Background: Strabismus is the most common amblyogenic factor and approximately 40% of children with manifest strabismus have amblyopia. In Nigeria, it is generally believed that strabismus is not common. However, few studies have been done to determine the prevalence of strabismus in Benin City, Edo State. Objective: This study aims to determine the prevalence and pattern of tropias and phorias in primary school children in Benin City. Methods: This was a cross-sectional study carried out on primary school pupils in government schools located within Egor Local Government Council Area, Edo State. Results: Two thousand one hundred and thirty-nine students (2139) were examined. There were 1024 males (47.87%) and 1115 females (52.13%). The overall prevalence of tropias in this study was 0.89%. Esotropia was seen in 0.56% (12 pupils, SE 0.03%) and exotropia in 0.33% (7 pupils, SE 0.02%) of the pupils. Infantile esotropia was the most common form of esotropia while alternating exotropia was the most common pattern of exotropia. 57.04% of the pupils had heterophoria. Conclusion: The prevalence of manifest strabismus in Benin City was low however there should be training of non-ophthalmic staff such as teachers to detect and refer cases of strabismus.

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Purpose: The aim of this study was to report the types and severity of glaucoma at presentation in patients attending the glaucoma clinic of the University College Hospital, Ibadan, Nigeria. This information will help in designing an awareness and management strategy that will help in reducing glaucoma blindness. Materials and Methods: Consecutive new glaucoma patients of all age groups who presented to the glaucoma clinic of the University College Hospital, Ibadan, over a 1-year period between January and December 2009 were evaluated. Each patient had a complete ophthalmic evaluation, including intraocular pressure (IOP), visual acuity, visual field, optic disc assessment and gonioscopy. Results: A total of 336 patients (669 eyes) presented with glaucoma (mean age was 56.5 ± 16.5, 56.3% male) during this period. The mean presenting IOP was 23 ± 11.6 mmHg and 48.5% of the 669 eyes evaluated had severe glaucoma (MD > −12dB, cup to disc ratio of ≥0.9). Primary open angle glaucoma (POAG) was the most common form (51.2%), glaucoma suspects were 55 (16.4%), 66 (19.6%) patients had normal tension glaucoma (NTG), 28 (8.3%) patients had primary angle closure glaucoma (PACG), and 15 (4.5%) patients had secondary glaucoma. Conclusion: POAG is the most common form of glaucoma seen in the glaucoma sub-specialty clinic in Nigeria. NTG and PACG were common in this case series. A large proportion of the patients had advanced disease at presentation.

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Purpose: To review updated knowledge on the epidemiology, pathogenesis, clinical features, and treatment of microbial keratitis (MK). Source of Data: International and local journals containing current literature on MK were sourced through the Internet. Study Selection: Findings consistent with our objectives were compiled and reviewed. Data Extraction: Data were extracted using endnotes. Results: MK is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. The pathogenesis comprises molecular mechanisms describing microbial activities which involve virulence and host factors responsible for ocular tissue damage and progression in keratitis. Clinical features include redness, pain, tearing, blurred vision, and inflammation, but symptoms vary depending on the causative agent. The primary treatment goal is the elimination of causative organism in addition to neutralization of virulence factors and healing of damaged host tissue. A timely review of our current understanding of MK with the recent advances in its treatment will ensure improved management outcomes. Conclusion: Optimal outcome from management of MK will require an updated knowledge of its pathogenesis, clinical features, and treatment protocols, especially in sub-Saharan Africa where its prevalence is on the increase.

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Objectives: (1) To review literature on the current understanding of the nature and pathogenesis of pterygium. (2) To highlight the recent advances in the treatment of pterygium. Materials and Methods: Relevant subheadings were entered into PubMed search engine and 165 articles addressing our objectives were retrieved and reviewed. Results: Pterygium may be proliferative rather than degenerative in nature. There is a strong correlation with ultraviolet radiation. Genetic alterations occur, such as point mutations of proto-oncogenesis such as Kirsten-Ras and alterations in the expression of tumor suppressor genes (TSGs) (p53 or p63), alteration of matrix metalloproteinase in limbal and corneal tissues, ultraviolet radiation (UVR) genetically mediated expression of various cytokines, growth factors, and growth factor receptors. Oxidative stress may play a role, evidenced by the expression of certain proteins in pterygium tissues presumed to have a protective role against oxidative stress-induced apoptosis. High prevalence of human papilloma viruses (HPVs) in pterygium tissue samples suggests a possible role for HPV. Several techniques of surgery have evolved over time including the modified bare-sclera techniques, sliding, “merest sclera,” adjunctive therapies with mitomycin C, 5-fluorouracil, corticosteroids, conjunctival autograft, limbal autograft, amniotic membrane graft, use of fibrin glue, and subconjuctival injection of bevacizumab. Conclusion: Advances in the understanding of pterygium have led to emerging treatment options that may not only reduce recurrent rates, but may also enable the use of less invasive treatment methods. Recommendation: Ophthalmologists working in hot climates should update their knowledge on the current concepts in the pathogenesis and management of pterygium to obtain better results.

