Fistula-in-Ano with Broomsticks: An Unusual Etiology.

ABSTRACT: Fistula-in-ano is caused by idiopathic infection of the cryptoglands located in the anal intersphincteric plane when the resultant cryptoglandular abscess drains internally and externally. It is a common surgical disease that responds well to surgical intervention. In cases of recurrent non-healing fistula-in-ano, an underlying cause should be suspected and searched for. We present a 29-year-old man who had recurrent complex fistula-in-ano caused by broomsticks of an unknown source. Fistulotomy, tactile wound exploration, extraction of the broomsticks, and wound debridement were done. The wound healed well by secondary intention. Few cases of recurrent complex fistula-in-ano had been reported in the literature. However, this is the first time to the best of our knowledge that broomsticks causing non-healing, complex fistula-in-ano that is being reported. We suggest the use of a bending machine instead of mashing broom bunch in the preparation of Ewedu soup which is a delicacy for the Yoruba tribe in Nigeria to eliminate the chances of inadvertent ingestion of broomsticks when eating Ewedu soup.

Analysis of diagnoses of chest injuries in a Nigerian trauma center.

Background: Chest injury is one of the most common types of trauma-related injuries accounting for about 10% of trauma admissions in emergency services. The injuries may be immediate, life-threatening, or potentially life-threatening based on diagnosis after initial assessment. This study is intended to analyze the pattern of diagnosis found in chest-injured patients in a trauma center of a developing country. Methods: This is a retrospective study carried out in the trauma center of the National Hospital Abuja, Nigeria, between January 2015 and December 2017, as an analysis of the existing trauma registry. Data procession was done using SPSS version 24.0. Results were presented in tables and figures. Results: A total of 637 patients' data was studied, male to female ratio of 3.58 and mean age of 34.18 ± 11.34 years. More patients sustained isolated chest injury (59.5%) and blunt chest injury (78%). The most frequent diagnosis was chest wall soft tissue injury (CWSTI) (46.6%) despite the exclusion of minor chest wall injuries who did not require any form of observation. Haemothorax and rib fractures were the next most common diagnoses after CWSTI constituting 13.5% and 8.7%, respectively, while flail chest and aortic injuries were the least comprising 0.6% and 0.2%, respectively. The commonest associated injuries were traumatic brain injury (11.3%), extremity fractures (11.1%), and abdominal injuries (7.8%). Penetrating injuries were more significantly associated with male gender and isolated chest injuries (P < 0.001). Conclusion: Chest wall soft tissue injuries constitute a large proportion of chest injuries seen in our setting. Despite its relatively low importance in the medical literature, it should be given attention in resource-poor settings in order to minimize missed significant injuries in the absence of diagnostic facilities. Therefore, high index of suspicion and low threshold for observation should be practiced in this group of patients.

Spectacle design preferences among school children in Enugu State, Nigeria.

BACKGROUND: Uncorrected refractive error has profound effects on children's educational and social development and spectacles are cost-effective in correcting this. However, the cosmetic appearance of spectacles may affect compliance to prescribed spectacles. AIMS: This study explored spectacle design preferences of school children in Enugu State, Nigeria and any associated sociodemographic factors. A cross-sectional study among children aged 5-15 years from schools in Enugu state, Nigeria. PATIENTS AND METHODS: The children independently selected from sets of spectacle frames, indicating their preferences on the basis of spectacle frame color, material, shape and size of the lens portion, design of the earpiece portions. Simple descriptive analysis was performed. Frequency tables were generated. Pearson's Chi-square test was used to test associations between categorical variables. Odds ratios were used to measure the strength of the associations where P < 0.05. Tests of significance were set at the 95% level. RESULTS: A total of 1,167 children (45.6% male and 54.4% female) were seen. Majority of the children preferred red colored spectacle frames 467 (40%), plastic frames 723 (62%), rectangular shaped lens-pieces (55.2%), and frames with a straight earpiece 987 (84.6%). There is a strong association between gender and choice of spectacle colour (P < 0.01), gender and lens size preference (P < 0.05), and between school location and shapes of spectacle earpiece (P < 0.01). CONCLUSIONS: Spectacle preferences exist among the study population and some demographic factors are associated with these preferences which should be considered in any childhood refractive error services.

Prevalence of refractive errors and visual impairment in school children in Enugu South-East Nigeria.

