To estimate the frequency of exfoliation syndrome (XFS) and its association with ocular diseases ... more To estimate the frequency of exfoliation syndrome (XFS) and its association with ocular diseases in Northern Nigeria. Consecutive patients who presented to the outpatient department of ECWA Eye Hospital Kano from February 2015 to May 2015 were included in the study. Each patient had a complete ophthalmic examination. The anterior segment examination included tonometry, gonioscopy, and detailed slit-lamp examination to assess for the presence or absence of exfoliation material, inflammatory cells, and other abnormal findings. Patients with exfoliation material on the anterior lens surface and/or pupillary margin in either or both eyes were considered to have XFS. Statistical analysis was performed using the Statistical Package for the Social Sciences version 16.0. A total of 620 patients living in Northern Nigeria from the 6 geopolitical zones were examined. The majority of them (34.5%) were indigenous Hausas. There was a male preponderance of 56.6%, while the mean age at presentatio...
The aim was to determine the prevalence and pattern of congenital colour vision deficiency among ... more The aim was to determine the prevalence and pattern of congenital colour vision deficiency among secondary school students in Ibadan, Nigeria. A descriptive cross-sectional study was conducted among students from three public secondary schools through a multi-staged sampling method. Ocular examination including visual acuity assessment and colour vision test with the Ishihara plate was performed for all students. Further assessment with the Farnsworth-Munsell D-15 panel was performed for those who failed the Ishihara test. One thousand six hundred and thirty-five students participated in the study. There were 769 (47.0%) males with mean age of 13.9 ± 1.9 years. The overall prevalence of congenital colour vision deficiency was 2.3% with prevalence of 3.8% and 0.9% in males and females, respectively, which was statistically significant (P = 0.00112), and equal proportion of deutans 11 (32.0%) and protans 12 (35.0%) ratio of 1:1.1. The prevalence of congenital colour vision deficiency among public secondary school students in Ibadan is comparable to findings in other parts of the country.
Purpose To determine whether prior instillation of amethocaine would increase the rate and magnit... more Purpose To determine whether prior instillation of amethocaine would increase the rate and magnitude of tropicamide-induced pupillary dilatation in darkly pigmented irides. Method A total of 50 healthy Africans aged 18–40 years, with darkly pigmented irides, received a drop of amethocaine in one eye and a drop of placebo in the contralateral eye, followed by two drops of tropicamide in both eyes. Serial pupil diameters were measured using a monocular infrared video pupillometer. Rate of pupillary dilatation was compared in both eyes. Survival statistics were calculated for the time taken to reach a clinically effective dilatation, clinically effective diameter (CED) of 6.0 mm. Results Mean difference in pupil diameters between amethocaine- and placebo-treated eyes was 0.30 ± 0.09 mm ( P < 0.002). In all, 62% of amethocaine-treated eyes and only 46% of placebo-treated eyes reached the CED. Conclusion We observed a small but statistically significant potentiating effect of a drop o...
Methods: Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and... more Methods: Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and after face wash with soap and water, and cleansing with Savlon and 5% povidone iodine. Specimens were cultured and Gram stained. Bacterial counts were carried out using standard techniques. Results: Face washing with soap and water increased the proportion of patients with bacterial isolates from 80.0% to 87.5%. The average colony count increased from 187.1 to 318.5 colony units per mL (p 5 0.02). Application of 5% povidone iodine without face washing with soap and water reduced the proportion of patients with bacterial isolates from 82.6% (mean count 196.5) to 28.6% (mean count 34.1) (p 5 0.001); in comparison, the application of 5% povidone iodine after face washing with soap and water reduced the proportion from 71.4% (mean count 133.9) to 40.0% (mean count 69.0) (p 5 0.01). Application of Savlon without face washing with soap and water reduced the proportion of patients with bacterial isolates from 100% (mean count 310.9) to 41.2% (mean count 19.8) (p 5 0.004) compared with the application after face washing, which reduced the proportion from 89.5% (mean count 240.3) to 41.2% (mean count 82.9) (p 5 0.02). Conclusions: Both povidone and Savlon are effective in reducing periocular bacteria in an African setting. Prior face washing with soap and water had no added benefit in reducing bacterial colony count. Objet : Établir l'effet du lavage de la figure à l'eau savonneuse et du nettoyage à l'iode de povidone et au gluconate de cétrimide/chlorhexidine (Savlon) sur les bactéries de la paupière supérieure. Nature : Étude clinique prospective, non randomisée. Participants : Quatre-vingt patients de la clinique oculaire de l'hô pital du Collège universitaire d'Ibadan (Nigéria). Mé thodes : Les 80 patients répartis en 4 groupes ont eu des prélèvements de la peau de la paupière supérieure avant et après le lavage facial à l'eau savonneuse, un nettoyage au Savlon et à l'iode de providone 5 %. Les spécimens ont fait l'objet de culture et de coloration de Gram. Les comptes bactériens ont été faits selon les techniques standard. Ré sultats : Le lavage de la figure à l'eau savonneuse a augmenté la proportion de patients qui avaient des isolats bactériens de 80,0 % à 87,5 %. En moyenne, le compte de la colonie a augmenté de 187,1 à 318,5 unités par mL (p 5 0,02). L'application d'iode de providone 5 % sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients ayant des isolats bactériens, de 82,6 % (moyenne 196,5) à 28,6 % (moyenne 34,1) (p 5 0,001) ; comparativement, l'application d'iode de providone 5 % après le lavage de la figure à l'eau savonneuse a réduit la proportion de 71,4 %) (moyenne 133,9) à 40,0 % (moyenne 69,0) (p 5 0,01). L'application de Savlon sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients avec isolats bactériens de 100 % (moyenne 310,9) à 41,2 % (moyenne 19,8) (p 5 0,004) comparativement à l'application après lavage de la figure, ce qui a réduit la proportion de 89,5 % (moyenne 240,3) à 41,2 % (moyenne 82,9) (p 5 0,02). Conclusions : Le providone et le Savlon sont tous deux efficaces pour réduire les bactéries périoculaires en milieu africain. Le lavage préalable de la figure à l'eau savonneuse n'a pas ajouté d'avantage pour la réduction du compte de la colonie bactérienne.
