Presentation, etiology and treatment outcome of neovascular glaucoma in Ekiti state, South Western Nigeria.

BACKGROUND: Neovascular glaucoma (NVG), a form of secondary glaucoma has varying causes across geographical locations. OBJECTIVE: The objective of this study was to determine the presentation, aetiology, and outcome of treatment of patients with NVG in a Nigerian tertiary hospital. METHOD: A retrospective review of records of all cases of NVG seen over a 5year period was carried out. Demographic characteristics, presenting visual acuity and coexisting ocular and systemic conditions were noted. Data were analysed with Statistical Package for Social Sciences (SPSS) version 25. RESULTS: 29 eyes of patients with NVG were analysed. Most of the patients (89.70%) presented with visual acuity less than 3/60 in the affected eye. All patients except one were treated with anti-glaucoma medications while only 9(31%) consented to and received anti-vascular endothelial growth factor. No patient had improvement in visual acuity despite resolution of other symptoms at 12week follow up. CONCLUSION: NVG though not as common as other forms of glaucoma accounted for a large proportion of monocular blindness in the affected eyes at presentation. There is need for health promotion and education among our people on the need for early preventive eye check practices.

Pattern of corneal disorders in Ekiti: A tertiary eye center experience.

Purpose: The cornea is the most significant refractive medium in the eye. Pathologies affecting the cornea usually have a great impact on vision. The etiology of corneal disorder varies from one geographical location to another. The objective of this study was to determine the pattern of corneal disorders at Ekiti State University Teaching Hospital, Ado-Ekiti. Materials and Methods: A retrospective study of case records of patients with cornea disorders over a 5-year period was carried out. Demographic characteristics, presenting visual acuity, and risk factor for cornea disorders were retrieved. Data were entered into the Statistical Package for the Social Sciences version 20, and statistical significance was inferred at P < 0.05. Results: Corneal disorders accounted for 3.3% of the eye disorders seen during the period of study. The median age was 37 years. Males outnumbered females giving a ratio of 1.9:1 and the age range from 0.25 to 92 years. There were more females than males in the 11-20 years' age group. Students (84, 25.4%) and artisans (62, 18.8%) were the two leading occupational groups. Infectious cases constituted 27.2% of the cases. Visual acuity at presentation was <3/60 in 131 (39.7%) cases. Foreign body entry was the leading etiologic agent in 101 (30.6%) cases. Conclusion: Half of the patients were blind at presentation, and many of them presented after more than 1 week of the onset of symptoms. Corneal foreign body, trauma, and vernal keratoconjunctivitis were the leading known predisposing factors. There will be need to emphasize more on the role of protective eye devices among our people, especially those who engage in outdoor activities.

RésuméObjectif: La cornée est le milieu de réfraction le plus important de l'œil. Les pathologies affectant la cornée ont généralement un grand impact sur la vision. L'étiologie du trouble cornéen varie d'un emplacement géographique à un autre. L'objectif de cette étude était de déterminer le schéma des troubles de la cornée à l'hôpital universitaire d'Ekiti State University, Ado Ekiti. Matériel et méthodes: Une étude rétrospective des dossiers des patients atteints de troubles de la cornée sur une période de 5 ans a été réalisée. Les caractéristiques démographiques, présentant l'acuité visuelle et le facteur de risque de troubles de la cornée ont été récupérées. Les données ont été entrées dans le progiciel statistique pour la version 20 des sciences sociales, et la signification statistique a été déduite à P <0,05. Résultats: Les troubles cornéens représentaient 3,3% des troubles oculaires observés pendant la période d'étude. L'âge médian était de 37 ans. Les hommes étaient plus nombreux que les femmes, ce qui.

Pattern of corneal disorders in Ekiti: a tertiary eye center experience

Purpose: The cornea is the most significant refractive medium in the eye. Pathologies affecting the cornea usually have a great impact on vision. The etiology of corneal disorder varies from one geographical location to another. The objective of this study was to determine the pattern of corneal disorders at Ekiti State University Teaching Hospital, Ado-Ekiti. Materials and Methods: A retrospective study of case records of patients with cornea disorders over a 5-year period was carried out. Demographic characteristics, presenting visual acuity, and risk factor for cornea disorders were retrieved. Data were entered into the Statistical Package for the Social Sciences version 20, and statistical significance was inferred at P < 0.05. Results: Corneal disorders accounted for 3.3% of the eye disorders seen during the period of study. The median age was 37 years. Males outnumbered females giving a ratio of 1.9:1 and the age range from 0.25 to 92 years. There were more females than males in the 11­20 years' age group. Students (84, 25.4%) and artisans (62, 18.8%) were the two leading occupational groups. Infectious cases constituted 27.2% of the cases. Visual acuity at presentation was <3/60 in 131 (39.7%) cases. Foreign body entry was the leading etiologic agent in 101 (30.6%) cases. Conclusion: Half of the patients were blind at presentation, and many of them presented after more than 1 week of the onset of symptoms. Corneal foreign body, trauma, and vernal keratoconjunctivitis were the leading known predisposing factors. There will be need to emphasize more on the role of protective eye devices among our people, especially those who engage in outdoor activities

Factors Responsible for Poor Visual Outcome Following Emergency Eye Surgery in a Tertiary Eye Centre.

