Objective: To establish population-specific reference values for periocular anthropometric dimensions among a healthy Ghanaian adult student population. Methods: This was a prospective cross-sectional study of the periocular dimensions of adult Ghanaian students aged 18 to 45 years in tertiary institutions in the Greater Accra Region from January to May 2019. A multistage sampling technique was used to select participants from four tertiary institutions. Demographic characteristics and periocular parameters such as age, sex, palpebral fissure height (PFH), palpebral fissure width (PFW), intercanthal distance (ICD), interpupillary distance (IPD), and margin crease distance (MCD) of study participants were measured. Descriptive statistics were used to summarize demographics and periocular measurements. Independent samples t -test and ANOVA were used to test for associations and differences. Results: A total of 796 eyes from 398 adult Ghanaians with a mean age of 30.5 ± 6.6 years and a slight male preponderance (200, 50.3%) were included in the study. The mean values for PFH, PFW, inner intercanthal distance (IICD), outer intercanthal distance (OICD), IPD, and MCD were 10.7 ± 1.1, 35.6 ± 2.3, 36.6 ± 3.0, 108.1 ± 5.8, 67.3 ± 3.1, and 5.6 ± 1.1 mm, respectively. The PFH and IPD were significantly higher in males than in females ( P < 0.05). There was a positive correlation between the age of participants and IPD ( P = 0.001) and MCD ( P = 0.001) using Pearson correlation analysis. Conclusion: This study has provided normative values for periocular anthropometric measurements in young Ghanaian adults in tertiary institutions, with variation in some of the parameters by sex and age.
Background: To improve the quality of care delivered to patients, there was an intentional shift toward subspecialty training for specialists in the West African subregion. This led to the training of specialists and commencement of the vitreoretinal clinic at the Federal Teaching Hospital (FTH), Owerri, Imo state, Nigeria, with a view to rendering retinal care/services to patients presenting at the hospital. Objective : This study aims to present some results and challenges experienced during the first 30 months of running the vitreoretinal clinic at FTH, Owerri, Imo State. Methods : This is a retrospective review of the medical records of patients who attended the vitreoretinal clinic between January 2022 and June 2024. Data were collected on retinal disorders, investigations, and treatments received. Results : A significant number of patients attending the retina clinic had sight-threatening diabetic retinopathy (25.2%), followed by age-related macular degeneration (11.9%), and retinal vascular occlusion (10.5%). There was a yearly increase in the uptake of services at the clinic, but this was affected by the breakdown of the optical coherence topography machine from October 2023. Any P -value ≤0.05 was considered statistically significant. Conclusion : Setting up a vitreoretinal service is capital-intensive and skill-demanding, and these challenges are further amplified in resource-constrained economies. The most common retinal disorders were sight-threatening but treatable. Advocacy and public–private partnerships are strongly recommended for the expansion of retinal services.
Background: Microbial keratitis is a major cause of corneal blindness worldwide. Evidence on the effectiveness of available therapies varies widely. Aim: This systematic review and meta-analysis evaluated the effectiveness of medical and surgical interventions for bacterial and fungal keratitis. Methods: A comprehensive search of databases and grey literature was conducted for studies published between January 2000 and December 2024. Eligible study designs included randomised controlled trials (RCTs) and cohort studies reporting treatment outcomes for microbial keratitis. Data on visual acuity, epithelial healing, microbiological cure and complications were extracted. Random-effects meta-analyses were performed, and heterogeneity was assessed using I 2 statistics. Risk of bias was evaluated using the Joanna Briggs Institute checklist. Results: From 6919 identified records, seven studies (four RCTs, three cohort studies) from five countries were included. The pooled odds ratio (OR) for ulcer healing or meaningful visual improvement across RCTs was 1.31 (95% CI: 1.00–1.72), favouring active treatment with targeted antimicrobial therapy (fourth-generation fluoroquinolones and fortified antibiotics) for bacterial keratitis. Fungal keratitis trials comparing natamycin with voriconazole yielded a pooled OR of 1.11 (95% CI: 0.89–1.39). The cohort studies’ pooled healing proportion was 0.72 (95% CI: 0.58–0.83), increasing to 0.76 after sensitivity exclusion. A Nigerian cohort study reported 45.6% of patients achieving a best-corrected visual acuity of ≥6/18. Conclusion: Evidence suggests generally favourable healing outcomes with current antimicrobial therapies for microbial keratitis. However, comparative effectiveness between specific agents remains uncertain in some contexts. Early presentation, microbiologic evaluation and targeted therapy are crucial to improving outcomes, especially in resource-limited settings.
