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Objectives: The purpose of the study was to describe the barriers to the utilization of eye care services in a rural community in South-South Nigeria. Material and Methods: A descriptive cross-sectional study using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of the eye clinic at the community’s Comprehensive Health Centre (CHC) for eye care. Results: The study sample included 200 participants. Only 40 (24.1%) respondents had previously consulted at the eye clinic at the CHC in search of eye care. The principal barriers to eye care services utilization were “Ignorance of the existence 53 (47.3%) and schedule” 37 (33.0%) of the eye clinic at the CHC, and “No felt need” 26 (23.2%). Conclusion: Despite the high prevalence of ocular disorders among the study participants, the utilization of available eye care services was markedly low. The common barriers cited were “Ignorance of the existence and schedule of the eye facility in the community. Improved strategies to improve uptake of services is required.”

Objectives: Out of the 38.0 million (30.2–45.0 million) with HIV/AIDS globally, about 35.9 million (28.9–43.0) adults live in sub-Saharan Africa. Ocular findings in HIV/AIDS are a cause of morbidity, visual impairment, and blindness and differ in different environments. This study aimed to investigate the pattern and prevalence of ophthalmic manifestations of HIV/AIDS in Calabar, Nigeria. Material and Methods: This study investigated ocular findings among patients attending the HIV/AIDS Special Treatment Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria. Using a descriptive cross-sectional study design, a total of 440 subjects met the inclusion criteria and were recruited into the study. Results: There were 166 (37.73%) male and 274 (62.27%) female respondents, indicating a female preponderance with a male-to-female ratio of 1:1.6. The modal age group was 26–35 and formed 40.4% of study population while 415 (94.30%) of the study population were 55 years old or less. While 316 (72.00%) of the respondents had some ocular morbidity, 136 (30.91%) were HIV/AIDS related. A total of 155 respondents (35.20%) had ocular symptoms. No person was blind, while 154 respondents (35.00%) were visually impaired. HIV/AIDS-related findings were retinal microangiopathy in 60 respondents (13.60%), conjunctival microvasculopathy in 30 (6.80%) respondents, hypertrichosis in 22 (5.00%) respondents, dry eye syndrome in 17 (3.90%) respondents, anterior uveitis in 17 (3.90%) respondents, presumed squamous cell carcinoma of the conjunctiva in 7 (1.60%) respondents, facial nerve palsy in 5 (1.14%) respondents, and Kaposi sarcoma of the eyelids and conjunctiva was in 4 (0.91%) respondents. There was increased ocular involvement among those respondents with lower CD4+ counts (P < 0.0001). Conclusion: Ocular manifestation of HIV/AIDS can occur in the presence of normal vision and are a cause of avoidable uniocular vision loss. Non-HIV/AIDS-related ophthalmic morbidity also occurs in patients with HIV/ AIDS. These facts justify targeted scheduled ophthalmic screening. Ophthalmologists need to recognize and manage the varying patterns and sometimes location specific signs and symptoms.

Objective: The objective is to determine the pattern and prevalence of diabetic retinopathy (DR) among patients living with diabetes mellitus. Methodology: Descriptive cross-sectional study in a tertiary hospital. Questionnaires were used to obtain data from eligible participants. Visual acuity measurement, fundal examination, and photography were performed together with fasting blood glucose and glycated hemoglobin A1c. The Statistical Package for Social Sciences (SPSS) for Windows version 20 was used for data analysis. Results: Overall 200 patients were enrolled of which 75.5% were female. The participant's mean age was 53.8 ± 11.7 years. DR was present in 53/200 (26.5%) of participants, of which 52 (98.1%) had nonproliferative DR (NPDR), and 1 (1.9%) had proliferative DR (PDR). NPDR was mild in 44/53 (83.0%) and moderate in 8/53 (15.1%) patients. Evidence of sight-threatening DR was found in 37/200 (18.5%) of participants (36 had diabetic macular edema and 1 had PDR + DMO). Conclusions: DR was present in 26.5% of the study participants, and 18.5% had sight-threatening DR mainly due to DMO. This finding underscores the need for routine screening of all people living with diabetes to detect early DMO and provide treatment to prevent visual loss.

