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Aim This study aimed to differentiate moderate to high myopic astigmatism from forme fruste keratoconus using Pentacam parameters and develop a predictive model for early keratoconus detection. Methods We retrospectively analysed 196 eyes from 105 patients and compared Pentacam variables between myopic astigmatism (156 eyes) and forme fruste keratoconus (40 eyes) groups. Receiver operating characteristic curve analysis was used to determine the optimal cut-off values, and a logistic regression model was used to refine the diagnostic accuracy. Results Statistically significant differences were observed in most Pentacam variables between the groups ( p  < 0.05). Parameters such as the Index of Surface Variance (ISV), Keratoconus Index (KI), Belin/Ambrosio Deviation Display (BAD_D) and Back Elevation of the Thinnest Corneal Locale (B.Ele.Th) demonstrated promising discriminatory abilities, with BAD_D exhibiting the highest Area under the Curve. The logistic regression model achieved high sensitivity (92.5%), specificity (96.8%), accuracy (95.9%), and positive predictive value (88.1%). Conclusion The simultaneous evaluation of BAD_D, ISV, B.Ele.Th, and KI aids in identifying forme fruste keratoconus cases. Optimal cut-off points demonstrate acceptable sensitivity and specificity, emphasizing their clinical utility pending further refinement and validation across diverse demographics.

Purpose To assess the Quality of Life (QoL) and understand the clinical characteristics of patients in Ghana presenting with RRD compared to age-matched controls. Methods This prospective case-control study included patients presenting with RRD at a tertiary hospital in Ghana between July 2021 and June 2022 compared to age-matched unaffected individuals. QoL was evaluated using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Demographic and clinical characteristics were analysed. Results Among 180 participants (57 RRD cases, 123 controls), QoL scores ranged 50–70 for RRD patients and 60–90 for controls. The overall composite score of NEI-VFQ-25 in the RRD patients (mean 61; SD 12) was significantly lower than that of controls (mean 78; SD 15), including 8 of 12 QoL subscales ( p  < 0.001). The lowest subscale scores for RRD cases were vision-specific role difficulties (mean 48; SD 8). Floaters were the most common presenting symptom among RRD cases (75.4% vs. 1.6%) ( p  < 0.001). RDD patients presented to a primary eye centre after an average 30.8 days (SD = 70.0) and to a tertiary centre after 200.4 days (SD = 306.8). Conclusion There is a significant reduction in the QoL for RRD patients. Early diagnosis and management of RRD are essential to mitigate the adverse impact on QoL and prevent further complications.

Glaucoma is a leading cause of irreversible blindness worldwide, with a disproportionate burden in Sub‑Saharan Africa. Identifying sociodemographic and clinical determinants is critical for early detection and prevention. This study identified glaucoma risk factors in Ghanaians and evaluated their prognostic significance. A prospective hospital-based case-control study conducted at a tertiary hospital in Ghana from 1st October to 31st December, 2021, including 150 glaucoma patients and 150 age- and sex-matched controls. Sociodemographic and clinical data were collected. Predictive risk factors were assessed via multivariate logistic regression in SPSS version 25. Statistical significance was set at  < 0.05. Three hundred participants were recruited, including 178 (59%) females. Mean ages of glaucoma patients and controls were 58.4 ± 17.4 and 52.35 ± 18.5 years, respectively. Primary open-angle glaucoma (POAG) was the predominant type (77.3%). Statistically significant risk factors for glaucoma were: age ≥ 40 years [OR: 3.5, 95% CI: 1.8-6.7,  = 0.001], positive family history [OR: 3.2, 95% CI: 1.7-5.9,  = 0.001], hypertension [OR: 2.7, 95% CI: 1.5-5.0,  = 0.002], myopia [OR: 4.3, 95% CI: 2.1-9.1,  = 0.001], and intraocular pressure (IOP) ≥ 22 mmHg [OR: 4.1, 95% CI: 1.9-8.9,  = 0.001]. Advanced glaucoma at presentation was significantly associated with IOP ≥ 22 mmHg (  = 0.002), myopia (  = 0.001), and hypertension (  = 0.001). POAG was significantly associated with age ≥ 40 years (  = 0.001), family history of glaucoma (  = 0.001), and education (  = 0.031). It was also significantly associated with IOP ≥ 22 mmHg, myopia, diabetes, and hypertension (all,  = 0.001). Age, family history of glaucoma, hypertension, myopia, and elevated IOP were key risk factors. Targeted screening and regular eye examinations among high-risk individuals may facilitate earlier detection and help prevent or delay progressive glaucomatous optic nerve damage.