Objective: To determine the effect of 2 versus 3mL sub-Tenon anesthesia and ocular compression on intraocular pressure (IOP) among cataract surgical patients. Methods: A cross-sectional comparative study conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Two hundred cataract patients were randomly allocated into two groups: group 1 (2 mL) and group 2 (3 mL). Intraocular pressure (IOP) was measured before and 5 minutes after administration of xylocaine for sub-Tenon anesthesia. Thereafter, a metallic weight was placed over the lid for ocular massage for a duration of 2 minutes, after which a repeat IOP check was done. Student’s t -test was employed to compare pre- and post-sub-Tenon injection mean IOP between the two groups, and any P value less than 0.05 was considered significant. Results: The mean age was 63.8 ± 12.64 years in group 1 and 64.14 ± 14.14 years in group 2. In both groups, a statistically significant rise in IOP was observed 5 minutes post-injection of xylocaine ( P = 0.005 for group 1 and P <0.001 for group 2). Though not statistically significant, the mean 5-minute post-injection IOP was slightly higher in group 2 compared to group 1. Compared with the 5-minute post-injection values, ocular massage reduced IOP by 15.4% in Group 1 and 13.01% in Group 2 ( P <0.001). Conclusion: Both the 2mL and 3mL sub-Tenon injections resulted in a modest, statistically significant elevation in IOP at five minutes, with no significant difference between the two volumes. Two minutes of ocular massage effectively reduced the mean IOP in both groups to below pre-injection values.
Objective: Ocular trauma is a significant cause of visual impairment and the leading cause of uniocular blindness worldwide. Traumatic cataract is one of the sequelae of ocular trauma and one of the pathways to visual impairment or blindness following a traumatic eye injury. This study aimed to determine the incidence of traumatic cataracts and the common objects and circumstances of trauma leading to traumatic cataracts. Methods: A 1-year retrospective study involving all patients who presented with eye trauma between January and December 2019 at Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Case files of patients were retrieved from the medical records department, the required information was extracted and entered into a proforma designed for the study. Only patients whose records met the inclusion criteria were included. Data were analyzed using IBM SPSS, version 22. Any P -value ≤ 0.05 was considered statistically significant. Results: In total, 115 patients out of 386 patients with ocular trauma who were followed up for ≥ 3 months developed cataracts, giving an incidence of 29.8%. The incidence was 33.8% and 24.1% among males and females, respectively. Eye injuries sustained during various work activities were the commonest causes of traumatic cataracts, and a stick was the commonest object of injury. Conclusion: A significant proportion of ocular trauma cases in the study population resulted in traumatic cataract. The commonest circumstances of trauma leading to traumatic cataract were injuries sustained during work activities. Efforts at reducing such injuries may help reduce the incidence of traumatic cataract.
Objective: Corneal blindness is a major public health challenge in Nigeria, but local eye donation rates are very low. This study assessed community awareness, knowledge, and attitudes towards eye donation in Ibarapa East to inform eye health planning. Methods: This cross-sectional household survey recruited 550 adults residing in Ibarapa East Local Government Area of Oyo State, Nigeria, using a two-stage cluster sampling method. A structured interviewer-administered questionnaire was used to collect data. The outcome measures were awareness and knowledge of eye donation, eye banking, and corneal transplantation; willingness to donate eyes postmortem and to accept corneal transplantation; attitudes toward eye donation and transplantation; and their socio‑demographic and ocular predictors. Results: Respondents were 57.6% male and had a mean age of 29.3 ± 11.3 years. Awareness of eye donation, eye banking, and corneal transplantation was 8.7%, 10.4%, and 10.2%, respectively. Only 21.1% were willing to donate eyes postmortem, and 39% would accept a corneal transplant if needed. Overall, 37.6% demonstrated a supportive attitude towards eye donation. Poor knowledge of eye donation (AOR=3.52, 95% CI: 1.44–8.59), being a student (AOR=2.57, 95% CI: 1.40–4.70), and primary education or lower (AOR=2.13, 95% CI: 1.22–3.71) were predictive of non-supportive attitude, while awareness of corneal transplantation and history of ocular trauma were protective. Conclusion: Awareness and willingness to donate eyes are low in Ibarapa East. Targeted education, particularly for students and less educated groups, together with improved visibility of eye banking, is needed to increase donation rates.