AIMS: To determine the prevalence of refractive errors and causes of visual impairment in school children in Enugu State, South-eastern Nigeria. METHODS: A descriptive cross-sectional, school-based survey in children aged 5-15 years from selected primary and junior secondary schools (public and private) in both urban and rural communities of Enugu State was carried out. Ocular examinations were performed on them according to the Refractive Error in School-age Children (RESC) protocol. RESULTS: A total of 1167 children were examined. The mean age (standard deviation) was 10.58 ± 3.0 years. Females were 653 (54.4%) of the study population. The uncorrected, presenting and best-corrected visual acuity of ≤20/40 (6/12) in the better eye of the children in this study were 3.6%. 3.5% and 0.4%. Among the children that had visual impairment, refractive error accounted for 33.3% of reduced vision while the overall prevalence of refractive error was 2.1%. Prevalence of myopia was 1.9% and hyperopia, 0.1%. The most prevalent astigmatism was ≤0.75 dioptre cylinder. CONCLUSION: The prevalence of refractive error in this study is low, with myopia being more common. Despite the low prevalence of refractive error, school vision screening is still important for African children as it serves as an opportunity to identify other ocular morbidities among the children.

Implementing trauma resuscitation protocol in COVID 19 Era: Our modifications at the national trauma centre, Abuja, Nigeria.

Trauma remains the leading cause of death in individuals less than 45 years. Management of major trauma is protocol driven around the world. Most protocols are in line with the popular Advanced Trauma Life Support (ATLS) principles. These principles have been adjudged to be safe and consistent even in the presence of infectious diseases while employing standard precautions. In view of the current community spread, large cases of COVID 19 in the Federal Capital Territory (FCT) and the magnitude of the infectivity, it has become necessary to adjust our local trauma resuscitation protocols in order to ensure the safety of the trauma team and the trauma patients as well.

Peri-Surgical Acute Kidney Injury in Two Nigerian Tertiary Hospitals: A Retrospective Study.

BACKGROUND: The incidence and outcomes of acute kidney injury (AKI) are worse in developing countries due to late diagnosis, poor access and high cost of care. Surgical patients may have up to 10 fold increased risk for AKI due to complications arising from the primary surgical illness, peri-operative complications and treatment. METHODS: This study was a retrospective cross-sectional study of the epidemiology of AKI in two Nigerian tertiary institutions. Patients who had surgery during a 1year period were included. Patients' identification were obtained from the theatre registers, and relevant data collected from their hospital files. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria. RESULTS: Two hundred and twenty patients were studied, and the majority were males (60.9%). Forty patients developed AKI (18.2%), with the majority in KDIGO stage 1 (12.7%). Mean age was 43.7±17.6 years compared to 37.2±21.7 years among those without AKI (mean difference=6.489, p=0.079). More males than females developed AKI (19.4% vs 16.3%, p=0.558). AKI was diagnosed in 38.5% of patients with sepsis compared to 16.9% of non-septic patients (p=0.061); in 23.9% of patients who had significant blood loss compared to 15.4% of patients without significant blood loss (p=0.128). Intensive care unit (ICU) admission was significantly commoner among patients with AKI (20% vs 7.8% p = 0.023). Mortality was 25% among patients who developed AKI compared to 7.2% in those without AKI (p=0.005) CONCLUSION: Patients diagnosed with AKI had a higher mean age. Perisurgical AKI was commoner in males, patients with sepsis, and those who lost significant blood intra-operatively. ICU admission and mortality were significantly higher among patients with AKI.

Gender disparity in risk factors for chronic kidney disease in a rural community in Southern Nigeria

