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Purpose: To determine the functional vision of pseudophakic children attending a child eye health tertiary facility in southwest Nigeria. Methods: A hospital-based descriptive study of pseudophakic children attending the Pediatric Ophthalmology outpatient clinic of a tertiary facility in southwest Nigeria was conducted between June and November 2021. Details of demography and clinical examination findings were obtained using a semi-structured questionnaire. Information about functional vision was obtained using the Pediatric Eye Questionnaire (PedEyeQ). Data obtained from the PedEyeQ were entered into a Rasch-calibrated PedEyeQ Excel response data sheet. Data analysis was done using Statistical Package for Social Sciences (SPSS) software version 22 (SPSS, Inc). Results: A total of 196 pseudophakic children were recruited. Their ages ranged from 2 to 16 years with a mean of 9.8 ± 3.4 years and there was a male-to-female ratio of 2.2:1. The median functional vision score of pseudophakic children across all age groups was 90.0. The functional vision scores were associated with the laterality of cataract, type of cataract, presence of comorbidities, visual acuity (distance and near) in the better eye, and number of surgeries. Conclusions: The functional vision scores of pseudophakic children were low. Significant predictors of low functional vision scores include surgery for congenital cataract, low average family income, longer duration of time between surgery and recruitment into the study, and poorer best corrected visual acuity in the better eye. The routine assessment of functional vision should be considered an important aspect of pseudophakic children's eye care with a view toward optimizing psychological and social well-being. [J Pediatr Ophthalmol Strabismus. 2024;61(2):138–146.]

PurposeTo compare the prevalences of diabetic retinopathy in diabetes mellitus patients, with and without primary open-angle glaucoma, with a view to determine if glaucoma is a risk factor for the development of diabetic retinopathy. MethodsCross-sectional, comparative study consisting of 86 diabetic patients with glaucoma matched with 86 diabetic patients without glaucoma. The two groups were matched by age, sex and duration of diabetes mellitus. Demographic data were obtained via patient medical records and self-administered questionnaires. Participants underwent a standardized examination protocol including blood pressure measurement and ocular examination. Main outcome measure was the presence of diabetic retinopathy.ResultsTwo hundred and ninety-two eyes (144 glaucomatous eyes and 148 non-glaucomatous eyes) of 172 participants with diabetes mellitus were assessed. The prevalence of diabetic retinopathy among 86 participants with glaucoma comorbidity was 23.6%, while the prevalence among 86 non-glaucomatous participants was 33.8% (p = 0.06).After the regression analysis, controlling for systemic and ocular risk factors for diabetic retinopathy, the odds of developing diabetic retinopathy were significantly higher in the glaucomatous eyes compared with eyes without glaucoma (OR: 2.75; p = 0.03; 95% CI: 1.10–6.87).ConclusionThis study demonstrated that glaucomatous diabetic eyes were almost three times more likely to develop diabetic retinopathy compared to non-glaucomatous diabetic eyes. Prospective studies may be required to establish a risk-cause relationship. Ocular perfusion pressure control should be considered in patients with diabetes mellitus and glaucoma.

Purpose The purpose of this study is to highlight the changing pattern of retinopathy of prematurity (ROP) incidence with improvement in economy and health care in Africa, pointing out the challenges and recommendations for sustainable, cost-effective screening and management. Recent Findings ROP was initially thought to be rare in some parts of Africa. Recent findings have shown this not to be true. Studies done over 2011–2016 reported the presence of any ROP stage in 12–52% of screened babies with the prevalence of treatable ROP at 2.9–9.8%. ROP-trained ophthalmologists available to screen with binocular indirect ophthalmoscope and manage babies are few. Awareness of this blinding disease, disease screening, adequate follow-up, treatment issues, and physician competing duties are the major factors militating against effective ROP programs. Summary Creating awareness and collaboration among stakeholders is urgently needed in most parts of Africa. Cost-effective, regional ROP screening program across several contiguous states using a telemedicine approach with widefield retinal imaging by middle-level personnel is strongly advocated to best address the growing problem of ROP in many parts of Africa.