BACKGROUND: Ocular emergencies can cause permanent vision loss if they are not recognized and treated promptly. This study was carried out to identify the factors responsible for poor visual outcome following emergency eye surgeries. METHODS: A cross-sectional study was carried out on all patients who had surgical emergency eye procedures. Clinic and theatre records of all eligible patients were retrieved. Demographic characteristics, duration of symptoms, laterality, presenting visual acuity, documentary pictures, classfication of eye injury, duration of days before surgery, surgical procedures performed and six weeks post-operative visual acuity were obtained from the records. Data were analyzed using Statistical Package for Social Sciences, version 25. RESULTS: One hundred and ninety-four patients had emergency eye surgical procedures constituting 16.3% of all ocular emergencies. There were 145(74.7%) males and 49 (25.3%) females with a male-to-female ratio of 3:1. The proportion of students, 48(67.6%), that presented within 24 hours of injury was the highest while the civil servants, 8(17.8%), had the lowest proportion. Corneo-scleral repair topped the list of surgeries and was the commonest, 106(54.6%), procedure carried out the same day of presentation. A 3rd of the patients, 28(34.1%), who presented within 24 hours had normal vision 6 weeks post-operatively while over 4/5th of the patients who presented after 24 hours were blind six weeks post-operatively. CONCLUSION: The prevalence of eye emergency surgical procedures was high with over 4/5th of these patients becoming blind six weeks post-operatively. Some of the factors responsible for poor visual outcome were delayed presentation, pre-operative visual acuity and delayed surgical intervention.

Factors Influencing the Academic Performance of Children with Sickle Cell Anaemia in Ekiti, South West Nigeria.

Background: There is a paucity of information on factors that influence the school performance of children with sickle cell anaemia (SCA) in Nigeria, despite her huge burden of the disease. Methods: In total, 101 children with SCA were recruited at a paediatric clinic in Nigeria. Their socio-demographic-matched classmates were the controls. Academic performance and cognitive functioning were obtained from school reports and Ziler's Draw-a-Person Test, respectively. Factors influencing the academic performance were determined. Results: Children with SCA had higher rates of school absence and lower haemoglobin concentration (p < 0.05). There was no difference in overall school performance between children with SCA and controls (59.0 vs. 60.6%; p = 0.256). School absenteeism > 1 week independently predicts poor school performance among the study participants (odds ratio = 15.71; 95% confidence interval = 5.93-41.66; p =0.000). Most SCA children with poor performance were absent from school for > 1 week. Conclusion: There is need to address causes of school absenteeism among children with SCA.

Clinical presentation and visual status of retinitis pigmentosa patients: a multicenter study in southwestern Nigeria.

BACKGROUND: To review the visual status and clinical presentation of patients with retinitis pigmentosa (RP). METHODOLOGY: Multicenter, retrospective, and analytical review was conducted of the visual status and clinical characteristics of patients with RP at first presentation from January 2007 to December 2011. Main outcome measure was the World Health Organization's visual status classification in relation to sex and age at presentation. Data analysis by SPSS (version 15) and statistical significance was assumed at P<0.05. RESULTS: One hundred and ninety-two eyes of 96 patients with mean age of 39.08±18.5 years and mode of 25 years constituted the study population; 55 (57.3%) were males and 41 (42.7%) females. Loss of vision 67 (69.8%) and night blindness 56 (58.3%) were the leading symptoms. Twenty-one (21.9%) patients had a positive family history, with RP present in their siblings 15 (71.4%), grandparents 11 (52.3%), and parents 4 (19.4%). Forty (41.7%) were blind at presentation and 23 (24%) were visually impaired. Blindness in six (15%) patients was secondary to glaucoma. Retinal vascular narrowing and retinal pigmentary changes of varying severity were present in all patients. Thirty-five (36.5%) had maculopathy, 36 (37.5%) refractive error, 19 (20%) lenticular opacities, and eleven (11.5%) had glaucoma. RP was typical in 85 patients (88.5%). Older patients had higher rates of blindness at presentation (P=0.005); blindness and visual impairment rate at presentation were higher in males than females (P=0.029). CONCLUSION: Clinical presentation with advanced diseases, higher blindness rate in older patients, sex-related difference in blindness/visual impairment rates, as well as high glaucoma blindness in RP patients requires urgent attention in southwestern Nigeria.

