Search

Nigeria has the third largest incidence of premature birth, after India and China. Most babies that will require treatment for retinopathy of prematurity (ROP) have birth weight (BW) less than 1500g and gestational age (GA) less than 32 weeks, with initial eye examination within the first 30 days of life. This report aims to present the findings in three babies with vision threatening ROP that developed at less than 30 days of life. Routine screening for ROP was conducted for three babies. One was born GA 33 weeks, BW 1.6kg, screened for ROP on the 13th day of life, while the other two were a set of twins born at GA of 33 weeks, both BW 1.3kg, screened for ROP first on the 16th day of life. The twins were found CC –BY 4.0 to have arborizing vessels at the initial exam, which progressed to stage 3 pre-plus ROP by the 23rd day of life. The 3rd child had stage -3 plus disease at the first screening, warranting immediate LASER therapy. The screening criteria of Nigeria ROP group is BW ≤ 1500g or GA of ≤ 34 weeks, with the first eye examination within the first 30 days of life. These case reports show that larger babies can also develop sight threatening ROP within the first two weeks of life. There is a need for constant review of ROP screening criteria and timing based on locally available data

Introduction: Despite transportation liberating man and making him mobile, his increasing reliance on vehicular movement has conferred great facilities on him and his activities. The most profound culprit of all modes of transport is the road, of which traffic accidents are the most disturbing consequence of its use. Road traffic-related ocular injuries often have severe consequences and form a significant part of ophthalmic emergencies. These injuries may be missed and are therefore often underreported. Aim: To determine the causation, types, and outcomes of road traffic-related ocular injuries at the University of Ilorin Teaching Hospital, Kwara, Nigeria. Materials and Methods: This was a cross-sectional study conducted on 78 eyes of consecutive patients with road trafficrelated ocular injuries who presented at the Accident and Emergency unit of the University of Ilorin Teaching Hospital, Kwara, Algeria, between September 2012 and August 2013. The materials included the HOTV chart for vision assessment, which is a standardised, easy-to-use assessment method for both literate and illiterate individuals, a pen torch, direct ophthalmoscope, binocular indirect ophthalmoscope, slit lamp biomicroscope, Perkins tonometer, 2% fluorescein strip, 0.5% GuttTetracaine, and a handheld portable slit lamp ophthalmoscope. Patients' demographics, duration of ocular injury before presentation, Visual Acuity (VA) at presentation, type of vehicle, place of injury, classification of ocular injury, treatment, and outcome on follow-up were recorded. Results: There were 78 eyes (72 patients) with road trafficrelated ocular injuries. The age range of the subjects was 3-55 years with a mean of 31.10 years. Forty-four (61.1%) patients were young men between 20-39 years. Fifty-one (70.8%) patients were males, and 21 (29.2%) were females, with a male-to-female ratio of 2.4:1. Most of the victims were traders (22, 30.6%), and fifty-two eyes (72.2%) presented within 12 hours of ocular injury. Motorcycles were associated with ocular injury in 37 (51.4%) patients. The most common injuries were of closed globe type (contusion, lamellar laceration, superficial foreign body) in 70 patients (89.7%). Conclusion: Road traffic-related injuries have increased over the past eight years in Nigeria. Males are more commonly injured in Road Traffic Injury (RTI), and motorcycles were the most common cause of injury to road users. Three out of 36 people injured in a vehicle at the time of injury used seat belts, while none of the riders and passengers on motorcycles wore helmets. The importance of prevention, the use of safety devices, and the avoidance of risk behaviors on the road need to be emphasised. [ABSTRACT FROM AUTHOR]

Background Statement: Inadequate retinopathy of prematurity (ROP) screening coverage portends a high risk for increasing the cases of ROP blindness. This study aims to report the clinical profile of pre-term babies who developed ROP blindness, highlight the usefulness in determining screening criteria and the role of private hospitals in ROP blindness prevention. Case Series Report: Online Google form and telephone survey was conducted from May to December 2020 among paediatric ophthalmologists who provided the clinical details of ROP blind children seen between 2016 and 2020. The main outcome measured included type of the hospital of birth, gestational age, birth weight, ROP Screening and treatment, and blinding ROP Stage among children born premature. The SPSS-IBM version 26 was used for the analysis. Eighteen children blind from ROP with an equal male-to-female ratio were reported. Mean gestational age was 28.4 ± 2.2 weeks (range 26 - 34 weeks, median was 28.0 weeks). Mean birth weight was 1173.7 ± 317.9 grams (range 776 - 2100 grams, median 1125 grams). Six (33.3%) babies were born in private hospitals between 28 and 32 weeks. Sixteen (88.9%) children never had ROP screening. Fifteen (83.3%) were blind in both eyes. Six (33.3%) had Stage IVb and 12 (66.7%) Stage V. Conclusion: About 90% of the babies who became blind did not undergo ROP screening. It is crucial that all babies born at 34 weeks or earlier and have birth weight of < 1500 grams in public/private hospitals be screened for ROP to prevent this avoidable blindness in Nigeria. [ABSTRACT FROM AUTHOR]

Background The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. Methods A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. Results Capture rate was 42.2% of expected patients from Africa and 108.8%from Europe. African patients were older (95%CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. Conclusions Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral. [ABSTRACT FROM AUTHOR]