Aim: This descriptive study describes a novel technique of hydro-free mechanical delamination during phacoemulsification in posterior polar cataract (PPC) cases. Methods: Fifty-one eyes with PPCs underwent complete anterior and posterior segment evaluation. Hydro-free mechanical delamination technique was done using an intraocular lens (IOL) dialer (Sinskey hook) or a bent cystotome to separate the endonucleus from the epinucleus, followed by safe phacoemulsification. Results: A total of 46 patients (51 eyes) with PPC underwent phacoemulsification between March 2021 and June 2023. Preoperative anterior segment optical coherence tomography (AS-OCT) confirmed intact posterior capsule (PC) in all but one case with pre-existing dehiscence. Most lenses were soft, with three moderately hard nuclei. Mechanical delamination was successfully performed in all cases, more easily in soft nuclei. Intraoperative extension of a pre-existing posterior capsular defect occurred in only one eye. A single-piece IOL was implanted in the bag in all cases, with haptics placed away from the area of posterior capsule rupture where present. Conclusion: The technique of hydro-free mechanical delamination is very helpful in PPC cases, as it is safe in creating a mechanical cushion around the nucleus and epinucleus and facilitates safe phacoemulsification.
Objective: This study aims to determine whether visual impairment (VI) is a significant risk factor for falls among older adults in Nigeria. Methods: A hospital-based, multi-center cross-sectional study was conducted among community-dwelling adults aged 60 and above, utilizing a semi-structured questionnaire. Results: A total of 578 participants took part in the study. Their average age was 68.46 ± 6.89 years with a range of 60–95 years and a male-to-female ratio of 2:3. One hundred and fifty-six (27%) participants reported experiencing at least one fall within the past 12 months, with 64.7% of them being female. More than 70% of participants recognized VI and fear as risk factors for a fall, with additional contributors being joint pain (79.6%), use of multiple medications (69.7%), unsteady gait (59.2%), and lower back pain (42.6%). Conclusion: VI was the second most commonly reported major risk factor causing falls after joint pains in this study.
Objective: Welders are a high-risk group for occupational ocular injury due to constant exposure to long-term infrared radiation. This study aimed to determine the factors associated with ocular disorders among welders in Owo, Southwest Nigeria. Methods: This is a descriptive cross-sectional study involving 241 welders. A semi-structured questionnaire was utilized to collect information, and biophysical measurements such as visual acuity, pupillary reflex, intraocular pressure, and cup disc ratio were recorded during the ocular clinical examination of all participants. Any P -value < 0.05 was considered statistically significant. Results: Ninety-one (37.8%) of the participants were between the ages of 30 and 39 years, all were males, 79.7% were married, and 44.8% had 6–10 years of working experience. More than half (56.8%) had a good knowledge of ocular disorders. The prevalence of ocular disorders was 53.1%, and the most common ocular disorders were presbyopia (26.6%), conjunctival disorders (22.4%), and corneal foreign body (15.8%). There was an association between age ( P = 0.04), monthly income ( P = 0.03), work experience ( P = 0.01), and ocular disorders. Conclusion: The prevalence of ocular disorders was relatively high among the welders in Owo. Hence, welders need to be educated on the prevention of ocular disorders.
Background: Patient eye health education is crucial to the provision of modern and personalized health care. However, various methods exist for the delivery of eye health education. This study aims to determine the preferred methods of eye health education among patients presenting at a tertiary eye care center. Methods: A cross-sectional study conducted at the eye clinic of a tertiary health center. An interviewer-administered questionnaire was used to obtain information on preferred methods of eye health education from adult patients aged 18 years and above who had a minimum of 6 months follow-up visit. Data were analyzed using frequencies and means, Chi-square was used to test for associations, and any P -value <0.05 was considered statistically significant. Results: Three-hundred and ninety-eight participants were interviewed. There were 212 (53.3%) males. The mean age of participants was 64.7 ± 20.9 years. The most preferred method of eye health education was one-on-one session with an eye care provider. 334 (83.9%) followed by printed educational materials provided by an eye care provider. 85(21.4%) older participants were significantly more likely to prefer one-on-one session with an eyecare provider compared to younger participants ( χ 2 = 15.519, P = 0.017). Housewives and civil servants had the highest preference for one-on-one session with an eye care provider ( χ 2 = 23.867, P = 0.001). Conclusion: Patient: educational preferences should be considered while planning and delivering educational programs in eye care facilities. These educational preferences should be tailored according to patients’ sociodemographic factors.
