Emmanuel Olu Megbelayin

Pattern of Refractive Errors Among Ophthalmic Outpatients of University of Uyo Teaching Hospital, Uyo, Nigeria

Introduction: Uncorrected refractive error (RE) is the most common cause of visual impairment (VI) in the world. It has significant effects on individuals and community, restricting some educational and occupational employment opportunities of the otherwise healthy individual. A significant percentage of the world population is visually impaired/blind from uncorrected RE. Aim: To determine the pattern of REs in ophthalmic outpatients in a teaching hospital. Materials and Methods: Records of consecutive patients attending a tertiary eye facility who were diagnosed with RE and/or presbyopia from January 2010 to December 2011 were retrieved. Data were analyzed using Statistical Package for the Social Sciences 20.0. Result: Presbyopia coexisting with other forms of RE 273 (40.4%) and presbyopia only was seen in 215 (31.8%). Myopia only was seen in 77 (11.4%), astigmatism only in 18 (2.7%), and hyperopia only in 13 (1.9%). Conclusion: In line with the objectives of VISION 2020, the data presented in this study will help in planning result-oriented intervention programs in the state.

Refractive errors and spectacle use behavior among medical students in a Nigerian medical school.

Aim: To determine the prevalence of refractive errors and spectacle use behavior among medical students in University of Calabar Teaching Hospital, Nigeria. Study Design: Cross sectional study. Place and Duration of Study: Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria, between April 2010 and July 2010. Methodology: The study population consisted of fifth year medical students. Subjects had cycloplegic auto refraction with Topcon auto refractor during their rotation in ophthalmology at the Ophthalmology department of the University of Calabar Teaching Hospital. A spherical equivalents (SE) ≥ +0.50D were determined as hyperopia; SE of >Original Research Article British Journal of Medicine & Medical Research, 4(13): 2581-2589, 2014 2582 0.50D myopia and >-0.50D cylinder as astigmatism. Statistical analysis, which included chi-square test was carried out with Statistical Package for Social Sciences (SPSS) version 20.0. Results: Sixty-six (79.5%) of subjects had a form of refractive error; 63.6%%, 16.7% and 19.7% were myope, hyperope or simple estigmat, respectively. The prevalence of ametropia was 82% in female and 78% in males. The association between refractive errors and gender was not statistically significant (p = 0.35, 95% Confidence Interval [CI], 0.34-0.36).Minus spherical errors ranged from -0.16 to -5.25 diopters (D) and plus spherical errors ranged from +0.25 to +1.00D, spherical equivalent between -0.25D and 2.75D being the most common type (85.5%). Eight students (12.1%) were wearing glasses at the time of the study corresponding with 10 (15.2%) who had eye pains while reading. Conclusion: The prevalence of refractive errors among fifth year medical students of the University of Calabar was high and eyeglasses were worn by students who were symptomatic.

Outcome of Visual Screening of Hospital Workers in University of Uyo Teaching Hospital, Uyo, South–South Nigeria

Background: The World Glaucoma Week (WGW) is a joint global initiative of the World Glaucoma Association (WGA) and the World Glaucoma Patients Association (WGPA) to raise awareness of glaucoma. As part of the celebration in 2013, the department of Ophthalmology University of Uyo Teaching Hospital organized a two -day free eye screening exercise for the staff of the hospital to determine the visual health status. Materials andMethods:A prospective observationalstudy of hospital workers in tertiary health institution in Nigeria. Participants who consented to vision screening had preliminary interview and ocular examination. Data obtained was analyzed using SPSS 20.0.Test of statistical significance was with the chi -square test. Observed difference whose probabilityof occurring by chance (pvalue<0.05) was considered statistically significant. Results:A total of 401 patients were analyzed comprising 121 males and 280 females

Challenges in the management of glaucoma in university of Calabar teaching hospital, Calabar, Nigeria: A 10 year review

