Traditional Eye Medications Research Articles

Self-medication as an Initial Treatment and its Associated Complications in Ophthalmic Patients at Al-Khidmat Teaching Hospital, Mansoorah, Lahore, Pakistan

Purpose: To identify self-medications used by patients as initial treatment for various eye problems and to analyze associated complications. Study Design: Cross sectional. Place and Duration of Study: Al-Khidmat teaching hospital, (University of Lahore) from October 2021 to September 2022. Method: This study included 117 patients using traditional eye medications (TEM) and over the counter (OTC) ophthalmic drugs before presenting in ophthalmic outdoor. A semi structured questionnaire was used as a tool to collect the data. All patients aged 18 years and above were directly questioned. For patients below 18 years, responses were collected from the patients themselves when possible; otherwise, the accompanying parent provided the information. Age, gender, educational status and area of residence were recorded. The symptoms compelling the use of TEM/OTC or both, the source and type of medication, diagnosis and any complications that resulted due to self-medication were documented. Complete ocular examination was done. MS Excel was used to record and analyze data. Results: There were 48% males and 52% females. Rosewater was the most frequently used TEM by 54.7%. Steroids-antibiotic combination eyedrops/ointments were used by 31.6%. Symptoms for which self-medication was done, were redness (64.1%), watering (35.9%), itching (32.5%) and discharge (26.5%). Symptoms did not improve in 54.7%, 26.5% required ophthalmic consultation and only 18.8% had temporary relief. Twelve percent developed complications. Conclusion: Self-medication with TEM or OTC drugs should be discouraged as these can cause detrimental effects on eyes.

Traditional Eye Practices: Economics and Visual Status of Users in North Central Nigeria.

Traditional medicine is a constellation of practices, approaches, knowledge, and beliefs, which encompass material-based medicines, spiritual therapies, and manual techniques applied individually or combined. This study seeks to determine the cost and visual status of traditional eye treatments users among new patients at a health facility. This is part of the study titled "Traditional eye practices: A facility-based study in North Central Nigeria." It is a cross-sectional, facility-based study conducted between July 2013 and June 2014 on new patients seen in the eye unit of Church of Christ in the Nations Rehabilitation Center, Mangu. Interviewer-administered structured questionnaire was used to gather information on patient demographics; cost of traditional eye medication and manipulations and visual status of new patients were recorded. The use of traditional eye treatment was reported by 134 (4.3%) of the 3113 new patients. Traditional operative couching of lens was more expensive than using traditional eye medications (P < 0.001). Payment modality varied, and poor visual status was significantly higher among traditional eye treatment users (P < 0.001). Since most respondents who had their eyes couched or used traditional eye medicine were able to pay such high price with dissatisfaction and poorer visual status, they should be able to pay for modern cataract surgery with good outcome. There is a need for health education of the general public about the deleterious effects of traditional eye treatment.

PRACTISE AND USE OF OVER-THE-COUNTER TOPICAL AND TRADITIONAL EYE MEDICINES AND THEIR EFFECTS IN FUNGAL KERATITIS CASES IN TERTIARY TEACHING HOSPITAL IN NORTHERN INDIA

Objective: The study goal is to evaluate the utilization and misuse of over-the-counter topical and traditional eye medications and their associated adverse effects in cases of fungal keratitis (FK) among patients. Methods: The research was conducted in the past 36 months at a tertiary teaching hospital in Northern India. All subjects provided informed consent, and the institutional ethical committee granted ethical approval. The study involved 127 cases of FK, clinically diagnosed and confirmed by a 10% KOH mount. Results: Among the baseline characteristics, 51 (40.18%) of the samples were in a 41–60-year-old age group; 78 (61.42%) were male; 116 (91.34%) were from rural areas; 114 (89.76%) had low socioeconomic status; 108 (85.4%) were illiterate; and 50 (39.37%) were farmers. According to visual acuity ratings, at the time of presentation, 57.48% of the patients had vision up to 1/60. In terms of over-the-counter medication usage, 109 (85.82%) respondents used them for the treatment of keratitis, with 64 (61.46%) using steroid drops. In the case of traditional eye medicines, 18 (14.18%) respondents used them, with 5 (27.11%) using milk and ghee. Conclusion: This study underscores the importance of addressing the misuse of over-the-counter and traditional eye medications in cases of FK and advocating for public health interventions to ensure rational and safe eye medication practices.

