Child Abuse and the Eye in an African Population

PURPOSE: There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determine the causes and circumstances surrounding these occurrences and their effects on the eye and vision in a pediatric population. METHODS: A 3-year study of consecutive cases of ocular features that presented to an eye clinic following a history suggestive of child abuse along with any associated eye injury was carried out. Socio-demographic characteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eye examination was also done. RESULTS: Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the mean age was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The most common ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocular pressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normal vision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairment in 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most common injurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstances predisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications were cataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). CONCLUSIONS: Injuries commonly resulted from canes and sticks used during beatings, as well as from child labor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negative psychosocial and economic impacts on the child, family and country as a whole.

Effects of fasting on intraocular pressure in a black population

There is a dearth of literature available on the effects of fasting on Intraocular pressure [IOP] among all races and worldwide. To determine the effects of fasting on IOP in a black African population. A population-based survey utilizing multistage random sampling techniques was carried out among healthy adult Muslims who were examined before and during Ramadan fast in Osogbo, Nigeria. Demographics were obtained, visual acuities, clinical examination of both eyes, and lOP[s] were done. Weights and waist circumference were measured. Data were analyzed using Statistical Package for Social Sciences [SPSS] Version 16. Analysis generated frequencies and cross tabulations, whereas statistical significant values were derived using paired sample t-test and P < 0.05. A total of 60 subjects with 120 eyes were examined. Mean age was 42.3 years standard deviation [SD] 16. 7, and the male to female ratio was 3:2. Majority were! professionals [33.3%]. Only 18.3% had less than secondary school education. Over 90% had normal vision [6/5-6/18]. Before and during fasting, the mean weights were 65.92 kg SD 12.98 and 65.29 kg SD 12.41 with a reduction of 0.63 kg SD 3.82 [P = 0.214, 95% confidence interval [CI]: 0.372-1.626]; and the mean waist circumference was 87.20 cm SD 12.39 and 81.78 cm SD 11.65 [P = 0.000, 95% CI 4.128-6.720], respectively. Mean lOP[s] were 15.98 mmHg SD 3.11 and 14.08 mmHg SD 2.71 before and during fasting, respectively [P= 0.000, 95% CI 0.98558-2.82798]. The study shows that fasting significantly reduced IOP in an ocularly healthy black African population

Awareness of and attitude towards glaucoma among an adult rural population of Osun State, Southwest Nigeria

To obtain baseline data and assess the level of awareness and attitudes towards glaucoma among rural communities of Osun State, Nigeria. This was a community-based study that involved interviews and descriptive cross-sectional analysis. Serial-recruitment was performed of consenting participants who presented at a community-based screening service in March 2011. Socio-demographic data and information about glaucoma were obtained through face-to-face semi-structured questionnaires. The study population comprised 259 respondents [mean age 49.73 +/- 16.6 years; range 18 to 90 years]. There were 159 females [61.4%]. Skilled workers were the most common 130/259 [50.3%] participants. Only 41 [15.8%; 95% CI: 11.4-20.2] participants had ever heard of glaucoma. Sources of information were from visits to an eye clinic for 21/41 [51.2%; 95% CI: 35.9-66.5] participants and 15/41 [36.6%] participants who know someone with glaucoma. Reponses to the causes of glaucoma included 20/41 [48.8%; 33.5-64.1] participant who said 'I don't know' and 24.4% of participants who responded 'curse-from-God'. Responses to questions on treatment included 20/41 [48.8%] participants who responded 'I don't know how it can be treated' and 10/41 [36.6%] said 'medically'. Thirty 30/41 [73.2%] participants would refuse surgery, half of them because 'it cannot cure or reverse the disease' while [26.7%] would refuse out of 'fear'. Only 8/41 [19.5%; 95% CI: 7.4-31.6] would accept surgery for maintenance. Statistically significant predictors of glaucoma awareness were older participants, males and skilled workers [teachers] [P = 0.028, P = 0.018, P = 0.0001, respectively]. The outcomes of study indicate a low level of awareness of glaucoma. Health education at all levels of health and eye care services is required to prevent ocular morbidity and irreversible blindness from glaucoma.