African journal of medicine and medical sciences, 2008
Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Informat... more Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Information about peri-ocular skin bacterial isolates and their determinants would help in planning appropriate interventions. This study aimed to determine the upper lid skin bacterial count and factors related to high counts if any, among surgical eye patients. A cross section of consenting new surgical eye patients seen at the Eye clinic of the University College Hospital Ibadan between May and July 2006 was studied. They were interviewed with a standard questionnaire, and swab of the upper eyelid skin taken. Specimens were Gram-stained, bacterial counts and culture were carried out using standard techniques. A total of 80 subjects were studied, age range 13 to 87 years (mean 57.8 +/- 15.8) years. Females were 42 (52.5%) while males were 38 (47.5%). Bacterial culture was obtained from 76 (95.0%) of those studied, with 24 (30.0%) having Staphylococcus aureus sensitive to gentamycin and amoxici...
African journal of medicine and medical sciences, 2008
The aim of this study was to evaluate the effect of Timolol maleate on tear film break-up time in... more The aim of this study was to evaluate the effect of Timolol maleate on tear film break-up time in a Nigerian population. 192 eyes of 96 subjects were examined in a hospital based case-control study after being administered pre-coded questionnaires. The mean tear film break-up time was measured. There was significant difference (t = 10.164, P < 0.001) in the mean break-up time of cases (10.45 secs) and controls (30.18 secs). Half of the cases had some ocular discomfort with the instillation of Timolol maleate, a significant number of them having just been commenced on the medication (chi2 = 8.889, P = 0.003). Long-term instillation of Timolol maleate impairs tear film stability. The ocular discomfort experienced by patients on Timolol may contribute to poor drug compliance observed in patients on chronic drug therapy. Regular screening of patients on Timolol maleate for tear film instability and dry eyes is important and drug manufacturers should explore the possibility of incorpo...
African journal of medicine and medical sciences, 2002
A retrospective review of cases of pterygium excision using the bare sclera method followed by ap... more A retrospective review of cases of pterygium excision using the bare sclera method followed by application of 2500-3500 rads of Sr 90 beta-radiation carried out between 1994 and the year 2000 at Ojulowo Eye clinic Ibadan and St Mary's Catholic Specialist Eye Hospital Ago-Iwoye, Nigeria. Follow up period was between six months and six years. A total of 124 eyes from 95 patients were operated. 58 (61.1%) were males and 37 (38.9%) were females. The youngest patient was 10 years old while the oldest was 89 years mean 46.1 +/- 2 STD of 13.5. Most pterygia were unilateral and nasal in location. Improvement in visual acuity of between 2-6 lines on snellen chart occurred in 6 (4.8%) of operated eyes. Recurrence necessitating repeat surgery and additional radiation occurred in 8 eyes (6.9%). The complications of surgery and beta radiation consisted of conjunctiva inflammation 10 (8.6%), cornea opacities 4 (3.2%), gritty sensation 3 (2.6), cataract 1 (0.8%). No case of sclera necroses was...
PURPOSE. To determine the prevalence and identify the types of glaucoma in the Akinyele district ... more PURPOSE. To determine the prevalence and identify the types of glaucoma in the Akinyele district of Oyo State in southwestern Nigeria. METHODS. Residents of Akinyele district of Oyo State in southwestern Nigeria aged 40 years and older were randomly selected in a stratified manner. All participants underwent comprehensive ophthalmic examination, including visual acuity assessment, anterior segment biomicroscopy, IOP measurement, gonioscopy, optic nerve head and disc evaluation, and central visual field assessment. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification scheme. RESULTS. A sample of 811 subjects (90% response rate) was examined. The crude prevalence of all forms of glaucoma was 7.3% (95% confidence interval [CI] 5.5%-9.1%) with an age and sex standardized rate of 6.9% (95% CI 6.88%-6.92%). Primary open angle glaucoma was found in 6.2% (95% CI 4.5%-7.8%) and primary angle closure glaucoma in 0.2% (95% CI 0.0%-0.6%). Secondary glaucoma accounted for 0.9% of the cases, with couching and neovascular process being the main causes (0.2% each). Prevalence of glaucoma increased significantly with increasing age (P for trend < 0.05). CONCLUSIONS. The high prevalence of glaucoma (7.3%) in the Akinyele district in southwestern Nigeria is comparable with those in predominantly black populations in the Akwapim-South district of Ghana and Barbados. Primary open angle glaucoma remains the most prevalent form of glaucoma.
