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PURPOSE To determine the correlation and agreement between intraocular pressure (IOP) parameters evaluated by the modified diurnal tension curve (mDTC) and the water drinking test (WDT) in primary open-angle glaucoma (POAG) in an indigenous African population. MATERIALS AND METHODS This was a prospective, interventional, comparative study of 50 newly diagnosed, previously untreated primary open-angle glaucoma patients at the out-patient clinic of the Eleta Eye Institute, Ibadan. A series of IOP measurements were taken 2 hourly (from 7:00 AM to 3:00 PM) for the mDTC, using Goldmann applanation tonometer. The WDT was performed thereafter. The patients drank 800 mL of water within 5 minutes, and another series of IOP measurements were taken every 15 minutes for a duration of 1 hour from the moment water was fully ingested. Both the mDTC and the WDT were performed on the same day. IOP peak, mean, and IOP fluctuations were estimated from the data collected. Comparison between the mDTC and the WDT was performed using the paired Student T test for means, Pearson correlation analysis for correlation, and Bland-Altman analysis for agreement. RESULTS Estimated IOP parameters were significantly higher for the WDT than for the mDTC. The average peak IOP was 27.8±4.0 mm Hg during the WDT and 24.9±3.1 mm Hg during the mDTC (P

Aim: The aim of this study was to determine the visual outcome of patients who had cataract surgery in the University College Hospital Ibadan. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at the University College Hospital conducted between May and October 2007. A total of 184 patients who presented to the hospital and met the inclusion criteria were recruited into the study. Patients were examined preoperatively, 1st day postoperatively and 8th week postoperatively. Results: The mean age was 66.5 years; and the male to female ratio was 1.2:1. Preoperatively, 137 patients (74.5%) were blind in the operated eye, while 39 patients (23.6%) were blind in both eyes at presentation. At 1st day postoperatively, 87 patients (47.3%) had pinhole visual acuity of 6/6-6/18. Best corrected vision after refraction eight weeks postoperatively showed that 127 patients out of 161 patients (78.8%) had good vision while 28 patients (17.4%) had borderline vision, and six patients (3.8%) had severe visual impairment after refraction. The number of bilaterally blind patients also reduced from 39 (23.6%) to one (0.6%). Uncorrected refractive error was the commonest cause of poor vision prior to refraction. Glaucoma was the commonest ocular co-morbidity accounting for poor vision in 9.1% of patients eight weeks after cataract surgery. Conclusion: This study demonstrates that good results can be obtained with cataract surgery and intraocular lens implantation in the developing world. More attention should be directed towards ensuring that successful outcomes are indeed being realized by continued monitoring of postoperative visual outcomes and prompt refraction for all patients. Keywords: Cataract, Visual outcome, Cataract surgery

Aim To determine the magnitude of visual impairment (VI) resulting from lens opacity/cataract among a rural population in southwestern Nigeria. Method A population-based cross-sectional survey using a multistage sampling method to select subjects ⩾50 years. Participants with pinhole visual acuity of ⩽6/18 in their better eye, exclusively from lens opacity/cataract, were further examined by an ophthalmologist. Their level of VI was categorised using the International Classification of Disease tenth revision and lens opacity was graded using the World Health Organization's cataract grading system. Results From the enumerated population of 1200 subjects, 1031 subjects were examined. The prevalence of VI from cataract/lens opacity in the population studied was 11.9% (95% CI: 10.1–14.0) with a cataract blindness prevalence of 2.0% (95% CI: 1.3–3.0). The odds for VI increased with increasing age and female patients had 1.6 times the odds for cataract blindness than did male patients. Mixed cataract was the most prevalent of the visually disabling cataract. (3.9% (95% CI: 2.8–5.2)), whereas posterior subcapsular cataract was the least prevalent (2.5% (95% CI: 1.7–3.7)). Conclusion VI from cataract remains a public health problem in the Akinyele district of Nigeria. The need for a comprehensive cataract surgical service using the VISION 2020 model is necessary in the district if the burden from the backlog of visually disabling cataract is to be reduced.