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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 χ² = <0.001. Conclusion: Based on the CDR benchmark, students' performance was not satisfactory.

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Background: In the developing countries, most patients present with advanced disease or glaucoma blindness. This has been attributed to lack of awareness and poor knowledge as major contributing factors. The outcome of glaucoma management, however, depends largely on the understanding and perception of the illness by the patients. Objectives: This study aims to determine the knowledge, perception, and attitude of patients living with glaucoma and attending the Eye Clinic of the Imo State Specialist Hospital Owerri Imo State, Nigeria. The information obtained can be utilized by the health authorities in planning eye health education programs. Subjects and Methods: This was a cross-sectional study involving all previously diagnosed glaucoma patients attending the eye clinic of the hospital during the study period. Data were collected on knowledge, perception, and social disclosure attitude of the subjects using a structured questionnaire. Results: Twenty-nine males and 25 females participated in this study. The majority (42.6%) had only primary school education with petty trading accounting for 38.9% of the different occupations. The mean age at presentation was 60.9 years. The majority (88.8%) identified their eye problem as glaucoma, 46.3% knew it caused a progressive, irreversible loss of vision, and most (68.5%) did not know glaucoma to be familial. Approximately 67% of the subjects rated their management as satisfactory, 37% considered the drugs expensive, 70% and 13%, respectively had no, and negative perception of glaucoma surgery while 87.0% had a poor disclosure attitude. Conclusion: The subjects had a good knowledge of their diagnosis but a poor knowledge of the disease process. There was also an appreciable poor disclosure attitude and a negative perception of glaucoma surgery. Education and interaction with eye care personnel and other glaucoma patients using focal groups may bring about the desired change.

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Aim: To compare the endothelial cell loss between phacoemulsification and manual small-incision cataract surgery (SICS). Endothelial cell loss was also compared in phacoemulsification group by temporal clear corneal incision (CCI) and by superior scleral incision (SI) technique. Materials and Methods: A total of 200 eyes of 200 patients were included in the study. Cases were randomly divided into two equal groups. Group A had undergone phacoemulsification and Group B had under gone manual SICS. In Group A 50 cases were performed by temporal CCI and remaining 50 cases were performed by superior SI technique. Endothelial cell count was evaluated by using a noncontact specular microscope. Results: Mean endothelial cell loss (cells/mm ² ) in Group A was 307.80 (12.33%), 397.79 (15.93%), and 421.69 (16.89%) on 1 week, 6 week, and 3 month postoperative period, respectively. In Group B, it was 270.86 (10.63%), 385.22 (15.12%), and 413.68 (16.24%) on 1 week, 6 week, and 3 month postoperative period, respectively. There was no clinical and statistically significant difference (P > 0.05) between the two groups. The mean endothelial cell loss in Group A by CCI was 340.68 (13.61%), 427.80 (17.08%), and 448.70 (17.92%) and by SI was 274.92 (11.05%), 367.78 (14.78%), and 394.68 (15.83%) on 1 week, 6 week, and 3 month postoperative period respectively. There was statistically significant difference in endothelial cell loss at 1 week (P < 0.05) but it was not statistically significant on 6 week and 3 month postoperatively (P > 0.05). Conclusion: There was no clinically or statistically significant difference in endothelial cell loss or visual acuity between phacoemulsification and manual SICS at 3 month postoperative period.