Background Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana. Methods A descriptive cross-sectional study was conducted. One hundred participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant. Results The mean ± SD age of the participants was 32.05 ± 11.48 years and age range, 18-67 years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death ( p  < 0.05, x 2  = 12.187). Conclusion There is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.

Background There seems a preponderance of hospital-based studies on the prevalence of Allergic Conjunctivitis (AC) compared to community-based ones, particularly among children in Ghana and Africa as a whole. Meanwhile, literature supports the possibility of underdiagnosing AC in the hospital setting; exponentially so when males generally have poor hospital-attending behavior. This may lead to underestimation of the true burden of AC. Consequently, the purpose of the current community-based study was to determine the prevalence of AC among basic school children in the Kumasi Metropolis, while identifying its associated symptoms. Methods A cross-sectional community-based study involving 1571 students from 11 basic schools (Primary and JHS) participated in the study. Data collection started in November 2011 and was completed in March 2014. After history taking, subjects underwent a battery of tests; visual acuity, objective refraction, anterior and posterior segments examination with a slit-lamp and a direct ophthalmoscope respectively. Results The prevalence of AC was 39.9 %. The mean (±SD) age of participants was 8 ± 0.65 years. AC was significantly associated with gender (p < 0.05), but not with age (p > 0.05). A total of 70 % of the students with AC never had any form of treatment. Conclusions AC is an endemic ocular disease among basic schools in the Kumasi metropolis and therefore calls for pragmatic and proactive measures to reduce its burden and effects on its victims. Public health measures may be required to help reduce the burden associated with this condition.

Background/Objective Describe vitreomacular interface abnormalities (VMIA) using spectral-domain optical coherence tomography (SD-OCT), and correlations with age-related macular degeneration (AMD) grade in Ghanaian Africans. Subjects/Methods Prospective, cross-sectional study of adults aged ≥50 years recruited in Ghana AMD Study. Participant demographics, medical histories, ophthalmic examination, digital colour fundus photography (CFP) were obtained. High-resolution five-line raster OCT, Macular Cube 512 × 128 scans, and additional line scans in areas of clinical abnormality, were acquired. SD-OCT VMI features classified by International Vitreomacular Traction Study Group system and relationships to AMD grade were evaluated. Outcomes: VMIA prevalence, posterior vitreous detachment (PVD), vitreomacular adhesions (VMA), vitreomacular traction (VMT), epiretinal membranes (ERM), correlations with AMD grade. Results The full Ghana AMD cohort included 718 participants; 624 participants (1248 eyes) aged ≥50 years (range = 50–101, mean = 68.8), 68.9% female were included in this analysis. CFP with OCT scans were available for 776 eyes (397 participants); 707 (91.1%) had gradable CFP and OCT scans for both AMD and VMI grading forming the dataset for this report. PVD was absent in 504 (71.3%); partial and complete PVD occurred in 16.7% and 12.0% respectively. PVD did not increase with age ( p  = 0.720). VMIA without traction and macular holes were observed in 12.2% of eyes; 87.8% had no abnormalities. VMIA was not significantly correlated with AMD grade ( p  = 0.819). Conclusions This provides the first assessment of VMIA in Ghanaian Africans. VMIA are common in Africans; PVD may be less common than in Caucasians. There was no significant association of AMD grade with VMIA.

Objective: To evaluate the pattern and incidence of orbital complications due to sinusitis in children in Komfo Anokye Teaching Hospital. Methods: Ninety-two children aged between 2 and 14 years who presented with various orbital complications as a result of sinusitis among 1627 children in a 5-year period were evaluated to analyze the pattern and the incidence of the various stages and forms. Results: Of the 1627 children evaluated, 92 (5.7%) had orbital complications. Among those with complications, 52.2% presented with orbital cellulitis, 22.8% presented with subperiosteal abscess, 14.1% presented with periorbital cellulitis, 8.7% presented with orbital abscess, and 2.2% presented with cavernous sinus thrombosis. Conclusion: Despite the low incidence of sinogenic orbital complications, this study showed that orbital cellulitis is the most common among all orbital complications as a result of sinusitis in children.

