The Effect of Music on Operative Anxiety markers in patients undergoing Cataract Surgery: Adual centre cross-sectional comparative study.

OBJECTIVE: To determine the effect of intraoperative music on various markers of anxiety among adult patients undergoing small incision cataract surgery. METHODS: This was a hospital-based, age-sex matched, comparative cross-sectional study of consenting 144 adult participants aged 46 years and above with operable, age-related cataracts undergoing small incision cataract surgery under local anaesthesia in two ophthalmic centres. All participants were allotted into two equal groups consisting of 72 participants in the experimental group (exposed to music of their choice) and 72 participants in the control group (no music exposure). Blood pressure, pulse rate and salivary cortisol assay levels were measured. Data obtained were analyzed using statistical package for social sciences (IBM SPSS version 23.0). RESULTS: One hundred and forty-four participants with total male-to-female ratio of 1:2.1 were studied. Gender ratio was 1:2.3 and 1:2.0 and the median age (Q1-Q3) of 65.00 (55.5-71.5) years and 65.50 (56.5-72.0) years for music and non-music groups respectively. Participants in the music group showed a statistically significant reduction in systolic blood pressure, diastolic blood pressure and pulse rate (p < 0.05) except at baseline. The mean value salivary cortisol level showed a statistically significant decrease in both groups from baseline for music (23.91ng/ml) and nonmusic (19.12ng/ml) group (p<0.001) respectively. Similarly, participants in the music group showed a statistically significant reduction of Spielberger State anxiety score after music intervention compared to control (p<0.001). CONCLUSIONS: This study demonstrated the effectiveness of music in decreasing anxiety indicators during cataract surgery with markers like salivary cortisol assay, pulse rate, systolic and diastolic blood pressure.

OBJECTIF: Déterminer l'effet de la musique intra-opératoire sur divers marqueurs d'anxiété chez les patients adultes subissant une chirurgie de la cataracte par petite incision. MÉTHODES: Il s'agissait d'une étude transversale comparative, basée à l'hôpital, appariée selon l'âge et le sexe, portant sur 144 participants adultes consentants âgés de 46 ans et plus, présentant des cataractes liées à l'âge opérables et subissant une chirurgie de la cataracte par petite incision sous anesthésie locale dans deux centres ophtalmologiques. Tous les participants ont été répartis en deux groupes égaux, soit 72 participants dans le groupe expérimental (exposé à de la musique de leur choix) et 72 participants dans le groupe témoin (pas d'exposition à la musique). La pression artérielle, la fréquence cardiaque et les taux de cortisol salivaire ont été mesurés. Les données obtenues ont été analysées à l'aid du logiciel statistique pour les sciences sociales (IBM SPSS version 23.0). RÉSULTATS: Cent quarante-quatre participants avec un rapport total d'hommes à femmes de 1:2,1 ont été étudiés. Le ratio hommes-femmes était de 1:2,3 et 1:2,0, avec un âge médian (Q1-Q3) de 65,00 (55,5-71,5) ans et 65,50 (56,5-72,0) ans pour les groupes musique et non-musique, respectivement. Les participants du groupe musique ont montré une réduction statistiquement significative de la pression artérielle systolique, de la pression artérielle diastolique et de la fréquence cardiaque (p < 0,05) sauf au départ. La valeur moyenne du taux de cortisol salivaire a montré une diminution statistiquement significative dans les deux groupes par rapport au départ pour le groupe musique (23,91 ng/ml) et le groupe non-musique (19,12 ng/ml) (p <0,001) respectivement. De même, les participants du groupe musique ont montré une réduction statistiquement significative du score d'anxiété à l'état de Spielberger après l'intervention musicale par rapport au groupe témoin (p <0,001). CONCLUSIONS: Cette étude a démontré l'efficacité de la musique dans la diminution des indicateurs d'anxiété pendant la chirurgie de la cataracte, avec des marqueurs tels que le dosage du cortisol salivaire, la fréquence cardiaque, la pression artérielle systolique et diastolique. Mots-clés: Musique binaurale, peur, anxiété, stress, chirurgie de la cataracte par petite incision, anxiolytique non pharmacologique.

Intraocular Pressure Changes Post Selective Laser Trabeculoplasty in the Contralateral Untreated Eyes of Nigerian Patients With Primary Open Angle Glaucoma.

