A review of 61 cases of ocular tumours seen over a 3-year period in Benin City, Nigeria: a 3-year descriptive retrospective study (1998-2000).

The aim of this study is to ascertain the tumour type, sex variation and mean age of presentation of ocular tumours, as well as to update the available literature on the prevalence of the common ocular neoplasms in our environment. In this study, we analysed the data of 61 ocular biopsy specimens received between January 1998 and December 2000 at the Morbid Anatomy Department of the University of Benin Teaching Hospital, Benin City, Nigeria. Slides from paraffin embedded blocks of all ocular biopsies received were reviewed to identify the tumour types, sex variation and age of presentation.

Presenting Visual Acuities in a Referral Eye Center in an Oil-Producing Area of Nigeria

Objectives: To determine the pattern of presenting visual acuities at an eye center in the Niger Delta region of Nigeria. Study Design: Retrospective chart review Methods: A retrospective review of patient records attending a private referral eye center providing services for company patients and the general public in the region. Information was obtained from computerized medical records of 6533 patients who attended the center for various eye concerns in a 5-year period (January 1998 to December 2002). Results: A total of 6533 patients were seen in this 5-year period of which 2472 (37.8) were company patients and 4061 (62.2). were private patients. There were 3879 males (59.4) and 2654 females (40.6). A visual acuity of 6/6 or better was seen in 50.8of the patients. In 76.6of patients; a visual acuity of 6/18 or better was recorded. There were 21.4of patients in the low vision group. Bilateral blindness occurred in 2.1of patients. Monocular blindness occurred in 3.7of patients. Low vision occurred in 16.9of company patients and 24.1of private patients. Bilateral blindness occurred in 0.9of company patients and 2.7of private patients; while monocular blindness occurred in 1.2of company patients and 5.2of private patients. The main ocular problems were refractive error; glaucoma; conjunctivitis; headaches; ocular trauma; retina and related pathologies; cataract; uveitis; pterygium and corneal problems. Conclusion: The incidence of low vision and blindness is high in the oil-producing area of the Niger Delta region of Nigeria. Low vision and blindness were more common in private patients than in company patients

Pattern of neuro-ophthalmic disorders in a tertiary eye centre in Nigeria.

AIM: To determine the incidence and types of neuro-ophthalmic disorders at the eye clinic of University of Benin Teaching Hospital, Benin City, Nigeria. METHODS: All the new patients presenting to the eye clinic of the University of Benin Teaching Hospital between May 2001 and April 2003 with neuro-ophthalmic disorders were interviewed, examined and investigated when possible. They were analysed in the context of age, gender, diagnosis, major clinical features and visual acuity. RESULTS: A total of 76 patients with neuro-ophthalmic disorders were seen among a total of 1,698 new patients giving an incidence of 4.47%. The most common disorders were motor nerve palsies (27.6%), optic neuropathies (22.4%) and migraine (14.5%). The most presenting features were poor vision (39.5%), double vision (18.4%) and headache (17.1%). Twenty-nine patients (38.2%) were blind in the affected eye. CONCLUSION: The incidence of neuro-ophthalmic disorders is relatively low but constitute a significant cause of ocular morbidity and blindness. Improvement in diagnostic facilities and awareness are required.

Ocular melanoma presenting as a case of panophthalmitis in a 78-year-old Nigerian woman (masquerade syndrome): an uncommon finding in Benin City, Nigeria.

Theodore states that the term 'masquerade syndrome' first appeared in the ophthalmic literature in 1967 to describe a conjunctival carcinoma that presented as chronic conjunctivitis. Since then, the masquerade syndrome label has been applied to a group of disorders that mimic ocular inflammatory disease. Although some benign conditions can be considered masquerade syndromes, most often the term refers to malignant entities. Tsai and O'Brien also report that ocular oncology, the subspecialty that concerns itself with ocular and orbital malignancies, is by nature a field of uncommon disorders. A discussion of the masquerade syndrome therefore becomes a study in uncommon presentations of uncommon diseases. Nevertheless, the subject deserves wide attention because, in many cases, the diseases that masquerade are not only vision-threatening but potentially fatal. Significant morbidity and mortality can be averted by early recognition and diagnosis of the masquerade. In this article, we present a case of a 78-year-old Nigerian woman who had an ocular melanoma that presented as a panophthalmitis, a rare case of masquerade syndrome in our environment.