Left ventricular mass formulae and prevalence rates of echocardiographic left ventricular hypertrophy in nigerians with essential hypertension.

BACKGROUND: Left ventricular hypertrophy (LVH) as a marker of cardiac damage in hypertension has important prognostic implications. With high prevalence of hypertension in Nigeria and the untoward effect of LVH, it is essential that the prevalence of LVH be determined. AIMS: To determine prevalence of LVH and its severity in clinical practice among hypertensive patients referred for echocardiographic assessment in Nigeria. MATERIALS AND METHODS: Devereux and Troy formulae were used to calculate echocardiographic LV mass (LVM) in 401 subjects and thereafter normalized to body surface area (BSA), heigth(2) (ht(2)) and height(2.7) (ht(2.7)) to define LVH to standard gender-specific thresholds. RESULTS: Mean age was 53.22 ± 16.56 years (male = 53.18 ± 15.80; female = 53.27 ± 17.43; P = 0.958) with a male:female ratio of 1.13:1. Prevalence rates of LVH ranged between 38.9-51.3% using the Devereux Formula and 62.4-71.1% using the Troy formula. LVM/(ht(2.7)) using the Troy formula gave the highest prevalence rate of LVH. Majority of the patients with LVH had severe form of hypertrophy with the prevalence rates ranging from 22.3% (LVM/BSA; Devereux formula) to 47.1% (LVM/ht(2.7); Troy formula). CONCLUSION: Prevalence of LVH by any echocardiographic criteria is high. There is a need to come to a consensus on the best formula and indexing variables, that will unify the reporting of LVH.

Utilization of Eye Care Services Among Staff of a Tertiary Hospital.

PURPOSE: To determine the level of utilization of eye care services and to identify the barriers to uptake of eye care services among the staff in a hospital. DESIGN: A cross-sectional study conducted at a university teaching hospital. METHODS: A total of 250 staff members were selected using a proportionate sampling among the segment of study population. Data were collected using semistructured questionnaires, including demographic data, awareness about eye clinic and the services rendered, facilities utilized by staff in receiving eye treatment, and reasons for not utilizing the hospital eye care services. Data analysis was done using SPSS version 15. RESULTS: The majority (66%) of the staff were younger than 40 years. Around 229 staff members (91.6%) were aware of the clinic, whereas 222 (88.8%) were aware of at least 1 of the various services rendered. They received treatment from chemists (30.7%), private hospitals (26.3%), and optical shops (16.1%). The hospital eye clinic (11.8%) was the least chosen place to receive eye treatment. The reasons for nonutilization of eye care services were lack of finance (42.1%), poor staff attitude (23.7%), fear of damage to the eye (15.3%), high cost of treatment (9.7%), and ignorance of its existence (9.2%). Visual impairment was seen in 14 of the staff (5.6%), whereas blindness was seen in 1 (0.4%). CONCLUSIONS: The level of utilization of eye care services in the hospital by the staff is poor and very low compared with other facilities, although the majority had previous history of eye complaints.

Pattern of eye diseases among welders in a Nigeria community.

BACKGROUND: Welders have been identified as a high risk group for eye disorders due to their exposure to ultraviolet radiation. OBJECTIVE: To determine the prevalence and types of eye diseases amongst welders in Ile-Ife, Osun state. METHODS: This is a cross sectional descriptive study of 405 consenting welders. Information on socio-demographic characteristics was obtained using a pre-tested proforma and all subjects had visual actuity test, anterior and posterior segments examination, test of stereopsis and macular function. RESULTS: Two hundred and seventy five (67.9%) of the respondents were arc welders, 99(22.5%) were gas welders while 39(9.6%) utilized both welding techniques. The age of the respondents ranged from 16 years to 80 years with a mean of 38 ± 13 years. Conjunctival degenerative disorders like pingueculum (50.1%) and pterygium(17.5%) constituted the commonest eye disorders among the welders. There were 6 blind eyes of 5 welders with pigmentary maculopathy accounting for the single case of bilateral blindness. There is a greater odd in developing pingueculum and Pterygium (OR=1.015, 1.039 respectively) in arc welders than in gas welders. CONCLUSION: Pingueculum, Pterygium, corneal opacity, and pigmentary macular deposits were the common eye disorders among welders.

Baseline CD4+ T lymphocyte cell counts, hepatitis B and C viruses seropositivity in adults with Human Immunodeficiency Virus infection at a tertiary hospital in Nigeria.