Objective: The aim of this study was to determine the visual outcome of patients who had manual small incision cataract surgery in a high volume secondary eye hospital in southwestern Nigeria, and to identify reasons for poor outcome. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at St Mary’s Catholic Eye Hospital, Ago Iwoye (SMEH) Nigeria conducted between May and October 2007. A total of 146 patients who presented to the hospital and met the inclusion criteria were recruited for the study. Patients were examined preoperatively, 1st day and 8th week post-operatively. Results were analyzed using the SPSS statistical software. Significant association was taken at 95% confidence interval i.e. < 0.05. Results: A total of 146 patients who met the inclusion criteria were studied. The mean age was 65.3±10.04 years; and the male to female ratio was 1.4:1. Preoperatively, 110 patients (75.3%) were blind in the operated eye, while 33 patients (22.6%) were blind in both eyes at presentation. At 1st day post-operatively, 17 patients (11.6%) had pinhole visual acuity of 6/6-6/18. Out of 137 patients that had refraction, 114 patients (83.2%) had a visual acuity of 6/6-6/18. The number of blind patients also reduced from 33 (22.6%) to 1(0.7%). Uncorrected refractive error was the commonest cause of poor vision post-operatively. Conclusion: This study demonstrates that good results can be obtained with small incision cataract surgery with intraocular lens implantation in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery.Key words: cataract, cataract surgery, visual outcome

Objective: To determine the relationship between tear function and ocular surface abnormalities with subjective symptoms of dry eye. Methods: Patients with various ocular irritation symptoms suggestive of dry eye were examined for tear break up time (TBUT), Schirmer's test 1, and Rose Bengal staining pattern. They were compared with a group of asymptomatic healthy subjects. Results: There were 63 subjects, mean age 43.8 years (+/-14.7 years) with various complaints of dryness presenting as having irritation or foreign body sensation. A group of 17 asymptomatic subjects, mean age 42.1 years (+/-12.7 years) were studied as controls. There were 22 (34. 9 %) males and 41(65.1%) females in the symptomatic group while the control group had 4 (23.5%) males and 13(76.5%) females. Ocular irritations included itching 38(60.3%), pricking and itching 10 (15.9%). Mean Shirmer's test values were lower for symptomatic subjects (mean 14.5mm +/-12.3 right eye; 14.9mm +/-12.4 left eye), compared to the controls (23.0mm +/-13.4 right eye; 17. 9mm +/-13.4 left eye) P=0.02, for right eye and 0.4 for left. The mean TBUT were also lower amongst the symptomatic subjects (10.5 seconds, right eye and 10.1 seconds left eye), while for controls mean TBUT was 12.7 seconds right eye and 12.1 seconds left eye (P=0.2). Fifty -six out of 126 (46.8%) eyes of all symptomatic subjects compared to 7 out of 34 (20.6%) eyes of asymptomatic subjects had positive staining of conjunctiva with rose Bengal (p=0.06). For subjects with itching as the primary symptom 44.7% of them as opposed to 23.5% of the controls were likely to stain positive with rose Bengal, (sensitivity of itching as screening tool for dry eye was 81% , specificity 38.2%). Itching and pricking sensation together (sensitivity 46.2% and specificity improved to 65%). Rose Bengal grades were also inversely correlated with mean Schirmers values (Pearson correlation -0.429; P = 0.001) and TBUT (Pearson correlation -0.316, P=0.005). Conclusion: Itching and other ocular irritation symptoms may be indicative of underlying abnormal tear function and ocular surface damage, their presence calls for further examination for tear deficiency and prompt institution of treatment for dry eye.

Objective: To review patients with clinical features of chloroquine retinopathy seen during the study period with the view of identifying the trend and creating public awareness for behavioural change. Methods: A retrospective review of case notes of patients seen between 1996 and 2002. Results: 19 patients with features of presumed chloro-quine retinopathy were reviewed: 5 women and 14 (73.7%) men. The age range is: 36-69 years, mean 50.7 years. Approximately 63% were civil servants, health care workers and teachers. Duration of chloroquine use ranged from six months to ten years, with a mean of 4.1 years. Total cumulative dose ranged from 10 gm to 312 gm, with a mean of 108 gm. Best corrected visual acuity of subjects ranged from 6/5-CF, mean 6/18. Conclusion: The majority of people using large amounts of chloroquine over long periods are educated, middle-aged males, whose loss of vision would have far reaching effects on their families. There is, therefore, a need to create public awareness of the danger of long-term chloroquine use. A follow up national survey would be desirable to determine the actual magnitude of the problem [Nig. J. Ophthalmology Vol.11(1) 2003: 24-28]