Impact of organized teaching programme on awareness of mothers regarding prevention of eye problems in children at selected rural areas of Kolar district

Background: Depending on the geographical area and socioeconomic state of the population, numerous diseases can cause visual impairment and blindness in children. Blindness in children in underdeveloped nations is typically caused by illnesses that result in corneal scarring such as vitamin A deficiency, measles infection, neonatal conjunctivitis, and dangerous traditional eye medications. Cataract, retinopathy of prematurity, genetic disorders, and congenital anomalies are the most common causes elsewhere. This issue is complicated by a lack of information about eye care and utilization of eye treatments. Methods: For this study, an evaluative technique was applied. The data was collected using a one-group pre-test and post-test design. The organized teaching programme on prevention of eye problems in children was the study's independent variable, while the knowledge level of mothers on prevention of eye problems was the dependent variable. A structured interview schedule was utilized to collect data from 100 mothers who were recruited using the purposive sample technique.Results: In the pre-test, the mean percentage of total knowledge was 56.35, with a standard deviation of 2.37. The mean percentage of total knowledge in the posttest was 75.83, with a standard deviation of 1.37. The obtained t value of 24.70 was larger than the table value of 2.66 and it was judged to be significant at the threshold of 0.01.Conclusions: Study demonstrated that the organized education programme was successful in raising mothers' awareness about the prevention of eye disorders in children.

Glaucoma care and follow-up in sub-Saharan Africa: Is there a need for modification of counselling practices to improve awareness, knowledge and treatment acceptance profiles? A prospective cross-sectional study.

Blindness from glaucoma is prevalent in parts of Africa. Lack of awareness, late diagnosis, poor acceptance and compliance to treatment as well as unorthodox care practices are among many contributing factors. Strategies that improve glaucoma awareness and treatment acceptance are required to resolve this trend. To evaluate the influence of counselling on glaucoma awareness, willingness to accept glaucoma surgery and eye care practices among primary open-angle glaucoma patients on medical treatment. A prospective cross-sectional interviewer-administered questionnaire-based study evaluating the demographics, glaucoma awareness, acceptance of operative care and use of traditional eye medications among patients with primary open-angle glaucoma on medical treatment followed up over a 12-month period. A total of 120 eligible participants were recruited. Glaucoma awareness and basic knowledge were 93.3 and 12%, respectively. Educational attainment and positive family history were associated with glaucoma awareness (p = 0.027 and p = 0.042, respectively). Seventy-five (62.5%) participants accepted glaucoma surgery as a treatment option. However, the duration of medical treatment was inversely related to the acceptance of glaucoma surgery (odds ratio = - 0.390, p = 0.009). Twelve (10.5%) participants use traditional eye medication for their current eye problem. Glaucoma counselling should be performed with a content template that delivers all relevant information to patients and caregivers. This will bridge gaps in knowledge and improve the early presentation, acceptance of glaucoma surgery and eye care practices.

A Preliminary Report of Predisposing Factors and Predominant Microbiological Diagnosis of Corneal Ulcers Seen at the Federal Teaching Hospital Abakaliki, Nigeria

Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives: To determine the predisposing factors and predominant microbiological diagnosis of corneal ulcers seen at the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria. Materials and Methods: This is a preliminary report of an on-going longitudinal descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period. Information obtained were socio-demographic data, presenting complaints, duration of symptoms prior to presentation, history of preceding trauma, medications used before presentation, presenting and final visual acuity and microbiological diagnosis. Results: A diagnosis of corneal ulcer was made in 8 out of the 852 outpatients seen over the study period giving a hospital prevalence rate of 0.59%. Five patients (62.50%) were males, five (62.50%) were farmers and 4 patients (50%) were above 60 years of age. The microbial diagnoses were bacterial keratitis 37.5% (Staphylococcus aureus), fungal keratitis 25% (Fusarium spp. and aspergillus) and acanthamoeba (25%). None of the patients ever used contact lenses. There was a history of eye trauma in 50% of the patients. All the eyes presented blind after a period of failed attempts to treat by self or quacks. Mean duration before presentation was two weeks. Treatment improved the visual acuity in 37.5% of patients. Conclusion: Bacteria, fungi and acanthamoeba organisms were the microbiological isolates from the scrapings of corneal ulcer patients seen in the eye clinic of FETHA; with bacterial organisms being the most common. Farming activities, preceding eye trauma, delayed presentation, self-medication and use of traditional eye medications (TEM) were common findings among the patients. A future larger study is recommended to confirm the findings of this study. Eye health education campaigns should be directed at farmers to encourage early presentation to hospitals.

Evaluation of content and cost of traditional eye medication in a resource-poor country - Implications for eye care practice and policy.

Cataract, glaucoma, and conjunctivitis are common causes of ocular morbidity in Nigeria. A major obstacle in reducing the burden of ocular morbidity in rural areas is access to eye care services. Up to 80% of the population in developing countries use traditional medications for their primary healthcare needs because they are accessible, available, and affordable. The aim of this study is to evaluate the content and cost of commercialized traditional medications used in the treatment of common eye conditions in Nigeria. All the registered traditional healers (THs) at an International Trade Fair in Enugu who treated eye problems were identified. Data on their location and scope of their practice were collected by the researchers. Proxy patients consulted THs in the trade fair with simulated cataract, glaucoma, and bacterial conjunctivitis, and treatment was sought. Medication for the treatment of the simulated disorders was paid for and procured. The mode of administration and the cost of the drugs were recorded by proxy patients. Each medication was labeled with a code and sent to the laboratories of the National Agency for Drug Administration and Control for analysis. Data were entered into a database on Microsoft Access and transferred to STATA V12.1 (StataCorp) for analysis. Cataract was treated by 87.5% of all the traditional eye healers interviewed. A total of 32 samples were collected and analyzed. These comprised mainly oral (53.1%) and topical traditional medications (43.8%). The pH of the topical samples ranged from 3.5 to 10, while the mean microbiological load per topical solution was 3.3 × 104 cfu/mL ± 0.96. The cost of treatment of cataract ranged from 4 to 70 USD. The content of the majority of the samples of traditional eye medications in this study had high extremes of pH and/or had a high microbial content. The practice of THs should be regulated.

Traditional eye medicine use among ophthalmic patients attending a secondary health care center in Southeast Nigeria

Introduction: The perceived high cost of eye care services has been implicated as one of the reasons for the use of traditional eye medications (TEMs) in the country. Other factors including distance, tradition, ignorance, and failure of medical treatment among others have also been documented as determinants of TEM use. TEMs constitute a wide range of unorthodox therapies utilized for treatment of ocular disorders. They have been reported to have no beneficial effect rather causing more harm than good. Aim: This study sought to determine the prevalence, types, and ocular indications for TEM use in the study population. Methods: This was a cross-sectional study in which a structured questionnaire was used to collect relevant data from consecutive patients attending the eye clinic during the study. Results: At a prevalence of 15.8%, the highest use of TEM was noted among artisans, those in the seventh decade of life, with low level of education, ocular complaints of poor vision, and illness of <1 year duration. Its use though high, was not significantly associated with age, sex, education, occupation and illness duration. Roots and herbs were the most common types of TEM used. Conclusion: There was a high prevalence of use of TEM in this study. The deleterious effect of its use is known and has been reported in literature. Education and enlightenment of the public are needed and highly recommended.