BACKGROUND: Glaucoma is the commonest cause of irreversible blindness in Nigeria and raised intraocular pressure (IOP) is the only modifiable risk factor. Selective laser trabeculoplasty (SLT), one of the treatment modalities, has been reported to have a cross-over effect on the fellow untreated eyes. OBJECTIVES: To determine the lOP lowering effect of SLT on the contralateral untreated eyes in patients with primary open angle glaucoma. METHODS: This was a retrospective chart review of patients who underwent SLT at Guinness Eye Centre, Lagos from June 2011-June 2012. Information on bio-data, diagnosis and modality of treatment were retrieved. Excluded were patients who had glaucoma surgery or needed additional medications. Each patient had SLT in one eye either as primary or adjunctive treatment. IOPs were measured post-operatively in both treated and untreated eyes at various time points using the Goldmann applanation tonometer. Data was analysed using paired and unpaired two-tailed t-test for comparison of means with level of significance set at p<0.05. RESULTS: Forty eyes of twenty subjects were included. 60% (12) were males and 40% (8) were females. The mean age was 48.9 +/- 17.0 years (range, 23-74 years). Reduction in IOP from baseline was found in both the treated and the fellow untreated eyes at the various time points. Mean IOP reduction was maximal at 3 months; 8 mmHg or 26% (p=0.024) in the treated eyes and 7 mmHg or 25.9% (p=0.097) in the untreated eyes. Mean IOP reduction from baseline-were 1.3 +/- 5.9mmHg or 6.3% (P=.624) in the treated eyes and 2.9 +/- 7.5 mmHg or 9.7% (P=.418) in the untreated eyes at 6 months. CONCLUSION: This study shows that there is a sustained IOP reduction in the fellow untreated eyes following SLT in patients with POAG. In view of the retrospective nature of the study, small sample size, non-randomization and lack of control definite conclusions cannot be drawn from the findings.

The Pattern of Uveitis In An African Tertiary Eye Care Centre.

OBJECTIVE: To determine the pattern of presentation of uveitis at the Guinness Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria. MATERIALS AND METHODS: The case files of all patients with the diagnosis of uveitis who presented at the center from January 2006 to December 2010 were reviewed. Data on age, sex, ethnicity, symptoms, duration of symptoms before presentation, eye affected, anatomical type of uveitis and clinical type of uveitis were extracted onto a form for analysis. RESULTS: A total of 68 cases of uveitis were reviewed. There were 38(60.3%) males and 25 (39.7%) females. The range was from 12 to 90 years. The peak incidence occurred within the age range 21-40 years inclusive. Anterior uveitis and posterior uveitis occurred in 34(54.0%) and 17(27%) patients respectively. While reduction in vision was reported as a symptom by 54(85.7%) patients, only 41(65.1%) patients presented within 4 weeks of onset of symptoms. CONCLUSION: Anterior uveitis was the most common clinical type in this study. The highest incidence of uveitis occurred in the third and fourth decades of life.

Retinopathy of prematurity and associated factors in Lagos, Nigeria.

BACKGROUND: Screening and early treatment of retinopathy of prematurity (ROP) is important to reduce visual impairment in at risk infants. AIM: To determine the frequency and risk factors associated with ROP in preterm infants in Lagos University Teaching Hospital. METHODS: This was a prospective cohort study of preterm infants with gestational age (GA) less than 32 weeks and birthweight 1500 g or less conducted from November 2011 to May 2014. The infants' eyes were examined using an indirect ophthalmoscope at 4-6 weeks of life or at 34 weeks post-conceptual age. Examinations were repeated weekly until regression or progression to a high risk pre-threshold disease. Staging was according to the revised International Classification for ROP and treatment criteria were as defined by the Early Treatment for ROP study. The GA, birth weight (BW), use of oxygen, presence of respiratory distress syndrome and other risk factors were recorded and tested for significance. RESULTS: Twelve (15%) of the 80 infants examined had any ROP and six (7.5%) had treatable ROP. The mean (SD) GA and BW for infants with ROP were both lower than for those without ROP; 28.2 (1.7) weeks vs 29.1 (1.6) weeks and 1124 (212) g vs 1251 (274) g for GA and BW, respectively. Risk factors such as supplemental oxygen, sepsis, respiratory distress and anaemia were not significantly associated with ROP. CONCLUSION: The frequency of ROP and treatable ROP was high; it is therefore recommended that routine care of preterm infants should include screening for ROP and that affordable treatment facilities should be provided in public hospitals.