Background: The evidence for gender disparity in prevalence of CKD is conflicting; while some studies report male preponderance, others have report female preponderance or no difference. Reasons for gender disparities in CKD prevalence may be related to differences in the occurrence of risk factors across the gender, amongst other factors. This study was to determine gender disparities in the risk factors for CKD. Method: This study is based on data from a community based cross-sectional study carried out in Ogbona, a rural community in Southern Nigeria. The WHO STEPS for surveillance of chronic diseases risk factors and chronic disease-specific morbidity and mortality questionnaire was adapted for this study. Four hundred and seventy-six participants were selected from 142 housing units in the community using multi-stage cluster sampling. Clinical examinations and laboratory investigations including serum creatinine, and urinalysis were performed. Results: Majority of participants were females (66.2%). CKD was commoner in females compared to males (14.3% vs. 12.7%, P= 0.06). More females than males had high body fat percentages (65.7% vs. 40.9%, P=<0.0001), high waist-hip ratio (99.7% vs 73.3%, P=<0.0001) and central obesity (43.1% and 4.3% P=<0.0001). More males compared to females used alcohol (56% vs. 9.2%, P=<0.0001), were overweight (42.2% vs 28.9%, P=0.004), and had proteinuria (6.2% vs 2.5%, P=0.054). The odds of females having central obesity are 16.7 times the odds of males having central obesity; similarly, the odds of females having high BF are 2.7 times the odds of males having high BF. Females had 122-fold the odds of men having high WHR. The odds of drinking alcohol are 92% less compared to males. There were no statistically significant gender differences regarding hypertension, diabetes mellitus, and use of nephrotoxins (NSAIDS, skin lightening agents, herbal medications). No female smoked cigarettes. Conclusion: This study shows that there is no statistically significant gender difference as regards prevalence of CKD, however several risk factors of CKD show gender disparity. The odds for central obesity, high WHR, high body fat percentages are significantly greater in females; while smoking, alcohol use, and over weightness, are commoner in males. There were no statistically significant gender differences regarding hypertension, diabetes mellitus, and use of nephrotoxins (NSAIDS, skin lightening agents, herbal medications)

Environmental Exposure to Crude Oil: A Potential Risk for Chronic Kidney Disease (CKD) in Disadvantaged Countries.

BACKGROUND: Exposure to environmental pollutants has been associated with the high burden of Chronic Kidney Disease (CKD) in disadvantaged populations. Although biologically plausible, the evidence for kidney damage from hydrocarbon or crude oil exposure is still conflicting. Several human and animal studies from as far back as the 1950s have associated some forms of chronic glomerulonephritis or CKD, with long-term human exposure to hydrocarbons. However, other studies have produced opposite findings or dispute findings of positive studies. METHODS: This paper reviews in detail the mechanisms of environmental and human exposure to crude oil and the evidence for crude oil associated chronic kidney disease. Additionally, a search was conducted on PubMed and Google Scholar, revealing 152 articles, out of which, 64 articles were included for review; animal studies and case reports were excluded Results: Overall, 64% of the studies reviewed supported an association between hydrocarbon exposure and kidney disease. Eight out of the nine cohort studies reported a positive association, and the only meta-analysis reported an increased risk for renal cancer. Conversely, 50% of the mortality studies reported no increased risk of deaths due to cancer among petroleum oil workers. Existing review articles on this subject were mostly inconclusive (55%). CONCLUSION: A significant proportion of studies have supported the increased risk for CKD in exposed individuals. The possibility that crude oil exposure may indeed cause harm underscores the need to re-open the subject matter. Well-designed epidemiological studies, particularly situated in oil producing communities of disadvantaged countries may be a step in the right direction.

Relationship between corneal biomechanical properties among pregnant women in a tertiary hospital in Nigeria.

OBJECTIVE: In Nigeria, many pregnant women as well as health-care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them. MATERIALS AND METHODS: A prospective longitudinal study was used. One hundred and thirty-four pregnant women attending the Obstetric Clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. Changes in CCT, CS, and IOP were monitored at the second and third trimesters and 6-week postpartum. Data obtained were analyzed using Statistical Package for the Social Sciences version 20. The effect of duration of pregnancy on these variables was determined using simple linear regression and further analysis was done using Bonferroni's post hoc test. RESULTS: The women were aged 18-48 years, with a mean age of 30.81(±5.49) years and majority of them (61.2%) were multigravida. The duration of pregnancy varied inversely and significantly with CS (P < 0.05) and IOP (P < 0.000) with the least values recorded in the third trimester, while it varied directly and also significantly with CCT (P < 0.000) with the highest value obtained in the third trimester. A negative correlation that was significant only in third trimester was found between CCT and IOP (P < 0.02) and CS (P < 0.03). CONCLUSION: There was a progressive increase in CCT with a corresponding decrease in CS and IOP across the trimesters of pregnancy, but these changes reversed 6-week postpartum.

Audit of ophthalmology discharge summaries in a Nigerian Teaching Hospital.