Purpose To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.

Purpose To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.

Health-seeking behavior is important as it reveals the preventive, curative, and rehabilitative actions taken by individuals to rectify perceived ill-health.To identify existing eye health-seeking behavior, factors influencing such behavior, and suggest ways in which the system can respond to the needs of the target population in order to reduce visual impairment and blindness.This was a descriptive cross-sectional study; 600 respondents were interviewed using a semistructured pretested questionnaire administered to every fifth new patient attending the eye clinic of University of Calabar Teaching Hospital (UCTH) for a period of 5 months by a single interviewer. People unable to respond appropriately were interviewed alongside their caregivers.Poor distant vision was the most frequent ocular complaint in this study. The mean duration of complaint before presentation to any health facility was 370.65 ± 889.48 days with a range of 0-9,125 days. Nature of eye complaint was the most significant factor that determined how early respondents sought help (P0.001). Place of residence, nature of eye complaint, and employment status were significant determinants of the choice of place of first presentation for ocular complaints.There is need for improved eye health education and awareness for prompt presentation to an appropriate eye care professional at the onset of symptoms and even case finding for potentially blinding eye conditions.

Aim: To determine the prevalence of refractive errors and spectacle use behavior among medical students in University of Calabar Teaching Hospital, Nigeria. Study Design: Cross sectional study. Place and Duration of Study: Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria, between April 2010 and July 2010. Methodology: The study population consisted of fifth year medical students. Subjects had cycloplegic auto refraction with Topcon auto refractor during their rotation in ophthalmology at the Ophthalmology department of the University of Calabar Teaching Hospital. A spherical equivalents (SE) ≥ +0.50D were determined as hyperopia; SE of >Original Research Article British Journal of Medicine & Medical Research, 4(13): 2581-2589, 2014 2582 0.50D myopia and >-0.50D cylinder as astigmatism. Statistical analysis, which included chi-square test was carried out with Statistical Package for Social Sciences (SPSS) version 20.0. Results: Sixty-six (79.5%) of subjects had a form of refractive error; 63.6%%, 16.7% and 19.7% were myope, hyperope or simple estigmat, respectively. The prevalence of ametropia was 82% in female and 78% in males. The association between refractive errors and gender was not statistically significant (p = 0.35, 95% Confidence Interval [CI], 0.34-0.36).Minus spherical errors ranged from -0.16 to -5.25 diopters (D) and plus spherical errors ranged from +0.25 to +1.00D, spherical equivalent between -0.25D and 2.75D being the most common type (85.5%). Eight students (12.1%) were wearing glasses at the time of the study corresponding with 10 (15.2%) who had eye pains while reading. Conclusion: The prevalence of refractive errors among fifth year medical students of the University of Calabar was high and eyeglasses were worn by students who were symptomatic.

Background: The huge burden of HIV/AIDS in sub-Saharan Africa has been associated with increased prevalence of malignant conjunctival tumours especially squamous cell carcinoma (SCC). In Nigeria, the national HIV sero-prevalence is 3.4%, and values in the South-South geopolitical zone where this review was performed ranges from 4.1% in Delta to 10.9% in Akwa-Ibom state. Aim: To review HIV and conjunctival tumours in patients seen at the University of Calabar Teaching Hospital (UCTH), Calabar Methodology: This retrospective clinic review of demographic data, clinical features, HIV sero-status and histopathologic findings in patients with conjunctival tumours seen from January 2005 to December 2014 including Ophthalmology clinic records and pathology request forms were analysed Results: A total of 32,102 new patients were seen in the ophthalmic outpatient within the study period, of which 108 patients comprising 57(52.8%) males and 42(38.0%) females had conjunctival tumours. Their ages ranged from 11-85 years, with a mean of 39 years ± 14.98. Histologically, eighty (74.1%) had Squamous cell carcinoma, ten (9.26%) Squamous intraepithelial lesion, six (5.56%) Papilloma, four (3.7%) Kaposis sarcoma, three (2.78%) Naevus and Melanoma each, one each (0.93%) had Conjunctival dysplasia and Lymphoma. The HIV status of only 55 (50.9%) could be ascertained having been documented in patients’ records of whom thirty-seven (67.3%) were HIV positive. Thirty four (>90%) of the HIV positive cases had squamous cell carcinoma. The other 3 patients had kaposis sarcoma, papilloma and conjunctival intraepithelial neoplasia(CIN). Conclusion: In Calabar, conjunctival squamous cell carcinoma is preponderant in HIV sero-positive patients when compared with the sero-negatives.