Knowledge and practice of the use of traditional eye medication in a semi-urban community

Background: Traditional eye medications may be harmful causing ocular morbidity. The aim of this study is to determine the knowledge and practice of traditional eye medication (TEM) among adults in a semi-urban community in Edo state. Materials and Methods: A 3 months cross-sectional descriptive study in Ekiadolor community in Ovia North East Local Government Area of Edo state, Nigeria. A cluster sampling technique was used. Four hundred and thirty respondents aged between 18 years and above were included in the study. Results: A total of four hundred and thirty respondents (430) which comprised of 184 (42.8%) males and 246 (57.2%) females with a male to female ratio of 1:1.3 were studied. The age range of the respondents was 21 to 84 years, with a mean age of 49.83 ± 19.99 years (standard deviation). Three hundred and ninety-two (91.2%) of the respondents knew about TEM. Herbal extract was the most known (94.4%). Although 71.6% said TEM was harmful, the prevalence of use of TEM was 48.7%. The male gender, low socioeconomic class, and no or low level of formal education were more likely to use TEM (P = 0.001). Conclusion: The knowledge and practice of TEM are high in this community. There is a great need to educate the people on the overall harmful effect of this practice through public enlightenment campaigns.

Health Seeking Behaviours of Patients Attending Primary Eye Care Centre in Nigeria

Purpose: To determine health seeking behaviour in relation to non-orthodox eye medication use among patients attending a primary eye health center in Nigeria. Materials and Methods: It was a cross-sectional study of consecutive respondents. Participants' socio-demographic profile, types and pattern of harmful traditional eye medications (HTEMs) use were obtained using a pre-tested questionnaire. Data analysis was by SPSS version 20.0. Results: Of the 303 patients enrolled in the study, 153 (50.5%) were males and 150 (49.5%) were females. The age range was from 13 years old to 94 years old with a mean of 53.8 ± 17.05 years old. Majority of the subjects (74.3%) used orthodox medical outfits for their eye care needs. The prevalence of use of HTEMs was 11.9%. Common forms of TEMs used were herbs 24 (66.7%), sugar water 3 (8.3%), breast milk 3 (8.3%) and onions 6 (16.7%). There was statistically significant association between age and use of HTEMs (p = 604.27, 2 χ =< 0.001, 95% CI = 0.000 - 0.010), and health seeking behaviour (p = 808.70, 2 χ =< 0.001, 95% CI = 0.000 - 0.010). Conclusion: Eye care providers and health care managers must have good knowledge of the various factors that negatively influence utilization of eye care services and be responsive to them.

Incidence of kerato conjunctivo uveitis caused by traditional eye medications in a teaching hospital of Andhra Pradesh

Traditional eye medications (TEM) usage is still a common practice as most patients in India consult a traditional healer. Poverty, socio-cultural beliefs, poor health-seeking behavior, and lack of access to health facilities are reasons for the persistence of this practice. [1],[2] Fifty patients with kerato conjunctivo uveitis who used TEM, especially some leaf extract for 3 days, visited ophthalmology clinic, Narayana Medical College Hospital during June 2012. Ocular complications included purulent conjunctivitis in 25 subjects, keratitis in 15 subjects, corneal ulcer in 1 subject, and iridocyclitis in 9 subjects respectively. All patients' disease condition was reversed by the local application of steroid drops, topical antibiotics, anti-allergic drops, and artificial tears. The use of TEM is harmful, further leads to blindness. Proper health education to the public can reduce the prevalence of preventable blindness.

Honeybee sting of the sclera: occular features, treatment, outcome and presumed pathogenesis

Ocular bee sting injury has caused several reactions in the eye but has rarely been reported among local African farmers, and Nigerians in particular. This case seeks to report the first ocular and external eye reactions following a honey bee sting of the eye through the sclera, highlighting the treatment and outcome. Oral interview, clinical examination and external photographs were used to obtain and document findings. Medical treatment was instituted as soon as subject presented. There was complete inflammatory resolution within a week, normal vision and no evidence of stinger migration after four weeks of follow up. The wound site healed with ciliary staphyloma. The role of physical properties, immunological and genetics interplay and the presumed pathogenesis is further discussed. Health education on early presentation and avoidance of harmful traditional eye medications should be promoted among the farming populations in our communities, in order to prevent blinding complications

Eye health seeking habits and barriers to accessing curative services among blind beggars in an urban community in Northern Nigeria.

