Ophthalmology- Scholarly Publications

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Browsing Ophthalmology- Scholarly Publications by Author "Akinsola, F.B"

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    Central corneal thickness changes following manual small incision cataract surgery
    (Clinical Ophthalmology, 2015) Aribaba, O.T; Adenekan, O.A; Onakoya, A.O; Rotimi-Samuel, A; Olatosi, J.O; Musa, K.O; Oyefeso, A.O; Akinsola, F.B
    Aim: To determine changes in post-cataract surgery central corneal thickness (CCT) at Lagos University Teaching Hospital by assessing the time it takes for the cornea to return to its pre- operative thickness value. Methods: This study is a prospective, hospital-based open within-patient controlled study with the unoperated eye controlling for the operated one. Results: Two hundred patients with 400 eyes were analyzed, with bilateral mature cataract in 47.0%. All the patients had manual small incision cataract surgery with posterior chamber intraocular lens implant. There is an increase in mean baseline CCT from 520.6±20.3 µm by 76.9 µm (597.9±30.4 µm) 24 hours after cataract surgery followed by relative reduction in the mean CCT to 555.2±24.7 µm and 525.1±19.7 µm at 2 weeks and 12 weeks, respectively. Increase in mean CCT in the unoperated and contralateral eyes were recorded in this study. Conclusion: There was a transient increase in corneal thickness following cataract surgery with subsequent decrease to preoperative thickness by 12th and fourth week in the operated and unoperated eyes, respectively. Corneal manipulations during cataract surgery must be minimal to reduce visual rehabilitation time to barest minimum. Postoperative refraction will be better at eighth week to 12th week considering the time it takes for the CCT to return to its stable preoperative values.
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    Indications for Destructive Eye Surgeries at a Nigerian Tertiary Eye Care Centre: A Ten Year Review
    (Nigerian Postgraduate Medical Journal, 2016) Musa, K.O; Aribaba, O.T; Onakoya, A.O; Rotimi-Samuel, A; Akinsola, F.B
    Background: Destructive eye surgeries are terminal treatment modalities for some ophthalmic conditions with psychological, emotional and cosmetic implications, especially for the patients and their relatives. Objective: The aim of this study was to determine the frequency and indications for destructive eye surgeries at an Eye Centre of a Nigerian Tertiary Hospital with a view to identifying the preventable indications for which appropriate preventive measures could be recommended. Patients and Methods: A retrospective, descriptive study of all patients who underwent evisceration, enucleation or exenteration at the Guinness Eye Centre, Lagos University Teaching Hospital from January 2003 to December 2012 was performed. Their outpatient, ward and theatre records were retrieved and reviewed. Information obtained included age, sex, eye affected, duration of symptoms before presentation, visual acuity of affected eye at diagnosis, indication for surgery and type of destructive surgery. Results: A total of 186 eyes of 185 patients were surgically removed constituting 4.8% of a total of 3866 surgeries performed during the period of study. Children below 16 years accounted for 33.5% of the cases while 30.3% were in their first decade of life. Overall, the most common indication for destructive eye surgery was trauma (36.2%) followed by tumour (27.6%) and ocular infection (18.4%). However, tumour (73.2%) was the most common indication in the first decade of life with retinoblastoma accounting for 92.7% of these. Conclusion: Ocular trauma, tumour and infection were the most common indications for destructive eye surgery in this centre. Key Words: Destructive, eye surgeries, indications, Nigerian, tertiary
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    Neovascular Glaucoma: Aetiology and Outcome of Treatment in Lagos University Teaching Hospital
    (Nigerian Journal of Ophthalmology, 2013) Rotimi-Samuel, A; Onakoya, A.O; Musa, K.O; Aribaba, O.T; Akinsola, F.B
    Objective: This paper investigates the causes and the intraocular pressure outcome of neo-vascular glaucoma at Guinness Eye Centre, Lagos University Teaching Hospital, Lagos, Nigeria. Materials and Methods: The case records of all patients with the diagnosis of neo-vascular glaucoma who presented at the Guinness Eye Centre from 1st January, 2008 to 31st December, 2012 were reviewed. Information extracted from their records included the biodata, eye affected, best corrected visual acuity, intra-ocular pressure, aetiology of neo-vascular glaucoma, ocular co-morbidity, systemic co-morbidity and forms of treatment received. Cases of retinoblastoma were excluded from the study. Data were analysed using SPSS V.17. Results: Thirty-one cases of neo-vascular glaucoma were reviewed. The male to female ratio was 1.8:1 and the age ranged from 26 years to 83 years. Over 70% of the patients were 51 years and above. The best corrected visual acuity in the affected eye or in the worse affected eye was determined by counting fingers in 30 (96%) patients. The presenting IOP was 30mmHg and above in 26 (83.2%) patients. Both eyes were affected in 3 (9.6%) patients. Patients with diabetes mellitus and hypertension or both constituted 57.8% of the total number of patients. Primary open angle glaucoma and retinal vein occlusion were the aetiologies of neo-vascular glaucoma in 14 (45.2%) patients. A total of 15 (48.4%) patients failed to turn up for repeat appointments. Only, 5 (16.0%) patients who received medications, intravitreal bevacizumab and pan-retinal photocoagulation showed a significant intraocular pressure reduction. Conclusion: Late presentation, failure to follow up and lack of full and complete treatment were important findings in this study. A significant intraocular pressure reduction occurred only in the patients who had a combination therapy of intraocular pressure lowering medication, intravitreal bevacizumab and pan-retinal photocoagulation. A routine eye examination for patients at risk is essential for early detection and treatment in order to minimize visual loss in neo-vascular glaucoma.