Aim: The aim was to determine the competence of medical students in performing direct ophthalmoscopy. Materials and Methods: It was a cross‑sectional study whereby year 5 medical students were assessed during Objective Structure Clinical Examination (OSCE) at the end of 4 weeks clinical rotation in ophthalmology. Every student had 5 min in each OSCE station, including the station for direct ophthalmoscopy. The correctness or otherwise of students’ quantitative assessment of cup‑disc ratio (CDR) was analyzed using Statistical Package of Social Sciences (SPSS, USA) version 20.0. Result: A total of 96 students were assessed in 6 groups over a 6 months period; age range was 20–33 years and a mean age of 24.8 ± 3.2. There were 57 males and 39 females (M:F = 1:0.25). Seventy‑eight (81.3%) were satisfied with teachings and tutorials on direct ophthalmoscopy. Eighty‑nine (92.7%) admitted visualizing the disc in the course of tutelage while 7 (7.3%) had never seen the disc with the direct ophthalmoscope. The retinal vessels were seen with the ophthalmoscope by 93 (96.9%). Direct Ophthalmoscopy was not considered to be difficult by 87(90.6%). Forty‑six (47.9%) got CDR correct on the right eyes while 50 (52.1%) got it correct on the left eyes. There was statistically significant relationship between the group students belonged and performance with 2 =

To determine the trend in frequency and clinical indications of surgical removal of eyes in a tertiary eye centre in Calabar, Nigeria. This is a 10-year retrospective review of patients who underwent surgical removal of eyes in a tertiary centre. The clinical records were reviewed (between Jan 2001 and Dec 2010) for demographic data, type of surgery, and clinical indications. A total of 137 eyes were surgically removed within the study period. Of these 46 were children (

Purpose: This article reports a case of corneal injury following a splash from the sap of plantain stem. Case Report: A 54-year-old female presented with a history of plantain stem sap splash into her right eye of 7-h duration with associated ocular pain, tearing, photophobia, and blurring of vision. On ocular examination, visual acuity was 6/18 OD; slit lamp examination revealed a well-delineated fluorescein-positive corneal epithelial defect with associated mild stromal edema. Left eye examination was essentially normal. She washed her face and eyes with water immediately after the splash and further had eye irrigation by attending ophthalmologist on presentation. The patient was immediately commenced on prednisolone, moxifloxacin, cyclopentolate, and ascorbate eye drops and tetracycline ointment. Corneal edema resolved in 4 days whereas the epithelial defect was completely healed by day 12 and visual acuity was restored to 6/6. Conclusion: Although farmers are exposed daily to various types of eye injuries from parts of plants, this report highlights corneal eye injury following plantain stem sap splash in a farmer who did not use protective eye goggles while working in the farm and how prompt institution of treatment can sight loss and loss of corneal integrity.

