria from January to December, 2008. PATIENTS AND METHODS: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age, sex, and types of refractive error. All patients had basic eye examination (to rule out other causes of subnormal vision) including intra ocular pressure measurement and streak retinoscopy at two third meter working distance. The final subjective refraction correction given to the patients was used to categorise the type of refractive error. RESULTS: Refractive errors was observed in 1584 patients and accounted for 26.9% of clinic attendance. There were more females than males (M: F=1.0: 1.2). The common types of refractive errors are presbyopia in 644 patients (40%), various types of astigmatism in 527 patients (33%), myopia in 216 patients (14%), hypermetropia in 171 patients (11%) and aphakia in 26 patients (2%). CONCLUSION: Refractive errors are common causes of presentation in the eye clinic. Identification and correction of refractive errors should be an integral part of eye care delivery.

Clinicopathologic presentation of malignant orbito-ocular tumors in Kano, Nigeria: A prospective multicenter study.

Background: Malignant orbito-ocular tumors are major causes of morbidity and mortality in the developing countries. Their presentation, morphologic type, and management are challenging, and earlier reports were mostly retrospective surveys. Histological analysis is essential in making correct diagnosis. Here, we determined the clinical presentations and histopathologic types of orbito-ocular tumors in some tertiary hospitals in Kano, Nigeria. Materials and Methods: This was a prospective cross-sectional multicenter clinical and pathologic study conducted between June 2012 and May 2013. A structured pro forma was used to record findings, patient's biodata, clinical presentation, type of surgical intervention, and histological diagnosis. Data were analyzed with STATA version 11.0. Results: Sixty-seven eye tumors were observed among 61 patients. There were 43 males and 18 females (male-to-female ratio = 2.4:1). Patients had a mean of 13.4 ± 18.3 with a median of 4.0 (0.5-70) years with a double peak in age distribution. The most common features were visual loss (90.2%), leukocoria (59%), proptosis (55%), and fungating mass (49.2%). The symptoms were for ≥6 months in 57.4% and unilateral in 82.1%. B-scan showed retinal masses and calcifications in 13.5% and 4.5%, respectively. Confirmation by histology was achieved in 91% with the most common tumor being retinoblastoma, conjunctival squamous cell carcinoma (SCC), and rhabdomyosarcoma with frequencies of 38 (56.6%), 11 (16.4%), and 6 (9.0%), respectively. Six patients were HIV positive and all had SCC. Conclusions: Retinoblastoma was the most common malignant orbito-ocular tumor observed in this study. Patients often present late to the hospital with visual loss.

RésuméContexte: Les tumeurs malignes orbito-oculaires sont des causes majeures de morbidité et de mortalité dans les pays en développement. Leur présentation, type morphologique et la gestion sont difficiles, et les rapports précédents étaient principalement des enquêtes rétrospectives. L'analyse histologique est essentielle en faisant un diagnostic correct. Ici, nous avons déterminé les présentations cliniques et les types histopathologiques de tumeurs orbito-oculaires dans certaines hôpitaux tertiaires à Kano, au Nigeria. Matériels et méthodes: Il s'agissait d'une étude clinique et pathologique multicentrique prospective transversale. menée entre juin 2012 et mai 2013. Un formulaire pro forma a été utilisé pour enregistrer les résultats, les données biographiques du patient, la présentation clinique, type d'intervention chirurgicale et diagnostic histologique. Les données ont été analysées avec STATA version 11.0. Résultats: Soixante-sept tumeurs oculaires étaient observés chez 61 patients. Il y avait 43 hommes et 18 femmes (ratio hommes / femmes = 2,4: 1). Les patients avaient une moyenne de 13,4 ± 18,3 avec un médiane de 4,0 (0,5 à 70) années avec un double pic dans la répartition par âge. Les caractéristiques les plus courantes étaient la perte de vision (90,2%), la leucocorie (59%), proptosis (55%) et masse fongative (49,2%). Les symptômes étaient ≥ 6 mois chez 57,4% et unilatéraux chez 82,1%. B-scan a montré rétinienne masses et calcifi cations dans 13,5% et 4,5%, respectivement. La confirmation histologique a été réalisée dans 91% des cas. étant un rétinoblastome, un carcinome épidermoïde conjonctival (SCC) et un rhabdomyosarcome avec des fréquences de 38 (56,6%), 11 (16,4%), et 6 (9,0%), respectivement. Six patients étaient séropositifs et tous étaient atteints de SCC. Conclusions: Le rétinoblastome était le cancer le plus courant tumeur orbito-oculaire observée dans cette étude. Les patients se présentent souvent tardivement à l'hôpital avec une perte de vision.

