Guinness Eye Centre Research Articles

Multiple medications and quality of life of Nigerians with primary open angle glaucoma.

To determine the impact of multiple medications on the quality of life of primary open angle glaucoma (POAG) patients on medical treatment at Guinness Eye Centre Onitsha, Nigeria. Adult patients diagnosed with POAG who were undergoing medical therapy were selected through systematic sampling. They were asked to provide information on socio-demographic background, the number and types of glaucoma medications they were using and any adverse effects encountered while using these medications. The patients' quality of life was assessed by utilizing the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and all patients completed ocular examination. Data analysis was with Statistical Package for Social Sciences (SPSS) version 23. One hundred and seventy-one patients, aged 40-83 years, mean 59.1 ± 11.1 were studied; there were 79(46.2%) males and 92(53.8%) females. One hundred and nine (63.7%) patients were on multiple medications. Side effects of treatment increased with increasing number of medications. The mean quality of life score in monotherapy group and double therapy group were 89.3 ± 15.8 and 80.2 ± 21.1 respectively; while that in ≥ triple therapy group was 78.9 ± 18.8. This decrease in mean quality of life score with increasing number of medications was statistically significant in bivariate analysis (P < 0.01), however, multiple regression analysis showed that the number of medications did not significantly affect the quality of life scores after adjusting for confounding variables(p = 0.881). Among the patients studied, use of multiple medications, unlike visual acuity (VA) and severity of glaucoma, was not an independent predictor of quality of life.

Comparative Analysis of Life Satisfaction of Patients before and after Diagnosis of Eye Pathologies

Aim: To compare the life satisfaction of patients before and after diagnosis of eye pathologies. Methods: This was a prospective cross-sectional survey amongst eye patients at Guinness Eye Centre, Onitsha, South East, Nigeria using pretested interviewer-administered structured questionnaire. Data collected included the socio -demographics and the life satisfaction scores of the patients before, and 4-6 weeks after diagnosis. Results: A total of 137 patients in the age range 18 to 88years, and with disease duration ranging from 1 to 23 years were enrolled. There was equal male to female ratio with mean age of 54.6 years. There was significant decreased mean life satisfaction scores from 25.9 before diagnosis to 24.3 after diagnosis among participants with eye pathology. Conclusion: The diagnosis of a vision threatening eye pathology is associated with lowering of life satisfaction hence the need to incorporate psychotherapy in the long term management of these patients.

Duration of Illness and Resilience as Determinants of Life Satisfaction amongst Patients with Eye Pathologies

Aim: To determine how duration of disease and resilience as determinants correlate with life satisfaction amongst eye pathology patients Methods: This was a prospective cross-sectional survey amongst eye patients at Guinness Eye Centre, Onitsha, South East, Nigeria using pretested interviewer-administered structured questionnaire. Information such as the socio -demographics, duration of disease and questions aimed at assessing the resilience and life satisfaction scores of these patients were collected. Results: A total of 137 patients in the age range 15 to 88years, and with disease duration ranging from 1 to 23 years were enrolled. Gender and age of the participants were controlled as covariate. There was significant correlation between duration of eye pathology diagnosis and life satisfaction r= -0.22, p= 0.01, and resilience and life satisfaction r= 0.30, p= 0.01. In other words as the duration of eye pathology diagnosis increases, the more likely that the patient will report lesser life satisfaction. In contrast, patients who report higher resilience were more likely to also report higher life satisfaction. Conclusion: Life satisfaction amongst eye pathology patients is significantly determined by duration of eye disease and resilience.

Knowledge and Attitude of Eye Care Workers towards Electronic Medical Records in a Tertiary Eye Facility in South-East Nigeria