Aim To determine the magnitude of visual impairment (VI) resulting from lens opacity/ cataract am... more Aim To determine the magnitude of visual impairment (VI) resulting from lens opacity/ cataract among a rural population in southwestern Nigeria. Method A population-based cross-sectional survey using a multistage sampling method to select subjects X50 years. Participants with pinhole visual acuity of p6/18 in their better eye, exclusively from lens opacity/cataract, were further examined by an ophthalmologist. Their level of VI was categorised using the International Classification of Disease tenth revision and lens opacity was graded using the World Health Organization's cataract grading system. Results From the enumerated population of 1200 subjects, 1031 subjects were examined. The prevalence of VI from cataract/lens opacity in the population studied was 11.9% (95% CI: 10.1-14.0) with a cataract blindness prevalence of 2.0% (95% CI: 1.3-3.0). The odds for VI increased with increasing age and female patients had 1.6 times the odds for cataract blindness than did male patients. Mixed cataract was the most prevalent of the visually disabling cataract. (3.9% (95% CI: 2.8-5.2)), whereas posterior subcapsular cataract was the least prevalent (2.5% (95% CI: 1.7-3.7)). Conclusion VI from cataract remains a public health problem in the Akinyele district of Nigeria. The need for a comprehensive cataract surgical service using the VISION 2020 model is necessary in the district if the burden from the backlog of visually disabling cataract is to be reduced.
The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the preventio... more The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the prevention of pterygium recurrence. A retrospective non-randomised review of cases of fleshy pterygium treated with bare scleral excision and adjuvant 5-FU were compared with similar morphologically appearing pterygia, matched for age and sex, treated with bare scleral excision and adjuvant beta-irradiation. All surgeries were carried out at the university college hospital and Ojulowo eye hospital, Ibadan, Nigeria. Twenty-seven eyes of 24 patients who had pterygium excision with adjuvant treatment with 5-FU were compared with 31 eyes of 24 patients who were treated with excision and beta-irradiation. The mean age for the 5-FU group was 46.1 years while that for the beta-irradiation group was 46.9 years. Both sexes were equally represented, 12 males and 12 females. There were seven (25.9%) initial recurrences in the 5-FU group but four of these became atrophic, and therefore, cosmetically acceptable leaving three eyes (11%) with unacceptable recurrent pterygia. The beta-irradiation group, however, had seven (22.5) initial recurrence but five of these became atrophic and fell short of the cornea, leaving two (6.5%) with clinically unacceptable recurrence. The difference was, however, not statistically significant (Zc = 0.74 and p &gt; 0.1). The associated complications were mostly mild in both groups and included cornea opacity of 10 (37%) complications, conjunctivitis of three (11%) complications, sclera granuloma of three (11%) complications and conjunctiva necrosis of one (3.7%) complication for the 5-FU group, and while the beta-irradiation group had corneal opacity of one (3.7%) complication and conjunctivitis of three (11%) complications. The non-statistical significance of a lower-pterigium recurrence rate with use of beta-irradiation for the treatment of fleshy pterygium compared with 5-FU may have been partly due to the small number of patients studied. A randomised-controlled study using a larger sample size is therefore proposed. However, the fact that over half of those with initial recurrence in the 5-FU group became atrophic (and therefore cosmetically acceptable) over time as well as less cost implication in the purchase of 5-FU relative to Strontium-90 association with few and mild complications makes it a desirable adjuvant therapy in depressed economies. However, beta-irradiation still has a place when cost issue is not an inhibiting factor in view of its clinically superior outcome.
African journal of medicine and medical sciences, 2003
Records of 15 patients presenting with pressurised bottled drinks related eye injuries between Ja... more Records of 15 patients presenting with pressurised bottled drinks related eye injuries between January 1996 and 2001 were reviewed to identify factors contributing to accidental eye injuries from pressurised bottled drinks, reason for poor outcome and to make recommendations. In all, 16 eyes of 15 patients were studied out of which 7 were males (M:F, ratio 1:1.1). Age range, 3 years-49 years, mean 23.6 years. The majority of those affected were students 46.7%, and traders 26.7%. The commonest activity leading to injury was explosion during the process of arranging the bottles or crates of drinks (43.8%) and accidental fall of bottle from hand or height (37.5%). Drinks implicated include, Coca-cola 50%, beer 25%, others (Fanta, Legend stout, Mirinda, Grape juice) 25%. Complications arising from the injury included, hyphema 43.8%, vitreous haemorrhage 12.5%, and retinal detachment 12.5%. The globes were retained in 12 (75%) cases, 3 defaulted and one eye became phthisical. The final v...
Ultraviolet (UV) rays and chronic irritation to dust have been implicated in the pathogenesis of ... more Ultraviolet (UV) rays and chronic irritation to dust have been implicated in the pathogenesis of degenerative conditions of the cornea and conjunctiva like pterygium and pinguecula. It has been postulated that exposure to these environmental factors cause corneal and conjunctival drying by disruption of the tear film. While some researchers have found tear film dysfunction in eyes with pterygia and pingueculae, others have found no such abnormalities. The differences in findings may be due to different methods of investigation, or differences based on geography and climate. The tear film has been studied using tear break-up time (TBUT) in adults with pterygia and pingueculae disorders, TBUT was measured in 73 eyes with pterygia and 74 eyes with pinguecula and were compared to TBUT in 74 eyes of age and sex matched normal controls. Abnormal TBUT was defined as TBUT less than 15 secs. Unstable tear film was defined as TBUT less than 10 secs. The mean TBUT was lower in eyes with pterygia (17.90 secs) than in control eyes (19.86 secs), although the mean difference was not statistically significant. Abnormal TBUT, defined as TBUT less than 15 secs, was found in 29 eyes out of 73 eyes with pterygia (39.7%), compared with 13 eyes out of 74 eyes with pingueculae (17.6%) and in 17(23.0%) of 74 control eyes (X2 = 10.01, df = 2, P = 0.0006). A TBUT of less than 15 secs was more significantly associated with eyes with pterygia compared to control eyes. Unstable tear film (TBUT less than 10 secs) was found in 12(16.4%) eyes with pterygia, compared to 4(5.4%) eyes with pingueculae and 4(5.4%) control eyes. Unstable tear film was significantly associated with eyes with pterygia (P = 0.027). Tear film abnormalities are associated with pterygium but not with pinguecula in the subjects studied. TBHT may vary in different populations.
