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Background: Corneal ulceration is sight-threatening. Accurate determination of the pattern, causative organisms and factors affecting severity and outcome will guide management. Objectives: To determine the pattern and microbiological diagnosis of corneal ulcers seen at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). Materials and Methods: This was a longitudinal descriptive study of all consenting consecutive corneal ulcer patients managed at AEFUTHA from December 2018 to December 2019. Socio-demographic data, relevant history, clinical and laboratory findings were documented. Data was analysed using Statistical Package for Social Sciences (SPSS) version 22. Findings: There were 18 corneal ulcer patients among the 3853 consecutive new patients seen within the study period (a hospital prevalence rate of 0.47%). All 18 patients were recruited. They were aged 23 to 84 years; mean age was 50.4 ± 15.7. Majority were females 11(61.1%); 50% were farmers; 50% had preceding eye injury; 94% practiced prior self-medication; 72.2% presented ≥ 2 weeks after onset of symptoms. The ulcers were mostly central (61.1%); wide (>5 mm) 77.8% and deep (posterior stromal) 77.8%. Microorganisms isolated from 11(61.1%) specimens were: bacteria 6 (54.5%); fungi 4 (36.4%); acanthamoeba 1 (9.1%). Bacterial isolates were: staphylococcus aureus (5.6%) and pseudomonas aeruginosa (5.6%). Conclusion: Corneal ulcers presenting at AEFUTHA were severe (centrallylocated, wide and deep) with poor visual outcome after treatment. The microbial isolates were bacteria, fungi and acanthamoeba. Late presentation after prior self-medication was common. Public education on early hospital presentation is necessary. Corneal transplant services are also needed for visual rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: To determine the current status and challenges of subspecialty eye care service delivery in Nigeria Study Design: Cross sectional descriptive study Setting: Ophthalmological society of Nigeria (OSN) conference Subjects or participants: Nigerian Ophthalmologists participating in the annual OSN conference. Interventions: Data of current status of eye care services and challenges of subspecialty practice were collected using a pretested self-administered questionnaire. Chi-square test was used to determine associations at a P-value of 0.05 Results: There were a total of 136 respondents; 60 males and 76 females. Highest age range of respondents was 41-50years. About 44.1% had undergone some form of subspecialty training. The commonest area of specialization was Glaucoma (13.2%) while the least area was Neuro-ophthalmology (1.5%). There were more subspecialists in the western region of the country. The major constraint for undergoing subspecialty fellowship was lack of funds. The major barrier to setting up subspecialty practice on completion of training was Lack of equipment for subspecialty practice. Majority of the present subspecialists got international sponsorship for their subspecialty training while those without subspecialty training cited cost as a major impediment to training. Conclusion: Subspecialty training and implementation is still developing in Nigeria. A major intervention has been put in place by CEHC, ICO and Fred Hollows foundation training some number of ophthalmologists. Subspecialty [ABSTRACT FROM AUTHOR]

Background A child's learning ability depends on vision, and visual impairment negatively affects neurological, intellectual, and emotional development by limiting children's exposure to a range of experiences and information. This study aims to determine the prevalence and pattern of ocular morbidity among primary schoolchildren in Abakaliki and provide evidence that can be used in planning a school eye health program for the state. Methodology A school-based, cross-sectional study was conducted within the Abakaliki metropolis between January and April 2018 to determine the ocular health status of schoolchildren recruited using stratified random sampling. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA) and presented using descriptive statistics. Univariate analysis was performed to determine the association between dependent and independent variables, with the level of significance determined by a p-value <0.05 (95% confidence interval (CI)). Results A total of 553 schoolchildren aged 6-16 years were examined. The prevalence of eye disorders was 23.5%. Common disorders included refractive error (12.7%) and allergic eye disease (7.1%). Other findings included glaucoma suspect (15, 2.7%), infective conjunctivitis (1, 0.2%), amblyopia (3, 0.5%), cataract (1, 0.2%), and squint (1, 0.2%). The prevalence of visual impairment was 3.1%. Univariate analysis showed a significant association between ocular morbidity and attending private schools (95% CI = 6.5-11.1, p = 0.003). Conclusions Eye disorders such as uncorrected refractive error and allergic conjunctivitis were common among schoolchildren. School eye health programs can ensure that eye screening is done periodically, allowing for early detection, referral, and prompt treatment of eye diseases that can potentially cause visual impairment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Aniemeka et al.)