Optic atrophy is the pathologic endpoint of all optic neuropathies regardless of etiology. There is no predilection for age, sex, or race. We highlight a case of optic atrophy in a child due to osteopetrosis, a rare bone disorder from the subfamily of sclerosing bone dysplasias. This report aims to draw attention to osteopetrosis as a possible cause of optic atrophy in young patients, with emphasis on the importance of detailed systemic review and the need for multidisciplinary care for ophthalmic patients.
Objective: To determine the common causes of visual impairment (VI) and blindness among attendees of a free community outreach program in Edo Central and Edo North Senatorial zones of Edo State. Methods: This report presents the findings from a free community outreach program conducted in the Edo Central and North Senatorial Zones. The participants were residents of these senatorial zones who attended the free ophthalmic outreach events organized between February and July 2022. Results: Four hundred and eighty-two people participated in the outreach events, which were conducted in four different locations across the two senatorial zones. There were 234 participants from the Edo Central senatorial zone and 248 participants from the Edo North senatorial zone. In the Edo Central senatorial zone, 46.2% were either visually impaired (moderate VI = 27.4%, severe VI = 4.7%) or blind (14.1%). In the Edo North senatorial zone, the prevalence of moderate and severe VI was 35% and 2% respectively, while the prevalence of blindness was 12.5%. Cataract was the leading cause of moderate, severe VI, and blindness (55%, 75%, and 64.1%), respectively, across both zones. Whilst refractive error was the second most common cause of moderate VI, and glaucoma was the second most common cause of blindness. Conclusion: The primary causes of VI and blindness in the Edo Central and North Senatorial zones are cataract, glaucoma, and refractive error. Strategies targeting these causes of blindness by promoting awareness and improving access to the available eye care services are recommended.
Purpose: This study aimed to determine the prevalence, types, and magnitude of refractive errors, and their relationship with gestational age and birth weight, among premature babies aged 6 to 12 months at a Nigerian tertiary hospital. Methods: A hospital-based cross-sectional study involving all consecutive, eligible babies born prematurely was carried out from January to April 2021. Biodata and ocular examination reports, including cycloplegic refraction, were analyzed using IBM-SPSS version 20. The significance of the relationship between the types of refractive errors and birth weight and gestational age was determined using Pearson’s correlation, with the level of significance set at P -value less than 0.05 at a 95% confidence interval. Results: One hundred twenty-six preterm babies, including 57 (45.2%) males and 69 (54.8%) females, were recruited. Gestational age at birth ranged from 28 to 36 weeks. There was a statistically significant relationship between the type of refractive error and gestational age ( P = 0.009), as well as birth weight ( P = 0.006). The refractive error was hypermetropia in 156 (61%) eyes, of which 123 (78.8%) eyes had <+2.00 DS hypermetropia. Only one baby (0.8%) had a significant refractive error (–5.75 DS both eyes) based on the American Association for Pediatric Ophthalmology and Strabismus guidelines. The baby’s gestational age was 31 weeks, birth weight was 1.5 kg, and the baby did not have retinopathy of prematurity. Conclusion: The prevalence of significant refractive error among babies born prematurely in the study was 0.8%. The majority had <+2.00 DS hypermetropia, and the relationship between refractive error and birth weight/gestational age was statistically significant.