ABSTRACT Objective: The aim of this study was to determine the visual outcome of patients who had... more ABSTRACT Objective: The aim of this study was to determine the visual outcome of patients who had manual small incision cataract surgery in a high volume secondary eye hospital in southwestern Nigeria, and to identify reasons for poor outcome. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at St Mary’s Catholic Eye Hospital, Ago Iwoye (SMEH) Nigeria conducted between May and October 2007. A total of 146 patients who presented to the hospital and met the inclusion criteria were recruited for the study. Patients were examined preoperatively, 1st day and 8th week post-operatively. Results were analyzed using the SPSS statistical software. Significant association was taken at 95% confidence interval i.e. &lt; 0.05. Results: A total of 146 patients who met the inclusion criteria were studied. The mean age was 65.3±10.04 years; and the male to female ratio was 1.4:1. Preoperatively, 110 patients (75.3%) were blind in the operated eye, while 33 patients (22.6%) were blind in both eyes at presentation. At 1st day post-operatively, 17 patients (11.6%) had pinhole visual acuity of 6/6-6/18. Out of 137 patients that had refraction, 114 patients (83.2%) had a visual acuity of 6/6-6/18. The number of blind patients also reduced from 33 (22.6%) to 1(0.7%). Uncorrected refractive error was the commonest cause of poor vision post-operatively. Conclusion: This study demonstrates that good results can be obtained with small incision cataract surgery with intraocular lens implantation in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery.
ABSTRACT Objective: To review patients with clinical features of chloroquine retinopathy seen dur... more ABSTRACT Objective: To review patients with clinical features of chloroquine retinopathy seen during the study period with the view of identifying the trend and creating public awareness for behavioural change. Methods: A retrospective review of case notes of patients seen between 1996 and 2002. Results: 19 patients with features of presumed chloro-quine retinopathy were reviewed: 5 women and 14 (73.7%) men. The age range is: 36-69 years, mean 50.7 years. Approximately 63% were civil servants, health care workers and teachers. Duration of chloroquine use ranged from six months to ten years, with a mean of 4.1 years. Total cumulative dose ranged from 10 gm to 312 gm, with a mean of 108 gm. Best corrected visual acuity of subjects ranged from 6/5-CF, mean 6/18. Conclusion: The majority of people using large amounts of chloroquine over long periods are educated, middle-aged males, whose loss of vision would have far reaching effects on their families. There is, therefore, a need to create public awareness of the danger of long-term chloroquine use. A follow up national survey would be desirable to determine the actual magnitude of the problem [Nig. J. Ophthalmology Vol.11(1) 2003: 24-28]
Middle East African Journal of Ophthalmology, 2008
To determine the relationship between tear function and ocular surface abnormalities with subject... more To determine the relationship between tear function and ocular surface abnormalities with subjective symptoms of dry eye. Patients with various ocular irritation symptoms suggestive of dry eye were examined for tear break up time (TBUT), Schirmer&amp;amp;#39;s test 1, and Rose Bengal staining pattern. They were compared with a group of asymptomatic healthy subjects. There were 63 subjects, mean age 43.8 years (+/-14.7 years) with various complaints of dryness presenting as having irritation or foreign body sensation. A group of 17 asymptomatic subjects, mean age 42.1 years (+/-12.7 years) were studied as controls. There were 22 (34. 9 %) males and 41(65.1%) females in the symptomatic group while the control group had 4 (23.5%) males and 13(76.5%) females. Ocular irritations included itching 38(60.3%), pricking and itching 10 (15.9%). Mean Shirmer&amp;amp;#39;s test values were lower for symptomatic subjects (mean 14.5mm +/-12.3 right eye; 14.9mm +/-12.4 left eye), compared to the controls (23.0mm +/-13.4 right eye; 17. 9mm +/-13.4 left eye) P=0.02, for right eye and 0.4 for left. The mean TBUT were also lower amongst the symptomatic subjects (10.5 seconds, right eye and 10.1 seconds left eye), while for controls mean TBUT was 12.7 seconds right eye and 12.1 seconds left eye (P=0.2). Fifty -six out of 126 (46.8%) eyes of all symptomatic subjects compared to 7 out of 34 (20.6%) eyes of asymptomatic subjects had positive staining of conjunctiva with rose Bengal (p=0.06). For subjects with itching as the primary symptom 44.7% of them as opposed to 23.5% of the controls were likely to stain positive with rose Bengal, (sensitivity of itching as screening tool for dry eye was 81%, specificity 38.2%). Itching and pricking sensation together (sensitivity 46.2% and specificity improved to 65%). Rose Bengal grades were also inversely correlated with mean Schirmers values (Pearson correlation -0.429; P = 0.001) and TBUT (Pearson correlation -0.316, P=0.005). Itching and other ocular irritation symptoms may be indicative of underlying abnormal tear function and ocular surface damage, their presence calls for further examination for tear deficiency and prompt institution of treatment for dry eye.
Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients w... more Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. To identify symptoms and surface abnormalities associated with dry eyes. One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer&#39;s 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Mean tear meniscus height, Schirmer&#39;s test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer&#39;s test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer&#39;s values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher&#39;s exact test) and 95.8% of dry right eyes compared to 61.1% of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.