BACKGROUND: Discharge summaries are important components of hospital-care transitions in ensuring continuity of care. AIM: We assessed the adequacy and accuracy of discharge summaries written by junior doctors. METHODS: An instrument, adapted largely from the current hospital discharge summary template and recommendations regarding content from the Joint Commission International, was used to study 420 discharge summaries written in 2012 from the ophthalmology service of a Rural Teaching Hospital in Nigeria. The simple descriptive analysis was done with Statistical Package for the Social Science version 17. RESULTS: Completeness of entries was relatively high in many traditional areas (biodata of patient, admission/discharge dates, name of supervising consultant, principal diagnosis, surgical procedures done, follow-up instructions, and condition on discharge) of the summaries. The portion of the paper-based template titled "summary" of the admission was most problematic; with information on medication changes and result of tests missing in 368/420 (87.6%) and 334/420 (79.5%), respectively. CONCLUSION: Educational intervention for doctors in training with the provision of oversight and feedback by their supervisors is required. Standardized discharge summary templates recognizing the peculiarities of specialized patient groups are recommended. Transition to electronic discharge summary system is imperative.

Evaluation of the learning and teaching environment of the Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus.

PURPOSE: The study aimed at evaluating the learning and teaching environment of undergraduate students of the Faculty of Medical Sciences, University of Nigeria. METHODS: The study was a descriptive, cross-sectional survey. The Dundee Ready Education Environment Measure (DREEM) questionnaire was self-administered to the final year medical students during the second semester of 2013/2014 academic year. The 50-items of the questionnaire were sub-divided into five sub-groups: perception of learning, perceptions of teachers, academic self-perceptions, perceptions of atmosphere, and social self-perceptions. RESULTS: The questionnaire was completed by 128 out of the 139 students (92.1%). Of the maximum score of 200, the total mean score was 101.82 ± 20.36 SD. The mean ± SD score of students' perception of learning was 25.97 ± 4.18 (maximum score, 48). The mean ± SD score of teachers was 24.40 ± 4.74 (maximum score, 44), whereas that of students' academic self-perception, perception of atmosphere, and social self-perception was 19.96 ± 5.29 (maximum score, 32), 19.02 ± 7.69 (maximum score, 48), and 11.86 ± 4.22 (maximum score, 28), respectively. CONCLUSION: The overall mean score shows that the students' perception of their learning environment was more positive than negative according to the practical guide of McAleer and Roff on the interpretation of DREEM questionnaire. However, there are problematic areas revealed by this study that will inform policy formulation and remedial intervention.

Correlates of Stone Quarry Workers' Awareness of Work-related Ocular Health Hazards and Utilization of Protective Eye Devices: Findings in Southeastern Nigeria.

OBJECTIVE: To assess the awareness of work-related ocular health hazards and utilization of personal protective eye devices (PPEDs) among stone quarry workers in Abakaliki, southeastern Nigeria. MATERIALS AND METHODS: In a cross-sectional survey of stone quarry industry workers in Abakiliki, conducted between March and April, 2012, data on participants' socio-demographics, job characteristics, PPED awareness, and utilization were collected. Descriptive and analytical statistics were performed. For intergroup comparisons, P < 0.05 was considered statistically significant. RESULTS: All workers were aware of the need for utilization of eye protective devices; however, 98.7% declined its use for various reasons. About 74.6% attributed nonutilization to nonavailability while 10.4% attributed it to high cost and 10.2% declined its utilization due to discomfort associated with its use. DISCUSSION: Usage of PPEDs was associated with job specification, educational level, duration of work experience, awareness of work hazards, and knowledge about the purpose of PPEDs. Nonusage was associated with unavailability, high cost of procurement, and ocular discomfort from poor fitting and misty/cloudy vision with use. Users were more numerous among blasters and crushers whose jobs were most predisposed to work related accidents and workers with formal education. CONCLUSIONS: Findings from the study reveal high level of awareness yet nonutilization of eye protection. Barriers to the utilization of these eye protective devices should be addressed to ensure greater compliance of its use.

Bilateral concomitant intravitreal anti-vascular endothelial growth factor injection: Experience in a Nigerian tertiary private eye care facility.

