Fg Adepoju

Challenges, Attitudes and Practices of the Spectacle Wearers in a Resource-Limited Economy

Purpose: To evaluate challenges, attitudes and practices among spectacle wearers to effect positive change when necessary, and determine positive change in a resource-limited economy. Materials and Methods: A multi-hospital descriptive, cross sectional survey of spectacle wearers was conducted between May 2007 and December 2008 in Nigeria. Results: A total of 214 wearers comprising 43.5% males and 56.5% females aged 18-84 years were surveyed. The majority of subjects (92.6%) had at least secondary education. The wearers’ challenges included expensive spectacles (43.0%), falling/scratched/broken lenses (29.4%) and fear that spectacles would damage the eyes (23.8%). The wearers’ attitudes were comprised of consultations with ‘road side dispensers’ (7%) and permitting other individuals to select spectacle frames for them (26%). Care and maintaince practices included use of handkerchief, tissue paper, fingers and water to clean spectacles (49.5%) and placing spectacles inside spectacle cases (30.4%). There were no associations (P > 0.05) between gender or literacy levels and who selected the frames for the subjects, caregivers consulted for spectacles, and cleaning materials for spectacles. The placement of spectacles when not in use was significantly associated (P < 0.05) with the wearers’ gender and literacy levels but not with the length of spectacle wear. Conclusion: Attitudes and practices requiring positive change crossed gender and educational levels among spectacle wearers. The cost of spectacles should be regulated and availability of standard eye care practices would reduce challenges including lens-related defects and quackery. During consultation with a recognized eye care professional, counseling of wearers on positive attitudes/practices as well as allaying fear of spectacle wear is required.

Surgical output and clinic burden of glaucoma in lagos, Nigeria.

Purpose:To estimate the outpatient clinic burden and surgical workload related to glaucoma in Lagos, Nigeria. Methods:A multicentre study involving the 2 tertiary eye institutions, 7 secondary eye centers with eye care facilities, and the largest private eye hospital in Lagos state, Nigeria. Data on outpatient department (OPD) visits were collected over a 4-week period, using a specially designed tally sheet. Theater records were examined in each hospital over a 1-year period (2009) for the number and types of glaucoma surgeries performed. Results:A total of 6240 patients visited the OPD over the 4-week period, out of which 1577 (25.3%) were glaucoma patients. OPD visit per ophthalmologist were 274, 323, and 61, whereas glaucoma visits per ophthalmologist were 75, 70, and 23 in the tertiary, secondary, and private centers, respectively. Glaucoma surgeries constituted 8.6% of total surgeries (n=4050). Trabeculectomy with intraoperative 5-fluorouracil was the most common procedure (81.0%). Number of glaucoma surgeries per ophthalmologist per month in the tertiary, secondary, and private centers were 0.5, 0.9, and 1.4, respectively. Overall number of glaucoma surgery per ophthalmologist per month was 1. Conclusions:Glaucoma visits constitute a significant proportion of eye clinic visits in Lagos state, Nigeria, and therefore, necessary manpower, infrastructure, and equipments should be mobilized for its optimal management. Also, there is a relatively low output of glaucoma surgeries that needs to be further investigated and appropriate measures taken to manage it.

Trainee ophthalmologists' opinions on ways to improve cataract surgical rate

OBJECTIVE To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. METHODS A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. RESULTS Most trainees had a positive view about actions towards raising CSR: Structured ophthalmic training- 25 (92.6%), monthly cataract camps by eye departments in teaching hospitals- 21 (77.8%), rural allowance for ophthalmologists- 26 (96.3%) and welfare package for indigent cataract patients- 21 (77.8%). Other actions included local production of cataract consumables- 22 (81.5%), duty-free importation of ophthalmic materials- 23 (85.2%), employment of ophthalmologists in the services of the state governments- 24 (88.9%) and local governments- 20 (74.1%), effective primary eye care- 25 (92.6%) and marketing of cataract surgical services- 23 (85.2%). However, only 16 (59.3%) trainees wanted first ladies (wives of the president, governors and local government chairmen) to adopt cataract elimination as pet projects, and 24 (88.9%) opposed the introduction of cataract surgeons. CONCLUSION Most trainees had positive perceptions about most actions that can raise CSR. However, top-priority actions to improve CSR were attractive rural allowance, structured training, resource availability, cost reduction and marketing of cataract surgical services. Multiple actions might be necessary to raise CSR.

Normal values of intraocular pressure in full-term Nigerian newborns

Purpose To determine the normative range of intraocular pressure (IOP) in full-term newborns and possible association with birth parameters during the first week of life. Methods This was an observational cross sectional study in which IOP was measured in 1000 eyes of 500 normal full-term newborns using the Perkins applanation tonometer under topical anesthesia. An average of three readings was taken as the IOP value. The relationship between IOP and birth parameters was analyzed. Results The male to female ratio was 1:1 with 254 (50.8%) male and 246 (49.2%) female babies. The (mean ± SD) value of IOP in the right eyes was 11.93 ± 1.80 mmHg, ranging between 9.00 and 16 mmHg. In the left eyes, the mean value of IOP was 11.84 ± 1.77 mmHg with a range of 8.00–15.00 mmHg. IOP in males (12.02 ± 1.84 mmHg) was not significantly different from that in females (11.89 ± 1.75 mmHg). There was no significant difference between right and left eyes (p = 0.42). The 95% range (mean ± 2 SD) was 15.53 mmHg for the right eye and 15.38 mmHg for the left. Correlational analysis showed that birth weight and gestational age were positively correlated with IOP. Conclusion This study provides useful normative data on IOP among Nigerian full-term newborns. Further studies on possible ethnic/geographic variations of IOP in children may be beneficial.

Cataract Surgical Services in Kwara State, Nigeria

Introduction:Service provision for tackling cataract blindness is a key priority and remains a challenge for eye care programs in Nigeria. At the moment, paucity of data on these services makes evaluation and effective planning difficult. Objective:To evaluate the i nfrastructure, equipment, and human resources for cataract surgical services, and determine the cataract surgical output in Kwara State, Nigeria. Materials and Method: A descriptive cross-sectional study of all cataract service institutions in Kwara state was conducted in May-July 2008 using pre-tested questionnaire and on-site review. Output data for 2003