PURPOSE: Routine eye examination in early life is not the practice in most resource-limited countries. Delay in the presentation for eye problems is typical. Community health officers are often consulted by caregivers for all health problems during routine immunization and well-baby clinics in primary healthcare for children aged 0–2 years. This study evaluated the value and limitation of interview, Bruckner red reflex test, and instrument vision screener by noneye care middle-level staff of rural and urban well-baby immunization clinics, in early detection and referral for childhood eye disorders. MATERIALS AND METHODS: This was a cross-sectional study. Middle-level community health workers (CHWs) working at well-baby/ immunization clinics were trained to perform vision screening using interview of caregivers, red reflex eye examination with ophthalmoscope, and instrument vision screener (Welch Allyn SPOT™ Vision Screener) without mydriatic drugs during routine immunization of children aged 0–2 years. IRB approval was obtained. RESULTS: Over a 6-month period in 2017, the CHWs screened 5609 children. Overall, 628 (11.2%) patients were referred to the tertiary child eye care unit. Referred cases included cataract, glaucoma, congenital nasolacrimal duct obstruction, ophthalmia neonatorum, retinoblastoma, and significant refractive errors. Referral from the interview of mothers was enhanced if specific questions to elicit visual function were asked. Bruckner red reflex test was more effective than instrument vision screener in the detection of cataract and life-threatening diseases such as retinoblastoma. Instrument vision screener was preferred by parents and better at detecting amblyopic risk factors. CONCLUSION: Preschool vision screening during routine immunization by primary healthcare workers in resource-limited settings was effective. Whenever instrument vision screener does not give any recommendation during screening, consider vision- or life-threatening pathology and refer. [ABSTRACT FROM AUTHOR]

Background: Retinopathy of Prematurity (ROP) is an avoidable condition that affects premature infants exposed to oxygen stresses at or soon after birth. In low- and middle-income countries, like Nigeria, neonatal mortality rates are high and very few infants live to develop ROP. With recent better care, ROP is now being diagnosed. Objective: This study aimed to characterize what Nigerian neonatologists understand about ROP. Methods: At a joint meeting of Nigerian pediatric ophthalmologists and neonatologists in Kebbi State held 26-29 July 2018, questionnaires collected attendees' perspective and experience with ROP including causes, risk factors and experiences. Results: Fifty-one neonatologists out of 71 returned a completed questionnaire (response rate: 71.8%). The male:female ratio was 1:1.8, and approximately 40% were aged 41-50 years (n=20, 39.22%). Only 3 (6.39%) had experience managing infants below 500g that survived. A majority managed babies with a mean weight of 913g ± 300.37 and age of 27.87 weeks ±2.37. Most had no access to oxygen monitors (n=39,78%). Most had 10 babies to one monitor and used average settings of 90-95%. One third had seen a case of ROP (n=15,29.41%). Only 5.88% (n=3) were unaware of uncontrolled oxygen use as a risk factor. Only 4 (8.89%) had a functional screening team. None were aware of local screening guidelines. Conclusions: Regular educational programs, collaborative clinical presentations and webinars about ROP targeted at the neonatologists and parents, including establishment of screening programs across country will likely help reduce the burden of ROP blindness in Nigeria. [ABSTRACT FROM AUTHOR]

Several epidemics of blindness due to retinopathy of prematurity (ROP) have been described, with the most recent (the third) occurring in middle income countries in Latin America and Eastern Europe initially, and more recently in the more advanced economies in Asia. In these settings, which are characterized by variation in the quality of neonatal care and inadequate coverage of ROP screening and treatment, larger, more mature infants are affected as well as extremely preterm infants. In 2010 the annual incidence of blindness and visual impairment from ROP globally was estimated to be 32,300, with the lowest incidence in sub-Saharan countries. However, ROP is likely to become an increasingly important cause of blindness in children in sub-Saharan Africa as neonatal care expands unless policies and programmes for control are included at the outset. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Copyright of Annals of African Medicine is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To characterize the demographic and psychosocial problems of a group of blind people as a way of attracting more attention to and providing data that can improve the psychosocial care of the visually impaired. Materials and Method: A cross-sectional descriptive study of a population of totally blind people in Ilorin, Nigeria using a self-report questionnaire (SRQ). The questionnaire was verbally administered by the study personnel in the local language. Simple frequency tables were obtained and the Chi-square test was performed to determine significant differences between variables. P-value <0.05 was considered statistically significant. Results: Sixty one blind patients consented to participate. Most participants were engaged in street begging for their livelihood. Most subjects desired a job change, signifying dissatisfaction with the present occupation. Up to 80% of the cohort was married and had spouses who were also blind in at least one eye. Approximately two-thirds had five or more children and majority lived with family members who were responsible for taking care of their personal hygiene, cooking and mobility. The majority developed blindness in childhood and 16% had a family history of blindness and 77% had never used conventional eye care, with corneal disease being the most frequent cause of blindness. Many feared that their children may also become blind. Thirty-one (51%) scored =5 on SRQ and were classified as probable cases of psychological disorder. Conclusion: Blindness in a majority of cases that started in childhood was probably preventable. Inaccessibility to or failure of the formal rehabilitation and social welfare systems may have caused this psychosocial dilemma. The high level of social and family interaction provides opportunity for organized preventive ophthalmology, community health care services and psychosocial care. [ABSTRACT FROM AUTHOR]