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    Nucleus Drop during small incision cataract surgery: A case report
    (Nigerian Postgraduate Medical Journal, 2015) Rotimi-Samuel, A; Onakoya, A.O; Aribaba, O.T; Musa, K.O; Alabi, A.S; Akinsola, F.B
    Small incision cataract surgery (SICS) offers the benefits of a phacoemulsification (phaco) surgery without the attendant high cost, but it is not without certain risk such as nucleus drop into the vitreous as seen in phaco. A retrospective study of SICS and associated factors leading to nucleus drop during surgery, challenges of management and the visual outcomes. Of 793 eye surgeries performed during the study 586 were SICSs. Nucleus drop during SICS occurred in 0.68% of patients. Can‑opener technique of capsulotomy, use of dispersive viscoelastic, diabetes mellitus, lack of anterior vitrectomy machine and poor access to immediate posterior vitrectomy were important problems in the management of the cases of nucleus drop in this study. The visual outcomes were poor in all the cases of nucleus drop. Careful patient selection for SICS and the use of continuous curvilinear capsulorhexis are advocated. An interior vitrectomy machine should be available to all cataract surgeons. It is good professional practice to be acquainted with the available vitreo‑retina surgeons for urgent assistance in cases of nucleus drop. Key words: Immediate vitrectomy, nucleus drop, small incision cataract surgery
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    Pattern of Childhood Visual Impairment and Blindness among Students in Schools for the Visually Impaired in Lagos State: An Update
    (Nigerian Postgraduate Medical Journal, 2018) Olowoyeye, A.O; Musa, K.O; Aribaba, O.T; Onakoya, A.O; Akinsola, F.B
    Abstract Aim: The aim of this study was to determine the pattern of childhood visual impairment and blindness (VI and BL) among students attending schools for the visually impaired in Lagos State, with a view to providing information on avoidable causes as well as emerging trends that would be useful to policy-makers for the planning and implementation of strategies for the control of avoidable childhood BL in Lagos State. Subjects and Methods: The study was conducted among students enrolled in two schools for the visually impaired in Lagos State who developed VI/ BL before the age of 16 years. Participants and their parents/guardians were interviewed to obtain medical history. Ocular and systemic examinations were also performed. Information was recorded using a modified World Health Organization/Prevention of BL Eye Examination Record for Children with BL and Low Vision and analysed using the Statistical Package for the Social Sciences version 23.0. Z-test determined differences in the proportions of the causes of VI/BL between this study and an earlier study. Results: A total of 116 students were enrolled in this study of which 65 (56.0%) were males. Avoidable causes accounted for 58.5% of VI/BL. Preventable causes predominated with measles (15; 12.9%) accounting for the largest proportion. Surgical complications (16; 13.8%) were the largest cause of VI/BL. A statistically significant decrease (P = 0.004; 95% confidence interval = 0.09–0.50) in the proportion of avoidable BL between a previous study carried out in Lagos State and this study was found. Hereditary cataract and cortical VI were the findings of this study not recorded in the previous study. Conclusion: Avoidable causes of childhood VI/BL still predominate among students in the schools for the visually impaired in Lagos State; however, there is a statistically significant decrease. Keywords: Causes, childhood blindness, pattern, schools for the visually impaired
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    Pattern of Ocular Morbidity among Children seen in a Nigerian Teaching Hospital
    (Nigerian Quarterly Journal of Hospital Medicine, 2016) Musa, K.O; Onakoya, A.O; Aribaba, O.T; Rotimi-Samuel, A; Akinsola, F.B
    Background: Children are peculiar beings and their eye care needs are different from that of adults. This is because a delay in treatment for some causes of childhood blindness can lead to amblyopia. Furthermore, the number of "blind years" resulting from childhood blindness is more than double the number of "blind years" attributable to adult cataract. Therefore, there is a level of urgency about managing eye diseases in children. Objective: This study was conducted to describe the pattern of ocular morbidity among children below 16 years of age seen at the Guinness Eye Centre, Lagos University Teaching Hospital with a view to determine the most common causes of childhood ocular morbidity in this cen • Methods: A retrospective, descriptive study of new patients below the age of 16 years who presented to the Guinness