The aim of the following study was to determine the types of intervention sought by the blind street beggars and assess the barriers to accessing available eye care services. This cross-sectional study was conducted among consenting blind street beggars in Sokoto, Nigeria between May and June, 2009. A semi-structured interview was conducted to probe issues on historical antecedents of the blindness and the eye heath seeking behavior including the use of traditional eye medications. Assessment of barriers to accessing curative services among the blind persons was explored. Questions were asked and the individual responses were recorded in the questionnaire under the appropriate sections. Two hundred and two of 216 (94.7%) of the examined subjects were found to be blind and included in the analysis. The principal cause of blindness was corneal opacity. Overall 82% of the blindness was due to avoidable causes with majority irreversibly blind. Only 38 subjects (18.8%) sought for intervention in hospitals, others resorted to self-medication (42.1%), medicine store (31.2%) and traditional facility (7.9%). Those that accessed treatment at a hospital did so mainly at a primary health center (50.0%) and General Hospitals (34.2%). The barriers to accessing treatment at the hospital were mainly due to "not taken to any hospital" by the parents/relatives (50.3%) and "services not available" (25.2%). Most respondents resorted to ocular self-medication particularly traditional eye medicines. We advocate for a provision of affordable, accessible and qualitative eye care services with a strong health education component on avoidable causes of blindness.

Indications for destructive ocular surgeries in Nigeria

Destructive ocular surgery (DOS) means eye loss. An audit of its indications would be useful in reducing its incidence. To determine indications for destructive ocular surgeries. The case records (files) of all the patients who had DOS in a tertiary health facility in Nigeria from January 2004 to December 2011 were reviewed retrospectively. The information extracted include the bio data, indication for DOS, type of surgery performed and history of the use of traditional eye medications (TEM) and willingness to use an artificial eye (AE). Thirty-seven patients had DOS. The mean age of the patients was 35.51years (SD 21.6) and the male to female ratio was 2.1:1. Evisceration was the commonest DOS performed , in 30 eyes (81.1 %). The most common indication for DOS was intraocular infection, in 15 eyes (40.5 %), followed, among others, by trauma in 13 (35.1 %) and malignant ocular tumours in 4 (10.8 %). There was association between age and indication for DOS (P = 0.032). Many patients, 15 (40.5%), used TEM and most, 34 (91.9%), refused an artificial eye (AE) after surgery. The most common indication for DOS in this study was intraocular infection. Evisceration was the commonest destructive eye surgery offered.

Prevalence of Harmful/Traditional Medication Use in Traumatic Eye Injury

Aim:Ocular trauma of varying aetiologies do occur frequently, however when different traditional/harmful substances are applied before presentation in the hospital, prognosis in terms of visual outcome following treatment may be worse than expected. This study is aimed at determining the prevalence of harmful/traditional eye medication practices among patients with traumatic eye injury in a tertiary institution.Study Design/Setting:It is a retrospective study of patients seen at the eye clinic of the Ekiti State University Teaching Hospital (a state government owned hospital), Ado Ekiti, from January to December 2009.Method:A review of case notes (medical records) of patients with history of ocular trauma both open and closed globe injury and who presented to the eye clinic of the Ekiti State University Teaching Hospital, Ado Ekiti from January to December 2009 was carried out. Demographic data of the patients, nature of the ocular trauma, substances applied to the eyes, visual acuity at presentation and after treatment were extracted. Frequencies and percentages were used in analysing the data.Result:A total of 1420 new patients attended the eye clinic during the study period (January to December 2009). Forty eight (3.4%) applied various substances into their eyes after sustaining ocular injury. Substances applied include Kerosene 25%, cassava water 20.8%, breast milk 12.5%, personal urine 10.8%, and cow urine 8.3%. Nearly half of the patients 23 (47.9%) presented with low vision and after treatment there was no visual improvement in almost all of them, 22 (45.8%). The period before presentation ranges between 1hr -2weeks post injury. However, the number of monocular blindness reduced from 8 (16.7%) to 5 (10.4%) after treatment.Conclusion:Kerosene and Cassava water were the common substances applied to the injured eye. The use of these harmful and traditional eye medications on injured eyes can reduce further the visual prognosis despite ophthalmic intervention.