To estimate the frequency of exfoliation syndrome (XFS) and its association with ocular diseases ... more To estimate the frequency of exfoliation syndrome (XFS) and its association with ocular diseases in Northern Nigeria. Consecutive patients who presented to the outpatient department of ECWA Eye Hospital Kano from February 2015 to May 2015 were included in the study. Each patient had a complete ophthalmic examination. The anterior segment examination included tonometry, gonioscopy, and detailed slit-lamp examination to assess for the presence or absence of exfoliation material, inflammatory cells, and other abnormal findings. Patients with exfoliation material on the anterior lens surface and/or pupillary margin in either or both eyes were considered to have XFS. Statistical analysis was performed using the Statistical Package for the Social Sciences version 16.0. A total of 620 patients living in Northern Nigeria from the 6 geopolitical zones were examined. The majority of them (34.5%) were indigenous Hausas. There was a male preponderance of 56.6%, while the mean age at presentatio...
The aim was to determine the prevalence and pattern of congenital colour vision deficiency among ... more The aim was to determine the prevalence and pattern of congenital colour vision deficiency among secondary school students in Ibadan, Nigeria. A descriptive cross-sectional study was conducted among students from three public secondary schools through a multi-staged sampling method. Ocular examination including visual acuity assessment and colour vision test with the Ishihara plate was performed for all students. Further assessment with the Farnsworth-Munsell D-15 panel was performed for those who failed the Ishihara test. One thousand six hundred and thirty-five students participated in the study. There were 769 (47.0%) males with mean age of 13.9 ± 1.9 years. The overall prevalence of congenital colour vision deficiency was 2.3% with prevalence of 3.8% and 0.9% in males and females, respectively, which was statistically significant (P = 0.00112), and equal proportion of deutans 11 (32.0%) and protans 12 (35.0%) ratio of 1:1.1. The prevalence of congenital colour vision deficiency among public secondary school students in Ibadan is comparable to findings in other parts of the country.
Purpose To determine whether prior instillation of amethocaine would increase the rate and magnit... more Purpose To determine whether prior instillation of amethocaine would increase the rate and magnitude of tropicamide-induced pupillary dilatation in darkly pigmented irides. Method A total of 50 healthy Africans aged 18–40 years, with darkly pigmented irides, received a drop of amethocaine in one eye and a drop of placebo in the contralateral eye, followed by two drops of tropicamide in both eyes. Serial pupil diameters were measured using a monocular infrared video pupillometer. Rate of pupillary dilatation was compared in both eyes. Survival statistics were calculated for the time taken to reach a clinically effective dilatation, clinically effective diameter (CED) of 6.0 mm. Results Mean difference in pupil diameters between amethocaine- and placebo-treated eyes was 0.30 ± 0.09 mm ( P < 0.002). In all, 62% of amethocaine-treated eyes and only 46% of placebo-treated eyes reached the CED. Conclusion We observed a small but statistically significant potentiating effect of a drop o...
Methods: Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and... more Methods: Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and after face wash with soap and water, and cleansing with Savlon and 5% povidone iodine. Specimens were cultured and Gram stained. Bacterial counts were carried out using standard techniques. Results: Face washing with soap and water increased the proportion of patients with bacterial isolates from 80.0% to 87.5%. The average colony count increased from 187.1 to 318.5 colony units per mL (p 5 0.02). Application of 5% povidone iodine without face washing with soap and water reduced the proportion of patients with bacterial isolates from 82.6% (mean count 196.5) to 28.6% (mean count 34.1) (p 5 0.001); in comparison, the application of 5% povidone iodine after face washing with soap and water reduced the proportion from 71.4% (mean count 133.9) to 40.0% (mean count 69.0) (p 5 0.01). Application of Savlon without face washing with soap and water reduced the proportion of patients with bacterial isolates from 100% (mean count 310.9) to 41.2% (mean count 19.8) (p 5 0.004) compared with the application after face washing, which reduced the proportion from 89.5% (mean count 240.3) to 41.2% (mean count 82.9) (p 5 0.02). Conclusions: Both povidone and Savlon are effective in reducing periocular bacteria in an African setting. Prior face washing with soap and water had no added benefit in reducing bacterial colony count. Objet : Établir l'effet du lavage de la figure à l'eau savonneuse et du nettoyage à l'iode de povidone et au gluconate de cétrimide/chlorhexidine (Savlon) sur les bactéries de la paupière supérieure. Nature : Étude clinique prospective, non randomisée. Participants : Quatre-vingt patients de la clinique oculaire de l'hô pital du Collège universitaire d'Ibadan (Nigéria). Mé thodes : Les 80 patients répartis en 4 groupes ont eu des prélèvements de la peau de la paupière supérieure avant et après le lavage facial à l'eau savonneuse, un nettoyage au Savlon et à l'iode de providone 5 %. Les spécimens ont fait l'objet de culture et de coloration de Gram. Les comptes bactériens ont été faits selon les techniques standard. Ré sultats : Le lavage de la figure à l'eau savonneuse a augmenté la proportion de patients qui avaient des isolats bactériens de 80,0 % à 87,5 %. En moyenne, le compte de la colonie a augmenté de 187,1 à 318,5 unités par mL (p 5 0,02). L'application d'iode de providone 5 % sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients ayant des isolats bactériens, de 82,6 % (moyenne 196,5) à 28,6 % (moyenne 34,1) (p 5 0,001) ; comparativement, l'application d'iode de providone 5 % après le lavage de la figure à l'eau savonneuse a réduit la proportion de 71,4 %) (moyenne 133,9) à 40,0 % (moyenne 69,0) (p 5 0,01). L'application de Savlon sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients avec isolats bactériens de 100 % (moyenne 310,9) à 41,2 % (moyenne 19,8) (p 5 0,004) comparativement à l'application après lavage de la figure, ce qui a réduit la proportion de 89,5 % (moyenne 240,3) à 41,2 % (moyenne 82,9) (p 5 0,02). Conclusions : Le providone et le Savlon sont tous deux efficaces pour réduire les bactéries périoculaires en milieu africain. Le lavage préalable de la figure à l'eau savonneuse n'a pas ajouté d'avantage pour la réduction du compte de la colonie bactérienne.