Clinical pattern and antibiotic sensitivity of bacterial corneal ulcers in Kano, Northern Nigeria.

Purpose: The purpose of this study is to determine predisposing factors, common bacterial causes, and antibiotic sensitivity of corneal ulcers in Murtala Muhammad Specialist Hospital. Materials and Methods: A prospective, cross-sectional, observational study was carried out on patients with corneal ulcers. Information on relevant clinical, sociodemographic profile was obtained. Examination includes visual acuity test and slit-lamp biomicroscopy, especially fluorescein staining. Corneal scrapings from the ulcer were inoculated onto the selected solid culture media plates. Gram staining for microscopic examination was done. Antibiotic sensitivity test on different antibiograms was done using modified Kirby-Bauer technique, determining bacterial isolate sensitivity or resistance to relevant antibiotics (chloramphenicol, ciprofloxacin, ofloxacin, gentamicin, tetracycline, ceftazidime, ceftriaxone, cefotaxime, and penicillin). Results: A total of 77 patients with corneal ulcer were examined. Ocular trauma, application of harmful traditional eye medication, and use of unspecified topical medication before presentation were among the predisposing factors. Bacterial growth was seen in 46.8% of the samples, of which 28.6% of the growth were Gram-positive. The common bacteria isolated were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Proteus species, and Klebsiella pneumoniae. Isolates were sensitive to ciprofloxacin and ofloxacin while an intermediate sensitivity was seen with chloramphenicol and gentamicin. Isolates were resistant to tetracycline, ceftazidime, ceftriaxone, cefotaxime, and penicillin. Conclusion: Ocular trauma was the major predisposing factor to corneal ulcer, and Staphylococcus species was the major bacterial organism isolated. Isolates were found to be sensitive to ciprofloxacin and ofloxacin, while an intermediate sensitivity was seen with chloramphenicol and gentamicin.

RésuméBut: Le but de cette étude est de déterminer les facteurs de prédisposition, les causes bactériennes courantes, et la sensibilité aux antibiotiques des ulcères de la cornée à l'hôpital Murtala Mohammed Specialist. Matériels et méthodes: une étude prospective, transversales, l'étude d'observation a été effectuée sur des patients atteints d'ulcères de la cornée. Des informations sur les caractéristiques sociodémographiques, cliniques a été obtenue profi l. Examen comprend test d'acuité visuelle et lampe à fente biomicroscopie, surtout fl uorescein la coloration. À partir de l'ulcère cornéen raclures ont été inoculées sur la plaque de culture solide. La coloration de Gram pour l'examen microscopique a été fait. Essai sur la sensibilité aux antibiotiques a été effectuée à l'aide d antibiograms différentes modifi Ed Kirby-Bauer technique, déterminer la sensibilité ou la résistance d'isoler des bactéries aux antibiotiques correspondants (chloramphénicol, oxacin oxacin ciprofl, ofl, la gentamicine, la tétracycline, la ceftazidime, la ceftriaxone, céfotaxime, et la pénicilline). Résultats: Un total de 77 patients atteints d' ulcère cornéen ont été examinés. Un traumatisme oculaire, l'application de médicament traditionnel des nuisibles, et l'utilisation d'unspecifi ed médicament topique avant la présentation ont été parmi les facteurs de prédisposition. La croissance bactérienne a été observée dans 46,8 % des échantillons, dont 28,6 % de la croissance des bactéries Gram-positives ont été. Les bactéries communes isolées étaient Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, espèces de Proteus et Klebsiella pneumoniae. Les isolats étaient sensibles à l'oxacin oxacin ciprofl et ofl tandis qu'une sensibilité intermédiaire a été vu par le chloramphénicol et la gentamicine. Isolats étaient résistants à la tétracycline, la ceftazidime, la ceftriaxone, céfotaxime, et la pénicilline. Conclusion: un traumatisme oculaire a été le principal facteur prédisposant à l'ulcère cornéen, et Staphylococcus espèce a été le principal organisme bactérien isolé. Les isolats ont été trouvés à être sensibles à l'oxacin oxacin ciprofl et ofl, tandis qu'une sensibilité intermédiaire a été vu par le chloramphénicol et la gentamicine.