Background: Glaucoma is a common cause of blindness in developing nations. The objective of this study is to determine the severity of primary open angle glaucoma and audit health records of glaucoma patients in our center. Materials and Methods: A retrospective case note search of glaucoma patients from out-patient clinic was carried out between January 2001 and December 2010. Data analysis included descriptive statistics and exact binomial 95% confidence interval (CI) calculated for the mean estimates. Results: Seventy-six patients (152 eyes), comprising 49 (64.5%) males and 27 (35.5%) females were included in the study. The age ranged from 15 to 88 years (mean: 54.2 ± 14.5). Forty-five (59.7%) presented with normal vision and 10 (13.2%) had visual acuity 0.6 0.9 = 35 (46.1%) and left eyes were 15 (19.7%), 29 (38.2%), 28 (36.8%), respectively. Mean intraocular pressure (right eyes) at presentation was 20.3 mmHg (95% CI, 17.4-23.3) and reduced to 13.4 mmHg (95% CI, 10.7-16.0) at the last readings while left eyes from a mean of 20.3 mmHg (95% CI, 16.9-23.8) reduced to 12.1 mmHg (95% CI, 10.0-14.3). The mean presenting CDR were 0.79 (95% CI, 0.74-0.83) and 0.73 (95% CI, 0.68-0.79) in right and left eyes, respectively. CDR showed statistical significance with age ( p 2 -test) but not with sex ( p = 0.807). Conclusion: Late presentation of glaucoma cases is a major problem in Calabar. We recommend public enlightenment, case detection, and early treatment to reduce ocular morbidity.

Ethical Dilemmas in Contemporary Ophthalmic Practice in Nigeria

Background: Ethics, as a branch of both philosophy and theology, is a systematic study of what is right and wrong with respect to conduct and character. As an intellectual discipline, ethics seeks to provide good reasons for our moral choices. Aim: The aim was to discuss common plausible clinical scenarios that pose ethical questions in typical ophthalmic set-ups in Nigeria and suggest modalities of resolving them. Methods: Involved extensive literature search on ethics and medical jurisprudence. Result: There is hardly an area in medicine that does not have an ethical aspect. For example, there are ethical issues relating to abortion, organ donations, birth control, euthanasia, etc., Ethics in Ophthalmology have not been the focus of scholarly articles particularly in our African environment. Yet there is increasing consciousness of patients′ right to self-determination that cuts across all areas of human endeavors. Conclusion: Ethics, and not the law, establishes the ultimate standard for evaluating conduct. Still, there is a moral obligation to obey the law, and thus ethical analyses need to take into account the relevant statutes and court decisions.

Unusual presentation of retained foreign body in ocular adnexa of a 3-year-old child

Aim: To report an unusual presentation of retained safety pin in ocular adnexae of a 3 year old child. Methods: A case report. The patient presented within the hour of accident and surgical intervention followed immediately after preliminary investigations. Results: Under general anesthesia, entry site of foreign body was explored. The safety pin was surprisingly lodged subtarsally in the matrix of firmly anchoring tenons. This was at variance to preoperative appearance of actual globe penetration. Conclusion : X-ray of the orbit confirmed by wound exploration correctly localized the foreign body.

Evaluation of Competence of Medical Students in Performing Direct Ophthalmoscopy

Aim: The aim was to determine the competence of medical students in performing direct ophthalmoscopy. Materials and Methods: It was a cross-sectional study whereby year 5 medical students were assessed during Objective Structure Clinical Examination (OSCE) at the end of 4 weeks clinical rotation in ophthalmology. Every student had 5 min in each OSCE station, including the station for direct ophthalmoscopy. The correctness or otherwise of students′ quantitative assessment of cup-disc ratio (CDR) was analyzed using Statistical Package of Social Sciences (SPSS, USA) version 20.0. Result: A total of 96 students were assessed in 6 groups over a 6 months period; age range was 20-33 years and a mean age of 24.8 ± 3.2. There were 57 males and 39 females (M:F = 1:0.25). Seventy-eight (81.3%) were satisfied with teachings and tutorials on direct ophthalmoscopy. Eighty-nine (92.7%) admitted visualizing the disc in the course of tutelage while 7 (7.3%) had never seen the disc with the direct ophthalmoscope. The retinal vessels were seen with the ophthalmoscope by 93 (96.9%). Direct Ophthalmoscopy was not considered to be difficult by 87(90.6%). Forty-six (47.9%) got CDR correct on the right eyes while 50 (52.1%) got it correct on the left eyes. There was statistically significant relationship between the group students belonged and performance with χ2 = <0.001. Conclusion: Based on the CDR benchmark, students′ performance was not satisfactory.