Open Access Commentary

Tackling the Burden of Blindness in Ogun State, Nigeria: The Success of Private / Public Partnerships

Tayo J. Bogunjoko, Adekunle O. Hassan, Karinya Lewis, Toyin Akanbi, Abimbola Ashaye, Ayo Akinye, Halima Bogunjoko

Ophthalmology Research: An International Journal, Page 1-8
DOI: 10.9734/or/2019/v10i230103

Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over the years. A private / public partnership together with private health /education partnership have strengthened government health systems, developing a sustainable model for delivery of eye services to the most indigent. Over the last four years, in Ogun state, screening for cataract alone has increased in fourfold and the number of cataracts surgeries performed, threefold. However, ongoing subsidising of surgeries may be needed until local health insurance schemes or other ways of financing eye care become reliable. Tackling health beliefs about eye care remain one of the main barriers to uptake of services.

Open Access Original Research Article

Study of Outcome of High Volume Manual Small Incision Cataract Surgery and Complications in Garhwal Himalayan Region

Achyut N. Pandey, Manoj Tyagi

Ophthalmology Research: An International Journal, Page 1-7
DOI: 10.9734/or/2019/v10i230100

Aim of the Study: To compare High Volume with Low Volume Cataract Surgery Outcomes in a tertiary eye care hospital in Garhwal Himalayan Region, over a 30-day period, in terms of Quality as gauged in terms of Intra-operative complications and their management and Post-operative complications and their management (on day 1 and day 30).

Materials and Methods: A prospective, randomized, observational study conducted on 300 eyes of 300 patients at a tertiary hospital, total duration of 4 months was taken for data collection. Patients were divided into 2 groups: A) those coming in the low volume season (summer months) and B) those coming in the high volume season (winter months). Normal standard protocols were followed pre/per/post operatively.

Results: Intra-operative complications between the two months (settings) by independent t-test the p value was 1.00 which was not statistically significant (mean of complication: August=0.86+1.83; December=0.86 + 1.29). 1 month post-operative complications between the two months (settings) by independent t-test the p value was 0.56 which was not statistically significant (mean of complication: August=0.09 + 0.30; December=0.18 + 0.4).

Conclusion: Intra-operative, post-operative complications on 1st day and at one month follow up, High Volume Cataract Surgery (greaterthan 40 Manual Small Incision Cataract surgeries) does not affect the quality when compared with Low Volume Cataract Surgery over a 30-days period in a tertiary institute in Central India.

Open Access Original Research Article

Demographics and Referral Pattern of Patients with Glaucoma at a Tertiary Eye Hospital in Port Harcourt, Nigeria

Elizabeth A. Awoyesuku, Ireju O. Chukwuka

Ophthalmology Research: An International Journal, Page 1-7
DOI: 10.9734/or/2019/v10i230101

Aims:  To assess the demographic characteristics and referral pattern of patients with glaucoma presenting at the University of Port Harcourt Teaching Hospital.

Study Design: A hospital-based cross- sectional study.

Place and Duration of Study: The Ophthalmology department, University of Port Harcourt Teaching Hospital between November 2018 and January 2019.

Methodology: Ninety-four (94) consenting consecutive Primary open angle glaucoma (POAG) patients above 18 years attending the glaucoma clinic of the Ophthalmology department of the hospital were recruited. All patients had a comprehensive eye examination and were diagnosed as POAG patients and were receiving treatment. Patients with secondary glaucoma were excluded from the study. A questionnaire was used to retrieve information on sources of referral, and distance travelled to assess care.

Data analysis employed the Epi Info Version 7.1.4. Significant differences in the comparison of means were determined by independent t-test while the difference in proportions was determined using Chi square statistics. Statistical significance was set at p=.05

Results: A total of 94 glaucoma patients on treatment at our facility were involved in the study. Mean age was 48.49±11.46years. Age range was 25-78years with M: F ratio =1.6:1. 36.2% had secondary education. Majority of referrals (36.3%) were by fellow patients, and most patients (42.6%) travelled less than an hour to access care. 68.1% had prior awareness of glaucoma before visit to clinic. Majority of patients had advanced glaucoma (45.7%) at presentation.

Conclusion: A large proportion of POAG patients presenting in our facility had advanced glaucoma and most referrals were from patients already accessing care and media. Advocacy to improve awareness and prompt referral of affected patients will help to reduce the problems associated with glaucoma in our environment

Open Access Original Research Article

Experience with Retinoblastoma at a Tertiary Centre in Port Harcourt, Nigeria: Trends in Outcome

Gracia Ker Eke, Adedayo Omobolanle Adio

Ophthalmology Research: An International Journal, Page 1-9
DOI: 10.9734/or/2019/v10i230102

Background: Retinoblastoma is the most common primary intraocular malignancy in children, and remains the most curable of all childhood cancers in the developed world. However, ocular and patient survival rates have remained very low in resource limited countries, where more than 90% of children with retinoblastoma live.

Objectives: To review the pattern of presentation of children with retinoblastoma at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria, and compare their treatment outcome with what was obtained in the previous decade in same centre.

Methods: All patients with retinoblastoma admitted into the Paediatric Oncology Unit of the UPTH from January 2011 to June 2017 were reviewed. Their demographics, clinical profile and outcome of treatment were analyzed using SPSS version 20.0.

Results: Nineteen children had retinoblastoma which represented 11% of all childhood malignancies. Eight(42%) males and 11(58%) females, all under-fives, were studied with M:F=1:1.4. Mean duration of symptoms was 29.6 weeks, with majority (73.7%) having been ill for more than 3 months. White spot in the eye and eye protrusion were commonest presenting complaints while loss of vision was found in all affected eyes. More children (57.8% versus 30.8% previously) were lost to follow up, 5(26%) died and 3(15.7%) completed treatment, whereas none did a decade earlier.

Conclusion: Retinoblastoma affected only under-five children. Late presentation with proptosis and loss of vision were common presenting features. A marginal improvement in outcome was noted while high default rate and lack of radiotherapy facilities in the State had remained important challenges to completion of therapy.

Open Access Original Research Article

Non-traditional Route for Three Antifungal Drugs in Fungal Keratitis Treatment

Christine R Sedhom, Mohamed S Abdel-Rahman, Mohamed S Hussein

Ophthalmology Research: An International Journal, Page 1-11
DOI: 10.9734/or/2019/v10i230104

Aims: This study aims to evaluate the efficacy of the intrastromal route of antifungal drugs in treatment of fungal keratitis.

Study Design:  Prospective non-controlled (single arm) interventional clinical study Place and Duration of Study: Ophthalmology Department, Assiut University Hospital, between March 2016 to November 2017.

Methodology: Corneal scrapings for direct smears and cultures were done for eighteen eyes of 18 consecutive patients and intrastromal injections were given according to sensitivity results.

Results: After one month of follow up of the cases in this study, 33.3% of the cases had rapid complete cure and the rest had incomplete cure with resolution of ulcer sizes by 55.34% ±6.78 after one or more intrastromal injection of antifungal drugs.

Conclusion: Intrastromal injection of antifungal drugs in treatment of fungal keratitis shows promising results in advanced cases of fungal keratitis when combined with the topical route.