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Introduction: Uncorrected refractive error (RE) is the most common cause of visual impairment (VI) in the world. It has significant effects on individuals and community, restricting some educational and occupational employment opportunities of the otherwise healthy individual. A significant percentage of the world population is visually impaired/blind from uncorrected RE. Aim: To determine the pattern of REs in ophthalmic outpatients in a teaching hospital. Materials and Methods: Records of consecutive patients attending a tertiary eye facility who were diagnosed with RE and/or presbyopia from January 2010 to December 2011 were retrieved. Data were analyzed using Statistical Package for the Social Sciences 20.0. Result: Presbyopia coexisting with other forms of RE 273 (40.4%) and presbyopia only was seen in 215 (31.8%). Myopia only was seen in 77 (11.4%), astigmatism only in 18 (2.7%), and hyperopia only in 13 (1.9%). Conclusion: In line with the objectives of VISION 2020, the data presented in this study will help in planning result-oriented intervention programs in the state.

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Background: Ocular trauma is an important public health hazard especially in the developing countries. The objective of the study was to determine the pattern of ocular injuries in patients who presented at the eye clinic of Federal Medical Center, Gusau, Zamfara State, Nigeria. Materials and Methods: A prospective study was conducted between 1^st January and 31^st December, 2008. All consecutive, consenting patients with ocular trauma were interviewed with the aid of an interviewer-administered questionnaire and underwent a detailed eye examination. Results: There were 121 patients in the study with 101 (83.4%) males and 20 (16.6%) females. The most common location of ocular trauma was more on the road (32.2%); road traffic accident (RTA), followed by home/domestic injury (23.1%) and at work in 15.8%. The most common anatomical site of injury was the cornea (40.6%) followed by the lids (17.5%) and the iris (14%). Conclusion: In this study, RTA was the most common cause of ocular trauma followed by domestic injuries. There is need for community education on preventive measures such as use of safety seat belts while driving and importance of supervising playing children at home.

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Background: Cataract is the principal cause of blindness in India, accounting for 62.6%. This problem can be tackled, and the backlog of cataract blind can be reduced by performing cataract operations on a large scale. Base hospital approach with screening camps has shown good visual outcome with lesser complications. Aim and Objectives: To study the profile of postoperative complications and visual outcome in eye camp patients undergoing cataract surgery at the base hospital. Materials and Methods: In this cross-sectional study, 413 patients were included following screening at community screening camps. Patients underwent sutureless small-incision cataract extraction with intraocular lens implantation under local anesthesia at the base hospital. Postoperative complications and visual outcome were recorded. Results: Immediate postoperative complications were corneal edema (9.44%), striate keratitis (6.77%), expected uveitis (5.56%), secondary glaucoma (2.66%), residual lens matter (2.66%), iris prolapsed (0.48%) and shallow anterior chamber (0.24%), hyphema (0.24%) and iris incarceration (0.24%). Endophthalmitis was reported in 0.48% (one grew citrobacter, rarely reported). Late complications included posterior capsular opacification (3.87%) noted and retinal detachment (0.48%) later. Majority 83.39% of the patients had postoperative best corrected visual acuity (BCVA) between 6/6 and 6/18, 13.42% had BCVA between 6/18 and 6/60, 3.19% had BCVA < 6/60 as at 6 months follow-up visit (overall percentage is 100%). Conclusions: The overall vision-threatening complications after cataract extraction in the base hospital are low. Our study reflects the efficacy of the base hospital approach, in terms of visual and surgical outcome, as an important aspect from the public health point of view, which can help in clearing the cataract backlog in developing countries like India.

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Objectives: To determine the prevalence, types, and risk factors for work-related eye injuries in a Nigerian population of stone quarry workers. Materials and Methods: The study was a questionnaire-based cross-sectional ophthalmic survey of stone quarry and stone processing industry workers in Abakaliki, south-eastern Nigeria. Data on participants’ socio-demographics, job characteristics, clinical ophthalmic symptoms and previous work-related eye injuries were collected and analyzed using descriptive and comparative statistics. Statistical significance was indicated by P < 0.05. Results: The participants (n = 384; males 158, females 226) were aged 32 ± 11.8 SD years (range, 14–68 years). Of them, 140 (36.5%) reported previous work-associated eye injury. Industrial injuries accounted for uniocular loss of vision in 2 (0.52%) of these workers. The most common eye injury was Blunt ocular trauma 106 (58.2%). The majority 379 (98.7%) of the workers did not use eye protective devices. Risk factors for work-related eye injury included unprotected eye exposure 85 (46.2%) for quarry sites and 117 (62.2%) for stone processing plant sites, following nonuse of eye protective devices, time of the day: 99 (53.8%) quarry site and 103(57.2%) stone processing site, occurred in the afternoon representing the highest time of occurrence. Occurrence of eye injury was found to be higher in the younger age group, male gender working in the stone processing plant, being a nontechnical worker, afternoon duty, and nonutilization of personal protective eye device (PPED). Conclusion: Adequate health education, emphasizing these risk factors, should be mandatory while comfortable and standard eye protective devices should be enforced for prevention of work-related eye accidents and work environment should be modified to ensure safety of workers.