African journal of medicine and medical sciences, 2008
Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Informat... more Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Information about peri-ocular skin bacterial isolates and their determinants would help in planning appropriate interventions. This study aimed to determine the upper lid skin bacterial count and factors related to high counts if any, among surgical eye patients. A cross section of consenting new surgical eye patients seen at the Eye clinic of the University College Hospital Ibadan between May and July 2006 was studied. They were interviewed with a standard questionnaire, and swab of the upper eyelid skin taken. Specimens were Gram-stained, bacterial counts and culture were carried out using standard techniques. A total of 80 subjects were studied, age range 13 to 87 years (mean 57.8 +/- 15.8) years. Females were 42 (52.5%) while males were 38 (47.5%). Bacterial culture was obtained from 76 (95.0%) of those studied, with 24 (30.0%) having Staphylococcus aureus sensitive to gentamycin and amoxici...
African journal of medicine and medical sciences, 2008
The aim of this study was to evaluate the effect of Timolol maleate on tear film break-up time in... more The aim of this study was to evaluate the effect of Timolol maleate on tear film break-up time in a Nigerian population. 192 eyes of 96 subjects were examined in a hospital based case-control study after being administered pre-coded questionnaires. The mean tear film break-up time was measured. There was significant difference (t = 10.164, P < 0.001) in the mean break-up time of cases (10.45 secs) and controls (30.18 secs). Half of the cases had some ocular discomfort with the instillation of Timolol maleate, a significant number of them having just been commenced on the medication (chi2 = 8.889, P = 0.003). Long-term instillation of Timolol maleate impairs tear film stability. The ocular discomfort experienced by patients on Timolol may contribute to poor drug compliance observed in patients on chronic drug therapy. Regular screening of patients on Timolol maleate for tear film instability and dry eyes is important and drug manufacturers should explore the possibility of incorpo...
African journal of medicine and medical sciences, 2002
A retrospective review of cases of pterygium excision using the bare sclera method followed by ap... more A retrospective review of cases of pterygium excision using the bare sclera method followed by application of 2500-3500 rads of Sr 90 beta-radiation carried out between 1994 and the year 2000 at Ojulowo Eye clinic Ibadan and St Mary's Catholic Specialist Eye Hospital Ago-Iwoye, Nigeria. Follow up period was between six months and six years. A total of 124 eyes from 95 patients were operated. 58 (61.1%) were males and 37 (38.9%) were females. The youngest patient was 10 years old while the oldest was 89 years mean 46.1 +/- 2 STD of 13.5. Most pterygia were unilateral and nasal in location. Improvement in visual acuity of between 2-6 lines on snellen chart occurred in 6 (4.8%) of operated eyes. Recurrence necessitating repeat surgery and additional radiation occurred in 8 eyes (6.9%). The complications of surgery and beta radiation consisted of conjunctiva inflammation 10 (8.6%), cornea opacities 4 (3.2%), gritty sensation 3 (2.6), cataract 1 (0.8%). No case of sclera necroses was...
PURPOSE. To determine the prevalence and identify the types of glaucoma in the Akinyele district ... more PURPOSE. To determine the prevalence and identify the types of glaucoma in the Akinyele district of Oyo State in southwestern Nigeria. METHODS. Residents of Akinyele district of Oyo State in southwestern Nigeria aged 40 years and older were randomly selected in a stratified manner. All participants underwent comprehensive ophthalmic examination, including visual acuity assessment, anterior segment biomicroscopy, IOP measurement, gonioscopy, optic nerve head and disc evaluation, and central visual field assessment. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification scheme. RESULTS. A sample of 811 subjects (90% response rate) was examined. The crude prevalence of all forms of glaucoma was 7.3% (95% confidence interval [CI] 5.5%-9.1%) with an age and sex standardized rate of 6.9% (95% CI 6.88%-6.92%). Primary open angle glaucoma was found in 6.2% (95% CI 4.5%-7.8%) and primary angle closure glaucoma in 0.2% (95% CI 0.0%-0.6%). Secondary glaucoma accounted for 0.9% of the cases, with couching and neovascular process being the main causes (0.2% each). Prevalence of glaucoma increased significantly with increasing age (P for trend < 0.05). CONCLUSIONS. The high prevalence of glaucoma (7.3%) in the Akinyele district in southwestern Nigeria is comparable with those in predominantly black populations in the Akwapim-South district of Ghana and Barbados. Primary open angle glaucoma remains the most prevalent form of glaucoma.