Ocular features and management challenges of Marfan′s Syndrome in Benin City, Nigeria

The objective of this study is to describe the ocular features of Marfan's Syndrome in Benin City, Nigeria and highlight problems associated with their management A study of all consecutive patients with a diagnosis of Marfan's syndrome at the eye clinic of the University of Benin Teaching Hospital, Benin City, Nigeria was done between June 1st 2009 and December 31st 2010. There were 13 patients (8 males and 5 females). The age range was 10 to 50 years with a mean age of 23+10.1 years. The duration of symptoms was 1 year to 22 years with a mean of 7.9 years. The ocular features were ectopia lentis in 92.3% of the patients, cataract in 69.2%, glaucoma and myopia in 30.8% each. Others were strabismus (7.7%), unilateral corneal opacities from the use of traditional eye medication (15.4%), phthisis bulbi and retinal detachment in 7.7% each. Three (23%) patients were bilaterally blind while 7(53.8%) had unilateral blindness. The best corrected visual acuity in 4 out of 5 patients who had cataract extraction at 8 weeks post op. was 6/60 to 6/12. There was no improvement in 1 patient. Patients with Marfan's syndrome in Benin City, Nigeria have visual impairment and blindness due to delay in presentation and the use of traditional eye medications. Health education and early presentation to hospital is recommended. This will help in reducing avoidable visual impairment and blindness and thus improve survival and quality of life in these patients.

Corneal ulcers in a tertiary hospital in Northern Nigeria

To highlight the pattern of corneal ulcers at the Guinness Ophthalmic Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria. A retrospective review of case notes of patients who presented with corneal ulcer at the Guinness Ophthalmic Unit, Ahmadu Bello University Teaching Hospital between January 1995 and December 2005. Information obtained include demographic data, presenting complaints, predisposing factors, microbiological diagnosis, use of orthodox or traditional medications before presentation, duration before presentation and, presenting and final visual acuity. A total of 228 cases presented within the 10 years study period. There were 129 (56.6%) males and 99 (43.4%) females. The age range was 15 months to 66 years. The commonest presenting complaints was poor vision 109 (47.8%) followed by lacrimation 97 (42.5%) and ocular pains 96 (42.1%). The common predisposing factors were trauma 117 (51.3%), use of traditional eye medications 39 (17.1%), self medication with topical steroids 13 (5.7%) and measles 9 (4.0%). The presenting visual acuity was <6/60 in 49.8% of the patients, <6/18-6/60 in 23.4%, and 6/6-6/18 in 25.5% of the patients. At discharge, 45.6% had a visual acuity of 6/6-6/18, 27.2% had borderline vision (<6/18-6/60), 18.0% had severe visual impairment (<6/60), while 6.6% had no light perception. The commonest organisms isolated were Staphylococcus aureus in 19.7%, fungal hyphae in 15.8% and Streptococcus pneumoniae in 4.8%. In this study most patients with corneal ulcer presented with poor vision and excessive lacrimation. Trauma was the commonest predisposing factor with bacterial organisms as the commonest isolate.

Pattern of traditional eye medications use as seen in a tertiary hospital-university of Uyo Teaching Hospital experience

BACKGROUND: Traditional eye medications (TEM) are biologically based concoctions instilled into the eye to achieve a desired ocular therapeutic effect but its use, though widely practiced, has no sound scientific evidence in the treatment of eye diseases.AIM: The aim of the study was to determine the prevalence and types of traditional eye medications in use in our environment.&#x0D; MATERIALS AND METHOD: This was a retrospective study of new patients who presented in the eye clinic between January 2008 and December 2009.&#x0D; RESULTA total of 47 of the 5,416 patients (0.87%) that were seen within the study period recorded to have used TEM before presentation at the Eye clinic were used for the study. Four (4) records were discarded because of incomplete documentation. Data obtained was analysed with SPSS version 17 for windows package. Mean age was 37.7years. Prevalence of use TEM was0.87%. The most common form of TEM was herbal concoction/roots (32.2%). CONCLUSION: The prevalence of TEM use is low but significant enough for definite steps to be taken by relevant authorities and eye care givers in educating the public. Primary eye care in the state should be upgraded and greater emphasis than it is now should be placed on the eye care during the training of nurses and community health extension workers.