Electronic Medical Records (EMR) has been an integral part of patient management in the developed world but still gradually gaining popularity in the developing world. It was met with resistance by health workers in Nigeria though this is changing in the post COVID era. However, there still appears to be some resistance to its acceptance for different and sometimes justifiable reasons. The aim is to determine the knowledge and attitude towards EMR among eye health workers in a teaching hospital in South East Nigeria. This cross-sectional quantitative study was conducted among consenting consecutive eye care workers at Guinness Eye Centre, Onitsha aged≥ 18years from July to September, 2023. A pretested semi structured self-administered questionnaire was used. Information of interest were biodata, knowledge and attitude towards EMR. They were summarized into simple frequencies and percentages. Knowledge scores were grouped into good and poor using the blooms cut off for knowledge attitude and practice. Univariate and bivariate analysis were done and results represented in tables and charts with levels of significance placed at p&lt;0.05. There was a total of 135 respondents; the mean age was 32.6 years ± 10 SD, male to female ratio of 1:1.1. The result showed good knowledge and positive attitude towards EMR (85.2% and 73.2% respectively) with younger age group, professional cadre and computer literacy found to be associated with good knowledge and positive attitude towards EMR in the population. The hospital/ clinic were the most common sources of EMR information. This study showed good knowledge and positive attitude toward EMR in the study population. It also suggested an association with younger age group, professional cadre and computer literacy.

Prevalence of refractive error in paediatric age group in a tertiary eye center in Onitsha, south east, Nigeria

Paediatric ophthalmology is an emerging subspecialty in Nigeria and there is a paucity of data on refractive errors in the country. This study set out to determine the prevalence, type, and factors affecting refractive error among paediatric patients at Guinness Eye Centre, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Onitsha. A retrospective cross-sectional study of 685 patients seen over a 3-year period using the simple random sampling technique. Collected data was analysed using the Statistical Package for the Social Sciences (SPSS) version 20. Of the 685 patients, 242 cases of refractive error were identified giving a prevalence rate of 35.3% with 66.5% of them being female and 33.5% males. The mean age range was 12.0 +/- 3.7 years. Prevalence increased with age from 1.7% among those 0-4 years to 46.3% among those 10-14 years. Myopia was the commonest type of refractive error (62%) while hyperopia was 22.7%. However, there was no case of astigmatism. Poor distant vision was the commonest presenting complaint (34.4%). There is a high risk for refractive error among children with eye complaints and females have a significantly higher proportion. It may be necessary to assess if the male children tend to shy away from complaining of any visual disturbance. Children with refractive errors may not be identified soon enough, and this could account for poor learning in childhood. So, children should be routinely screened for refractive error.

Patients’ Awareness and Knowledge of Their Ophthalmic Condition at Lagos University Teaching Hospital (LUTH)

Purpose: To assess patient’s awareness of their ophthalmic conditions following their clinic visits with the aim of improving communication between patients and health practitioners and enhancing care. Methods: A hospital-based cross-sectional quantitative survey carried out in subjects over 18 years of age, attending the Guinness Eye Centre Clinic (Lagos University Teaching Hospital) over a four week period in 2019. Results: A total of 250 subjects were surveyed. Male:Female 1:1.7 Age range 41-80 years. 42.4% had at least tertiary education. Although the majority of subjects (&gt;70%) had enough time to ask questions from their doctors/nurses, 76.8% did not know the diagnosis of their ophthalmic conditions, 43.8% didn’t know their treatment options, and 62% did not know the names of their eye drops. 95.2% of subjects, however agreed that a simple information leaflet explaining their ophthalmic condition and treatment will increase their understanding. Patients with tertiary education or higher are three times more likely to have knowledge of the condition and treatment compared with patients with lesser education. Odds ratio 3.07 CI:1.82 to 5.19 P &lt; 0.0001. Conclusion: Clinics should have counsellors who can spend more time to discuss with patients about their ophthalmic conditions. Information leaflets (in different languages) on different common medical conditions which include; Cataract, Glaucoma, Pterygium, should be printed in the simplest of language for patients to not only hear but also read to assimilate and enhance awareness in patients.

Patients’ Awareness and Knowledge of Their Ophthalmic Condition at Lagos University Teaching Hospital (LUTH)

