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Corneal opacities are a major source of corneal morbidity in Africa and many resource-limited parts of the world. Unfortunately, there is a dearth of specialist corneal services either from lack of manpower or non-availability of materials and tools. This makes penetrating keratoplasty inaccessible from prohibitive cost or lack of donors. The index case was a 45-year-old indigent female farmer who presented with a right atrophic eye and defective vision on the left eye due to stick injury from farm work. Examination revealed a 2/60 eccentric vision and extensive adherent leukoma on the left eye. Superonasal optical iridectomy was done and vision improved to 6/18 with correction at sixth postoperative week. In conclusion, optical iridectomy, in selected patients, can restore useful vision.
RESUMEN
Background: The access to universal eye health is still poor in many developing countries. There are various initiatives to address this problem, but the initiatives are majorly under the support of external funding. This study reports community outreaches supported by community-based organisations over a 7-year period in resource-poor settings in Ilorin, Kwara State, Nigeria. Aims and Objectives: This study aims to describe the processes/procedures, output, and funding of eye care services provided in the rural communities over a 7-year period. The study seeks to present the process, demographical profiles, disease pattern, challenges, and recommendation in finding the core area of development to improving eye care services for these communities as well. The setting of this research work is 65 rural communities around the Ilorin metropolis of Kwara State, Nigeria. The design of the study is a retrospective review. Materials and Methods: This is a descriptive study of 7-year community eye outreaches in Ilorin, Nigeria. Data were analysed with IBM-Statistical Package for Social Sciences (SPSS-20). Results: A total of 65 communities with 235 visits were carried out between the years 2013 and 2019, with a total of 13,661 persons screened. The major eye diseases seen were refractive errors, allergic conjunctivitis, cataract, and pterygium. Common surgical eye problems were cataract, pterygium, and glaucoma. Community-based organisation direct financial support built up from USD 855 in 2013 and totalled USD 27,250 in 2019. Community-based organisation funding is an alternative and useful means of meeting the unmet needs of eye care in resource-poor communities. Subsidised care was provided to community-sourced patients due to support by local community-based organisations. This subsidy assisted in reaching the outreach numerical goal. However, it was still inadequate to meet the total needs as seen by the lower number of clinical care and surgeries rendered against the total numbers identified. Conclusion: To achieve sustainable and wider coverage of care, a combination of local source and external funding is required. This study shows that community eye care programme can be supported by local or indigenous sponsors in a sustainable manner, thereby contributing considerably to addressing prevalent cases of avoidable blindness.
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PURPOSE: To determine the normative range of intraocular pressure (IOP) in full-term newborns and possible association with birth parameters during the first week of life. METHODS: This was an observational cross sectional study in which IOP was measured in 1000 eyes of 500 normal full-term newborns using the Perkins applanation tonometer under topical anesthesia. An average of three readings was taken as the IOP value. The relationship between IOP and birth parameters was analyzed. RESULTS: The male to female ratio was 1:1 with 254 (50.8%) male and 246 (49.2%) female babies. The (mean ± SD) value of IOP in the right eyes was 11.93 ± 1.80 mmHg, ranging between 9.00 and 16 mmHg. In the left eyes, the mean value of IOP was 11.84 ± 1.77 mmHg with a range of 8.00-15.00 mmHg. IOP in males (12.02 ± 1.84 mmHg) was not significantly different from that in females (11.89 ± 1.75 mmHg). There was no significant difference between right and left eyes (p = 0.42). The 95% range (mean ± 2 SD) was 15.53 mmHg for the right eye and 15.38 mmHg for the left. Correlational analysis showed that birth weight and gestational age were positively correlated with IOP. CONCLUSION: This study provides useful normative data on IOP among Nigerian full-term newborns. Further studies on possible ethnic/geographic variations of IOP in children may be beneficial.
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OBJECTIVE: To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. METHODS: A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. RESULTS: Most trainees had a positive view about actions towards raising CSR: Structured ophthalmic training- 25 (92.6%), monthly cataract camps by eye departments in teaching hospitals- 21 (77.8%), rural allowance for ophthalmologists- 26 (96.3%) and welfare package for indigent cataract patients- 21 (77.8%). Other actions included local production of cataract consumables- 22 (81.5%), duty-free importation of ophthalmic materials- 23 (85.2%), employment of ophthalmologists in the services of the state governments- 24 (88.9%) and local governments- 20 (74.1%), effective primary eye care- 25 (92.6%) and marketing of cataract surgical services- 23 (85.2%). However, only 16 (59.3%) trainees wanted first ladies (wives of the president, governors and local government chairmen) to adopt cataract elimination as pet projects, and 24 (88.9%) opposed the introduction of cataract surgeons. CONCLUSION: Most trainees had positive perceptions about most actions that can raise CSR. However, top-priority actions to improve CSR were attractive rural allowance, structured training, resource availability, cost reduction and marketing of cataract surgical services. Multiple actions might be necessary to raise CSR.