OBJECTIVES: To evaluate the indication and safety profile of same-session bilateral intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF). METHODS: This is a retrospective case series of all the patients that received same-session bilateral intravitreal anti-VEGF in Eye Foundation Hospital, Ikeja, Lagos, from March 2013 to March 2015. Data retrieved from the patients' medical records includes demographics, indications for injections, complications, and systemic comorbidities. RESULTS: During the study period, a total of 442 injections were performed on 126 eyes of 63 patients (M:F ratio; 1.4:1) whose mean age was 55.7 ± 15.6 standard deviation years. The modal age group was 51-70 years. All the patients received injection Bevacizumab (Avastin; Genentech Inc., South San Francisco, California, USA-1.25 mg). The most common primary indication for initiating bilateral intravitreal therapy was diabetic macular edema 23 (36.5%). Mean follow-up period was 40.6 days (range: 1-364 days). A combined diabetes mellitus and hypertension accounted for most of the systemic comorbidities 28 (44.4%). Subconjunctival hemorrhage was the only complication seen in these patients with 6 (9.5%) occurring intraoperatively and 9 (14.3%) postoperatively. There was no association between intraoperative complication and age (P = 0.66) or gender (P = 0.96). Furthermore, there exist no association between postoperative complication and age (P = 0.49) or gender (P = 0.99). CONCLUSIONS: No major systemic or ocular adverse events were noted. Given that there are potentially serious complications following anti-VEGF injection, further study with a larger number of patients will be necessary to definitively prove the safety of this treatment modality.

Topical-intracameral anesthesia in manual small incision cataract surgery: A pilot study in a Tertiary Eye Care Center in Africa.

BACKGROUND: Cataract remains a leading cause of blindness worldwide. Manual small incision cataract surgery (MSICS) is currently practiced as the technique of choice in Sub-Saharan Africa to reduce the backlog of cataract blindness. Optimal pain control during surgery remains a challenge to cataract surgeons. AIM: To evaluate the efficacy and safety profile of the use of aqueous topical/intracameral anesthesia in MSICS. MATERIALS AND METHODS: In this hospital-based case series, consecutive patients presenting at the eye clinic with operable cataract and willing to have surgery were enrolled. Baseline sociodemographics (age, sex, and occupation), type of cataract by morphology, pain perception, and surgeons experience were recorded. Descriptive and comparative statistical analyses were performed. A P < 0.05 was considered statistically significant. RESULTS: The surgeries were performed on 30 eyes of 16 (53.3%) males, and 14 (46.7%) females (sex ratio, 1:0.9) who were aged 60.3 ± 16.32 standard deviation (SD) (95% confidence interval [CI] of mean; 53.94-66.13) (range; 20-98 years). Using the visual analog scale, the mean pain score was 2.7 SD ± 2.215 (1.87-3.53 95% CI). There was no correlation between degree of pain perception and gender (P = 0.806) or age (P = 0.388). Patient's cooperation was excellent in 22 (73.3%) of patients. Intraoperative complications occurred in 3 (10%) of patients. CONCLUSION: The mean pain score in this study is low. There is no correlation between perception of pain with gender or age. Surgeons experience is excellent in most of the cases. This method of anesthesia in MSCIS is adequate for patient's comfort and safe cataract surgery.

The impact of increased plasma ratios in massively transfused trauma patients: a prospective analysis.

PURPOSE: Transfusion ratios approaching 1:1 FFP:PRBC for trauma resuscitation have become the de facto standard of care. The aim of this study was to prospectively evaluate the effect of increasing ratios of FFP:PRBC transfusion on survival for massively transfused civilian trauma patients as well as determine if time to reach the target ratio had any effect on outcomes. METHODS: This is a prospective, observational study of all trauma patients requiring a massive transfusion (≥10 PRBC in ≤24 h) at a level 1 trauma center over a 2.5-year period. The ratio of FFP:PRBC was tracked hourly up to 24 h post-initiation of massive transfusion. A logistic regression model was utilized to identify the ideal ratio associated with mortality prediction. A stepwise logistic regression was performed to identify independent predictors of mortality. RESULTS: The study population was predominantly male (89 %) with a mean age of 34.8 ± 16. On admission, 22 % had a systolic blood pressure ≤90 mmHg, 47 % had a heart rate ≥120, and 25 % had a GCS ≤8. The overall mortality was 33 %. The ratio of FFP:PRBC ≥ 1:1.5 was the second most important independent predictor of mortality for this population (R (2) = 0.59). Survivors had a higher FFP:PRBC ratio at all times during the first 24 h of resuscitation. CONCLUSIONS: Achieving a ratio of FFP:PRBC ≥ 1:1.5 after the initial 24 h of resuscitation significantly improves survival in massively transfused trauma patients compared to patients that achieved a ratio <1:1.5.

