Oculopalpebral dimensions of adult Nigerians: report from the Enugu normative ocular anthropometry study

To determine the normal oculopalpebral anthro-pometric measurements of a Nigerian adult population. A population-based prospective observational random survey was conducted in Enugu, South-Eastern Nigeria between January and April 2010. The participants were healthy adults comprising 248 males and 252 females aged 18-76 years. One thousand eyes were examined. Demographic data, and bilateral direct manual millimetre measurements of the horizontal palpebral fissure [HPF], vertical palpebral fissure [VPF], upper lid crease [ULC], brow height [BH], and margin reflex distance [MRD] were obtained from all participants. Data were categorised by demographic variables and analysed to yield frequencies, percentages and proportions. Between-gender comparisons, using the independent t test, were considered significant at p < 0.05. The mean age of the participants was 36.5 +/- 14.6 years. There was no significant difference between the genders in mean age [men: 37.3 +/- 15.7 vs. women: 35.8 +/- 13.3, p = 0.2302]. The mean values of the parameters were [male, female] HPF: 32.8 +/- 2.0 vs.32.6 +/- 3.0; VPF: 10.6 +/- 1.2 vs. 10.6 +/- 1.2; ULC: 8.2 +/- 2.5 vs. 7.9 +/- 2.2; BH: 13.1 +/- 2.4 vs. 13.6 +/- 2.7; and MRD: 4.1 +/- 0.5 vs. 4.2 +/- 0.8. Significant between-gender difference was observed only in BH measurements [p = 0.029] and variable trends with age. Oculopalpebral measurements of normal adult Nigerians in Enugu showed variations by age and gender. This may have implications for clinical evaluation and surgical management of oculopalpebral disorders in adult South-Eastern Nigerians. Future longitudinal studies are needed

Assessing the knowledge and skills in clinical ophthalmology of medical interns: survey results from Enugu, South-Eastern Nigeria

To compare the skills and knowledge of clinical ophthalmology among medical interns in Enugu, Nigeria, to the recommendations of the International Council of Ophthalmology [ICO]. A questionnaire-based cross-sectional survey was conducted of Medical Interns attending the University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital, from April 2010 to June 2010. Data on cohort demographics, undergraduate ophthalmology exposure, clinical skills and diagnostic competencies were collected and analyzed. Statistical significance was indicated by P<0.05. The cohort comprised 81 males and 48 females [sex ratio=1.7: 1], aged 21-35 years [mean: 26.8 +/- 2.4 years]. The gender difference was significant [P<0.05]. The response rate was 88.7%. The duration of undergraduate ophthalmology exposure ranged from 1 to 4 weeks. Exposure was often adequate in cornea/external eye [95.3%], lens/cataract [95.3%] and glaucoma [92.2%]; but not in vitreo-retinal disease [47.3%], neuro-ophthalmology [45.7%] and refractive surgery [0.0]. The majority were competent at visual acuity testing [97.7%] and visual field examination [93.0%]. There was lower competency at anterior chamber assessment [49.6%] and slit-lamp examination [39.5%]. The majority could confidently diagnose conjunctivitis [96.1%] and cataract [90.7%], but not strabismus [42.6%] or macular degeneration [20.2%]. Medical interns in Enugu displayed gaps in their undergraduate ophthalmology exposure, clinical knowledge and skills. This has implications for stakeholders in medical education and eye care delivery. Review of the curriculum, provision of training resources and compliance with ICO guidelines could address the deficiencies

Ophthalmic manifestations of leukemia in a tertiary hospital population of adult Nigerian Africans

To determine the prevalence and pattern of leukemic ophthalmopathy among adults at the University of Nigeria Teaching Hospital [UNTH], Enugu, south-eastern, Nigeria. This prospective, observational case series surveyed adult leukemia patients presenting at UNTH's departments of Hematology/Immunology and Ophthalmology from July 2003 to August 2008. The demographic profile, clinical data from for each individual in the cohort were statistically collated and analyzed. A P <0.05 was considered as statistically significant. There were 72 participants [45 males and 27 females], aged 32.7 +/- 9.8 years [range, 18 years to 72 years]. Leukemic ophthalmopathy was present in 77.8% of subjects. The leading ophthalmic manifestations of leukemia were retinal vascular abnormalities in 50.0% of subjects, conjunctival pallor in 27.8% of subjects, sub-conjunctival hemorrhage in 19.4% of subjects, and retinal hemorrhage in 16.7% of subjects. Ocular co-morbidity was present in 47.2% of subjects. Vision loss occurred in 37.5% of subjects, of which 32.1% was leukemia related, and the remaining due to ocular co-morbidity. Leukemic ophthalmopathy was more prevalent in chronic leukemia [P <0.05], frequently affected the ocular posterior segment [P < 0.05], and often resulted from secondary hematologic complications [P <0.05]. There was no gender difference in the prevalence of leukemia [P = 0.0822] or leukemic ophthalmopathy [P = 0.6624]. The prevalence of leukemic ophthalmopathy in Enugu is high. It is often associated with significant ocular co-morbidity and vision loss. These have implications for clinicians involved in leukemia management. Early diagnosis and regular ophthalmic examinations are recommended to optimize treatment outcomes