Prevalence and Pattern of Eye Disorders Among Primary Schoolchildren in Abakaliki, Nigeria: A Cross-Sectional Study.

Background A child's learning ability depends on vision, and visual impairment negatively affects neurological, intellectual, and emotional development by limiting children's exposure to a range of experiences and information. This study aims to determine the prevalence and pattern of ocular morbidity among primary schoolchildren in Abakaliki and provide evidence that can be used in planning a school eye health program for the state. Methodology A school-based, cross-sectional study was conducted within the Abakaliki metropolis between January and April 2018 to determine the ocular health status of schoolchildren recruited using stratified random sampling. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA) and presented using descriptive statistics. Univariate analysis was performed to determine the association between dependent and independent variables, with the level of significance determined by a p-value <0.05 (95% confidence interval (CI)). Results A total of 553 schoolchildren aged 6-16 years were examined. The prevalence of eye disorders was 23.5%. Common disorders included refractive error (12.7%) and allergic eye disease (7.1%). Other findings included glaucoma suspect (15, 2.7%), infective conjunctivitis (1, 0.2%), amblyopia (3, 0.5%), cataract (1, 0.2%), and squint (1, 0.2%). The prevalence of visual impairment was 3.1%. Univariate analysis showed a significant association between ocular morbidity and attending private schools (95% CI = 6.5-11.1, p = 0.003). Conclusions Eye disorders such as uncorrected refractive error and allergic conjunctivitis were common among schoolchildren. School eye health programs can ensure that eye screening is done periodically, allowing for early detection, referral, and prompt treatment of eye diseases that can potentially cause visual impairment.

Distribution of phthisis bulbi and status of fellow eyes at a tertiary eye-care centre in Nigeria: a ten-year review.

BACKGROUND: Phthisis bulbi is an irreversible cause of visual loss with insufficient evidence about its aetiology and status of patients' fellow eyes. OBJECTIVES: To identify the distribution of patients with phthisis bulbi and determine the status of their fellow eyes at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. METHODS: We analysed data retrospectively retrieved from medical records of patients diagnosed with phthisis bulbi at initial clinic visit from January 2008 to December 2017. Information abstracted included biodata, laterality of phthisical eye, duration and aetiology of phthisis bulbi, visual acuity, and morbidities present in fellow eyes. RESULTS: Seventy-nine patients presented with unilateral phthisis bulbi. The mean age was 51±21.2 years and forty (50.6%) were males. The commonest aetiologies of phthisis bulbi were trauma 37 (46.8%), infection 17 (21.5%) and uveitis/inflammation 11 (13.9%). Seventy (88.6%) patients had morbidities in their fellow eye such as glaucoma 26 (32.9%), refractive errors 23 (29.1%) and cataract 22 (27.9%). Forty (50.6%) patients were either visually impaired or blind in their fellow eye (p=0.001). CONCLUSION: The commonest cause of phthisis bulbi was trauma. Approximately nine out of ten patients had ocular morbidities in their fellow eye. A thorough follow-up of patients with phthisis bulbi is recommended.

Outcomes in paediatric external dacryocystorhinostomy: a single-centre experience.

PURPOSE: To report the outcomes of external dacryocystorhinostomy (Ext DCR) in paediatric patients. METHODS: A single-centre, retrospective, interventional, non-comparative case series was performed on all paediatric patients who underwent Ext DCR between July 2010 and July 2014. Surgery was performed as per standard Ext DCR protocols with only anterior flap suturing. Data collected include demographics, clinical presentations, primary diagnosis, associated systemic anomalies, past interventions, indications for the surgery, use of adjuvants, intraoperative and post-operative complications, aetiology of DCR failure, anatomical and functional successes. RESULTS: 135 eyes of 114 children underwent Ext DCR during the study period. Mean age was 9.68 ± 4.36 years and epiphora was the most common presentation (92.5%, 125/135). Persistent congenital nasolacrimal duct obstruction refractory to earlier interventions of probing or intubation was the most common indication for the surgery noted in 57% (77/135). Adjuvants like mitomycin C and intubation were used in 70% (95/135) and 72% (98/135) of the surgeries, respectively. At a 6-month follow-up, anatomical and functional successes were noted in 91.1% (124/135) and 90.3% (123/135), respectively. 12 eyes showed anatomical failure and one eye showed functional failure. The most common cause of DCR failure was a complete cicatricial closure of the ostium (83.4%, 10/12). CONCLUSIONS: This study shows that Ext DCR is a safe surgery for paediatric populations with a high success rates of beyond 90%.

