Ophthalmology- Scholarly Publications

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    Open Access
    Subspecialty Preferences among Ophthalmology Resident Doctors in Nigeria
    (Nigerian Journal of Ophthalmology, 2017) Musa, K.O; Aribaba, O.T; Rotimi-Samuel, A; Oluleye, T.S; Idowu, O.O; Onakoya, A.O
    Abstract Purpose: To determine the subspecialty preferences of ophthalmology resident doctors in Nigeria as well as the factors influencing the choice with a view to provide useful insight into the future of ophthalmic practice in Nigeria. Materials and Methods: A descriptive, cross-sectional study was conducted among consenting ophthalmology residents in all the 23 accredited training institutions in Nigeria between July, 2015 and June, 2016. A semi-structured questionnaire with consent form was used to obtain information concerning socio-demographics, residency training information, awareness of ophthalmology subspecialties, subspecialty preference, and the reason for the choice as well as future practice plan. Results: A total of 198 (66.2%) out of the expected 299 ophthalmology resident doctors participated in this study. Their ages ranged from 27 to 51 years with a mean age of 34.4 ± 4.5 years. One hundred and ten (55.6%) participants were females and 157 (79.3%) were married. Anterior segment (including cornea and refractive surgery) and vitreoretinal surgery were the two most preferred subspecialties. The two most important reasons that influenced the choice of subspecialty were personal interest and desire to acquire special skills documented in 81 (48.2%) and 51 (30.4%) respondents, respectively. Younger (P = 0.03) and single (P = 0.04) respondents were more likely to prefer vitreoretinal surgery, while married respondents were more likely to choose anterior segment relative to other subspecialties (Fischer exact P = 0.02). Only 62 (31.3%) respondents had undergone stereopsis test. Conclusion: Anterior segment (including cornea and refractive surgery) and vitreoretinal surgery were the two most preferred subspecialties by Nigerian ophthalmology resident doctors. Key words: Doctors, Nigeria, ophthalmology, resident, subspecialty
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    Open Access
    Spectrum of Childhood Strabismus seen at Lagos University Teaching Hospital, Lagos, Nigeria
    (Nigerian Quarterly Journal of Hospital Medicine, 2017) Musa, K.O; Ikuomenisan, S.J; Idowu, O.O; Salami, M.O; Olowoyeye, A.O
    Background: Strabismus is the misalignment of the visual axes of the eyes. It may lead to the development of amblyopia, impaired reading performance, absent or reduced binocular single vision as well as reduced self-esteem. Objectives: To describe the spectrum of childhood strabismus seen at Guinness Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria with a view to determining the most common type of strabismus as well as associated probable risk factors. Methods: A retrospective, descriptive study of all new patients below the age of 16 years who were diagnosed to have strabismus (squint) at the Guinness Eye Centre, Lagos University Teaching Hospital between January, 2012 and December, 2015. Their case files were retrieved and relevant information extracted. Information obtained included age at presentation, gender, duration of symptoms before presentation, presenting visual acuity and family history of strabismus in first degree relatives. Also, type of strabismus, extent of deviation, refraction, ocular and systemic comorbidities, pregnancy, delivery as well as developmental history were extracted. Results: One hundred and sixty-six new cases of children below 16 years of age with strabismus were seen during the period under review constituting 9.1% of 1,815 new paediatric ophthalmic presentations during the same period. There were 105 (63.3%) females with a male to female ratio of 1:1.7. The most common types of strabismus were alternating, constant, comitant and esotropia documented in 83 (53.0%), 139 (83.7%), 159 (95.8%) and 108 (65.1%) patients respectively. Forty-five (41.7%) out of the 108 patient with esotropia had congenital/infantile esotropia being the most common while the most common type of exotropia was intermittent seen in 22 (43.2%) out of the 51 exotropic patients. Hypermetropia was significantly associated with esodeviation (p=0.04) while myopia was significantly associated with exodeviation (p=0.003). Also, positive family history of strabismus in first degree relatives was found to be associated with exodeviation. Conclusion: The most common type of childhood strabismus in this study was comitant strabismus (based on variability with gaze) and esotropia (based on direction of deviation). Keywords: Spectrum, Childhood, Strabismus, Nigerian, Hospital.
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    Open Access
    Indications for Intravitreal Injections in Lagos University Teaching Hospital, Lagos, Nigeria.
    (Nigerian Quarterly Journal of Hospital Medicine, 2017) Adenekan, A.O; Rotimi-Samuel, A; Oluleye, T.S; Ilo, O.T; Musa, K.O; Amusan, O.O
    Background: The influence and contribution of angiogenesis in retinal diseases has been documented in many literature emphasizing the role of Vascular Endothelial Growth Factor (VEGF) as a major factor in proliferative retinopathies. The use of Anti-Vascular Endothelial Growth Factors (antiVEGF) is now employed in the treatment of these diseases. With the objective of reviewing the indications of all intravitreal antiVEGF given in Lagos, this study aimed to describe the common ones and re-emphasizing the need for more awareness. Methods: The ophthalmic surgical records of patients (n=104) who had intravitreal antiVEGF at the Guinness Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria from November 2013 to November 2015 were reviewed in a retrospective manner after obtaining ethical approval. Results: A total of one hundred and four antiVEGF injections were given in the study period. The commonest indication was clinically significant macular edema from Diabetic Maculopathy, 32 (30.7%) followed by Wet Age Related Maculopathy, 21 (20.2%) and retinal vein occlusion, 18 (17.3%). Newer indication included idiopathic polypoidal choroidal vasculopathy 7, (6.7%). Conclusion: Diabetic maculopathy and wet age related macular degeneration are the major indications for intravitreal antiVEGF injection in Lagos.
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    Open Access
    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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    Open Access
    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