Eye Centre, Lagos University Teaching Hospital (LUTH) between January, 2012 and June, 2013. Children with no eye disorder and those who defaulted from clinic with inconclusive diagnosis were exclu¢ied from the study. Results: A total of 4,253 new patients were seen over the eighteen months under review out of which 723 were analysed constituting 17% of all new patients seen in the clinic. The most frequently seen age group was 0-5 years (41.8%) with 74.3% of all the children presenting in their first decade of life. Refractive error (19.5%) was the most common ocular morbidity seen, followed by ocular trauma (13.1%), allergic conjunctivitis (11.1%) and cataract (10.9%). Conclusion: Refractive error, ocular trauma, allergic conjunctivitis and cataract were responsible for more than half of the ocular morbidities in this study. This information will help in prioritization of equipment acquisition for effective and efficient children eye care services in this centre in the face of limited resources. Keywords: Ocular Morbidity, Children Hospital, Nigeria
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    Practice of external ocular photography among Ophthalmologists in Nigeria, Sub-Saharan Africa
    (Nigerian Journal of Ophthalmology, 2018) Aribaba, O.T; Idowu, O.O; Musa, K.O; Abikoye, T.M; Onyekwelu, O.M; Onakoya, A.O; Akinsola, F.B
    Background: External ocular photography (EOP) has become an essential tool in the day-to-day practice of ophthalmology as it entails the imaging of the external eye, ocular adnexa, face, and the anterior segment of the eye. The aim of this study was to assess the practice of EOP among ophthalmologists in Nigeria with a view to providing baseline information that will be useful in the advancement of ophthalmic practice. Materials and Methods: An online cross-sectional survey among practicing ophthalmologists in Nigeria. Information regarding reasons for external photography, type of camera, ownership of camera and barriers to external photography were obtained. The data obtained were analysed using IBM Statistical Package for the Social Sciences version 22.0 software for Windows (IBM Corp., Armonk, NY, USA). Results: A total of 183 out of 355 ophthalmologists completed the survey (51.5% response rate), with a mean age of 43.9 ± 8.1 years. Of the respondents, 84.7% use EOP in their practice with 53.6% making use of smartphones. Indications for the use of EOP were documentation (71.0%), teaching purposes (54.2%), patient’s communication (47.1%), and surgical/treatment planning (45.8%). Among the users of EOP, 87.1% obtained consent and only 5% use written informed consent. There is an association between obtaining consent and younger years in practice (P = 0.005). Conclusion: The use of EOP is high among ophthalmologists in Nigeria and with its increasing popularity comes the need for ethical and medico-legal considerations, especially in oculoplastic practices. Most importantly, whenever the effective concealment of patient’s identity and privacy cannot be guaranteed during clinical photography, the use of oral consent may be inadequate. Keywords: External ocular photography, Nigeria, ophthalmologist, practice, Sub-Saharan Africa
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    Presbyopia and Near Spectacle Correction Coverage among Public School Teachers in Ifo Township, South-west Nigeria
    (Nigerian Postgraduate Medical Journal, 2016) Idowu, O.O; Aribaba, O.T; Onakoya, A.O; Rotimi-Samuel, A; Musa, K.O; Akinsola, F.B
    Background: Presbyopia is an age-related loss of lens accommodation resulting in difficulty in performing near task with attendant effect on the quality of life. Objective: The objective of the study was to determine the prevalence of presbyopia and presbyopic spectacle correction coverage among public school teachers in Ifo township, with a view to providing a baseline information that could be useful for advocacy and planning appropriate intervention. Study Design: The study was a descriptive, cross-sectional study. Materials and Methods: Six hundred public school teachers aged 30 years and above were examined in 25 clusters using a multistage random sampling technique with probability proportional to size. Questionnaire was used to obtain information on demographic data, sources of spectacle and barriers to spectacle use. All participants underwent a standardised protocol including visual acuity assessment (distance and near acuity), anterior and posterior segment examinations and refraction. Results: Six hundred teachers were examined with an age range of 30–61 years. The mean age was 44.7 ± 7.5 years and the male to female ratio was 1:2.2. The prevalence of presbyopia was 81.3% and 38.5% of the presbyopic teachers did not have presbyopic correction. However, the average age of onset of presbyopia was earlier in females 33 years compared to 36 years observed in males, although not statistically significant (P = 0.88). The presbyopic correction coverage was 61.5%. One hundred and eighty-six (62%) presbyopic teachers obtained their spectacle from opticians, and the main barriers to the use of near vision spectacle were lack of awareness (23.7%) and cost (13.7%). Conclusion: This study demonstrated a high prevalence of presbyopia among public school teachers in Ifo town, South-West Nigeria, but less presbyopic spectacle correction coverage. Keywords: Presbyopia, school teachers, spectacle coverage