Background: Schoolteachers who have knowledge on eye diseases can detect early children with eye disorders and refer them promptly to an eye specialist. The aim of this study is to assess the effectiveness of teachers in a vision screening program for primary school children in Abakaliki., Methods: This descriptive cross-sectional study was conducted among 20 randomly selected primary schoolteachers in Abakaliki to screen for vision abnormalities and detect eye problems among 350 children from 5 schools. Teachers participated in a 2-day training using a modified training algorithm on vision screening using a Snellen's chart and in the identification of common ocular abnormalities. Data was analysed using IBM SPSS version 26 statistical program and a p-value of <0.05 at 95% confidence level was statistically significant., Results: A total of 379 children were enrolled into the study however, 350 (92.3%) children participated in the study. School teachers correctly identified 283 (92.8%) children who had normal vision and 33(73.3%) who had impaired vision. Overall 60 (17.1%) children with perceived eye defects were referred to the ophthalmologist for re-examination. Refractive error and allergic conjunctivitis were the most common eye problems identified and children with refractive error and other ocular morbidity were referred to the base hospital., Conclusion: Teachers are a valuable resource in the detection of eye disorders among school children. Their effectiveness can be further enhanced by regular training, and collaboration with eye care professionals. Addressing these limitations through policy implementation can lead to better eye health outcomes for school children in Nigeria., (© Association of Resident Doctors, UCH, Ibadan.)

Background: Phthisis bulbi is an irreversible cause of visual loss with insufficient evidence about its aetiology and status of patients' fellow eyes., Objectives: To identify the distribution of patients with phthisis bulbi and determine the status of their fellow eyes at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria., Methods: We analysed data retrospectively retrieved from medical records of patients diagnosed with phthisis bulbi at initial clinic visit from January 2008 to December 2017. Information abstracted included biodata, laterality of phthisical eye, duration and aetiology of phthisis bulbi, visual acuity, and morbidities present in fellow eyes., Results: Seventy-nine patients presented with unilateral phthisis bulbi. The mean age was 51±21.2 years and forty (50.6%) were males. The commonest aetiologies of phthisis bulbi were trauma 37 (46.8%), infection 17 (21.5%) and uveitis/inflammation 11 (13.9%). Seventy (88.6%) patients had morbidities in their fellow eye such as glaucoma 26 (32.9%), refractive errors 23 (29.1%) and cataract 22 (27.9%). Forty (50.6%) patients were either visually impaired or blind in their fellow eye (p=0.001)., Conclusion: The commonest cause of phthisis bulbi was trauma. Approximately nine out of ten patients had ocular morbidities in their fellow eye. A thorough follow-up of patients with phthisis bulbi is recommended., (© 2021 Adewara BA et al.)