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Background/Introduction: Macrophthalmia and microphthalmia are cardinal signs of many orbito-ocular and systemic diseases which are seen in northern Nigeria. Some cases of refractive error may also be directly related to the ocular axial length (AL). The need for an imaging parameter that will aid their early diagnosis is necessary, as visual compromise is a major consequence if they are not diagnosed and managed appropriately. Aim and Objectives: To use magnetic resonance imaging, to determine the normal AL of the eyeball and to establish the association, if any, between AL and inter-zygomatic line (IZL), age and sex. Materials and Methods: The study was conducted over a 6-month period (29^th November 2011 to 28^th May 2012) at the Department of Radiology, Ahmadu Bello University Teaching Hospital, Zaria. The anterio-posterior dimension of the globes (AL) and the length of IZL were measured at the level of the lens for 340 normal ocular globes of 170 patients on T₁-weighted MR images. Results: The normal ranges for ocular measurements were as follows (mean ± SD): AL of the right globe, 23.32 ± 1.34 mm (range 22.0–24.7) and AL of the left globe, 23.29 ± 1.22 mm (range 22.10–24.51). The length of the IZL was 103 ± 4.78 mm (range 98.2–107.78). All measurements in male patients were significantly higher than those in female patients (P < 0.001). Conclusion: The results obtained from this study may help ophthalmologists, radiologists and other clinicians to quantitatively evaluate patients with macrophthalmia, microphthalmia and/or refractive errors.

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Concurrent occurrence of subgaleal haematoma (SGH) and orbital subperiosteal haematoma (OSPH) is an unusual post-traumatic phenomenon. It is especially seen in cases of massive SGH. This report is a review, illustrated with a personal clinical experience, of this clinical disease association. Extensive literature review using the PubMed search engine for all cases of blindness from SGH and OSPH in the English language was conducted for this report. Vision-threatening complications of massive traumatic SGH that is associated with OSPH are rare but well described. The resulting orbital bleed most commonly involves the extraconal orbital roof. It is essentially an orbital epidural haematoma. Its aetiopathogenesis is that of an orbital space occupying lesion (SOL) causing clinical evidence of raised intraorbital pressure (IOP) including chemosis, proptosis, ophthalmoplegia, exposure keratopathy and orbital cellulitis and blindness. The visual impairment is usually temporary and responds well to prompt intraorbital decompression. However, permanent blindness ensues if suboptimal treatment including missed diagnosis and or delayed treatment is offered.

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Fishing is a common pastime as well as an important source of daily income for people around the world, be it a developed or a developing nation. It can be associated with unusual ocular injuries. Here, we report a case of a young man who presented with a fishhook injury into his right lateral half of upper eyelid piercing through the fornix. To the best of our knowledge, this is the first reported case of fishhook injury from this part of the world and only a few have been published in the literature till date. This case report aims at familiarizing the reader with this uncommon and atypical injury and its better management.

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A rare case of congenital anomaly of the optic disc is presented to draw attention to the occurrence of this anomaly in rural India. The typical case presented with excavated, enlarged colobomatous optic nerve head filled with glial tissue surrounded by peripapillary pigmentary abnormalities. Ocular complications in affected eye may include strabismus, retinal detachment and reduced visual acuity. Contralateral eye may also be involved as a part of anterior chamber cleavage syndrome. It may have systemic associations as in Aicardi syndrome. Therefore, the comprehensive ophthalmic examination of both eyes using various ocular investigations for its early diagnosis and of associated systemic disorders and complications is essential.

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X-linked juvenile retinoschisis is a hereditary macular dystrophy that is transmitted in the X-linked recessive mode. Clinical signs include a macular star with or without peripheral retinoschisis responsible for decreased visual acuity. This study dealt with a 12-year-old boy who came in for a consultation for progressive decline in visual acuity. His distance visual acuity without correction was scored at 5/100; the right eye (RE) improved to 10/100 after the correction of a myopic astigmatism; and the unimproved left eye was scored at 20/100. The eye fundus showed perimacular radial lines without increased separation for the right eye with some microcysts and a macular hole on the left. An examination of the retinal periphery of both the eyes found inferotemporal retinal splitting. The electrophysiological assessment showed a major dysfunction on the electroretinogram.