Background : Because of the appalling health indices in West Africa, Physicians there need to be at the forefront of the organizational challenge in managing and improving health systems. Aim : To collate the views of West African surgeons on how well their educational and professional backgrounds may have prepared them for leadership and managerial roles in health care, and draw appropriate policy implications. Material and Methods : Filled structured questionnaires from 110 surgeons that were attending an annual conference were analyzed. The respondents' bio data, professional, educational, health administrative backgrounds were probed. Their views on justifications for physicians' involvement in health managerial roles, probable influence of some physicians' characteristic traits and professional attributes on health leadership roles, and suggestions for improvement were also collated. Results : 71.8% of the respondents had held or were then holding health-related administrative posts; 90% had attended different varieties of management courses; 95.4% identified physicians as the inherent leaders of the health care team; but only 28.4% adjudged their health management role strongly important (28.4%) among their multi-faceted roles; and they largely agreed that some stated professional and characteristic traits of physicians tend to make them poor leaders and managers. Conclusions : Our findings suggest that the preparations that the respondents got from their formal and professional education for leadership and managerial roles in health care were not optimal. We recommend for a paradigm shift for physicians on health leadership issue which is to be facilitated by a well-focused short time duration health management course for all physicians, particularly specialists.

Objective: To assess the knowledge, beliefs, and practices among participants with diabetes mellitus (DM) receiving care at a tertiary government hospital in Calabar, Nigeria, on DM and diabetic eye disease. Materials and Methods: A hospital-based, cross-sectional study where serial recruitment of consenting participants was performed. Ethical approval was obtained from the hospitals’ ethics committee. Data were obtained using a structured interviewer-administered questionnaire. Data were collated and analyzed using the SPSS for Windows (version 20; SPSS Inc., Chicago, Illinois, USA). Categorical variables were presented as frequencies and continuous variables as means. Results: Of the 123 study participants, majority 87 (70.7%) were females and 36 (29.3%) were males. Forty-three (35%) had a duration of DM greater than 10 years. A total of 54 (44%) had good knowledge of DM. One hundred and six (86.2%) had the knowledge that regular eye checkups for a diabetic person was important, and 92 (69.9%) knew that DM could affect vision, whereas 84 (68.3%) believed that DM frequently affects vision. Eye-health-seeking behavior was good in 83 (67.5%) of participants, and an ophthalmologist was the medical personnel sought for by most participants. Conclusion: The knowledge of diabetic eye disease as a potential cause of vision loss among study participants was good. However, the knowledge on DM was poor in majority of study participants. The beliefs and practice toward eye-health were also good. Sustained health education including eye health education will most likely improve the knowledge base of DM and encourage early presentation for eye evaluation in patients with DM.

Background: Corneal diseases are major causes of severe visual impairment and blindness in developing countries, unfortunately. Keratoplasty, which is a major treatment modality, is either nonexistent or at its infancy in these climes. Indications for penetrating keratoplasty (PKP) and the short-term success and survival rates vary in different geographical locations. We sought to evaluate the indications and short-term success rates of penetrating keratoplasty (PKP) in a Nigerian Private Practice Setting in South South Nigeria. Patients and Methods: It was a retrospective audit of 12 patients that had undertaken PKP in the hospital by December 2017. Data obtained from medical records included demographic information like age and sex. Others included preoperative diagnosis, indications for surgery, and pre- and postoperative best corrected visual acuity (BCVA) of subjects. Other information included intraocular pressure pre- and postoperatively, levels of corneal clarity, presence of other ocular comorbidities, and documentation of preoperative graft failure risk assessments. All patients in the series had optical penetrating keratoplasty, performed by a single experienced surgeon for purpose of vision restoration. Results: The mean age of the patients was 50.1 years, with a standard deviation of ± 15.5 years. The indications for PKP were bullous keratopathy seven (58.3%) and five corneal scars (41.7%). The etiological distribution was six patients with pseudophakic bullous keratopathy, one patient was postuveitic bullous keratopathy, three patients were postinfectious corneal scar, and two patients were postmeasles adherent leucomatous corneal scar. Pre-PKP 10 patients (83.4%) were corneal blind on the affected eye and the corneal clarity grades were 2 patients (16.7%) in grade 0, 7 patients (58.3%) in grade 1, and 3 patients (25.0%) in grade 2. At 6 months post-PKP, three patients (25.0%) remain blind in the affected eye, two patients (16.7%) in pre-PKP blind category moved to SVI, one patient (8.3%) with SVI and five patients (41.7%) with blindness at pre-PKP had respectively moved to MVI, and one patient (8.3%) with MVI at pre-PKP had regained normal vision. At 6 months post-PKP, corneal clarity improved from grades 0–2 to grades 3 and 4, in 25% and 75% of the patients, respectively, compared to the pre-PKP grades 0, 1, and 2, in 16.7%, 58.3%, and 25.0% of patients, respectively. Conclusion: In this study, bullous keratopathy and corneal scar were the main indications for penetrating keratoplasty. The short-term (6 months) success and survival of corneal grafts were reasonably good.