Incidence and complications of traditional eye medications in Nigeria in a teaching hospital

Purpose:The aim of this study was to determine the types and nature of traditional eye medications (TEMs), their sources, and the ocular complications that may arise from use in a teaching hospital in Nigeria.Materials and Methods:A prospective study of consecutive subjects who used TEM before presentation to the Eye Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria between July 1, 2004 and June 30, 2008. P < 0.05 was considered statistically significant.Results:A total of 113 subjects were evaluated of which 64 were males (56.6%), females (43.4%) were females. There was no significant difference in the number of males and females (P > 0.05). Rural dwellers were more likely to use TEM than urban dwellers (P < 0.0001). The mean age of the subjects was 47.9 ± 22.3 years (range, 4-90 years). The most common traditional medication was derived from plant extracts (54.9%) followed by concoctions (21.2%). Complications occurred in 54.8% of the subjects. Ocular complications included corneal opacities in 13.35% of subjects, staphyloma in 9%, and corneal ulcers in 8%. Other complications were panophthalmitis, endophthalmitis, uveitis, cataract, and bullous keratopathy. Eleven subjects underwent evisceration or enucleation of the affected eye. There was no significant difference in the type of medication used and ocular complications (P = 0.956). Sources of TEM were self-medication in 38.9% of subjects, relatives in 27.4%, and traditional healers in 17.7%.Conclusion:The use of TEM is a common practice that could be harmful and lead to blindness. Proper health education of the public and traditional healers can reduce the prevalence of preventable blindness.

Keratitis in Children as Seen in a Tertiary Hospital in Africa

Blindness studies have shown that keratitis complicated by the use of traditional eye medications is a major factor of childhood blindness in developing countries. Most cases of such keratitis were presumably due to nutritional causes or bacterial infection. The patterns of outcome that are seen in hospitals may be different. To determine the clinical types of keratitis seen in children at a tertiary hospital and compare with other reports. A retrospective analysis was conducted using the records of children who presented with keratitis to the eye unit of the University College Hospital, Ibadan, Nigeria, over a three-year period from January 2003 to December 2005. Information obtained were the demographic data, the etiological type of keratitis and visual outcome of management. Ninety-five patients with keratitis seen during this three-year period were children. Of these, 47 (49.5%) patients had presumed herpes simplex keratitis; 78.9% of children with herpes simplex keratitis presented with combined epithelial and stromal disease; 21 (22.1%) had keratitis that was associated with a recent measles infection and protein calorie malnutrition. Fifteen (15.8%) had keratitis associated with phlyctenular keratoconjunctivitis, eight (8.4%) patients had bacterial/fungal keratitis, while four (4.2%) had vernal ulcers. Both the right and left eyes were affected in 47.6% and 52.4% of cases, respectively. Bilateral keratitis occurred in eight of the children with measles, and six patients with herpes simplex keratitis. Fifty-nine eyes had visual acuity recorded after the keratitis healed. Of these, the visual outcome was very poor in six (20.0%) eyes with herpes simplex keratitis and eight (100%) eyes with bacterial/fungal keratitis. All eyes with suppurative keratitis associated with measles developed dense corneal scars or were perforated. Herpes simplex keratitis was the leading cause of keratitis in children seen at this tertiary hospital, and clinical presentations do not differ from those reported in other populations. Very poor visual outcome was associated with all types of keratitis except those with herpes keratitis. Blindness studies may underrepresent the burden of herpes simplex keratitis in the location of this study.