Aim To determine the magnitude of visual impairment (VI) resulting from lens opacity/ cataract am... more Aim To determine the magnitude of visual impairment (VI) resulting from lens opacity/ cataract among a rural population in southwestern Nigeria. Method A population-based cross-sectional survey using a multistage sampling method to select subjects X50 years. Participants with pinhole visual acuity of p6/18 in their better eye, exclusively from lens opacity/cataract, were further examined by an ophthalmologist. Their level of VI was categorised using the International Classification of Disease tenth revision and lens opacity was graded using the World Health Organization's cataract grading system. Results From the enumerated population of 1200 subjects, 1031 subjects were examined. The prevalence of VI from cataract/lens opacity in the population studied was 11.9% (95% CI: 10.1-14.0) with a cataract blindness prevalence of 2.0% (95% CI: 1.3-3.0). The odds for VI increased with increasing age and female patients had 1.6 times the odds for cataract blindness than did male patients. Mixed cataract was the most prevalent of the visually disabling cataract. (3.9% (95% CI: 2.8-5.2)), whereas posterior subcapsular cataract was the least prevalent (2.5% (95% CI: 1.7-3.7)). Conclusion VI from cataract remains a public health problem in the Akinyele district of Nigeria. The need for a comprehensive cataract surgical service using the VISION 2020 model is necessary in the district if the burden from the backlog of visually disabling cataract is to be reduced.
The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the preventio... more The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the prevention of pterygium recurrence. A retrospective non-randomised review of cases of fleshy pterygium treated with bare scleral excision and adjuvant 5-FU were compared with similar morphologically appearing pterygia, matched for age and sex, treated with bare scleral excision and adjuvant beta-irradiation. All surgeries were carried out at the university college hospital and Ojulowo eye hospital, Ibadan, Nigeria. Twenty-seven eyes of 24 patients who had pterygium excision with adjuvant treatment with 5-FU were compared with 31 eyes of 24 patients who were treated with excision and beta-irradiation. The mean age for the 5-FU group was 46.1 years while that for the beta-irradiation group was 46.9 years. Both sexes were equally represented, 12 males and 12 females. There were seven (25.9%) initial recurrences in the 5-FU group but four of these became atrophic, and therefore, cosmetically acceptable leaving three eyes (11%) with unacceptable recurrent pterygia. The beta-irradiation group, however, had seven (22.5) initial recurrence but five of these became atrophic and fell short of the cornea, leaving two (6.5%) with clinically unacceptable recurrence. The difference was, however, not statistically significant (Zc = 0.74 and p &gt; 0.1). The associated complications were mostly mild in both groups and included cornea opacity of 10 (37%) complications, conjunctivitis of three (11%) complications, sclera granuloma of three (11%) complications and conjunctiva necrosis of one (3.7%) complication for the 5-FU group, and while the beta-irradiation group had corneal opacity of one (3.7%) complication and conjunctivitis of three (11%) complications. The non-statistical significance of a lower-pterigium recurrence rate with use of beta-irradiation for the treatment of fleshy pterygium compared with 5-FU may have been partly due to the small number of patients studied. A randomised-controlled study using a larger sample size is therefore proposed. However, the fact that over half of those with initial recurrence in the 5-FU group became atrophic (and therefore cosmetically acceptable) over time as well as less cost implication in the purchase of 5-FU relative to Strontium-90 association with few and mild complications makes it a desirable adjuvant therapy in depressed economies. However, beta-irradiation still has a place when cost issue is not an inhibiting factor in view of its clinically superior outcome.
African journal of medicine and medical sciences, 2003
Records of 15 patients presenting with pressurised bottled drinks related eye injuries between Ja... more Records of 15 patients presenting with pressurised bottled drinks related eye injuries between January 1996 and 2001 were reviewed to identify factors contributing to accidental eye injuries from pressurised bottled drinks, reason for poor outcome and to make recommendations. In all, 16 eyes of 15 patients were studied out of which 7 were males (M:F, ratio 1:1.1). Age range, 3 years-49 years, mean 23.6 years. The majority of those affected were students 46.7%, and traders 26.7%. The commonest activity leading to injury was explosion during the process of arranging the bottles or crates of drinks (43.8%) and accidental fall of bottle from hand or height (37.5%). Drinks implicated include, Coca-cola 50%, beer 25%, others (Fanta, Legend stout, Mirinda, Grape juice) 25%. Complications arising from the injury included, hyphema 43.8%, vitreous haemorrhage 12.5%, and retinal detachment 12.5%. The globes were retained in 12 (75%) cases, 3 defaulted and one eye became phthisical. The final v...
Ultraviolet (UV) rays and chronic irritation to dust have been implicated in the pathogenesis of ... more Ultraviolet (UV) rays and chronic irritation to dust have been implicated in the pathogenesis of degenerative conditions of the cornea and conjunctiva like pterygium and pinguecula. It has been postulated that exposure to these environmental factors cause corneal and conjunctival drying by disruption of the tear film. While some researchers have found tear film dysfunction in eyes with pterygia and pingueculae, others have found no such abnormalities. The differences in findings may be due to different methods of investigation, or differences based on geography and climate. The tear film has been studied using tear break-up time (TBUT) in adults with pterygia and pingueculae disorders, TBUT was measured in 73 eyes with pterygia and 74 eyes with pinguecula and were compared to TBUT in 74 eyes of age and sex matched normal controls. Abnormal TBUT was defined as TBUT less than 15 secs. Unstable tear film was defined as TBUT less than 10 secs. The mean TBUT was lower in eyes with pterygia (17.90 secs) than in control eyes (19.86 secs), although the mean difference was not statistically significant. Abnormal TBUT, defined as TBUT less than 15 secs, was found in 29 eyes out of 73 eyes with pterygia (39.7%), compared with 13 eyes out of 74 eyes with pingueculae (17.6%) and in 17(23.0%) of 74 control eyes (X2 = 10.01, df = 2, P = 0.0006). A TBUT of less than 15 secs was more significantly associated with eyes with pterygia compared to control eyes. Unstable tear film (TBUT less than 10 secs) was found in 12(16.4%) eyes with pterygia, compared to 4(5.4%) eyes with pingueculae and 4(5.4%) control eyes. Unstable tear film was significantly associated with eyes with pterygia (P = 0.027). Tear film abnormalities are associated with pterygium but not with pinguecula in the subjects studied. TBHT may vary in different populations.