Aim: To find out the short-term outcome of ciliary ablation with diode laser contact cyclophotocoagulation in Nigerians with neovascular glaucoma. Methods: The study is a retrospective, non-comparative, interventional case series. Demographic data, ocular and systemic history were obtained. Clinical examination included visual acuity, intraocular pressure, number of intraocular pressure-lowering medications and type of treatment administered at the time of NVG diagnosis. Treatment with diode laser cyclophotocoagulation was instituted. Short-term outcomes were observed and patients were followed-up for three months. Results: The study included 3 eyes of 3 patients; all above 40 years, 1 female and 2 male. At the time of NVG diagnosis, all three patients presented with severe ocular pain, and had VA between PL and NPL. Intraocular pressure on the average was 33mmHg at presentation, and associated with corneal oedema. At 3 months after initial diode laser photocoagulation (DLPC), the VA remained the same in all patients. No patient required repeat treatment. Pain reduction and lowering of the intraocular pressure were achieved at 3 months followup post-DLPC without anti-glaucoma medication. Conjunctival burns and chemosis were seen. All three eyes had corneal oedema and spontaneous hyphema by the 7 day; with subsequent s th evere corneal blood stain. Conclusions: Diode laser photocoagulation can be used as an acceptable non-invasive surgical intervention for the reduction of pain and lowering of intraocular pressure in Nigerians with neovascular glaucoma. Most shortterm complications are uneventful. The presence of hyphema with corneal oedema may enhance the occurrence of corneal blood stain in black people. The presence of corneal oedema may thus be a risk factor for corneal blood staining. Key words: short-term outcome, diode laser, corneal staining

Aim: To document and share our experience in setting up a Child Eye Care Centre within a rural mission eye hospital and document subsequent development of services. Method: The location of the project was Mercy Eye Hospital (MEH) Abak, Akwa Ibom State in the South South zone of Nigeria). Consent to commence the Child Eye Care Centre was obtained from the base hospital proprietor of MEH as well as the University of Calabar Teaching Hospital management. Services were subsidized or free. Appraisal of the project was done, for the period January to December 2003. Results: A total of 520 children were seen. Eighty per cent of children came from the South-South zone. The age group 0-5 years made up 42% of attendees, while 74% of all the attendees were males. The major causes of bilateral surgical ocular morbidity included cataract 24 (4.6 %), glaucoma 6 (1.2 %) and retinoblastoma 4 (0.7%).Causes of non-surgical ocular morbidity were refractive errors 32 (6.2 %) and vernal conjunctivitis 12 (2.3 %). Penetrating ocular trauma, 12 (2.3 %), was the main cause of uniocular pathology. Operations performed were cataract extraction, trabeculectomy, corneal/corneoscleral repairs, and enucleation. Glasses were dispensed to those in need and a short course in child eye health was held for capacity building. Conclusion: This report shows the need for specialized child eye care services in the South-South zone of the Niger Delta region of Nigeria. There is a great potential for further development of the centre. Keywords : Child eye care centre, Requirements, Challenges PHMJ Vol. 2 (2) 2008: pp. 118-125