BACKGROUND: Ekiti State of Nigeria is known to have the lowest prevalence of HIV in Nigeria. University Teaching Hospital (UTH), Ado Ekiti was recently upgraded to serve as one of the three centres for HIV/AIDS referral, diagnosis and treatment in Ekiti State. We evaluated the baseline immunologic and biochemical parameters of patients presenting at the ART clinic of University Teaching Hospital, Ado Ekiti, Ekiti State. METHODS: All HIV seropositive patients not yet on antiretroviral therapy, who presented at the ART Clinic within the study period had at the first visit to the clinic, their blood sample taken for CD4 cell counts estimation, HBsAg and anti- HCV screening, ALT, AST as well as hemoglobin estimation as part of the routine workup to assess their disease health status and need for antiretroviral therapy. Statistical significance was taken as p< 0.05. RESULTS: A total of 273 patients comprising 79 (28.9%) males and 194 (71.1%) females were included in the study (F:M = 2.46: 1). The mean age of the study population was 36.21 ± 10.20 years with mean age of males (39.52 ± 9.95 years) significantly higher than females (34.88 ± 10.02; p=0.001). The overall prevalence of HBsAg in the study population was 6.6% with a sex specific prevalence of 8.1% and 6% for males and females, respectively. No statistically significance difference in the mean serum alanine transaminase, serum aspartate transaminase, hemoglobin and CD4+ T- Lymphocytes cell count of those who had HBsAg negative status compared to those who had HBsAg positive status. Two (0.7%) of the patients had positive serum anti HCV antibodies. The CD4+ T- Lymphocytes cell count ranged between 5 - 1050 cells/µl with a mean of 286.19 ± 233.31 cells/µl. The majority of patients (71.8%) had a CD4+ T- Lymphocytes cell count < 350 cells/µl. CONCLUSION: At the time of presentation, majority of our patients had a CD4+ T- Lymphocytes cell count less than 350 cells/µl consistent with significant immune-suppression. More sustained and vigorous awareness campaigns still need to be done in Ekiti State to diagnose this disease early. There is also a need to accelerate the integration of hepatitis B virus screening and treatment programme into HIV/AIDS programme because of the morbidity and mortality implication of HBV and HIV co-infection.

Awareness and utilization of protective eye device among welders in a southwestern Nigeria community.

OBJECTIVE: To determine the level of awareness and practice of use of protective eye devices among welders in Ile-Ife. METHODS: This is a cross-sectional descriptive study of 405 consenting welders. A pretested proforma was utilized to obtain information on sociodemographic characteristics, as well as awareness and use of protective eye device. RESULTS: The age of the respondents ranged from 16 to 80 years. The mean age was 39 ± 13 years. A large proportion (315, 78%) of the welders was aged between 21 and 50 years. The youngest group aged ≤ 20 years accounted for 15 (4%) of all welders, while the oldest group aged > 60 years accounted for 21 (5.2%). 402 were males (99.3%) and three were females (0.7%). Three hundred thirty-six (83%) of the welders had practiced for 6 years and above. There was a high level of awareness of protective eye devices among the welders (367, 90.6%), being higher among arc welders compared with gas welders (P < 0.001). Less than half (186, 45.9%) of the welders possessed protective eye devices. Of these, only 39 (9.6%) made use of the devices always. Some of the reasons for not using the protective eye devices include discomfort and poor visibility (56, 13.6%) and inadequate appreciation of the necessity to wear it (49, 12.1%). CONCLUSION: The findings of this study suggest that a significant proportion of welders in Ile-Ife were not utilizing protective eye device. Health education and awareness campaigns about the importance and benefits of utilizing protective eye devices are recommended.

Retinal diseases in a tertiary hospital: the need for establishment of a vitreo-retinal care unit.

AIM: To evaluate the need for vitreo-retinal care for suburban and rural communities of southwestern Nigeria. METHODOLOGY: A retrospective review of patients with posterior segment diseases attending the general ophthalmology clinics of Obafemi Awolowo University Teaching Hospital's complex, Ile Ife, southwestern Nigeria, between January 2001 and December 2006 was conducted. The age, sex and diagnosis were analyzed and needs assessment conducted. RESULTS: Three-thousand, one-hundred-thirty-one new cases were reviewed of which 407(13%) patients presented with retinal diseases. Their mean age was 46.3 +/- 21.4 years, mode 60 years and male:female ratio 1.3:1 (P=0.05). Macula diseases (35.6%), hypertensive retinopathy (12%), retinochoroiditis (11.5%) and diabetic retinopathy (9.6%) were the predominant retinal diseases. Age-related macular degeneration was the most frequent of the macular diseases (38.6%), with a female preponderance (p=0.06). It is estimated that fundus photography +/- fluorescein will be beneficial in 89.4%, laser photocoagulation in 36.4% and vitreo-retinal surgical procedure in 16.4%. CONCLUSION: Posterior segment diseases are not uncommon in rural communities of southwestern Nigeria. Facilities for fundus angiography, laser photocoagulation and a vitreoretinal surgical unit in trained hands will improve the capacity for specific diagnosis and appropriate management of vitreo-retinal diseases in these communities.