Purpose: To assess patient’s awareness of their ophthalmic conditions following their clinic visits with the aim of improving communication between patients and health practitioners and enhancing care. Methods: A hospital-based cross-sectional quantitative survey carried out in subjects over 18 years of age, attending the Guinness Eye Centre Clinic (Lagos University Teaching Hospital) over a four week period in 2019. Results: A total of 250 subjects were surveyed. Male:Female 1:1.7 Age range 41-80 years. 42.4% had at least tertiary education. Although the majority of subjects (&gt;70%) had enough time to ask questions from their doctors/nurses, 76.8% did not know the diagnosis of their ophthalmic conditions, 43.8% didn’t know their treatment options, and 62% did not know the names of their eye drops. 95.2% of subjects, however agreed that a simple information leaflet explaining their ophthalmic condition and treatment will increase their understanding. Patients with tertiary education or higher are three times more likely to have knowledge of the condition and treatment compared with patients with lesser education. Odds ratio 3.07 CI:1.82 to 5.19 P &lt; 0.0001. Conclusion: Clinics should have counsellors who can spend more time to discuss with patients about their ophthalmic conditions. Information leaflets (in different languages) on different common medical conditions which include; Cataract, Glaucoma, Pterygium, should be printed in the simplest of language for patients to not only hear but also read to assimilate and enhance awareness in patients.

Conjunctival Fungal Flora in a Tertiary Eye Hospital in Nigeria.

The aim of this study is to determine the hospital incidence and pattern of conjunctival fungal flora in adult patients at the Guinness Eye Center Onitsha, Nigeria. New adult patients, without anterior segment disease, were randomly recruited. Using a sterile swab stick, specimen was taken from the inferior conjunctival fornix of each participant's right eye and inoculated into Sabouraud dextrose agar slant in a test tube and incubated at 27°C. The specimens were examined for fungal growth every 48 h for 4 weeks. Specimens with fungal growth were further examined under a high power microscope for fungal identification and characterization. A total of 225 patients (105 males, 120 females) were examined. The age range was 18-75 years; mean age was 41 ± 17.1 years; 62 (27.6%) were culture-positive: 25 (40.3%) were males and 37 (59.7%) were females (P >0.05). Both moulds and yeasts were isolated with moulds constituting 44 (74.2%). Aspergillus [26 (41.9%)] and Candida [16 (25.8%)] were the commonest organisms. Participants >60 years had the greatest burden. Pensioners (61.5%), traders (44.0%), farmers (30.1%), and artisans (27.3%) were occupational groups with significantly higher proportions of culture-positive specimens (P < 0.05). Over a quarter of new adult patients without anterior segment disease harbour fungi, some of which are pathogenic, in their conjunctival fungal organisms. While Aspergillus and Candida were the commonest isolates, older participants, pensioners, traders, farmers, and artisans had significantly higher proportion of culture-positive specimens. These findings should be considered when formulating pre-operative guidelines for ocular surgery in our environment.

Sub-tenon Versus Sub-conjunctiva Anaesthesia for Intraocular Surgery.

To compare the pain relief achieved using sub-Tenon anesthesia with that of sub-conjunctival anesthesia technique in intraocular surgery at the Guinness Eye Centre Onitsha Nigeria. Consecutive adult patients who had intraocular surgery under local anesthesia were randomized into having sub-Tenon (3 mL) or sub-conjunctival (0.5 mL) injections using xylocaine ± adrenaline. The manual suture-less surgery technique was used for cataract surgery alone and cataract surgery with pterygium excision; the extra-capsular cataract extraction technique was adopted for combined trabeculectomy and cataract surgery. Surgery duration was recorded. Patient's pain perception graded as none, mild, moderate or severe. 100 patients made up 51 (51.0%) males and 49 (49.0%) females, age range was 31-88 years, median - 68 years, participated. Sub-Tenon anesthetic technique was used in 52 (52.0%) and sub-conjunctival in 48 (48.0%) participants. Seventy-eight (78.0%) patients had cataract surgery; 10 (10.0%) had trabeculectomy; 7 (7.0%) had combined trabeculectomy and cataract surgery and 5 (5.0%) had pterygium excision with cataract surgery. The mean surgery duration in the sub-Tenon anesthesia group was 31.8 ± 8.5 minutes and 30.2 ± 9.8 minutes in the sub-conjunctival group (P > 0.05). Fifty (96.2%) patients in the sub-Tenon group and 38 (79.2%) in the sub-conjunctival group experienced mild or no pains; 2 (4.2%) patients in the sub-Tenon group and 10 (20.8%) in the sub-conjunctival group experienced moderate to severe pains (P < 0.05). Both sub-conjunctival and sub-Tenon anesthetic achieved effective analgesia in intraocular surgery. But sub-Tenon anesthesia is significantly associated with lower incidence of severe pains.