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Objective: Benzalkonium chloride, a commonly used preservative in many ophthalmic preparations, has been postulated as a cause of ocular surface toxicity, resulting in dry eye disease in patients on long-term treatment with topical medications. This study aims to determine the effect of benzalkonium chloride–preserved timolol maleate on dry eye disease in an African population. Materials and Methods: Information was retrieved from the data generated at a cross-sectional study on the prevalence of dry eye disease conducted in a randomly selected local government area, southwestern Nigeria, and analysis was conducted on participants with glaucoma and using benzalkonium chloride–preserved timolol maleate (cases), and age- and sex-matched controls. Results: One hundred and seventy-four participants were included in this study with a mean age of 65.05 ± 11.65 years. There was no significant association (P > 0.05) between the use of benzalkonium chloride–preserved timolol maleate and tear-film break-up time, Schirmer 1 test, fluorescein staining score, and overall diagnosis of dry eye disease in the patients. Conclusion: Benzalkonium chloride–preserved timolol maleate did not contribute significantly to dry eye disease in the studied population.

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Background: Fireworks are an important part of festivals in India, especially Diwali. The use of these fireworks often result in ocular trauma with a loss of vision. The aim of this study was to determine the pattern of eye injuries from fireworks during the Diwali festival and the visual outcome at a tertiary eye hospital in south India. Materials and Methods: The cases of ocular trauma from fireworks over a 3-year period were retrospectively reviewed. Information regarding patient’s age, gender, laterality, the type of firework, whether user or bystander, best-corrected visual acuity (BCVA) at presentation, the details of injuries, diagnosis, management, and BCVA at last follow-up visit were documented and analyzed using Epi Info 7.1.5.0 software. Results: A total of 114 eyes of 110 patients were analyzed. The study population comprised 89 (81%) males and 21 (19%) females, with a male-to-female ratio of 4.2:1. The median age was 14.0 years, with 61 (56%) patients aged <18 years. One hundred (88%) eyes had closed globe injury (CGI), whereas 14 (12%) eyes had open globe injury (OGI). Thirty-five (35%) eyes with CGI and 8 (57%) eyes with OGI had a BCVA of <3/60 at presentation. This improved with management with only 12 (12%) eyes with CGI and two (14%) eyes with CGI and 2 (14%) eyes with OGI having a BCVA of <3/60 at the last follow-up visit. These differences in visual acuity were not statistically significant with P-values >0.5. Twenty-two (19%) eyes developed long-term complications such as glaucoma, retinal detachment, and phthisis bulbi. Conclusion: Ocular trauma from fireworks commonly affects young boys and often results in serious, preventable, vision-threatening complications. The enforcement of existing legislation, health education, and public awareness are essential if the current trend in India is to be reversed.

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Aim: To investigate the risk factors associated with amblyopia among primary school pupils in Kosofe town, Lagos State, Nigeria. Materials and Methods: A descriptive, cross-sectional, school-based study was conducted, in which a multistage random sampling technique was employed for recruiting the children. Data were collected using self-administered questionnaires by the parents or caregivers and from detailed ocular examinations performed by the investigators. Data analysis was performed using the IBM Statistical Package for Social Sciences software version 20.0. Results: A total of 1702 children participated in the study, with over 90% of the children being aged 4–10 years. Most (78.5%) of the mothers were aged 20–39 years at childbirth, and the mean age was 30.5 ± 7.8 years. Amblyopia was detected in 24 (1.41%) children. Following multivariate logistic regression analysis, children whose mothers had no formal education at childbirth had an 11-fold greater risk of having amblyopia [odds ratios (OR) = 11.25, 95% confidence intervals (95% CI) = 1.25–1.49], while those with birth weight <2500 g were 10 times more likely to have amblyopia at the time of examination (OR = 10.15, 95% CI = 0.70–0.90). In addition, children with a positive family history of crossed eyes had an eightfold greater risk of having amblyopia (OR = 8.14, 95% CI = 0.24–0.46). Conclusion: Mother’s educational qualification at childbirth, low birth weight, and a positive family history of crossed eye were found to be strongly associated with the development of amblyopia.

