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

burden and spectrum of vitreo-retinal diseases among ophthalmic outpatients in a resource-deficient tertiary eye care setting in south-eastern Nigeria

This study was designed to determine the rate and pattern of vitreo-retinal diseases at a tertiary eye care center in South-eastern Nigeria. The outpatient register at the Eye clinic of the University of Nigeria Teaching Hospital, Enugu, was retrospectively examined to identify all new patients registered between January 2004 and December 2008. A chart review of subjects with vitreo-retinal disease was conducted to record relevant demographic and clinical data including the needs for vitreo-retinal care. Descriptive and analytical statistics were performed. A P-value <0.001 [one degree of the needs of freedom] was considered statistically significant. Of the 8.239 new patients reported during the period, 326 subjects [males-59.3%; females- 40.7%; sex ratio= 1.1:1] aged 49.3 +/- 16.8 years [range 3-82 years] had vitreo-retinal disease. The rate of vitreo-retinal disease was 3.9%. The rate was higher in subjects above 40 years old [P<0.001], but did not differ between sexes [P=0.469]. Diabetic retinopathy [24.9%], hypertensive retinopathy [13.3%], and age-related macular degeneration [10.7%] were the leading vitreo-retinal diseases. Blindness from vitreo-retinal disease was bilateral in 6.1% of subjects and unilateral in 17.5% of subjects. The common co-morbidities were ocular conditions such as refractive error [19.8%], cataract [14.2%], and glaucoma [10.4%]; and systemic conditions such as diabetes mellitus [14.6%] and hypertension [13.2%]. The rate of vitreo-retinal diseases among new ophthalmic outpatients at UNTH, Enugu, is 3.9%. Retinal vascular disorders and age-related maculopathy are the leading retinal diseases. At UNTH, resource needs for vitreo-retinal care are urgent including retinal photography/angiography, laser photocoagulation, intra-vitreal pharmacotherapy, and vitreo-retinal surgery