Purpose: The aim of the study was to determine the prevalence and types of corneal disorders at the University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria. Materials and Methods: This retrospective hospital-based study includes all patients seen between January 2018 and December 2022. Information on patients aged ≥18 years with a clinical diagnosis of any corneal pathology was retrieved from the Eye Clinic register. The data obtained were entered and analyzed using STATA/IC version 15.0. Results: A total of 15,423 patients aged 18 years and above were seen at the Eye Clinic during the study period. Of these, 462 patients (3.0%) were diagnosed with various forms of corneal disorders affecting 498 eyes. The patients’ ages ranged from 18 to 88 years, with a mean age of 41.9 ± 15.1 years. The peak ages at presentation were 21 to 30 years (26.2%) and 31 to 40 years (25.1%). There were more males (281, 60.8%) compared to females (181, 39.2%). Infectious corneal disorders were seen in 185 eyes (37.0%), while 313 eyes (63.0%) had noninfectious corneal disorders, resulting in a ratio of 1:1.7. Slightly over half (259 eyes, 52.0%) were blind at presentation. Conclusion: Corneal disorders are prevalent in our environment. Infectious keratitis accounts for a significant proportion of corneal disorders. Males within the economically productive age group are predominantly affected. Slightly over half of the eyes were blind at the time of presentation. Most causes of corneal disorders are avoidable. Consequently, corneal disorders in our environment constitute substantial public eye health significance.
Sudden vision loss caused by vitreous hemorrhage (VH) is a medical urgency and can occur due to several conditions, including proliferative diabetic retinopathy (PDR), retinal tears, or trauma. Sometimes, uncommon triggers like sneezing—especially when it involves a Valsalva maneuver—can lead to VH. This report discusses a 55-year-old man with type 2 diabetes and previously treated PDR, who lost vision in his right eye after a violent sneeze during a social event. His vision was stable after prior panretinal photocoagulation, but the sneezing episode resulted in a dense VH, confirmed by B-scan ultrasonography. The case underscores the importance of recognizing rare causes of VH and ensuring timely access to specialist retinal care. It also highlights that even after treatment, patients with PDR are still at risk from such events.
Background Applying mitomycin C (MMC) during trabeculectomy surgery impacts both success rates and complications. Increasing the concentration or amount of MMC improves its intrascleral penetration. The length of MMC exposure and the method used for delivering MMC might impact outcomes and complications just as much as the concentration. However, the manner of applications varies significantly. Research has identified the following ways for application: the direct sponge method, posterior scleral application method, subconjunctival MMC injection, intra-tenon MMC injection, and application of high concentrations of MMC. The traditional method of administering MMC is to soak a sponge and apply it to the subconjunctival space. This approach allows for adjusting drug concentration and duration to reduce the probability of failure. Subconjunctival injection of MMC is being investigated as an alternative to these sponges because of increased complications associated with the former. Recently, posterior application of MMC has been proposed to reduce the complications associated with previous methods of application of MMC. Purpose: To review updated knowledge on the different methods of MMC application and to highlight newer approaches in MMC application. Methods: Source of Data: International and local journals containing current literature on application techniques of MMC during trabeculectomy were sourced through the internet. Study selection: Findings consistent with my objectives were compiled and reviewed. Data Extraction: Data were extracted using Mendeley. Conclusion: Emerging newer approaches in MMC application during trabeculectomy offer superior surgical outcomes and reduced complications compared to the conventional sponge application of MMC.
Purpose: To evaluate visual outcomes and surgically induced astigmatism (SIA) following manual small incision cataract surgery (MSICS) using three different scleral incision geometries: straight, frown, and chevron. Methods: In this prospective, randomized clinical trial, 150 patients with age-related cataracts were assigned to one of three incision groups (straight, frown, and chevron). All surgeries were performed by a single surgeon using a standardized technique. Visual acuity (VA) and keratometric readings were measured preoperatively and at multiple postoperative intervals, with the primary outcomes being the uncorrected and best-corrected VA (UCVA and BCVA) and SIA at 30 days. Statistical significance was set at P < 0.05. Results: There were 50 patients in each group. All the patients had preoperative VA <6/60. At postoperative day 30, UCVA ≥ 6/18 was achieved in 90% (straight), 88% (frown), and 92% (chevron) of patients ( P = 0.570), with BCVA ≥ 6/18 in over 98% across all groups ( P = 0.365). Mean SIA was lowest in the chevron group (0.90 ± 0.22 D) compared to the straight (1.10 ± 0.42 D) and frown (1.07 ± 0.37 D) groups, although this difference was not statistically significant ( P = 0.208). The chevron group also had the highest proportion of eyes with postoperative astigmatism <1 D (68%). Conclusion: All three scleral incision types in MSICS yielded excellent visual outcomes. However, the chevron incision demonstrated a trend toward less SIA, making it a potentially advantageous choice in resource-limited settings where postoperative optical correction may be challenging.