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Purpose: Globally, amblyopia remains a common cause of visual impairment in children. Early screening and treatment is necessary to prevent permanent visual loss. This study aimed to evaluate the prevalence, etiologic factors, and characteristics of amblyopia among rural, public primary school children in Ijebu East Local Government Area (IELGA) of Ogun state, southwest Nigeria. Materials and Methods: The study was a cross-sectional descriptive study conducted among pupils of randomly selected public primary schools in IELGA from 27^th October to 7^th November 2014. Data on sociodemographics, ocular history, and ocular examination were collected. Descriptive and comparative analyses were performed. Values of P < 0.05 were considered statistically significant. Results: There were 1180 public primary school pupils enrolled for the study. The data of 1153 pupils were analyzed giving a 97.7% response rate. The mean age was 9.2 ± 2.8 years with age range from 4 years to 16 years. There were more female students (586; 50.8%) with a male-to-female ratio of 1:1.03. Majority of the pupils were from the Yoruba ethnic group (819; 71.0%) and from basic one academic class (236; 20.5%). Six of the examined pupils were found to have amblyopia, giving a prevalence of 0.5%. The following three types of amblyopia were seen in this study: anisometric amblyopia (2; 0.17%), ametropic amblyopia (2; 0.17%), and strabismic amblyopia (2; 0.17%). Three pupils had unilateral amblyopia while three had bilateral amblyopia. All amblyopias were classified as mild-to-moderate amblyopia. Conclusion: The prevalence of amblyopia among these rural school children was low. However, because children with amblyopia could have a lifetime of blindness ahead of them, the number of “blind person years” in those whose blindness started in childhood is enormous. Early screening is required to prevent the attendant consequences of socioeconomic burden following visual impairment in this vulnerable subsection of the Nigerian rural populace.

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Introduction: Trachoma is the leading cause of infectious blindness worldwide and is targeted for elimination by the year 2020 by the World Health Organization (WHO). The aim of our study was to provide baseline data on trachoma for eight local government areas (LGAs) of Zamfara state, Nigeria to enable planning and control activities in affected communities. Materials and Methods: A population-based cross-sectional survey was conducted in the selected LGAs between October 2010 and July 2011 using a two-stage sampling with probability proportional to size. The WHO guidelines for trachoma control were used in planning the survey, while the risk factors assessment was based on a recommendation from another WHO publication. Results: Trachomatous inflammation - follicular prevalence in children 1-9 years was 0.04-18%; while trachomatous trichiasis (TT) prevalence in persons ≥ 15 years was 0-1.4% across the LGAs. Access to improved water sources was worst (>40%) in Bakura and Maradun LGAs. Latrine accessibility was the highest (64%) in Bakura and Bukkuyum LGAs. Awareness of trachoma as a disease was 7-92% across the LGAs, whereas knowledge of trachoma prevention is poor (1-8%). Chi-square analysis shows access to latrine, knowledge of trachoma as a disease, and its prevention was significantly protective for active disease (odds ratio [OR] <1, P < 0.05). A regression analysis, however, showed that only access to latrine and knowledge of trachoma prevention remained significantly protective (OR < 1, P < 0.05). Conclusion: The risk factors for trachoma are endemic in the study areas, and active control measures are needed. The burden of the disease is, however, clustered with most LGAs having a low burden of both the active and blinding disease.

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Purpose: To determine the impact of cataract surgery on visual functions (VFs) and quality of life (QoL) in patients with cataract at the National Eye Center, Kaduna. Methods: VFs and QoL questionnaires were administered to the patients preoperatively and 6 weeks postoperatively. Correlation was assessed among subjective VF, QoL, and visual acuity (VA). The preoperative and sixth-week postoperative VA, VF scores, and QoL scores were compared. A paired t-test was used for comparison between before and after surgery. Results: Two hundred and seventy-one patients were studied. The age range of the patients was 45 to 85 years with a mean age of 64.2 years (SD ± 6.51). There was significant improvement in overall VF and QoL following cataract surgery (P < 0.0001). Mean VF scores preoperatively and at 6 weeks postoperatively were 28.6 (SD ± 7.9) and 15.1 (SD ± 3.5), respectively. The overall mean QoL scores were 23.7 (SD ± 9.0.) preoperatively and 13.5 (SD ± 1.1) postoperatively. This difference was statistically significant P < 0.0001. Bilateral cataract surgery patients had greater gain in VF and QoL than those that had uniocular surgery. Conclusion: This study demonstrated that cataract surgery is effective in improving overall VF and vision-related QoL, which resulted in functional independence. The second eye surgery confers additional gains in terms of VF and QoL in patients with bilateral cataract.

