Ea Awoyesuku

Congenital upper lid eversion and severe chemosis in a new born

The purpose of this study is to report a case of bilateral congenital eversion of the upper eyelid in an 8 h- old male baby. JD is an 8 h-old male baby born by normal vaginal delivery after prolonged labor, to a 24-year-old primigravida. Pregnancy was said to be term but was complicated by pregnancy-induced hypertension. A midwife delivered the baby and it was by spontaneous vertex delivery. He was said to have cried immediately after birth, but shortly afterward parents noticed a reddish fleshy swelling over the eyes and this made it difficult for them to see the eyeballs. The reddish swelling steadily increased in size necessitating their prompt referral to our center. On examination, a full term baby was seen with complete eversion of both upper eyelids and marked conjunctival chemosis. Ocular examination revealed normal globes with healthy cornea and briskly reactive pupils. The child was admitted and started on 3-hourly chloramphenicol ointment, ciloxan eye drop (ciprofloxacin hydrochloride United States Pharmacopeia equivalent to ciprofloxacin 0.3% w/v) - 8 times daily and 5% hypertonic saline patch over the chemosed conjunctiva. The pediatrician was also invited to co-manage the patient. After 9-days of treatment, the conjunctival chemosis fully resolved and lids reverted back to normal position. At 4-week follow-up, the lids continued to maintain their normal position and child could now open eyelids spontaneously. Congenital upper eyelid eversion is a rare clinical entity even though it is said to be commoner in blacks. Knowledge of its complete resolution with conservative management will help in future management of such cases thereby preventing complications that may arise from poorly treated cases.

The relationship between vertical cup-disc ratio and body mass index in Port Harcourt, Nigeria

BACKGROUND Glaucoma is the leading cause of irreversible blindness in the world and risk factors to developing glaucoma must be determined early to prevent blindness from the disease. AIM To determine the relationship between vertical cup disc ratio (VCDR) and body mass index (BMI) in a population screened for glaucoma in Port Harcourt, Nigeria. MATERIALS AND METHOD This study was part of a one-day screening exercise for glaucoma at the University of Port Harcourt. Demographic data included age, sex, race and occupation. Height was measured with a wall-mounted tape and weight with a bathroom scale. Intraocular pressure was measured with Perkins applanation tonometer and funduscopy was with direct ophthalmoscope. BMI was calculated as weight in kilograms divided by the square of height in meters (Weight/Height2). RESULTS A total of 491 subjects were screened; consisting of 230 males (46.8%) and 261 females (53.2%). The mean age was 35±13.29 years. About 28%(n=141) of the participants were overweight while 17.7%(n=87) were obese. The mean BMI was 25.39 ± 4.82 kg/m 2 and the mean VCDR for both eyes was 0.38±0.13mmHgratios have no units. Most participants (n=864; 89.4%) had normal VCDR. Only 102 (10.6%) had cupped discs. There was no statistically significant relationship between BMI and VCDR (P= 0.947; R2 = 0.01). CONCLUSION Obesity was not associated with a larger VCDR.

A 3-year review of cranial nerve palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

Purpose: To provide the types, frequency and clinical information on common cranial nerve palsies seen at the Eye Clinic at the University of Port Harcourt Teaching Hospital. Materials and Methods: A chart review was performed of patients who presented with cranial nerve palsy at the Eye Clinic over a 3-year period (January 2009-December 2011). Data were collected on age, sex, type of cranial nerve palsy, a history of systemic disease such as diabetes mellitus (DM), hypertension and cerebrovascular disease. Exclusion criteria included medical charts with incomplete data. Data was analyzed using Epi-info Version 6.04D. Statistical significance was indicated by P < 0.05. Results: Twenty-four patients had cranial nerve palsies. There were 11 males and 13 females with a mean age of 34.50 ± 18.41 years. Four patients (26.6%) had exotropia while three patients (20%) had esotropia. Complete ophthalmoplegia was noted in two patients (13.3%). The 3rd and 6th cranial nerves were affected in seven patients each (29.2%) and five patients (20.8%) had 7th cranial nerve palsy. Approximately 38% of patients with cranial nerve palsies had systemic disorders (16.7% systemic hypertension; 12.5% DM). The relationship between cranial nerve palsy and systemic disorder was statistically significant (P < 0.01). Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6th cranial nerve palsy.

The relationship between body mass index and intra-ocular pressure in Port Harcourt Nigeria.

Background : There are conflicting reports regarding the relationship between body mass index (BMI) and intraocular pressure (IOP). There is a need to evaluate these contradicting findings in our environment. Aim: To examine the relationship between intraocular pressure and body mass index (BMI) in a population screened for glaucoma at the University of Port Harcourt, Nigeria Materials and Method: This study was part of a one -day screening exercise for glaucoma at the University of Port Harcourt. All subjects participated with willful consent. Demographic data included age, sex, race and occupation. Height was measured with a wall-mounted tape and weight with a bathroom scale. Intraocular pressure was measured with Perkins hand-held applanation tonometer and funduscopy was carried out with a direct ophthalmoscope. BMI was calculated as weight in kilograms divided by the square of height in meters (Weight/Height 2

Nonglaucomatous optic neuropathies in Port Harcourt

Aim To review the types of nonglaucomatous optic neuropathies seen in Port Harcourt, Nigeria. Materials and methods Medical case records of all cases of nonglaucomatous optic neuropathy seen in the Eye Clinic of University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria over a 5-year period were reviewed. Relevant data including patient demography, presenting visual acuity and intraocular pressure, and fundus findings were extracted. Other details included central visual field analysis and color vision results. Cases of glaucomatous optic neuropathy were excluded. Results Ninety-nine cases of optic neuropathy were seen over this time period. There were 52 (52.5%) males and 47 females. The mean age of those with optic neuropathy was 40 ± 18.774 years. Twenty-two patients (22.2%) had bilateral involvement, while the rest were unilateral. About 40% of the patients with optic neuropathies had optic atrophy. Nutritional causes accounted for 31.3% and optic neuritis 27.3%. Over 60% of the patients presented with visual acuities ≤6/60. Most patients (40%) had cecocentral scotoma. Conclusion Nonglaucomatous optic neuropathies resulting in optic atrophy is not uncommon in our environment and several factors may be implicated but the actual cause is difficult to determine because of late presentation of most patients.