“The Theology of Baptism: Equipping Parents to be Christian Educators After Infant Baptism” was an intensive, church-based project which lasted for one year and twenty days respectively. It was constructed to educate eight African-American and two non African-American families (one from Liberia, West Africa and one from Trinidad, West Indies), about the sacrament of Infant Baptism and the role of parents. This project was designed to equip parents to understand the biblically informed responsibilities of training children in spiritual matters, to analyze systematically the mandate for baptism given by the church and to develop in participants the skills needed to formulate rituals to celebrate the first eighteen years of a baptized child's life. The parents were from Goler Memorial African Methodist Episcopal Zion Church located at 630 North Patterson Avenue in Winston-Salem, North Carolina. The Holy Bible is abundantly clear on the role of parents in the life of the child. Proverbs 22:1–6 served as the biblical basis for this project. The particular verse of interest was the 6th verse, which states, “Train up a child in the way the child should go; and when child is old, the child will not depart from it”. Dealing with this verse critically, “train up” is the Hebrew word Chanak, which means to initiate, to teach, to dedicate, to consecrate, and to inaugurate. It also means very early training of children. The assumption of this text is that the ones doing the training have the “know-how” to train a child. The requirement that the bible places upon the parents is the root cause of this project. The distinct purpose of this project was to formulate a theological curriculum of Infant Baptism, to be used to train and equip parents to be the teaching agents of grace and Christian educators as soon as possible after Infant Baptism. In the teaching sessions, parents were evaluated on the nature of Christian baptism and they were provided with the knowledge required to understand the nature and method of nurturing infants to comprehend the doctrines of the Christian faith. The sessions included a pre-test as well as a post-test which was designed to determine the level of knowledge and experience possessed by parents regarding Infant Baptism. Following the pre-test, the participating parents were introduced to the theological foundation of the project (i.e. Proverbs 22:1–6), the problem in the ministry (i.e. adults who had been baptized as infants desired to be re-baptized), and a fifteen hour training session which equipped parents on the fundamentals of the sacrament of Infant Baptism, issues in child psychological development, understanding the stages of faith in the development of faith in the child and finally, the parents were instructed in the process of establishing an eighteen year ritual to celebrate the infant's baptism.

Background: Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana. Methods: A descriptive cross-sectional study was conducted. 100 participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant. Results: The mean ± SD age of the participants was 32.05 ± 11.48years and age range, 18-67years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p<0.05, ᵪ 2 = 12.187). Conclusion: There is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.

The Agricultural Development Bank (ADB) is an important financial organisation and is the main source of credit for agricultural projects in Ghana. The purpose of this study is to examine the procedures and method of analysis in project planning and management adopted by the ADB with the main object of identifying some of the neglected issues and to suggest some methods for improvement.Agricultural project planning and management by the ADB have been found to be plagued by a number of problems and inefficiencies in the areas of identification and selection, formulation, approval, implementation, supervision, monitoring and control. These areas are systematically examined and the main problems and bottlenecks are identified.An examination of the current state of project appraisal methodology is undertaken. The main project appraisal procedures are also reviewed, bringing out the difficulties of economic costbenefit analysis and offering a critique of the appraisal procedures.Suggestions for improving project identification and selection, formulation, implementation and supervision in the ADB are made based on the writer's insights into and experiences of the various problems identified with the production process. Cues are also taken from recommendations made for developing countries by such organisations as the FAO, IBRD and USAID.The major contribution of the study is the use of probability appraisal to analyse risk in a maize and pineapple project financed by the ADB. The Monte Carlo Simulation technique is adapted for use in this analysis. Results from this technique are compared with original results of the same projects obtained by the use of conventional cost-benefit analysis where single value estimations of costs and prices are made.Results from the probability analysis indicate that the methodology enables us to provide management with more appropriate information for making the right decisions by recognising the variability of outcomes of projects in the face of risk and uncertainty. Mean values of three indicators of worthiness obtained under this technique arc also thought to be more reliable and acceptable, especially since we do not have to fear any large variations around these values.Limitations of the analysis and directions for future research are indicated.