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Objective: Update courses in ophthalmology are organized in Nigeria with the aim of improving understanding of the basics of ophthalmology and also enhance chances of pass at the part one fellowship examination. It is assumed that the desired effect should be achieved at the end of the courses. This study was conducted to assess the candidates' views on impact of the program. Methods: A descriptive study involving administration of semi-structured questionnaires to consultants and residents was carried out. Information was sought on how participation in the prepart one update courses influenced their success at the examination. Results: Together, 84 respondents filled and returned the questionnaires. 51 (60.71%) were consultants and 33 (39.29%) were resident doctors. 44 (94.12%) of the consultants and all resident doctors participated in the update courses. 30 (63.83%) of the 47 consultants agreed that they understood the topics better, after the course. 16 (34.04%) responded that it assisted them to some extent, but one person felt it was no use. 18 (54.55%) of the resident doctors felt the update courses gave them a clearer insight, 13 (39.39%) said to some extent, and 2 (6.06%) concluded it was of no effect. 27 (81.82%) of the residents and 44 (93.62%) of the consultants agreed that the course contributed a lot to their success in the examination. Conclusion: Update courses have been found useful by majority of persons who participated in the study and should continue. Reorganization may be very helpful, especially, for those who felt that the courses made little or no impact on them.

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Purpose: To evaluate the effects of laser retinopexy in retinal breaks and the recurrence cases. Materials and Methods: 45 eyes of 25 patients who underwent laser retinopexy in retinal breaks between the period of July 2009 and January 2013 are included. All the breaks and suspicious areas for possible breaks are treated with laser photocoagulation. The breaks were surrounded with three rows of laser spots. After the routine controls, the patients are called every 6 months and advised to come immediately to our clinic if new flashing or floaters occur. Results: The patients were followed-up for an average period of 29.65 ± 10.45 months. New breaks were treated again and evaluated for the possible reasons. We found in three patients new breaks after an average period of 27.33 ± 2.03 months. No specifications are observed in these subjects. Conclusion: Retinal breaks can occur even a long time after. It is not known why this process is progressing and new tears develop. For this reason, patients who underwent a laser therapy because of retinal breaks should followed-up for a lifetime. We advise that, unsymptomatic patients who underwent laser retinopexy, should be examined every 6 months and every new complaint of flashing and big floaters should be carefully taken into consideration to prevent retinal detachments.

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Objectives: The aim was to determine the hospital incidence, pattern and clinical presentation of retinal detachment at the Guinness Eye Center, Onitsha, Nigeria. Materials and Methods: Case files of all retinal detachment patients seen at the Guinness Eye Center Onitsha between June 1997 and May 2012 were reviewed. Information on age, gender, symptoms duration, type and anatomic location of detachment, presenting visual acuity, and predisposing factors were analyzed. Results: A total of 93 patients (99 eyes) were seen with a male preponderance (M:F = 2:1) and age range 10-89 years; median - 61 years; mode - 55 years; incidence - 0.13%. Rhegmatogenous retinal detachment comprised 93.6%. Symptoms duration was 5 days to 8 years; median - 9 months; mode - 6 months. All the affected eyes had low vision with 79.8% blind; of the unaffected eyes, 40.2% had low vision with 24.7% being blind. Trauma was the precipitating factor in 33 (35.5%) patients. Proliferative vitreoretinopathy, 19 (19.2%) eyes, and lattice degeneration, 13 (13.1) eyes, were the commonest ocular risk factors. Common ocular co-morbidities in the affected eyes were cataract, 13 (13.1%) eyes; uveitis, 9 (9.1%) and glaucoma, 6 (6.1%) eyes. Supero-temporal, subtotal and total detachment constituted 84.8%; the macula was detached in 91.4%. The tears in eyes with rhegmatogenous detachment ranged from 1 to 6, with 51 (54.8%) having multiple tears. 10 (10.8%) eyes had giant tears; 6 (6.5%) had dialysis and 3 (3.2%) had coexisting macula holes; in 73.1% the tears were located in the superior retina. Conclusions: Retinal detachment incidence is low in our hospital; most patients presented late with severe visual loss. A community-based study will provide more information on the magnitude of the problem. Education of the public on retinal detachment symptoms, the predisposing/precipitating factors and the need for early reporting to hospital are required.

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