Purpose: To report the outcomes of external dacryocystorhinostomy (Ext DCR) in paediatric patients., Methods: A single-centre, retrospective, interventional, non-comparative case series was performed on all paediatric patients who underwent Ext DCR between July 2010 and July 2014. Surgery was performed as per standard Ext DCR protocols with only anterior flap suturing. Data collected include demographics, clinical presentations, primary diagnosis, associated systemic anomalies, past interventions, indications for the surgery, use of adjuvants, intraoperative and post-operative complications, aetiology of DCR failure, anatomical and functional successes., Results: 135 eyes of 114 children underwent Ext DCR during the study period. Mean age was 9.68 ± 4.36 years and epiphora was the most common presentation (92.5%, 125/135). Persistent congenital nasolacrimal duct obstruction refractory to earlier interventions of probing or intubation was the most common indication for the surgery noted in 57% (77/135). Adjuvants like mitomycin C and intubation were used in 70% (95/135) and 72% (98/135) of the surgeries, respectively. At a 6-month follow-up, anatomical and functional successes were noted in 91.1% (124/135) and 90.3% (123/135), respectively. 12 eyes showed anatomical failure and one eye showed functional failure. The most common cause of DCR failure was a complete cicatricial closure of the ostium (83.4%, 10/12)., Conclusions: This study shows that Ext DCR is a safe surgery for paediatric populations with a high success rates of beyond 90%.

Aim: To determine whether evisceration with optic nerve disinsertion and nonporous implant placement increases the risk of implant migration., Methods: This was a single-center, retrospective consecutive comparative interventional case series including patients undergoing evisceration with nonporous implant between January and December 2014. Patients were grouped into 2 groups: group I where the optic nerve was not disinserted (n = 37) and group II with optic nerve disinsertion (n = 50). Implant migration was assessed clinically and on patient photographs. Migration was subclassified as decentration that did not affect the prosthetic outcome and displacement that affected the prosthetic outcome. The secondary outcome measures were the mean implant diameter, volume of the custom ocular prosthesis, and implant-related complications like exposure and extrusion between the 2 groups., Results: At a mean follow up of 12.5 months, none of the sockets in group I and 3 (6%) sockets in group II (p = 0.35) had evidence of implant decentration. There were no cases of implant displacement in both groups. The mean implant diameter in group I was 16.97 mm ± 0.65 mm and in group II 19.2 mm ± 0.83 mm (p = 0.0001). Implant extrusion was not different between the 2 groups. The mean custom ocular prosthesis volume in group I was 3.86 ml ± 0.52 ml and in group II 2.50 ml ± 0.68 ml (p < 0.0001)., Conclusions: The rate of nonporous implant migration due to optic nerve disinsertion is not statistically or clinically significant in evisceration with optic nerve disinsertion, allowing placement of a larger implant and fabrication of a custom ocular prosthesis with an ideal weight.

Purpose: To investigate the quality and accuracy of three-dimensional spectral-domain optical coherence tomography (OCT)-guided corneal incisions with the Catalys precision femtosecond laser system (OptiMedica, Sunnyvale, CA) in living human tissue., Methods: In vivo cataract and intrastromal corneal incisions were made with a femtosecond laser designed for cataract surgery with a patient scheduled for enucleation., Results: An accurate correlation between the pre-incision spectral-domain OCT and the post-incision histology was demonstrated., Conclusions: The OCT-guided femtosecond laser is capable of creating accurate, precise, and histologically demonstrable incisions in preselected intrastromal locations., (Copyright 2013, SLACK Incorporated.)

Purpose: To report femtosecond laser-assisted cataract surgery in pediatric Marfan syndrome., Methods: Case report., Results: A 10-year-old boy with ectopia lentis due to Marfan syndrome underwent femtosecond laser-assisted cataract surgery (Catalys Precision Laser System; OptiMedica, Sunnyvale, CA) under general anesthesia. Anterior capsulotomy was performed on the decentered lens. Routine irrigation/aspiration devices were used for lens and cortex removal. Centration of the capsular bag was achieved using a Cionni scleral fixation ring. A foldable intraocular lens was implanted. A free-positioned and precise sized capsulotomy was cut by the femtosecond laser. No intraoperative or postoperative complications were observed within the 10 weeks of follow-up., Conclusions: The use of a femtosecond laser has potential to perform a circular, well-centered capsulotomy for subsequent capsular tension ring and intraocular lens implantation without decentration in patients with Marfan syndrome., (Copyright 2013, SLACK Incorporated.)