Hand Hygiene Practice and Face Mask Use among Eye Health Workers at the Guinness Eye Centre Onitsha, Nigeria

Hand Hygiene Practice and Face Mask Use among Eye Health Workers at the Guinness Eye Centre Onitsha, Nigeria

Relationship between axial length, keratometry and central corneal thickness in patients with refractive errors at a teaching hospital in Southwest, Nigeria

Background: Aim of the study was to determine the relationship between axial length (AL), keratometry and central corneal thickness (CCT), and refractive errors in adult patients attending the Guinness eye centre (GEC), Lagos university teaching hospital (LUTH) Idi-Araba, Lagos.Methods: A descriptive cross-sectional study conducted among consecutive patients aged 16 years and above with refractive errors attending the GEC, LUTH. Ocular parameters measured included AL, anterior corneal curvature, CCT and refractive errors. AL and keratometry were measured with IOL master and CCT with ultrasonic A scan pachymeter. Refraction was done with auto-refractor-keratometer. Data analysis was done with statistical package for social science (SPSS) 20. Results: A total of 394 patients were studied, 157 males and 237 females. The age range was 16-65 years, mean -37.9±13.3 years and median -36.5 years. There were more myopic patients 215 (54.6%) than hyper-metropes 179 (45.4%). The mean AL was 23.9±1.1 mm and eyes with longer AL were more likely to be myopic (r=-0.676, p&lt;0.001); to have flatter cornea (r=0.519, p&lt;0.001) and thicker cornea (r=0.149, p=0.003). The mean CCT was 520.3±31.0 µm. There was a weak negative correlation between CCT and refractive error (r=-0.111, p=0.027).Conclusions: The mean CCT was lower than the mean CCT of other Nigerian studies. Hypermetropic patients were more likely to have thinner corneas. This may lead to underestimation of intraocular pressure (IOP) in these patients. Significant correlation was seen between AL and refractive error, CCT and keratometry. AL correlated with less spherical equivalent refractive error, flatter and thicker cornea. It is therefore important to measure the CCT of all patients going for refractive surgery to detect those at risk of developing corneal ectasia following refractive surgery.

Perception and Acceptance of COVID-19 Vaccination among Patients in a Tertiary Hospital in South-East Nigeria

Aims: To determine the perception and acceptance of COVID-19 vaccination among patients in a tertiary eye hospital.&#x0D; Study Design: A cross-sectional hospital-based study.&#x0D; Place and Duration of Study: Guinness Eye Centre Onitsha, South-East Nigeria between 1st to 29th June 2021&#x0D; Methodology: An interviewer-administered semi-structured pretested questionnaire on sociodemographic, knowledge, perception and acceptance on coronavirus disease and its vaccine was used to collect data on eligible patients. Data obtained was analyzed with SPSS version 23 (IBM Corporation, Armonk, NY, USA). Descriptive statistics including frequency tables, mean and standard deviation was used to present categorical variables.&#x0D; Results: A total of 386 patients were interviewed comprising 157 (40.7%) males and 229(59.3%) females, and aged 18 to 93 years (mean age of 44.73±18.49 years). Two hundred and fifty-eight (66.8%) patients knew of COVID-19 vaccine availability in Nigeria, with 90 (34.9%) not knowing where they could obtain the vaccine. Only 34 (8.8%) had taken the vaccine. Uptake of COVID-19 vaccine is strongly associated with patient’s perception of COVID-19 being real (P=0.006), patients trust in the information head about the vaccine (P=0.001), and their trust on the efficacy and safety of the COVID-19 vaccine (P˂0.001). Acceptance of COVID-19 vaccine is not significantly associated with their faith in the previous human vaccinations(P=0.076).&#x0D; Conclusion: The uptake of COVID-19 vaccine in the study group is low. Therefore, there is an urgent need for re-strategizing on various ways to enlighten the public and widen the scope of information dissemination.