A ten year review of diabetic retinopathy at the Guinness Eye Centre, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos.

BACKGROUND: Diabetic retinopathy is an important complication of diabetes mellitus, which may lead to blindness. OBJECTIVE: The study is to analyze posterior segment lesions in Diabetes Mellitus patients seen in Guinness Eye Centre, Lagos University Teaching Hospital in relation to the number, duration and severity. METHODS: All the case files of Diabetes Mellitus patients seen during the period of study were retrieved and data extracted from them were analyzed. Such information included age, sex, duration of Diabetic Retinopathy and its severity. RESULTS: A total of 84 case files were reviewed. There were 47 males and 37 females with a male to female ratio of 1.3:1. No diabetic patient was seen in the age group 30 years and below. Fifty-five (65%) patients who presented themselves did so very late. Of the 35 patients found to have diabetic retinopathy at presentation, 16 had the disease bilaterally. The most common form of Diabetic Retinopathy was clinically significant macula oedema. The study shows that a high proportion of the patients (41.6%) had Diabetic Retinopathy. CONCLUSIONS: Patients with DM should be referred early for eye examinations. Physicians Residents should be made to rotate through eye Departments for a period of at least 2 weeks so they can learn fundoscopy. Diabetic patients should be educated on the eye complications that may arise from their condition. Regular eye screening with fundus camera and laser therapy should be part of the routine management of Diabetics in Nigeria as is done in advanced countries.

Ocular findings in acquired immunodeficiency syndrome patients in Lagos, Nigeria.

BACKGROUND: There is paucity of studies on the prevalence and pattern of ocular complication in HIV patients in developing countries where 90% of all HIV sufferers live. Most studies were carried out in industrialized countries and are not representative of the spectrum of ocular complication of HIV and it's prevalence in developing countries. OBJECTIVE: To determine the prevalence of ocular disorders in adult (> 15 years ) AIDS patients at PEPFAR clinic in Lagos, Nigeria. MATERIAL AND METHODS: All consecutive adult Seropositive HIV/AIDS patients of PEPFAR Clinic at the Lagos University Teaching Hospital between February 1st-March 15th 2008 were enrolled into the study Cross sectional and non randomized, convenient study was used. Biodata and medical history were recorded on interviewer administered questionnaire. Participants were examined according to standard protocol comprising visual acuity, intraocular pressure, anterior segment examination with slit lamp biomicroscopy, dilated fundoscopy and fundus photograph where necessary. PCV, CD4+ count, viral load at diagnosis, stage of HIV disease were extracted from patients' records. Details of drug were regimen also recorded. Data analysis was performed with EPI-lnfo 6.04 version; Chi square and student t test used to describe statistical association. RESULTS: A total of 400 patients were studied. Male:female ratio was 1.7 and mean age was 40 years (S.D. + 9.12). Ocular disorders seen in 78.5% of patients; HIV related ocular disorders occurred in 45 (11.3) patients. Conjunctival microvasculopathy 166 patients (41.5%), pingueculum in 114 (28.5%), pterygium in 76 (19.0%), refractive error in 93 (23.3%), cataract in 12 (3.0%), and 22 (5.5%) Glaucoma suspects. HIV retinopathy and allergic eye disease in one patient each (0.3%). Presumed Cytomegalovirus retinitis 7 (1.8%), 14 (3.5%) Toxoplasmosis, 8 (2.0%) HZO, and 15 (3.8%) Presumed Squamous cell carcinoma. Eighty six (21.5%) of the patients had no abnormality. 91.4% of eyes examined had visual acuity with best correction of > 6/18. CD4+ in 79.3% of the patients was > 200 cells/ul and < 5% had counts < 50 cells with an overall mean of 406 cell/ul. 375 (93.8%) patients were on Highly Active Antiretroviral therapy (HAART), and 25 (6.2%) were not. CONCLUSION: Study revealed low prevalence of HIV related ocular disorders. This could be due to few patients at low level of immunosuppresion where the infections occur.