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    Prevalence and Pattern of Congenital Color Vision Defect among Public Secondary School Students in Kosofe Local Government Area, Lagos, Nigeria
    (Nigerian Quarterly Journal of Hospital Medicine, 2016) Salami, M.O; Aribaba, O.T; Musa, K.O; Rotimi-Samuel, A; Onakoya, A.O; Akinsola, F.B
    Background: Congenital color vision defect is one of the commonest genetic defects. It affects daily and professional living. Objective: This study was conducted to determine the prevalence of color vision defects among public secondary school students in Kosofe Local Government Area, of Lagos State with a view to providing data that could be useful for advocacy to institute regular school screening. Materials and Methods: A descriptive cross sectional study conducted among public school students in all the seven public secondary schools in Kosofe Local Government Area of Lagos State. Sample size was determined by Leslie-Kish formula. Students were selected using multistage sampling technique. Visual acuity was determined using the literate Snellen’s chart. Color vision status was screened using lshihara pseudo-isochromatic test and further categorization of degree of severity of color vision defects was determined using of Farnsworth- Munswell D-15. Results: Five hundred and forty students were examined with a mean age of 13.7+1.8 years (ranging 9-20years). There were 307 females and 233 males, with a female to male ratio of 1.3:1. The prevalence of color vision defects among respondents was 1.9% (10 students). There were 8 males and 2 females with color vision defects with a statistically significant difference between gender (p=0.02). There were 8 students with deuteranomaly and 2 students with protanoamaly but there was no tritan defect detected. Conclusion: The prevalence of color vision defect in this study is within the range of prevalence values reported in Nigeria. Color vision screening programs should be integrated into the pre-existing eye screening programs. Keywords: Color vision, defects, students, Nigeria
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    Retinopathy of Prematurity and associated factors in Lagos, Nigeria
    (Paediatrics and International Child Health Journal, 2015) Fajolu, I.B; Rotimi-Samuel, A; Aribaba, O.T; Musa, K.O; Akinsola, F.B; Ezeaka, V.C; Onakoya, A.O
    Background: Screening and early treatment of retinopathy of prematurity (ROP) is important to reduce visual impairment in at risk infants. Aim: To determine the frequency and risk factors associated with ROP in preterm infants in Lagos University Teaching Hospital. Methods: This was a prospective cohort study of preterm infants with gestational age (GA) less than 32 weeks and birthweight 1500 g or less conducted from November 2011 to May 2014. The infants’ eyes were examined using an indirect ophthalmoscope at 4-6 weeks of life or at 34 weeks post-conceptual age. Examinations were repeated weekly until regression or progression to a high risk pre-threshold disease. Staging was according to the revised International Classification for ROP and treatment criteria were as defined by the Early Treatment for ROP study. The GA, birth weight (BW), use of oxygen, presence of respiratory distress syndrome and other risk factors were recorded and tested for significance. Results: Twelve (15%) of the 80 infants examined had any ROP and six (7.5%) had treatable ROP. The mean (SD) GA and BW for infants with ROP were both lower than for those without ROP; 28.2 (1.7) weeks vs 29.1 (1.6) weeks and 1124 (212) g vs 1251 (274) g for GA and BW, respectively. Risk factors such as supplemental oxygen, sepsis, respiratory distress and anaemia were not significantly associated with ROP. Conclusion: The frequency of ROP and treatable ROP was high; it is therefore recommended that routine care of preterm infants should include screening for ROP and that affordable treatment facilities should be provided in public hospitals. Frequency, Retinopathy of prematurity, Risk factors, Treatment, Neonatal unit, Lagos, Nigeria Keywords: Frequency, Retinopathy of prematurity, Risk factors, Treatment, Neonatal unit, Lagos, Nigeria