ABSTRACT Objective: The aim of this study was to determine the visual outcome of patients who had... more ABSTRACT Objective: The aim of this study was to determine the visual outcome of patients who had manual small incision cataract surgery in a high volume secondary eye hospital in southwestern Nigeria, and to identify reasons for poor outcome. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at St Mary’s Catholic Eye Hospital, Ago Iwoye (SMEH) Nigeria conducted between May and October 2007. A total of 146 patients who presented to the hospital and met the inclusion criteria were recruited for the study. Patients were examined preoperatively, 1st day and 8th week post-operatively. Results were analyzed using the SPSS statistical software. Significant association was taken at 95% confidence interval i.e. &lt; 0.05. Results: A total of 146 patients who met the inclusion criteria were studied. The mean age was 65.3±10.04 years; and the male to female ratio was 1.4:1. Preoperatively, 110 patients (75.3%) were blind in the operated eye, while 33 patients (22.6%) were blind in both eyes at presentation. At 1st day post-operatively, 17 patients (11.6%) had pinhole visual acuity of 6/6-6/18. Out of 137 patients that had refraction, 114 patients (83.2%) had a visual acuity of 6/6-6/18. The number of blind patients also reduced from 33 (22.6%) to 1(0.7%). Uncorrected refractive error was the commonest cause of poor vision post-operatively. Conclusion: This study demonstrates that good results can be obtained with small incision cataract surgery with intraocular lens implantation in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery.
ABSTRACT Objective: To review patients with clinical features of chloroquine retinopathy seen dur... more ABSTRACT Objective: To review patients with clinical features of chloroquine retinopathy seen during the study period with the view of identifying the trend and creating public awareness for behavioural change. Methods: A retrospective review of case notes of patients seen between 1996 and 2002. Results: 19 patients with features of presumed chloro-quine retinopathy were reviewed: 5 women and 14 (73.7%) men. The age range is: 36-69 years, mean 50.7 years. Approximately 63% were civil servants, health care workers and teachers. Duration of chloroquine use ranged from six months to ten years, with a mean of 4.1 years. Total cumulative dose ranged from 10 gm to 312 gm, with a mean of 108 gm. Best corrected visual acuity of subjects ranged from 6/5-CF, mean 6/18. Conclusion: The majority of people using large amounts of chloroquine over long periods are educated, middle-aged males, whose loss of vision would have far reaching effects on their families. There is, therefore, a need to create public awareness of the danger of long-term chloroquine use. A follow up national survey would be desirable to determine the actual magnitude of the problem [Nig. J. Ophthalmology Vol.11(1) 2003: 24-28]
Middle East African Journal of Ophthalmology, 2008
To determine the relationship between tear function and ocular surface abnormalities with subject... more To determine the relationship between tear function and ocular surface abnormalities with subjective symptoms of dry eye. Patients with various ocular irritation symptoms suggestive of dry eye were examined for tear break up time (TBUT), Schirmer&amp;amp;#39;s test 1, and Rose Bengal staining pattern. They were compared with a group of asymptomatic healthy subjects. There were 63 subjects, mean age 43.8 years (+/-14.7 years) with various complaints of dryness presenting as having irritation or foreign body sensation. A group of 17 asymptomatic subjects, mean age 42.1 years (+/-12.7 years) were studied as controls. There were 22 (34. 9 %) males and 41(65.1%) females in the symptomatic group while the control group had 4 (23.5%) males and 13(76.5%) females. Ocular irritations included itching 38(60.3%), pricking and itching 10 (15.9%). Mean Shirmer&amp;amp;#39;s test values were lower for symptomatic subjects (mean 14.5mm +/-12.3 right eye; 14.9mm +/-12.4 left eye), compared to the controls (23.0mm +/-13.4 right eye; 17. 9mm +/-13.4 left eye) P=0.02, for right eye and 0.4 for left. The mean TBUT were also lower amongst the symptomatic subjects (10.5 seconds, right eye and 10.1 seconds left eye), while for controls mean TBUT was 12.7 seconds right eye and 12.1 seconds left eye (P=0.2). Fifty -six out of 126 (46.8%) eyes of all symptomatic subjects compared to 7 out of 34 (20.6%) eyes of asymptomatic subjects had positive staining of conjunctiva with rose Bengal (p=0.06). For subjects with itching as the primary symptom 44.7% of them as opposed to 23.5% of the controls were likely to stain positive with rose Bengal, (sensitivity of itching as screening tool for dry eye was 81%, specificity 38.2%). Itching and pricking sensation together (sensitivity 46.2% and specificity improved to 65%). Rose Bengal grades were also inversely correlated with mean Schirmers values (Pearson correlation -0.429; P = 0.001) and TBUT (Pearson correlation -0.316, P=0.005). Itching and other ocular irritation symptoms may be indicative of underlying abnormal tear function and ocular surface damage, their presence calls for further examination for tear deficiency and prompt institution of treatment for dry eye.
Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients w... more Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. To identify symptoms and surface abnormalities associated with dry eyes. One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer&#39;s 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Mean tear meniscus height, Schirmer&#39;s test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer&#39;s test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer&#39;s values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher&#39;s exact test) and 95.8% of dry right eyes compared to 61.1% of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.
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