Eye cancers at the guinness eye center Onitsha, Nigeria

Objectives: To describe the hospital incidence and pattern of ocular and adnexal cancers at the Guinness Eye Center, Onitsha. Materials and Methods: The case files of all new patients seen with ocular and adnexal tumors at the Guinness Eye Center, Onitsha, between 2005 and 2017 were reviewed. Those with histological diagnosis of malignancy were selected and analyzed. Information obtained included age, sex, disease duration, diagnosis and co-morbidity. Results: There were 85 patients (0.1% of all the new patients), made up of 42 males and 43 females. The median age was 5 years; range: 5 months­70 years. The commonest cancers were retinoblastoma, 45 patients (52.9%) and conjunctival squamous cell carcinoma, 30 (35.3%). Twenty eight (93.3%) squamous cell carcinoma patients were HIV-positive. No child had squamous cell carcinoma. All retinoblastoma patients were aged ≤6 years. Conclusions: The incidence of ocular and adnexal cancers at the Guinness Eye Center, Onitsha, was low with retinoblastoma and conjunctival squamous cell carcinoma accounting for most of the cancers. While retinoblastoma would most likely be suspected in a child with ocular tumor, young adults with squamous cell carcinoma should be evaluated for HIV infection. Since these lesions threaten sight and life, the public should be educated on the early signs of the diseases and the need to report to hospital early

Knowledge and awareness of undergraduate university students towards eye donation in North-west, Nigeria: a cross-sectional study

Background: Corneal blindness still remains a large contributor of childhood blindness in Africa. Corneal transplant is a sight saving procedure that is still lacking in most of African countries despite the first successful corneal transplant in 1905 by Dr. Eduard Zirm. The cornea eye bank and transplant procedure in Nigeria is still in the infancy stage despite Federal Government of Nigeria acknowledged the need for an eye bank and promulgated the decree No. 23 titled Corneal Grafting Decree 1973. Objectives: To assess the level of knowledge and awareness on eye donation among the undergraduate students of Kebbi State University of Science and Technology. Methods: A cross-sectional study was undertaken among undergraduate university students, using a pre-tested, self-administered questionnaires. Information on the socio-demographics, the participants' knowledge and willingness to donate eye was obtained. The questionnaires were analyzed using SPSS version 20. Results: Of 281 participants, 157 (55.9%) were males and Muslim 204 (72.6%). Few students 59 (21%) were willing to donate their eyes after death, while131 (46.6%) were not willing to donate their eye because of their religious belief. Ninety-three (33.8%) of the students support eye donation. Television was the main 94 (33.5%) source of information about eye donation. Conclusion: The knowledge and awareness of eye donation among the students was low. Furthermore, majority were not willing to donate their eye mostly because of their religious belief. Health education on eye donation is needed to increase the uptake of eye donation among population

Ocular manifestations of rheumatoid arthritis and complications of hydroxychloroquine treatment

Background: Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of RAvary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Antimalarial drugs [hydroxychloroquine (HCQ) and chloroquine (CQ)] have been used for the treatment of RA. Objective: The aim of this study was to study the ocular manifestations of rheumatoid arthritis and the complications of the use of hydroxychloroquine in treatment. Patients and methods: A prospective study that was conducted at Al-Zahraa University Hospital. The study included a total of 80 eyes of 40 patients. Patients were divided into two groups: Group (1) 20 RA patients not using HCQ treatment and group (2) 20 RA patients using HCQ treatment. All patients underwent complete ophthalmic examination including SD-OCT. Results: the most ocular manifestations found in patients were keratoconjunctivitis sicca (KCS) 93.8%, scleritis and episcleritis 2.5%, acute anterior uveitis (AAU) and sclerosing keratitis 1.3%. Regarding SD-OCT finding comparing between the two groups, we found signs of early HCQ retinopathy in patients of group 2 in the form of parafoveal and perifoveal thining compared to group 1. Conclusion: RA is associated with many extra-articular manifestations, HCQ and CQ used in treatment of RA have significant efficacy and safety, but with long duration of using can cause retinopathy, and follow up of patients is necessary to detect early retinopathy

Chronic maxillary sinusitis complicated by right orbital abscess with ruptured globe following tooth extraction: a case report