Visual function is important for optimal orientation in functional and social life, and has an effect on physical and emotional well-being. Visual impairment, therefore, leads to restrictions in all aspects of daily living and is related to quality of life. The aim of this study was to provide information on the causes of visual impairment in patients presenting to their family physician, the spectrum of impairment, and its impact on quality of life for these patients. This descriptive cross-sectional study of 375 adult patients with ocular symptoms was performed in the general outpatient department of the University College Hospital, Ibadan, from July to September, 2009. After checking their presenting visual acuity, the patients were interviewed using the Vision-Related Quality of Life questionnaire to determine the impact of visual impairment on their quality of life. Ophthalmic examinations were performed to determine the causes of visual impairment. The results were analyzed using proportions and percentages. The main causes of visual impairment were cataracts (58.7%), refractive error (19.4%), and glaucoma (2.9%). Visual impairment was found to be associated with advancing age, low education, and unemployment (P<0.001). Most patients (85.1%) were found to have good quality of life overall. Quality of life was found to be poor in the domains of visual function (64.2%) and social interaction (50.9%). Quality of life was found to be related to the degree of visual impairment, ie, blind patients reported poor quality of life (41.4%) when compared with those having low vision (8.6%) or near normal vision (2.4%, P<0.001). This study identified poor quality of life in patients with a higher degree of visual impairment. Family physicians need to identify these visually impaired patients early and make timely referrals.

Vogt-Koyanagi-Harada's (VKH) disease has been reported to be rare in sub-Saharan Africa. Two Nigerians with the disease are presented in this report. The first patient, a 32-year-old pregnant Nigerian woman presented with a 1-month history of bilateral blurring of vision, persistent headache, and alopecia. Presenting visual acuity was 1 m counting fingers in both eyes. Examination revealed vitiligo and poliosis with bilateral panuveitis as well as bilateral exudative retinal detachment. A clinical assessment of complete VKH disease was made. The patient commenced systemic and topical steroids that resulted in remarkable recovery of vision and control of inflammation. The second patient, a 56-year-old Nigerian woman presented with severe headache, tinnitus, and visual loss in both eyes of 2 weeks duration. There was associated redness of both eyes and photophobia. Examination showed visual acuity of Hand motion (HM) and counting fingers at 1 meter (CF). in the right and left eye, respectively, with bilateral panuveitis and bilateral exudative retinal detachment. Subsequent follow-up showed poliosis, vitiligo, and sunsetting fundus appearance. The patient improved with systemic and topical corticosteroids. Developing a high index of suspicion is necessary in diagnosing VKH disease, even in sub-Saharan Africa. Prompt institution of appropriate treatment prevents blindness.

Stargardt's disease is an inherited macular dystrophy that is transmitted in an autosomal recessive or dominant pattern. The disorder is typically characterized by impairment of central vision, with onset around the first 10-20 years of life. Stargardt's disease is rare in sub-Saharan Africa. This is probably the first reported case in the subregion. We present two siblings with the disease. Presentation, pathophysiology, and management modalities are discussed.

The aim of the study was to determine the prevalence and causes of eye diseases and visual impairment in students in the Ilesa East local government area of Osun state, Nigeria. A cross-sectional survey that utilised a multistage random sampling method to select 1,144 primary and secondary school students. A total of 1,144 students (504 males and 640 females) were involved in the study. Their ages ranged from 4 to 24 years. The majority (97.8%) of them were below 18 years of age. A total of 177 (15.5%) of the school children were found to have eye diseases. The major ocular disorders were in the following order: conjunctiva 91 (51.4%), refractive error 66 (37.3%), lid 7 (4.0%), corneal, including staphyloma and keratoconus 5 (2.8%) and then others. These included conjunctival diseases 91 (8%) constituted mainly by allergic/vernal conjunctivitis 85 (7.4%), refractive error 66 (5.8%), lid disorders 6 (0.6%), squint 3 (0.3%), corneal scarring 3 (0.3%) and cataract 2 (0.2%). A total of 15 students were visually impaired, with a prevalence of 1.26%. Only two students were blind, with a prevalence of 0.17%. Causes of visual impairment were refractive error 10 (0.87%), bilateral immature cataract 1 (0.08%), corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and cataract 1 (0.08%). The causes of blindness in students were bilateral corneal scars presumed to be due to vitamin A deficiency in one (0.08%) student and complicated bilateral keratoconus with complicated vernal ulcers in another (0.08%). Eye diseases are common amongst Nigerian students. Eye examination for all new intakes and regular screening in both public and private primary and secondary schools is advocated. Wearing of corrective glasses should be emphasised for children with refractive error. Causes of blindness and visual impairment in children attending regular schools in Nigeria were avoidable.

ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.DesignDescriptive case study.SettingNeonatal intensive care units in Nigeria.ParticipantsStaff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).Methods and analysisA WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017–2018 and to assess challenges in service provision.ResultsIn 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.ConclusionROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.

Background: Visual function is important for optimal orientation in functional and social life, and has an effect on physical and emotional well-being. Visual impairment, therefore, leads to restrictions in all aspects of daily living and is related to quality of life. The aim of this study was to provide information on the causes of visual impairment in patients presenting to their family physician, the spectrum of impairment, and its impact on quality of life for these patients. Methods: This descriptive cross-sectional study of 375 adult patients with ocular symptoms was performed in the general outpatient department of the University College Hospital, Ibadan, from July to September, 2009. After checking their presenting visual acuity, the patients were interviewed using the Vision-Related Quality of Life questionnaire to determine the impact of visual impairment on their quality of life. Ophthalmic examinations were performed to determine the causes of visual impairment. The results were analyzed using proportions and percentages. Results: The main causes of visual impairment were cataracts (58.7%), refractive error (19.4%), and glaucoma (2.9%). Visual impairment was found to be associated with advancing age, low education, and unemployment (PC0.001). Most patients (85.1%) were found to have good quality of life overall. Quality of life was found to be poor in the domains of visual function (64.2%) and social interaction (50.9%). Quality of life was found to be related to the degree of visual impairment, ie, blind patients reported poor quality of life (41.4%) when compared with those having low vision (8.6%) or near normal vision (2.4%, PC0.001). Conclusion: This study identified poor quality of life in patients with a higher degree of visual impairment. Family physicians need to identify these visually impaired patients early and make timely referrals. Keywords: quality of life, visual impairment, blindness, low vision

Background: The prevalence of sickle cell disease (SCD) is high in Nigeria, and macular thinning is one of its ocular complications. However, there are currently no local data in the literature on macular thickness in Nigerians with SCD. This study provides comparative baseline data on the macular thickness profile of an indigenous Nigerian population to address this gap. Aims: To determine the macular thickness of participants with SCD and compare with their age- and sex-matched participants without SCD at the University College Hospital (UCH), Ibadan. Materials and Methods: This was a hospital-based comparative study conducted at the University College Hospital, Ibadan. Patients with SCD aged 18 years and above were age- and sex-matched with non-SCD controls (haemoglobin AA genotype). All participants underwent a full ophthalmic examination, refraction and A-scan biometry and macular thickness was measured with an Optovue iScan spectral-domain optical coherence tomography machine. Data from the left eye of each participant were analysed with IBM Statistical Package for Social Sciences (SPSS) version 25.0. Results: Seventy participants were recruited into the study and 30 (42.9%) were males. The mean age of all the subjects in the study was 35.9 ± 11.0 years. Group 1 (SCD) comprised 19 (27.1%) Hb SS and 16 (22.9%) Hb SC, whereas Group 2 (non-SCD) were 35 (50%) Hb AA subjects. The SCD group had lower mean macular thickness (MMT) of 271.1 ± 20.2 µm compared to non-SCD group with MMT of 278.5 ± 13.5 µm, but this was not statistically significant (P = 0.076). Macular thickness was generally lower in SCD group in all the ETDRS map regions of the macular compared to the non-SCD group with values ranging from 3.0 to 11.5 µm, but statistically significant difference was observed only in the inner inferior macular (P = 0.026) and inner temporal macular (P = 0.046) regions. There was no statistically significant difference in distant visual acuity between non-SCD and SCD participants (P = 0.605). Conclusion: This study observed focal macular thinning in SCD compared to non-SCD. However, focal macular thinning was not associated with poorer distant visual acuity in patients with SCD.