Clinical features of Primary Open Angle Glaucoma at initial presentation: Experience at a tertiary eye care center in Nigeria

Introduction: Glaucoma is a group of optic neuropathies and the leading cause of irreversible blindness worldwide. Primary open angle glaucoma is the commonest type of glaucoma. In affected people, optic nerve fibres are damaged with ensuing loss and raised intraocular pressure in some sufferers. Aim/objectives: To increase knowledge and understanding for improved care of primary open angle glaucoma patients. Method: This was a retrospective study of consecutive 167 hospital patients presenting in Guinness Eye Center Onitsha over a period of February to December 2018 who were diagnosed as having primary open angle glaucoma. Relevant clinical data were studied. Descriptive and correlation statistics were used to ascertain significance of features detected. Results: The patients were 87 (52.1%) males and 80 (47.9%) females. The age range was 17 to 76 years (Mean of 56.4 ± 3.02 years). Mean duration of disease before presentation was 30.4 ± 5.9 months. Visual acuity at presentation was less than 3/60 in 121 (36.2%) eyes. Intra-ocular pressure mean was 26.6 ± 1.6mmHg. The mean of Cup to optic disc ratio is 0.77 ± 0.2. The visual field loss was total or advanced in 69.6%. Using Pearson’s correlation 2-tailed test: cup/disc ratio correlates with duration of presenting symptoms in months at p=0.05, and with intra-ocular pressure at P= 0.01 On non-parametric correlation, using Spearman’s rho 2-tailed test, at p= 0.5, duration of presenting symptoms correlates with age; and at P = 0.01 cup/disc ratio correlates with level of intraocular pressure Conclusion: Primary open angle glaucoma present at an advanced stage of the disease. Advocacy is needed for dissemination of information about this disease and where to get care.

Comparison of autorefractor with focometer in patients with refractive errors attending Lagos University Teaching Hospital, Lagos, Nigeria - A cross sectional survey

Background: Uncorrected refractive error is the most common cause of visual impairment globally. Yet, there is paucity of refractionists in rural areas of most developing countries. Thus, there is a need for a cost effective but accurate method of refraction that could be used by rural health workers with minimal training. To compare refractive error measurements of autorefractor with that of focometer with a view to determining the accuracy and reliability of focometer. Methods: This was a comparative cross-sectional study conducted among patients with refractive errors attending the Guinness Eye Centre Clinic, Lagos University Teaching Hospital, Lagos, Nigeria. Consecutively consenting patients who met the eligibility criteria were recruited until the sample size was attained. All participants had a standardized protocol examination including visual acuity assessment and ocular examination. Refractive error was measured using the autorefractor, focometer and subjective refraction in both eyes of each participant. Comparison was done based on the means of variables of autorefractor, subjective refraction and focometer measurements using the paired-sample t-tests, Pearson's correlation and linear regression. Agreement between the measurements was investigated using the Bland-Altman analysis and reliability of the repeated measurements tested with Cronbach's alpha. The analysis was considered statistically significant when the P &lt; 0.05. Results: Four hundred eyes of 200 patients were analyzed in this study. The mean age of respondents was 45.1 ± 16.3yrs and the male:female ratio was 1: 2.1. There was a statistically significant difference between the mean spherical (P &lt; 0.001) and cylindrical (P &lt; 0.001) readings of the focometer and autorefractor. However, the mean difference between the spherical equivalent of focometer and that of the autorefractor was not statistically significant (P = 0.66). Pearson correlation coefficient was high for the compared methods of refraction as both the bivariate linear regression between the autorefractor and focometer, and that between the subjective refraction and focometer showed good linearity. Bland-Altman plot showed good agreement between the mean focometer measurements with both the autorefractor (mean difference = +0.02 ± 0.85 DS; mean difference ± 1.96 standard deviation [SD] = 1.69 to − 1.65 DS) and subjective refractive (mean difference = +0.06 ± 0.72 DS; mean difference ± 1.96 SD = 1.49 to − 1.36 DS) measurements. Cronbach's alpha showed good reliability of focometer and autorefractor repeated measurements. Conclusion: This study showed a good correlation and agreement between focometer and autorefractor. Hence, focometer could be used for refraction in low resource settings where locals could be trained in its use.

