Visual impairment among eye health workers in a tertiary eye centre in Ghana.

Objective: To determine causes of visual impairment (VI) among staff of the Eye Centre at the Korle Bu Teaching Hospital. Design: This was a cross-sectional study. Setting: The Eye Centre, Korle Bu Teaching Hospital (KBTH), from October 2016 to March 2017 on all consenting members of staff. Participants: Eighty-four (79.3%) of 106 consenting staff members participated in this study. Data collection/Intervention: A detailed history (demographic, ocular, medical co-morbid conditions), ocular examination and relevant diagnostic investigations were conducted. Interventions initiated included treatment for glaucoma, dry eye and allergic conjunctivitis and spectacles prescription for refractive errors. Main outcomes: Prevalence of avoidable causes of VI (glaucoma, cataract, refractive errors). Secondary outcomes included prevalence of unavoidable causes of VI. Results: Eighty-four (79.3%) members of staff participated in this study. Most of the participants were females, 54(64.3 %). Age ranged from 23 to 60 years with an average of 35.8±9.9 years (mean ± SD).Prevalence of VI was 9.5 % (8/84), all due to uncorrected refractive error. Other known causes of VI included open angle glaucoma in 12(14.3 %), macular scar of unknown cause, 1(1.2 %) and sutural cataract, 1(1.2 %) but were all visually insignificant. Conclusions: The prevalence of VI among the staff of the Eye Centre of the KBTH was 9.5 %, all due to refractive errors. Other known causes of avoidable visual impairment and blindness encountered were glaucoma (14.3 %), macular scar (1.2 %) and cataract (1.2 %), all asymptomatic. Routine eye screening should be part of periodic medical examination for employees. Funding: None declared.

Complicated sinusitis in developing countries: an African perspective.

PURPOSE OF REVIEW: Complicated rhinosinusitis continues to be a diagnosis not to be missed because of the potential life-threatening and life-changing outcomes. This is true for clinicians in both developed and developing countries. Advances in diagnostic imaging, appropriate antibiotic use and timely surgical intervention have resulted in better outcomes particularly in the developed world. This review focuses on the current management of complicated sinusitis in resource-limited settings. RECENT FINDINGS: Recent publications indicate leaning toward endoscopic sinus surgery as a standalone procedure or in combination with traditional external approaches in the management of complicated rhinosinusitis with less morbidity and shorter recovery time. It is becoming increasingly evident that multidisciplinary specialties should be involved in the effective management of patients with complicated sinusitis. SUMMARY: Early recognition, prompt surgical intervention and antibiotic therapy remain keys in the management of complicated rhinosinusitis. In many African countries and other developing countries, the absence of specialized imaging and endoscopic diagnostic equipment and endoscopic surgical facilities and expertise means that reliance must be placed on clinical acumen both for diagnosis and monitoring of treatment response of complicated sinus infections.