Pattern of conjunctival masses seen at Guinness Eye Centre Luth Idi-Araba.

BACKGROUND: Conjunctival masses are growth on the surface of the outer eye; which may represent benign or malignant transformations. OBJECTIVE: To determine the pattern of presentation of conjunctival masses at the Guinness Eye Centre (GEC), Lagos University Teaching Hospital (LUTH) Idi-Araba over a 13 year period (Jan 1995-Dec 2007). METHOD: A retrospective review of the clinical notes of all patients that presented to GEC with conjunctival masses during the study period was carried out. The bio-data, clinical features, stage, laterality and associated features of the masses were noted. The diagnosis, treatment and complications of treatment were also recorded. RESULTS: Case notes of 612 eyes of 393 patients were included in the study. There were 219 (55.7%) males, 174 (44.3%) females with ages ranging from 4-85 years with a male to female ratio of 1.26: 1. Three hundred and eighty-eight patients (98.7%) presented as elective cases to the outpatient department while 5 (1.3%) presented as emergencies on account of associated ocular inflammation. There were 220 (56%) bilateral masses while 44% were uniocular. Pterygium was the leading conjunctival mass affecting 548 eyes (89.5%) of 329 patients. Pingueculae occurred in 53 eyes (8.7%), conjunctival cysts in 5 (0.8%) eyes, neoplastic growths in 3 (0.5%) eyes, conjunctival granulomas in 2 (0.3%) eyes and limbal teratoma in 1 (0.2%) eye. Most of these patients defaulted from surgery as only 141 eyes (23%) of 121 patients had surgery. Post-operative complications occurred in 33 eyes (5.4%) of 30 patients. The commonest postoperative complication was pterygium recurrence which occurred in 18 eyes of 15 patients. CONCLUSION: Pterygium was the commonest conjunctival mass and preventive strategies need to be advocated. Prevention of recurrence remains a challenge in the management of pterygium as recurrence after surgical excision occurred in 13.2% of eyes. Our study however did not confirm outdoor occupations as a risk factor for pterygium.

Hydrocephalus and the eyes: a teaching hospital experience.

BACKGROUND: The eye developes from prosencephalon, the primitive forebrain and hence share similar embryonic origin with brain. This gives insight into primary or secondary involvement of eyes in intra-cranial pathology. OBJECTIVE: The study was done to describe ocular findings in hydrocephalus patients and effect of intervention on the complications. METHODS: Forty one consecutive hydrocephalus patients were examined pre and post ventriculo-peritoneal shunts. Comprehensive ocular examinations included dilated fundoscopy in all cases. RESULTS: A total of 41 patients were examined with the age range of between 4 hours to 108 months and a mean age of 21 months. Onset of the hydrocephalus varies from 4hours to 108 months, with a mean of 4.1 weeks. Twenty two patients (51.2%) presented after 2 months of onset of hydrocephalus. Most common presenting complaint was enlarged head seeing in 29 patients (70.7%). CONCLUSION: A total of 12 (30%) out of 41 patients with hydrocephalus had optic atrophy. Another 10 patients had sun-setting phenomenon, 3 of these sun-setting phenomena resolved a week after ventriculo-peritoneal shunts. The ocular morbidity is high among hydrocephalus patients.

Aetiology of vitreous haemorrhage in Guinness Eye Centre, Lagos University Teaching Hospital over a two year period (June 2007-May 2009).

BACKGROUND: The Vitreous Humour is the transparent biological gel which fills the posterior 5/6th of the eyeball. Extravasations of blood into this delicate tissue may cause visual loss. OBJECTIVE: The study was to determine the causes and pattern of vitreous haemorrhage in Guinness eye centre, Lagos University Teaching Hospital. METHODS: Retrospective consecutive case series of all patients with Vitreous haemorrhage over a 2 year period (June 2007 - May 2009) RESULTS: A total of 5137 new patient were seen at Guinness eye centre during the study period. 13 of them had vitreous heamorrhage giving an incidence of 0.25%. 12 of the patients were males. The mean age was 41 year. The age range was from 14years to 69 years. Majority of the patients (69%) presented within 4 weeks of drop in vision. Vitreous heamorrhage was caused by trauma in 46% of the patients and proliferative sickle cell retinopathy in 30% of the patients. All the patients with vitreous haemorrhage due to proliferative sickle cell retinopathy had the Hb genotype SC. CONCLUSION: Trauma and proliferative sickle cell retinopathy were found to be important causes of vitreous heamorrhage in this case series.