Pattern of presentation of primary open-angle glaucoma in Benin City, Nigeria.

Late presentation is a major problem in the management of patients with primary open-angle glaucoma. The aim of this study was to determine the clinical features and the degree of visual disability of glaucoma patients at initial presentation. This was a prospective study of new patients with a diagnosis of primary open-angle glaucoma seen between January 2001 and August 2002 at the University of Benin Teaching Hospital, Nigeria. The patients were analysed in the context of age, gender, geographical abode, educational and socioeconomic status and clinical presentation. The patients were examined using the Snellen's chart, pen torch, slit lamp biomicroscopy, ophthalmoscopy, tonometry, perimetry and gonioscopy. Over a 20-month period 154 patients were studied; the mean age was 52.73 years (standard deviation +/- 15.98) and the highest incidence was in the seventh decade. The male to female ratio was 2.1:1. In all, 119 patients (77.3%) presented with subjective visual loss in one or both eyes, while 57.1% dated the onset of their symptoms to 1-5 years before presentation. Overall, 38 patients (24.7%) were blind when using visual acuity as the criteria, while 87 patients (56.5%) were blind when using visual fields as the criteria. The problem of late presentation has not improved over the last two and a half decades. More measures towards early detection by extensive health education, screening programmes and training of more eye care providers need to be put in place.

Ocular leprosy in Nigeria: a survey of an Eku leprosorium.

To determine the ocular morbidity, visual disability and potential for blindness in leprosy patients recently released from treatment. In-patients from Eku leprosy settlement were interviewed and examined for ocular disease from leprosy and other causes. They were examined using the Snellen's chart, pentorch, Kowa portable slit-lamp, direct ophthalmoscope and the pulsair non-contact tonometer. The patients were also refracted. In all, 60 inpatients who were recently released from treatment, comprising 39 men (65%) and 21 women (35%), were examined. Fifty-eight patients (96.67%) had ocular symptoms, the most common being blurred vision in 23 patients (38.33%). Nine patients (15%) were blind. Cataract was the most common cause of blindness occurring in three of the nine patients (33.33%). The most common types of ocular lesions were madarosis (31.67%), lagophthalmos (16.67%) and cataract (16.67%). Potentially blinding conditions due to leprosy were seen in 42 patients (70%). The incidence of ocular involvement, blindness and potentially blinding conditions are high in leprosy patients recently released from treatment. Regular ophthalmic evaluation and integration into Vision 2020 programmes are recommended.

Management of optic neuritis in a developing African country.

AIM: To show the value of sub-Tenon's depo-methylprednisolone acetate followed by oral prednisolone in the management of optic neuritis in African patients. METHODOLOGY: Two female patients who presented to the University of Benin Teaching Hospital, Benin city, Nigeria and one male patient who presented to the Eye clinic of the Nigerian National Petroleum Corporation, Warri, Nigeria with optic neuritis were given a single dose of sub-Tenon's depo-methylprednisolone acetate 40 mg followed by oral prednisolone 60 mg daily and their vision monitored. RESULTS: In all the 3 cases, there was rapid improvement in visual acuity from as low as ? light perception, counting fingers at 1 metre and at 4 metre to 6/6 within 2-3 weeks with improvement in colour vision. After 3 years and 5 years follow-up in 2 cases, there was no recurrence of optic neuritis and no neurological deficit occurred. CONCLUSION: Sub-Tenon's depo-methylprednisolone acetate followed by oral prednisolone is a safe and effective alternative treatment for optic neuritis in black African patients.

Bilateral total loss of vision following eclampsia--a case report.

Visual loss following eclampsia is usually reported to be a result of retinopathy, exudative retinal detachment or cortical blindness. This paper reports the case of a 31-year-old para 5 + 0 housewife who developed bilateral visual loss following eclampsia and presented to the ophthalmologist four weeks later with a vision of light perception in both eyes. Examination showed evidence of hypertensive retinopathy. Convinced that the ocular findings were not responsible for such marked visual loss, she was commenced on systemic, topical and sub-conjunctival injection of steroids, acetazolamide and multivitamins. Her vision improved progressively to 6/6 right eye and 6/9 left eye after three weeks. Obstetricians are advised to refer cases of visual loss following eclampsia promptly to the ophthalmologist who should in turn manage aggressively with systemic, topical and sub-conjunctival steroids.