Objective: This article reports a case of a chronic maxillary sinusitis complicated by right orbital abscess with ruptured globe following tooth extraction in a 70-year-old female diabetic patient 4 weeks after forceps extraction of the upper right 1st premolar. Case Description: Patient gave a history that prior to the tooth extraction, there was a carious cavity on the tooth, pain on mastication with background nasal congestion and post nasal drip of over one year duration. 4 weeks following extraction, there was marked right buccal and periorbital swelling. Examination by the ophthalmologist revealed rupture of the right globe with copious pus discharge from the lower eyelid of the right eye. Examination by the dental team and the Head and Neck Surgeon revealed the presence of oroantral communication with pus discharge from the oroantral fistula and the retropharyngeal area. Fasting Blood Sugar on presentation was 278mg/dl. Patient was referred to the physician for optimization of her blood sugar level.Evisceration of the right eye was carried out along with incision and drainage of the right eyelid and buccal space. Intravenous ceftriaxone 1g daily,intravenous metronidazole 500mg 8 hourly, intramuscular genticin 80mg 8 hourly, eusol A&B dressing twice daily, paracetamol per oral 1g 8 hourly, menthol crystals steam inhalation twice daily, Diazepam 5mg nocte were prescribed for the patient. Inferior meatal antrostomy with antral washout was carried out by the Head and Neck Surgeon 2 weeks after. Following surgery, patient was placed on per oral Tavanic 500mg once daily, metronidazole 400mg 8 hourly, vitamin c 100mg 8hrly,guaifenesin/pseudoephedrine 25mg nocte, diclofenac potassium 50mg twice daily and menthol crystals steam inhalation twice daily. Review of the patient four weeks' after surgery showed marked improvement in the clinical parameters of the patient, disappearance of swelling and cessation of pus from all points of previous discharge.Conclusion: Chronic maxillary sinusitis complicated by right orbital abscess with ruptured globe following tooth extraction may be considered a potential complication of forceps extraction of maxillary premolars and molars especially in a medically compromised patient. The authors hereby recommend (1) ensuring adequate medical and dental evaluation of patients before forceps extraction (2) all medically compromised patients must be optimized before forceps extraction (3) The need for multidisciplinary management of medically compromised patients with dental diseases

Utilisation of public eye care services by the rural community residents in the Capricorn district, Limpopo Province, South Africa

Background: Visual impairment and blindness are major health problems worldwide; especially in the rural and remote areas of developing countries. Utilisation of eye care services is essential to reduce the burden of visual impairment and blindness; and it is therefore important that it is monitored. Objectives: The objectives of this study were to determine the level of utilisation of publiceye care services and factors that might have influenced their usage in rural communities; Capricorn district; Limpopo Province; South Africa. Method: A population-based cross-sectional study design was used. Participants were residents in selected rural villages located within approximately 5 km of six Government hospitals. Following ethical approval and receipt of informed consent; a questionnaire with closed and open-ended questions was used to collect information on the utilisation of eye care services and factors that might influence utilisation. Descriptive statistics and Pearson's Chisquare test were used to analyse and compare the data. Results: Many (62.7) of the respondents had used the government eye care services in the past. Over fifty-nine per cent (59.3) of them were satisfied with the services. Factors reported to influence utilisation (such as monthly income; knowledge of available services and the need for regular eye tests) were positively associated with utilisation of eye care services in this study (p 0.05). Conclusion: Utilisation of eye care services was relatively good; but varied significantly between sites. An awareness campaign by government and non-governmental organisations about eye care services may increase utilisation amongst rural communities

Teaching Corner: Regional Anaesthesia for Ophthalmic Surgery

Performing safe and effective regional anaesthesia for ophthalmic surgery is an important skill for anaesthetic and ophthalmologic practitioners. Akinetic sharp-needle blocks are generally safe but rare; sight and life threatening complications occur. Sub-Tenon's block using a blunt canula provides akinesa and is a safer alternative but serious complications have been reported. This review provides an introduction to the relevant anatomy; local anaesthetic drugs and commonly used techniques and a practical guide to their safe performance

Incidence and Risk Factors for Traditional Eye Medicine Use among Patients at a Tertiary Eye Hospital in Nigeria

Objective: To determine the incidence and risk factors for traditional eye medicine use among patients at the Guinness Eye Center Onitsha; Nigeria. Materials and Methods: Consecutive new adult ophthalmic patients seen at the Guinness Eye Center Onitsha between January and April 2007 were interviewed on the use of traditional eye medicines and the type of traditional eye medicine used. Results: Of the 500 patients interviewed; 66 (13.2) had used traditional eye medicines (TEM). The 66 patients; aged 18-84; were made up of 32 males and 34 females. The commonly used TEM were liquid from plant leaves and roots and other concoctions of unknown origin. Conjunctivitis and cataract constituted 54.5of the ocular problems; 15(22.7) patients had visual impairment while 5(7.6) other patients were blind. Risk factors for TEM use include age above 50 years (P0.001); residence outside Onitsha metropolis (P0.001) or 0.05); chronic nature (P0.05) or painfulness of the ocular disease (P0.05). Conclusions: Traditional eye medicine is highly patronized by the people. Health education programmes with emphasis on safe eye care practices need be intensified in traditional healers and among the groups at risk

Primary Health Eye Care: Evaluation of the Competence of Medical Students in Performing Fundoscopy with the Direct Ophthalmoscope

Background: To evaluate the skill of fifth-year medical students at the University of Cape Town in the performance of fundoscopy at the end of their ophthalmology rotation.Methods: The design was a prospective cohort study. The study was conducted at Groote Schuur Hospital in Cape Town. The ability of fifth-year medical students to perform fundoscopy on mannequin heads fitted with fundus photographs using direct ophthalmoscopes was evaluated. The outcome measures used were ability to see the fundus and ability to recognise fundus pathology. Results: The fundus photographs could be seen in 95of cases. The correct diagnosis could be made in only 57of cases. Conclusion: Medical students at the University of Cape Town need more than the current one week of practical ophthalmology training to improve their fundoscopy skills