Familiarity with modern health management trends by West African surgeons.

OBJECTIVES: To collate the self-reported assessment of familiarity with some aspects of managerial competencies on the part of some surgeons and their observations on the managerial environment of their health institutions and draw appropriate policy implications. DESIGN: Cross-sectional study using a structured questionnaire. SETTING: The study was conducted during the 50th Annual Scientific Conference of the West African College of Surgeons, which was held in Calabar, Nigeria, from 6th to It 12th February 2010. SUBJECTS: One hundred and ten out of 150 surgeons who were attending the conference returned their filled questionnaires. RESULTS: Their familiarity with business and financial concepts was lacking on crucial ones related to marketing strategies. Respondent largely found the listed objections to advertisement of medical services as very appropriate. They preferred largely to interact with themselves in professional associations rather than with others in cross-cultural groupings. Funding (66.4%) and political/ethnic influences (43.9%) were rated as impacting very negatively on their health institutions, while the deployment of information communication technology to institutional processes was adjudged to be unsatisfactory. CONCLUSIONS: Most of the indices of core competencies in modern health leadership and management appeared deficient among our study participants and their health institutions managerial environments were equally deficient. We recommend for a well-focussed short time duration health management course for all physicians particularly specialists.

Primary open angle glaucoma and intraocular pressure in patients with systemic hypertension.

OBJECTIVE: To investigate the association between Primary Open Angle Glaucoma (POAG), Intraocular Pressure (IOP) and systemic hypertension. DESIGN: Cross-sectional, convenient and controlled study. SETTING: Eye Clinic of the Lagos University Teaching hospital, Idi-Araba, Lagos, Nigeria. SUBJECTS: Consecutive newpatients with documented history of hypertension medication of over three months and current attendees at hypertension clinic of the same hospital were enrolled into the study. RESULTS: A total of 150 hypertensive patients and 50 age-sex matched controls were studied. Age range of hypertensives was 34-54 years and controls 31-71 years. The mean age for hypertensive group was 56 years (+/- 12.95) and controls 54.76 years (+/- 9.65) p > 0.1. The mean IOP was 28.45 mmHg (+/- 10.3) in hypertensive group and 15.2 mmHg (+/- 5.09) in controls (P < 0.001). POAG was present in 58 (38.7%) of the hypertensive patients whilst only nine (18.0%) had POAG in control group (p < 0.01 odds ratio: 22). lOP > 21 mmHg was found in 28 (18.7) of hypertensive group and two (4.0%) of the control (p < 0.01 odds ratio 4.7). CONCLUSION: Systemic hypertension showed a modest positive association with elevated intraocular pressure. The strong relationship with IOP in part supports the association with POAG.

Marfan syndrome: a study of a Nigerian family and review of current cardiovascular management.

BACKGROUND: Marfan's syndrome is a connective tissue disorder inherited as an autosomal dominant disorder. It causes a myriad of distinct clinical problems, of which the musculoskeletal, cardiac, and ocular system problems predominate. Nearly 50 percent of patients have to undergo aortic surgery in their lifetime resulting in reconstruction or replacement of the aortic root or total of this vessel's parts. OBJECTIVE: To describe a Nigerian family with multiple cases of Marfan syndrome and discuss current cardiovascular management of the syndrome. MATERIALS: Detailed history, clinical and laboratory investigations including ophthalmologic assessment and echocardiography were carried out on all members of a nuclear family of a child who reported with complaints of poor eye sight later diagnosed to have Marfan syndrome. RESULTS: Diagnosis of Marfan syndrome was made in three members of the nuclear family--a father and his two children following eye examination of one of the children. Afollow up cardiovascular assessment revealed that the father required aortic surgery while the two children also had aortic root dilatation. CONCLUSION: This report underlines the importance of a detailed history, physical examination and family study in patient assessment. Current cardiovascular management in Marfan syndrome involves a blocker therapy and an annual cardiovascular evaluation involving clinical history, examination and echocardiography. Prophylactic aortic surgery should be considered when aortic diameter at the sinus valsalva exceeds 50 mm.

Central nervous system stimulants: effect on visual functions and occurrence of road traffic accidents.

OBJECTIVE: To determine the influence of the use of central nervous system (CNS) stimulants on visual functions and occurrence of road traffic accidents (RTA) amongst commercial drivers. DESIGN: A cross-sectional study in which two hundred and fifteen consecutive drivers were interviewed and their eyes examined. SETTINGS: Ife Central Local Government Area (LGA) of Osun State, Nigeria. MATERIALS AND METHODS: Out of the estimated 270 commercial drivers registered in the four major parks of the LGA, 215 consecutive drivers participated in the survey Questionnaires were administered by face-to-face interview and the drivers' eyes examined by the authors. RESULTS: The prevalence of visual impairment (visual acuity < 6/18) in the better eye without correction was 3.3%, and there was a significant association between uncorrected visual acuity impairment in the better eye and RTA (p = 0.0152). The prevalence of refractive error was 8.4%, but none of these drivers wear corrective glasses. Alcohol consumption is common (57.7%) amongst the drivers, and there was a significant association between alcohol consumption and RTA (p = 0.00124). There was also a significant association between the use of CNS stimulants (kolanut, marijuana and cigarette) and RTA (p = 0.005). CONCLUSION: It was therefore concluded that visual impairment in the better eye, alcohol consumption and the use of other CNS affecting substances contribute to the occurrence of RTA among the drivers.

Vernal keratoconjunctivitis at Guinness Eye Centre, Luth (a five year study).

INTRODUCTION: Vernal keratoconjunctivitis (VKC) (Spring Catarrh) is a chronic, seasonally exacerbated bilateral external allergic ocular inflammation which causes a lot of ocular discomfort to children and young adults and, in severe or poorly managed cases, can even lead to blindness. OBJECTIVES: To determine age/sex distribution, seasonal pattern, and frequency of clinical features. METHODOLOGY: A review of medical records of patients who presented with VKC between January 2001 - December 2006. RESULTS: A total of 148 patients' records were reviewed. There was male preponderance with a Male to Female ratio of 1.27:1, and higher frequency in patients less than 10 yrs was observed. A trimodal peak pattern (January-February, April-July and September-October) was seen. Itching was the most common symptom and brownish conjunctival discolouration, the most common sign. CONCLUSION: This study is in agreement with previous findings of male preponderance and the tendency for the condition to affect children and young adults. It also detected an increase in number of cases in periods of seasonal changes from dry to wet. The necessity of patients' being assessed by an ophthalmologist was highlighted as several patients had been treated with antibiotics solely, which is insufficient for control of the condition.

Pattern of ocular emergencies seen at L.U.T.H. over a period of 1 year.

AIM: To determine the commonest type of ocular emergencies seen at L.U.T.H. over a period of one year. METHODOLOGY: Data of all consecutive patients seen as emergencies within the designated period was taken. These included age, sex, symptoms, signs, agents of injury, duration and the complications. RESULTS: A total of 304 patients were seen. 207 (68.0%) of them were males, while 97 (32.0%) of them were females giving a ratio of 2.1:1. Out of the total number, 159 (52.3%) had non-injurious emergencies. Of the 145 (47.7%) injurious emergencies, blunt trauma was the commonest with 77 patients (25.3%). Penetrating trauma was next in frequency with 37 patients (12.2%) as compared to blunt injury with 77 patients. Foreign body injuries were seen in 18 patients (5.9%), followed by chemical injuries which constituted the least with 13 patients (4.3%). CONCLUSION: Majority of the ocular emergencies seen were due to non-injurious type, while blunt trauma was the commonest of the injurious type. RECOMMENDATION: Health education and awareness creation should be intensified on the various causes of the ocular emergencies, more importantly on the non-injurious causes to prevent the resultant ocular morbidity.

Visual functions of commercial drivers in relation to road accidents in Nigeria.

OBJECTIVE: To determine the effects of the visual functions on the occurrence of road traffic accidents (RTA) amongst commercial drivers in Ife central local government area (LGA) of Osun state of Nigeria. DESIGN: A cross-sectional study. SETTINGS: Four major motor parks located at Ife Central LGA. MATERIALS AND METHODS: Of the estimated 270 commercial drivers in the four major parks of the LGA, 215 consecutive drivers were interviewed and had their eyes examined. Structured questionnaires were administered by an ophthalmologist. RESULTS: The prevalence of visual impairment (visual acuity < 6/18) in the better eye without correction was 3.3% ± 2.4 and there was a significant association between uncorrected visual acuity impairment in the better eye and RTA (P = 0.0152). Refractive error was seen in 8.4% of the drivers, but none of these wear corrective glasses. Visual field defect, abnormal stereopsis and color vision impairment did not have any significant association with RTA. CONCLUSION: Poor visual acuity is strongly associated with RTA amongst Nigerian commercial drivers as opposed to visual field defect, abnormal color vision and stereopsis. A significant proportion of visual impairment was due to uncorrected refractive errors.

A clinicopathological analysis of the efficacy of lodoxamide 0.1% eye drops on the conjunctiva of patients with vernal keratoconjunctivitis seen at Guinness Eye Centre, Lagos University Teaching Hospital.

OBJECTIVE: To ascertain the efficacy of Lodoxamide 0.1 in the reduction of Clinicopathological signs of the conjunctiva in Vernal Keratoconjunctivitis. STUDY DESIGN: Prospective, non-comparative, Convenient Interventional Case Series. PARTICIPANTS: One Hundred consecutive patients; 57 males and 43 females within age range 2-55 years diagnosed with active and untreated Vernal conjunctivitis were enrolled. Approval was obtained from Ethical committee of Lagos University Teaching Hospital, Idi- Araba, Lagos. METHODS: Patients were given a bottle of Lodoxamide 0.1 each to instill four times daily into both eyes. Pre-treatment Clinical photographs and conjunctival biopsies were taken in 15 volunteered patients. Ocular signs and symptoms were evaluated on day 1 (baseline), days 2-3 (Interim) and then weekly for 6 weeks (final). Post treatment Clinical photographs and conjunctival biopsies were done at the 6th week. The conjunctival tissues were fixed for 24 hours in 10 Neutral buffered formalin prior to paraffin wax embedding and routinely stained with Haematoxylin and Eosin (H & E) stains. MAIN OUTCOME MEASURE: Primary outcome was based on the reduction of inflammatory cells especially the eosinophils on histological micrographs. Secondary efficacy was based on the rate and extent of reduction of the severity scores of the clinical signs and symptoms. RESULTS: Lodoxamide 0.1 ophthalmic solution significantly reduced the density of the inflammatory cells especially eosinophils in the post treatment conjunctival biopsy cytology specimen. The mean physician severity scores for signs and symptoms consistently reduced from 72 hours of commencement of Lodoxamide with remarkable improvement in a week and complete resolution of all parameters at the end of 5th week. CONCLUSION: Lodoxamide 0.1 ophthalmic solution is highly effective in alleviating the clinical signs and symptoms of Vernal Keratoconjunctivitis and its antiallergic activity is exerted by inhibiting migration of inflammatory cells mainly eosinophlis.

Clinical trial of diclofenac sodium (Naclof) eye drops on Nigerians.

Twenty-eight eyes of 26 age-matched patients who had planned extracapsular cataract extraction with or without intraocular lens implantation were enrolled into a double blind randomised actively controlled study of 2 groups. Each group of 14 eyes was assigned to receive 0.1% diclofenac sodium (Naclof) eye drops or 1% prednisolone acetate eye suspension. The patients received either 0.1% Diclofenac sodium eye drops or 1.0% prednisolone acetate eye suspension four times a day as their post operative anti-inflammatory medication for a period of four weeks. No significant difference was noticed in the subjective assessment of pain and conjunctival injection in the 28 days follow-up period except day 1 in the diclofenac sodium group (0.05> p >0.01). Other measured objective variables of inflammation such as anterior chamber cells and flare showed no significant difference from the 3rd-28th postoperative days (0.05< p > 0.20). The result demonstrated that 0.1% diclofenac sodium eye drops was as effective as 1% prednisolone acetate eye suspension in the control of postoperative inflammation after cataract surgery, and could serve as a viable alternative to topical steroids in Nigerians who are steroid responders.