Eliminating the barriers to uptake of cataract surgery in a resource-poor setting: a focus on direct surgical cost.

BACKGROUND: Cataract remains a leading cause of blindness worldwide. Despite the high therapeutic efficacy of cataract surgical interventions, surgical uptake has been sub-optimal, especially in low- and middle-income countries. OBJECTIVE: The objective was to investigate the effect of surgical fee reduction on the uptake of cataract surgical services at the University of Nigeria Teaching Hospital (UNTH) Enugu. METHODS: In a retrospective comparative study, all patients who underwent cataract surgery at UNTH between January 2008 and December 2011 were identified from the eye theatre's surgical logbook. Their clinical charts were recalled and relevant demographic and clinical data were abstracted, categorized into pre (January 2008 to December 2009, Group A), and post (January 2010 to December 2011, Group B) surgical fee reduction groups. Descriptive and comparative statistical analyses were performed. RESULTS: A total of 376 cataract surgeries (Group A, 164 [43.6%]; Group B, 212 [56.4%]) was performed during the 4-year study period. The surgeries were performed on 217 males, and 159 females aged 55.4 ΁ 23.4 standard deviation years (range, 7 months to 89 years). The average annual uptake of cataract surgery was 94 overall, 82 pre and 106 postsurgical fee reductions. The two groups did not differ significantly by age (P = 0.8750) or gender (P = 0.8337). CONCLUSION: There is low uptake of cataract surgery at UNTH Enugu. Direct surgical fee reduction alone caused only a modest increase in uptake without alteration in age and gender balance. Further fee reduction and exploration of other uptake barriers are warranted.

Patients' satisfaction with eye care services in a Nigerian teaching hospital.

BACKGROUND: Understanding the patients' perception of services received is essential as the parameters important to the patient may be quite different from that to the eye health provider. AIM: This study aims to evaluate patients' satisfaction with the care received from the pioneer teaching hospital in south-eastern Nigeria and use it to audit services. MATERIALS AND METHODS: This was a descriptive cross-sectional study. An interviewer-administered questionnaire was administered to 307 consecutive consenting patients seen at the eye clinic of the University of Nigeria Teaching Hospital Enugu in April 2013. The questionnaire asked questions regarding satisfaction with the time spent in the clinic, attitude of various categories of staff, physical facilities, cleanliness of the clinic and willingness to come again to the clinic or recommend it to others. RESULTS: The respondents were more satisfied with the attitude of the doctors and nurses than that of revenue and medical records clerks (P = 0.001). Most patients, 288 (93.8%) expressed satisfaction with the overall cleanliness of the eye clinic; 220 (71.7%) and 288 (93.8%) were not satisfied with the toilet facilities and cost of services, respectively. Only 140 (45.6%) participants will recommend the hospital to others strongly, 145 (47.2%) will do so hesitantly. CONCLUSION: Majority of the patients were satisfied with the services received. The major dissatisfaction points were cost of services and inadequate toilet facilities.

Refractive errors in children with autism in a developing country.

BACKGROUND: In a resource-limited country visual problems of mentally challenged individuals are often neglected. AIM: The present study aims to study refractive errors in children diagnosed with autism in a developing country. MATERIALS AND METHODS: Ophthalmic examination was carried out on children diagnosed with autism attending a school for the mentally challenged in Enugu, Nigeria between December 2009 and May 2010. Visual acuity was assessed using Lea symbols. Anterior and posterior segments were examined. Cycloplegic refraction was performed. Data was entered on the protocol prepared for the study and analyzed using Statistical Package for the Social Sciences version 17 (Chicago IL, USA). RESULTS: A total of 21 children with autism were enrolled in the school; 18 of whom were examined giving coverage of 85.7%. The age range was 5-15 years, with a mean of 10.28 years (standard deviation ± 3.20). There were 13 boys and 5 girls. One child had bilateral temporal pallor of the disc and one had bilateral maculopathy with diffuse chorioretinal atrophy. Refraction revealed 4 children (22.2%) had astigmatism and 2 children (11.1%) had hypermetropia. CONCLUSION: Significant refractive error mainly astigmatism was noted in the children with autism. Identifying refractive errors in these children early and providing appropriate corrective lenses may help optimize their visual functioning and impact their activities of daily life in a positive way.