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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 (

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

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.