Ophthalmic Patients’ Perceptive on Corona Virus Disease (Covid-19) Pandemic in Onitsha, Nigeria

Objectives To determine patients’ perception of COVID-19 and their practice of disease prevention measures. Materials and Methods: Consenting, consecutive new adult patients at the Guinness Eye Centre Onitsha were interviewed using a pretested questionnaire. Information sought included patients’ COVID-19 knowledge, its symptoms, transmission, preventive measures, compliance, and worries. Results: Of 81 participants, the mean age was 47.9 ± 17.6 years; 31 (38.3%) were males; 61 (75.3%) attained secondary or higher education. All participants knew about COVID-19; radio/television was the most common information source (88.9%). Although 85.2% participants knew that COVID-19 is a communicable disease, 86.4% knew of its viral etiology and 86.4% knew that it could be transmitted by close contact with persons/fomites. Common symptoms known to the participants were cough (82.7%), fever (61.7%), and breathlessness (55.6 %); the most common known preventive measures were wearing face mask in public (90.1%) and handwashing (82.7%). Although 44.4% knew that physical distancing was a preventive strategy, only 11.1% knew that the distance of separation should be at least one meter; 49.4% always wore face mask in public, 61.7% washed hands frequently, whereas only 4.9% maintained physical distancing; 44.4% worried that pandemic restrictions negatively affected their access to eye care and 29.6% feared contracting the disease in eye clinics. Conclusions: All study participants knew of the COVID-19 pandemic. However, knowledge of the disease, its transmission, and preventive measures was suboptimal; many patients do not adhere to the recommended preventive measures. Repetitive public health education is required to improve compliance with disease control measures and allay fears.

Pterygium in Onitsha, Nigeria.

To determine the pattern and risk factors of pterygium in adults at the Guinness Eye Centre Onitsha, Nigeria. Consecutive adults aged ≥30 years with pterygium were studied. Each patient had comprehensive ocular examination including visual acuity, anterior segment, and adnexal assessment and fundoscopy. The pterygium was graded in terms of severity and type. A total of 156 patients with pterygium participated; 92 (59%) females versus 64 (41%) males (F:M =3:2). The age range was 30-65 years; mean: 43.9 ± 8.4 years. The majority of the study population (36.5%) was of the age group 40-49 years. The subjects were predominately traders 78 (50%) and 93 (59.6%) of the pterygium patients were outdoor workers. Bivariate analysis indicated that those involved in outdoor work were six times at greater risk of developing pterygium than indoor workers (P = 0.001; OR = 6.2). Out of the 156 pterygium patients seen, 107 (68.6%) of them complained of associated symptoms. Redness of the eye was the commonest symptom reported by 79 (50.9%) cases while 8 (5.1%) cases complained of burning sensation. There was a preponderance of nasal pterygia with temporal pterygia being the least. Blinding pterygium was seen in three eyes (1.3%). Pterygium is a common disorder presenting at eye clinics. Outdoor workers are at a greater risk of developing pterygium. Thus, health education is of great importance.

Vision-Related Activities among Glaucoma Patients in Onitsha Nigeria

Objective: To evaluate performances of different task by Primary open angle glaucoma (POAG) patients at Guinness Eye Centre Onitsha Nigeria. Materials and methods: POAG patients underwent a modified culturally relevant five items of the Activities of Disability Related to Vision (ADREV) tasks. These tasks were recognizing facial expression, detecting motion, locating objects, placing pegs into different sized holes and matching socks. The score ranged from 0 to 7(0=inability to carry out any task, 7=task carried out effortlessly with grades in between scores based on ease of carrying out task). Glaucoma severity was also assessed. Results: Two hundred and four patients with mean age of 61.0 years; 46.1% males and 53.9% females participated in this study. The total mean score of the 5 tasks carried out was 26.6 ± 9.9SD; range of 0-35. The ratings for the individual tasks were: motion detection 6.21 ± 1.8; placing pegs 5.77 ± 2.1; object location 5.39 ± 2.2; facial expression 4.73 ± 2.1 and matching socks 4.49 ± 2.5. Patients aged ≥ 60 years had more advanced glaucomatous damage and greater difficulty performing the task (p=0.01) Conclusion: Older age and more glaucomatous damages were associated with poor ADREV performance. Matching of socks and identification of facial expressions were the most tasks. Older glaucoma patients and those with advanced disease require support for vision-related activities of daily living.