Nutrition and the Eye

Objective: To review ocular pathology associated with poor nutrition and highlight nutrients necessary for healthy eyes Method: Information obtained through review of literature in a pubmed/medline search using the words nutrition; eye; disease; journals; review articles and textbooks. Results: Nutritional deficiencies can lead to ocular diseases such as Xerophthalmia (Vitamin A deficiency) and nutritional optic neuropathy. Poor nutrition has been implicated in the pathogenesis of cataracts and age related macular degeneration. Good nutrition thus helps in preventing and retarding progression of several diseases. Conclusion: It is advisable to pay attention to what we eat and increase our intake of fruits; vegetables and fish for healthy eyes

Eye Care Preferences among Rural Nigerians

This is a cross sectional community based study that determined the eye care seeking dispositions of the adult Nigerians using the inhabitants of Afon a rural community in Kwara State; Nigeria as a case study. A total of three hundred and thirty nine (339) adult inhabitants of the Community were selected using cluster sampling technique. Semi-structured questionnaires were administered on the respondents by the author and three assistants. Most respondents (62.5) resorted to orthodox eye care while a few (8.8) sought traditional eye care. Others (26.3) received no treatment at all while 2.4sought spiritual and other combinations. The preferred mode of eye care was the orthodox care

Glaucome primitif a angle ouvert chez le diabetique noir africain: a propos de 207 patients etudies a Abidjan Service d'ophtalmologie - CHU de Treichville

Notre etude transversale; de type exploratoire et descriptive; avait pour objectif d'etudier les caracteristiques epidemio-cliniques du glaucome primitif a angle ouvert chez le diabetique ivoirien. Elle a porte sur une periode de douze (12) mois allant de Decembre 2004 a Decembre 2005 inclus 207 patients. Il ressort de cette enquete que : -Le glaucome a ete plus frequent sur le terrain diabetique avec une prevalence hospitaliere de 18;8pour cent contre 2pour cent dans la population generale comparativement a la litterature. -Les femmes diabetiques ont ete les plus atteintes par le glaucome que les hommes diabetiques; soit respectivement 52;4pour cent contre 47;6pour cent. -La tranche d'age la plus touchee a ete celle comprise entre 51 et 60 ans. -Le glaucome a pression normale s'est avere etre la forme clinique du glaucome primitif a angle ouvert la plus frequente avec 60;7pour cent des cas observes. Cette etude a donc permis de nous rendre compte que l'association glaucome diabete est une realite en Cote d'Ivoire

Causes of removal of the eye in Mulago Hospital

During the period January 1987-December 1991; 248 patients were studied and 350 eyes removed. Two patients had both eyes removed. Out of the 348 patients; 236 or 67.82were males and 112 or 32.18were females. Of the 350 eyes removed in the 5 year period; 170 were enucleated and 169 were evicerated. Exenteration was done in 11 cases for malignant tumours. Trauma was the commonest cause of eye removal (35.43); followed by ocular infection; (21.14) and then malignant tumours; (18.8). Retinoblastoma was the commonest tumour encountered. The age group 0-9 years had the largest number of patients at 23.56. All the patients were of African origin; and the local ethnic group; Ganda; were the majority. The largest number of patients were peasants

La rétinopathie diabétique: une étude angiofluorographique chez le noir Africain

Les auteurs ont entrepris ce travail prospectif pour rechercher les lesions angiofluorographiques et certains facteurs de risque des lesions de retinopathie chez le diabetique Noir Africain. 100 malades tous porteurs de diabete; chez qui les donnees demographiques; le type de diabete; les valeurs des glycemies; l'anciennete du diabete; les resultats de l'angiofluorographie ont ete colliges. L'age moyen des 100 malades est de 50;33 ans avec 12;08 ans d'ecart-type sans influence sur la presence de la retinopathie; p=0;287; le sex-ratio de 2 hommes pour 1 femme; 28 pour cent avaient une hypertension arterielle associee; 18 pour cent un antecedent familial hta-diabete; aucune influence des antecedents sur le type de diabete; p=0;2264; 77 pour cent avaient un diabete non insulinodependant ; 23 pour cent un diabete insulinodependant; l'anciennete moyenne du diabete etait de 54;77 mois et influencait la presence ou non de retinopathie; p=0;00537; la glycemie moyenne de base de 15;12 mmol/l; la derniere glycemie 9;50 mmol/l. 52 pour cent de retinopathies etaient observees; dont 88;8 pour cent de retinopathie non proliferative contre 11;12 pour cent de retinopathie proliferative. Ce groupe domine par les diabetes non insulinodependants avaient une anciennete moyenne de diabete relativement basse; une glycemie de base et une derniere glycemie elevees; et un taux important de retinopathie