The astigmatic effect of pterygium in a Tertiary Hospital in Kano, Nigeria.

AIM: This study aims to determine the effect of pterygium excision on the degree of corneal induced astigmatism and visual acuity. PATIENTS AND METHODS: This was a prospective interventional study conducted between September 2012 and June 2013. Consecutive patients with pterygium who met the inclusion criteria were recruited into the study. They had a basic eye examination, and those with existing comorbidity were excluded. Selected patients had pterygium excision using the bare sclera technique with intraoperative application of Mitomycin C. Detailed pre- and post-operative evaluation and refraction was done. RESULTS: There were 45 eyes of 33 patients aged 28-75 years. The mean age was 56.12 + 12.38 years. Six eyes had Grade I, 29 eyes had Grade II and 10 eyes had Grade III pterygium. The mean value for preoperative astigmatism was 2.12 ± 1.09 diopter cylinder (DC) while that for postoperative astigmatism was 0.72 ± 0.50 DC (P = 0.000). Surgery was associated with statistically significant increase in postoperative visual acuity. (P = 0.000). CONCLUSION: This study has shown that the degree of pterygium-induced astigmatism reduces significantly following surgical excision. Pterygium excision was associated with improvement in visual acuity.

Refractive errors in presbyopic patients in Kano, Nigeria.

BACKGROUND: The study is a retrospective review of the pattern of refractive errors in presbyopic patients seen in the eye clinic from January to December, 2009. PATIENTS AND METHODS: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age, sex, and types of refractive error. Unaided and pin hole visual acuity was done with Snellen's or "E" Charts and near vision with Jaeger's chart in English or Hausa. All patients had basic eye examination and streak retinoscopy at two third meter working distance. The final subjective refractive correction given to the patients was used to categorize the type of refractive error. RESULTS: There were 5893 patients, 1584 had refractive error and 644 were presbyopic. There were 289 males and 355 females (M:F= 1:1.2). Presbyopia accounted for 10.9% of clinic attendance and 40% of patients with refractive error. Presbyopia was seen in 17%, the remaining 83% required distance correction; astigmatism was seen in 41%, hypermetropia 29%, myopia 9% and aphakia 4%. Refractive error was commoner in females than males and the relationship was statistically significant (P-value = 0.017; P < 0.05 considered significant). CONCLUSION: Presbyopia is common and most of the patients had other refractive errors. Full refraction is advised for all patients.

Pattern of diabetic retinopathy in Kano, Nigeria.

BACKGROUND: The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria. MATERIALS AND METHODS: Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient's bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS). RESULTS: A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23%) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77%) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X(2) =29.77 {95% CI}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X(2) = 65.85, {95% CI} P= 0.000]. Based on ICDRDSS scale, 136 patients (64%) had no retinopathy and 78 patients (36%) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8%). Cataract and glaucoma were the cause in 6 patients (2.8%). CONCLUSION: Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment.