Accidental tear gas injuries in security agents.

BACKGROUND: Tear gas is a noxious vapour used in quelling civil disturbances. The law enforcement agents who usually handle this are well trained and rarely injured by the use of this weapon especially during peace times. METHODS: We report injuries sustained by two policemen handling tear gas as a result of accidents. Case notes of the patients were the source of information. RESULTS: Two policemen were injured while handling tear gas. The equipment accidentally dropped and exploded on attempting to pick them. The mechanisms of injuries and parts of the body injured were similar ie the hands and face with traumatic cataract of an eye in one patient. CONCLUSION: We conclude that proper training of the law enforcement agents will go a long way in reducing these types of morbidity from tear gas use.

Ocular status of commercial drivers in Osun State, Nigeria.

AIMS/OBJECTIVES: To determine the ocular status of commercial vehicle drivers in Osun State, Western Nigeria and highlight the effect on safety on the road. DESIGN: A cross-sectional-survey utilizing a multistage-random-sampling-technique done between May and June 2004. PARTICIPANTS: 99 consenting commercial vehicle drivers, registered with NURTW, Osogbo. Motorcyclists and non-registered NURTW drivers were excluded. METHODS: Clearance from LAUTECH Teaching Hospital's (LTH) ethical committee and informed consent obtained. Structured questionnaire and complete eye examination with vision test was done in the clinic. Driving test and ability to read number plates from a distance of 20.5m before and after dilatation were done in the hospital premises. RESULTS: Mean age of the subjects was 45.9 years (SD 7.7). Prevalence of visual impairment was 6.1%.and of failed driving test was 6.1%, while, uniocular blindness was 5.1%. Pupillary dilatation significantly reduced both ability to drive and to read number plate p < 0.05. Road traffic accident was associated with visual impairement, field loss, protan colour deficiency, cup:disc ratio > 0.5, and intraocular pressure > 21 mmHg. RTA was less likely among those who could read number plates (OR = 0.51). Prevalence of cataract was 24.3%, pterygia 20.7%, cornea opacity 6.6% and uncorrected-refractive errors 31.3%, with hypermetropia being most prevalent (19.7%). None had corrective lenses as at time of examination. CONCLUSION: Eye diseases causing uniocular blindness, visual impairment and uncorrected refractive errors were seen to be common among the commercial vehicle drivers. Mandatory, specific-periodic ophthalmological examination for correcting and preventing these are necessary before first issuance and revalidation of driver's license. Health education about eye care is therefore necessary to enhance safety on our roads.

The dangers of bunk beds to the eye - a case report and preventive measures.

This is to illustrate the case of a 14 year old male student of a secondary school who fell off the top of an unguarded bunk bed in his hostel while sleeping and sustained a fracture of the left orbital margin, severe periorbital echymosis and conjunctivitis. He was managed conservatively. Two weeks post injury; the swelling resolved. At 2 months post injury, he improved tremendously and his visual acuity in the affected eye was 6/6. The swelling resolved and his anterior and posterior segments were normal. The patient was lucky to have had an intact eyeball. If it had been a penetrating eye injury, it could have been disastrous. Blinding eye injuries may be irreversible.Unguarded bunk beds may be dangerous to the eye. A recommendation of minimal standard for bunk-beds for children or no bunks at all in schools is suggested.

Pattern of pre-hospital consultation among ophthalmic patients seen in a tertiary hospital in South West Nigeria.

This hospital based study aimed to seek information on the factors influencing non-doctor consultation practices in South West Nigeria. A high prevalence of such practices and the attendant public health significance have been reported in different regions of the world, yet studies related to this are generally lacking in this region. Semi-structured questionnaires were administered to 142 ophthalmic patients presenting newly to the out-patient unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria. Information were obtained on demographic data, health care facilities visited before presenting to the eye clinic, drugs prescribed, and reasons for consulting such facilities. The age of the participants ranged from 16 to 85 years with a mean of 44.79 years (SD 17.25 years). 32 (22.5%) of these had not used any pre-visit consultation. 110(77.5%) had consulted one form of health care provider or the other, with only 48 of them (43.6%) having consulted allopathic doctors. 62 (56.4%) had consulted alternative practitioners. Thus 43.7% of the patients practiced non-doctor consultation. The main reasons given for engaging in non-doctor consultation are 'problem not serious' (25.8%), 'no nearby hospital' (25.8%), and 'to save time' (21.0%). Non-doctor consultation practices are prevalent in South West Nigeria as in many other developing regions of the world. Ignorance and inadequate health care providers contribute a great deal to this. Increased public enlightenment, making health care services available and accessible to the populace and stricter government policies on drug dispensing will go a long way in reducing these practices.

Visual standards in commercial driving.

OBJECTIVES: The study was carried out to review the ocular factors involved in road traffic accidents (RTA) in order to reduce associated injuries and possibly suggest a standard for driving. MATERIALS AND METHODS: The study was carried out in the eye clinic of Ladoke Akintola University of Technology Teaching Hospital, Osogbo between May and June 2004. A stratified random sample technique was used to select 99 drivers (198 eyes) from 6 motor park units. Information obtained included age, sex, past history of road traffic accident (RTA), visual acuity and field, colour vision and ability to read number plate tests. RESULTS: Six drivers (6.1%) were visually impaired. There were 5 cases of monocular blindness. Twenty (20.20%) drivers had accidents in the past, 24(24.24%) could not read number plate at 20.5meters, 6 (6.1%) were colour blind while 36 had visual field loss within 120 degrees horizontally. All the six drivers that had visual field loss encroaching within 20 degrees of fixation had accidents in the past. CONCLUSION: This study has shown that there is need to improve on the standard of vision testing before licenses are issued or renewed. Where visual acuity alone is used, it must be done properly by testing one eye at a time. However, a comprehensive eye test using a battery of tests comprising visual acuity, colour vision, visual field and number plate test at 20.5 meters before first issue of driving license and at renewals will be better. Drivers with visual impairment or inability to read number plate test at 20.5 meters should be disqualified from driving commercial vehicles. Drivers with monocular blindness or visual field loss encroaching within 20 degrees of fixation must also not be allowed to drive commercial vehicles. However, further large scale studies will be necessary in order to prove all these propositions scientifically.

Common causes of red eye presenting at an ophthalmic clinic.

BACKGROUND: Redness of the eye is a common ophthalmic symptom. The problem causing redness could arise from within or outside the globe. These range from cases of simple inflammation following itching and minor trauma for example, to severe cases like orbital cellulitis and tumours. Patients may not even be aware of the redness. The aim of this study is to highlight the common causes of red eye as seen in an outpatient department in an ophthalmic set up. This should be of immense help to the general medical practitioners to whom the patients often first present. METHODS: All patients presenting for the first time to Ladoke Akintola University of Technology Teaching Hospital over a four month period were screened. 117 had red eyes and were recruited. 125 eyes were found to be red. The characteristics of the redness were then studied to determine the cause. RESULTS: There was a male preponderance, M : F of 2:1. Persons 45 years and below, were most commonly involved 88 (66.67%). The most frequent cause of red eye was trauma, in 48 (41.03%) patients, followed by allergic conjunctivitis in 29 (24.77%). The main causes of redness differed in different age groups and occupation. There was no case of angle closure glaucoma seen as a cause of redness. CONCLUSION: There are diverse causes of redness of the eye. Persons who are not eye specialists to whom patients with red eyes present first should be conversant with the causes, to know what action to take, especially when to refer to the eye specialist.

Respiratory arrest after retrobulbar anaesthesia.

This is a report of a patient who developed respiratory arrest some minutes after retrobulbar block was given for ocular anesthesia before cataract extraction. She was managed by artificial ventilation and haemodynamic support without any cardiac or neurological sequelae. This report highlights this rare but fatal complication of suspected brain stem anaesthesia after retrobulbar anaesthesia. Retrobulbar and peribulbar blocks should be performed in safe situations where individuals trained in airway maintenance and ventilatory support should be immediately available.

Mortality on an ophthalmic ward.

This study was performed to investigate the causes and prevalence of death on an ophthalmic ward. Over a ten-year period, thirteen deaths occurred among 3545 admitted patients (0.4%) mortality rate). Ten deaths occurred in patients with advanced neoplasms or complications of severe orbital infection. Three deaths were sudden. They occurred in the post-operative period among apparently healthy patients admitted for surgery. The possible causes of such sudden deaths are discussed.