Effect of Optic Nerve Disinsertion During Evisceration on Nonporous Implant Migration: A Comparative Case Series and a Review of Literature.

AIM: To determine whether evisceration with optic nerve disinsertion and nonporous implant placement increases the risk of implant migration. METHODS: This was a single-center, retrospective consecutive comparative interventional case series including patients undergoing evisceration with nonporous implant between January and December 2014. Patients were grouped into 2 groups: group I where the optic nerve was not disinserted (n = 37) and group II with optic nerve disinsertion (n = 50). Implant migration was assessed clinically and on patient photographs. Migration was subclassified as decentration that did not affect the prosthetic outcome and displacement that affected the prosthetic outcome. The secondary outcome measures were the mean implant diameter, volume of the custom ocular prosthesis, and implant-related complications like exposure and extrusion between the 2 groups. RESULTS: At a mean follow up of 12.5 months, none of the sockets in group I and 3 (6%) sockets in group II (p = 0.35) had evidence of implant decentration. There were no cases of implant displacement in both groups. The mean implant diameter in group I was 16.97 mm ± 0.65 mm and in group II 19.2 mm ± 0.83 mm (p = 0.0001). Implant extrusion was not different between the 2 groups. The mean custom ocular prosthesis volume in group I was 3.86 ml ± 0.52 ml and in group II 2.50 ml ± 0.68 ml (p < 0.0001). CONCLUSIONS: The rate of nonporous implant migration due to optic nerve disinsertion is not statistically or clinically significant in evisceration with optic nerve disinsertion, allowing placement of a larger implant and fabrication of a custom ocular prosthesis with an ideal weight.

Histological sections of corneal incisions in OCT-guided femtosecond laser cataract surgery.

PURPOSE: To investigate the quality and accuracy of three-dimensional spectral-domain optical coherence tomography (OCT)-guided corneal incisions with the Catalys precision femtosecond laser system (OptiMedica, Sunnyvale, CA) in living human tissue. METHODS: In vivo cataract and intrastromal corneal incisions were made with a femtosecond laser designed for cataract surgery with a patient scheduled for enucleation. RESULTS: An accurate correlation between the pre-incision spectral-domain OCT and the post-incision histology was demonstrated. CONCLUSIONS: The OCT-guided femtosecond laser is capable of creating accurate, precise, and histologically demonstrable incisions in preselected intrastromal locations.

Femtosecond laser-assisted cataract surgery in pediatric Marfan syndrome.

PURPOSE: To report femtosecond laser-assisted cataract surgery in pediatric Marfan syndrome. METHODS: Case report. RESULTS: A 10-year-old boy with ectopia lentis due to Marfan syndrome underwent femtosecond laser-assisted cataract surgery (Catalys Precision Laser System; OptiMedica, Sunnyvale, CA) under general anesthesia. Anterior capsulotomy was performed on the decentered lens. Routine irrigation/aspiration devices were used for lens and cortex removal. Centration of the capsular bag was achieved using a Cionni scleral fixation ring. A foldable intraocular lens was implanted. A free-positioned and precise sized capsulotomy was cut by the femtosecond laser. No intraoperative or postoperative complications were observed within the 10 weeks of follow-up. CONCLUSIONS: The use of a femtosecond laser has potential to perform a circular, well-centered capsulotomy for subsequent capsular tension ring and intraocular lens implantation without decentration in patients with Marfan syndrome.