This paper presents health outcomes and associated socioeconomic factors of 41 children admitted to a tertiary care institution in south-east Nigeria with Burkitt's lymphoma (BL) between 1987 and 2004. BL responds well to chemotherapy and does not pose a significant threat to health in industrialized nations. However, in resource-poor settings where it is endemic, socioeconomic factors significantly affect access to care for affected children, making this readily treatable condition a cause of considerable distress and early death in affected children. Half of the children reported in this paper presented with late stage disease. Although laboratory facilities were available, they were not accessible to all the children. Nearly a quarter of parents of these children could not afford the cost of confirmatory tests, and about a fifth (n = 8; 19.5%) of the children received no chemotherapy because of their parents' inability to pay. Only 21 of 41 children (51.2%) remained on treatment long enough (at least 12 weeks) to enable them to be confirmed either as short-term cure (n = 9; 64.3%), or as early relapse (n = 2; 4.9%). Owing to financial constraint, 13 of the parents (31.7%) withdrew their children against medical advice (n = 7; 17.1%) or left the hospital (n = 6; 14.6%). To address the challenge posed by these factors, we call for the establishment of a regional BL programme in Africa to help establish a critical mass of resources (human and material) to facilitate the development of an effective and accessible control programme in the region.

Background: Cataract is the leading cause of blindness in developing countries. Phacoemulsification is beyond the reach of many in these resources limited setting. Manual Small Incision Cataract Surgery (SICS) is a safe, low-cost, high-quality alternative. This is a review of outcome of SICS performed by trainee Surgeons during the first SICS training course in our centre. Patients and Methods: Eleven experienced Extracapsular Cataract Extraction (ECCE) surgeons from training centers across Nigeria were selected for a weeklong SICS training and conversion course. A review of visual outcome and complications of surgeries performed by these trainees on adult subjects is here reported. Results: Eighty-two eyes met the inclusion criteria. Male to female ratio was 1.4:1. Intraocular lenses were implanted in 80 eyes (97.5%). Visual outcome at 3 months post-operatively was good in 58 eyes (70.7%), borderline in 20 (24.4%), and poor in 4 (4.9%) subjects. The most common late post-operative complication, resulting in poor outcome was uncorrected aphakia in 2 (2.4%) eyes. Conclusion: The outcome did not meet World Health Organization (WHO) recommendations but was better than that reported for ECCE in the country. Conversion to SICS may not be difficult for competent ECCE surgeons as trainees achieved reasonable dexterity with acceptable post-operative outcome and complications profile in one week. To maximize patient safety and good outcome, a longer training period is recommended.

Background: Glaucoma is a common cause of blindness in developing nations. The objective of this study is to determine the severity of primary open angle glaucoma and audit health records of glaucoma patients in our center. Materials and Methods: A retrospective case note search of glaucoma patients from out-patient clinic was carried out between January 2001 and December 2010. Data analysis included descriptive statistics and exact binomial 95% confidence interval (CI) calculated for the mean estimates. Results: Seventy-six patients (152 eyes), comprising 49 (64.5%) males and 27 (35.5%) females were included in the study. The age ranged from 15 to 88 years (mean: 54.2 ± 14.5). Forty-five (59.7%) presented with normal vision and 10 (13.2%) had visual acuity 0.6 0.9 = 35 (46.1%) and left eyes were 15 (19.7%), 29 (38.2%), 28 (36.8%), respectively. Mean intraocular pressure (right eyes) at presentation was 20.3 mmHg (95% CI, 17.4-23.3) and reduced to 13.4 mmHg (95% CI, 10.7-16.0) at the last readings while left eyes from a mean of 20.3 mmHg (95% CI, 16.9-23.8) reduced to 12.1 mmHg (95% CI, 10.0-14.3). The mean presenting CDR were 0.79 (95% CI, 0.74-0.83) and 0.73 (95% CI, 0.68-0.79) in right and left eyes, respectively. CDR showed statistical significance with age ( p 2 -test) but not with sex ( p = 0.807). Conclusion: Late presentation of glaucoma cases is a major problem in Calabar. We recommend public enlightenment, case detection, and early treatment to reduce ocular morbidity.