Self-Reported Quality of Life among Primary Open Angle Glaucoma Patients at Guinness Eye Centre Onutsha,Nigeria

Objective: To evaluate the quality of life of newly diagnosed Primary Open Angle Glaucoma (POAG) patients at Guinness Eye Centre, Onitsha. Materials and method: The quality of life amongst newly diagnosed POAG patient’s aged ≥ 40 years was assessed with the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) questionnaire. Also obtained was information on the patients’ sociodemographic characteristics. Result: A total of 207 new POAG patients, aged 40 to 92 years (mean age of 61.0) responded. There were 95 males (45.9%) with 100 (48.3%) less than 60 years of age. These patients had a mean quality of life score of 66.6 ± 27.1SD; and general vision had the least subscale score (40.6 ± 23.4SD) while ocular pain subscale had the highest score (84.2 ± 20.6SD). The mean quality of life score for males and females were 63.5 ± 29.3SD and 69.2 ± 25.0SD respectively; while the mean quality of life scores for age group < 60 years and ≥ 60 years were 73.0 ±26.5 and 60.6 ± 30.0SD respectively. Conclusion: There was no difference in quality of life scores among gender (p=0.1). However quality of life scores were lower in patients ≥ 60 years (p=0.001), rural dwellers (p=0.002), dependents (p=0.001) and those with non-formal education (p=0.001). Patients in this study report a moderate quality of life score. Likely factors that may be responsible for reduction in quality of life should be explored in this group.

Eye Cancers at the Guinness Eye Center Onitsha, Nigeria

Objectives: To describe the hospital incidence and pattern of ocular and adnexal cancers at the Guinness Eye Center, Onitsha. Materials and Methods: The case files of all new patients seen with ocular and adnexal tumors at the Guinness Eye Center, Onitsha, between 2005 and 2017 were reviewed. Those with histological diagnosis of malignancy were selected and analyzed. Information obtained included age, sex, disease duration, diagnosis and co-morbidity. Results: There were 85 patients (0.1% of all the new patients), made up of 42 males and 43 females. The median age was 5 years; range: 5 months–70 years. The commonest cancers were retinoblastoma, 45 patients (52.9%) and conjunctival squamous cell carcinoma, 30 (35.3%). Twenty eight (93.3%) squamous cell carcinoma patients were HIV-positive. No child had squamous cell carcinoma. All retinoblastoma patients were aged ≤6 years. Conclusions: The incidence of ocular and adnexal cancers at the Guinness Eye Center, Onitsha, was low with retinoblastoma and conjunctival squamous cell carcinoma accounting for most of the cancers. While retinoblastoma would most likely be suspected in a child with ocular tumor, young adults with squamous cell carcinoma should be evaluated for HIV infection. Since these lesions threaten sight and life, the public should be educated on the early signs of the diseases and the need to report to hospital early.

Retinitis Pigmentosa in Onitsha, Nigeria.

Background:Retinitis pigmentosa describes a heterogenous group of progressive hereditary degeneration of the photoreceptor-retinal pigment epithelium complex with varying clinical manifestations. Although studies on the epidemiology of blindness and visual impairment in Nigeria have documented the contribution of retinitis pigmentosa, detailed study of the prevalence, incidence, and pattern of retinitis pigmentosa in Nigeria are few.Objectives:The aim of this study was to describe the relative frequency rate and pattern of retinitis pigmentosa among new patients at the Guinness Eye Center Onitsha Nigeria.Materials and Methods:Case files of new patients with clinical features of retinitis pigmentosa seen over a 6-year period were reviewed. Information on age, sex, and associated clinical features were extracted into a standard proforma and analyzed.Results:Thirty-seven (0.6%) of 5876 new patients had retinitis pigmentosa. There were 25 (67.6%) males and 12 (32.4%) females with an age range of 4–76 years; the median age was 33 years. Family history suggested autosomal dominant inheritance in 15 (40.6%) patients, autosomal recessive inheritance 4 (10.8%), X-linked inheritance 9 (24.3%), and 9 (24.3%) sporadic. Six (16.2%) patients were blind (acuity <3/60) and 22 (59.5%) patients had visual impairment (acuity <6/18). Eight (21.6%) patients had coexistent deafness (syndromic retinitis pigmentosa) including two (5.4%) cases of Usher syndrome.Conclusions:The relative frequency rate of retinitis pigmentosa among new patients in our hospital is low but the associated visual and otologic incapacitation are enormous. A prospective study incorporating molecular genetics would more exactly determine the inheritance pattern and the common genes of retinitis pigmentosa in Nigerians.