Sokoto blind beggars: causes of blindness and barriers to rehabilitation services

To determine the causes of blindness and the barriers to accessing rehabilitation services [RS] among blind street beggars [bsb] in Sokoto, Nigeria. A cross-sectional survey of 202 bsb [VA < 3/60] using interviewer administered questionnaire. The causes of blindness were diagnosed by clinical ophthalmic examination. There were 107 [53%] males and 95 [47%] females with a mean age of 49 years [SD 12.2]. Most bsb 191 [94.6%] had non-formal education. Of 190 [94.1%] irreversibly bsb, 180/190 [94.7%] had no light perception [NPL] bilaterally. The major causes of blindness were non-trachomatous corneal opacity [60.8%] and trachoma corneal opacity [12.8%]. There were 166 [82%] blind from avoidable causes and 190 [94.1%] were irreversibly blind with 76.1% due to avoidable causes. The available sub-standard RS were educational, vocational and financial support. The barriers to RS in the past included non-availability 151 [87.8%], inability to afford 2 [1.2%], unfelt need 4 [2.3%], family refusal 1 [0.6], ignorance 6 [3.5%] and being not linked 8 [4.7%]. The barriers to RS during the study period included inability of 72 subjects [35.6%] to access RS and 59 [81.9%] were due to lack of linkage to the existing services. Corneal opacification was the major cause of blindness among bsb. The main challenges to RS include the inadequate services available, societal and users factors. Renewed efforts are warranted toward the prevention of avoidable causes of blindness especially corneal opacities. The quality of life of the blind street beggar should be improved through available, accessible and affordable well-maintained and sustained rehabilitation services.

Survey of the attitudes of Nigerian ophthalmologists to and resources for ophthalmic research

To study the views of ophthalmologists on their attitude to and the resources for ophthalmic health research in Nigeria and draw appropriate policy implications. Structured questionnaires were distributed to 120 ophthalmologists and ophthalmic residents who were attending an annual congress in Nigeria. Data were collected on background information, importance attributed to research, motivation for conducting research, funding, ethical oversight, literature search, and statistical support. The coded responses were statistically analyzed. P<0.05 was statistically significant. Eighty-nine of the 120 questionnaires were returned giving a response rate of 74.2%. Research function was rated a distant last by 49.5% of the respondents after clinical service [93.2%], teaching [63.1%], and community service [62.8%]. Advancement of knowledge was the strongest motivating factor for conducting research [78.2%]. Securing funding [91.8%] and finding time [78.8%] were the major constraints. The ethical review committees were considered suboptimal by the respondents. Literature searches for research were conducted on the internet [79.3%] and was independent of age [P=0.465]. Research data were stored and analyzed on commonly available statistical software. Although study respondents regarded research highly, they were severely constrained in conducting research due to lack of access to funds and finding time away from the clinical workload. We recommend periodic [re]training on conducting good research including preparation of successful applications for research grants and allotting protected research time for ophthalmologists in Nigeria

Cataract blindness in Osun state, Nigeria: results of a survey

To estimate the burden of blindness and visual impairment due to cataract in Egbedore Local Government Area of Osun State, Nigeria. Twenty clusters of 60 individuals who were 50 years or older were selected by systematic random sampling from the entire community. A total of 1,183 persons were examined. The age- and sex-adjusted prevalence of bilateral cataract-related blindness [visual acuity [VA] < 3/60] in people of 50 years and older was 2.0% [95% confidence interval [CI]: 1.6-2.4%]. The Cataract Surgical Coverage [CSC] [persons] was 12.1% and Couching Coverage [persons] was 11.8%. The age- and sex-adjusted prevalence of bilateral operable cataract [VA < 6/60] in people of 50 years and older was 2.7% [95% CI: 2.3-3.1%]. In this last group, the cataract intervention [surgery + couching] coverage was 22.2%. The proportion of patients who could not attain 6/60 vision after surgery were 12.5, 87.5, and 92.9%, respectively, for patients who underwent intraocular lens [IOL] implantation, cataract surgery without IOL implantation and those who underwent couching. "Lack of awareness" [30.4%], "no need for surgery" [17.6%], cost [14.6%], fear [10.2%], "waiting for cataract to mature" [8.8%], AND "surgical services not available" [5.8%] were reasons why individuals with operable cataract did not undergo cataract surgery. Over 600 operable cataracts exist in this region of Nigeria. There is an urgent need for an effective, affordable, and accessible cataract outreach program. Sustained efforts have to be made to increase the number of IOL surgeries, by making IOL surgery available locally at an affordable cost, if not completely free

Ophthalmic research priorities and practices in Nigeria: an assessment of the views of Nigerian ophthalmologists

To study the views of ophthalmologists on research priorities and outcomes in Nigeria. Materials and Methods' A structured questionnaire was distributed to 120 ophthalmologists and ophthalmic residents who were attending an annual congress in Nigeria. The participants' background information, relative research priorities, frequency of publications, research types, publication media, challenges faced in publishing and impact on health practice or policy were collected. Eighty-nine [74.2%] of the 120 questionnaires were returned. Childhood blindness was given the highest priority for ophthalmic research by 42.9% of the respondents, and genetic studies had the least priority [19.8%]. About two

hirds of the respondents had either never been involved or only involved occasionally in any type of ophthalmic research. Clinical trials [13.1%] and basic science studies [12%] were the least-performed types of research. About 51% of the respondents indicated that they had never published in journals nor did so [occasionally]; only 9% quarterly and 43% published less than once a year. They also indicated that their research very rarely resulted in change of clinical practice or health policy [20%]. Research works conducted by respondents were largely simple low-budget ones that rarely had significant impacts and outcomes, including publication. There is a need to retrain and emphasize the importance of research during undergraduate and postgraduate medical education. Adequate resources and research infrastructure should be provided for ophthalmic research in Nigeria