Nigerian Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2021  |  Volume : 29  |  Issue : 2  |  Page : 150--151

Oculoplasty as a Career in Nigeria: The Journey so Far


Kehinde Fasasi Monsudi1, Abayomi Olusola Ayodapo2, Joshua Foluso Owoeye3,  
1 Department of Ophthalmology, Federal Medical Center, Birnin-Kebbi, Kebbi State, Nigeria
2 Department of Family Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
3 University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

Correspondence Address:
Kehinde Fasasi Monsudi
Department of Ophthalmology, Federal Medical Center PMB 1126 Birnin-Kebbi, Kebbi State
Nigeria




How to cite this article:
Monsudi KF, Ayodapo AO, Owoeye JF. Oculoplasty as a Career in Nigeria: The Journey so Far.Niger J Ophthalmol 2021;29:150-151


How to cite this URL:
Monsudi KF, Ayodapo AO, Owoeye JF. Oculoplasty as a Career in Nigeria: The Journey so Far. Niger J Ophthalmol [serial online] 2021 [cited 2022 Jul 3 ];29:150-151
Available from: http://www.nigerianjournalofophthalmology.com/text.asp?2021/29/2/150/335915


Full Text



 Introduction



Undisputedly, Nigeria is Africa’s most populous black nation, with an estimated population of about 200 million. Incidentally, ophthalmologists, only in their hundreds serve this population. Over the last two decades, ophthalmology in Nigeria has undergone a radical change as subspecialty-based ophthalmology was introduced. Oculoplastics is currently enjoying a ready market of patients, but with scarce services and specialists available. Anecdotal evidence from primary-care physicians (PCP) reported an increase in number of patients requiring the expertise of an oculoplastic surgeon, but because of dearth in spread and expertise, referral has become a dilemma. Most of the cases witnessed by PCP are those who required either reconstructive or cosmetic surgeries or both. In centers where an oculoplastic surgeon is available, patients are faced with the challenges of long appointments, making the services not reachable as at when needed.

Oculoplasty is a subspecialty of ophthalmology that deals with the pathology (disease), rehabilitation, research and surgery of the eyelid, orbit, facial, eye and associated structures. An oculoplastic surgeon is an ophthalmologist who has undergone 1 to 2 years specialist training after residency program and possesses skills in reconstruction of orbit (socket), lacrimal drainage system, facial structures (eyelid, eyebrows, forehead, and cheek), and ocular destructive surgery.[1] In high-income countries, oculoplastic surgery is rapidly becoming a highly paid and expanding subspecialty.[2] Oculoplasty is a special area that requires a well-dedicated ophthalmologist who can work with empathy to both patient and relative(s). The choice of a subspecialty (including oculoplasty), by a young fresh ophthalmologist would be influenced by remuneration, job satisfaction, and career opportunities. Worldwide increase in old age, awareness of cosmesis (appearance), and advancement in technology have led to an increase in the demand for oculoplastic practice.[3] Choosing oculoplasty as a career requires an individual with sound knowledge of anatomy, physiology and pathology of the eye, orbit (eye socket), facial and surrounding structures.

Oculoplastic surgery began in 1755 by a renowned ophthalmologist, Jaques Daviel, with the beautiful presentation of his case series of tumor resection at Royal Society of London meeting.[4]

Oculoplastic surgeons interact with other specialties (plastic surgeon, oral and maxillofacial, otolaryngologist surgeons, ocularist, etc.) for the betterment of the patients in the management of complex trauma and disease condition.

 Oculoplastic Surgeon and Ophthalmic Plastic Surgery Association of Nigeria (OPSAN)



Standard oculoplastic services in Nigeria were still in infant stage until 7 years ago, when it was mandated by the Ophthalmological Society of Nigeria (OSN) for the formation of oculoplastic services at the Abuja Annual General Meeting in 2012.[5] About 2 years later, the Oculoplastic Society of Nigeria was formed, which was later renamed OPSAN. The OPSAN is responsible for advanced education, research and improved quality of clinical practice in plastic, aesthetic and reconstructive surgery (orbit, eyelids, face, and lacrimal drainage system).

Presently, there are less than 20 oculoplastic surgeons in Nigeria[6] following short- and long-term training at various eye hospitals outside Nigeria with the aid of scholarship from International Council of Ophthalmology and Commonwealth. On the other hand, others were through individual self-sponsorship, as well as support from various organs of government, both state and federal.

Currently in Nigeria, only 27 teaching hospital (government and private) and health institutions are accredited to train residents in ophthalmology,[5] where only 14 teaching hospitals are accredited for subspecialty training in ophthalmology.[7] These include nine for the oculoplasty subspecialty.

Challenges

There are enormous challenges facing the developing of oculoplastic services in Nigeria. These include dearth of trained personnel, uneven distribution of the available specialists, and few training (accredited) centers. Other challenges are high cost of training subspecialists abroad, lack of equipment, lack of awareness, and acceptability of the oculoplastic services (especially cosmetic) among the populace.

Success

Despite the few numbers of oculoplastic surgeons in Nigeria, their efforts have resulted in reducing medical tourism abroad.[4] Furthermore, services rendered by these few oculoplastic surgeons are expected to lead to reduction in the morbidity and mortality from eyelid and orbital tumors.

Recommendation

There is a need for the establishment of more oculoplastic subspecialty training units in all the residency training centers in Nigeria with support of government (federal and state), National Postgraduate Medical College of Nigeria, OSN, and nongovernmental organizations.

Linkage of each oculoplastic training center to a well-established oculoplastic training center abroad will go a long way in improving the quality of services delivery.

Provision of oculoplastic equipment to all the training centers with support from Tertiary Education Trust Fund (TET fund) and the Federal Ministry of Health.

Training and retraining of oculoplastic surgeons in all the training centers using the platform of OPSAN is also recommended. It should be mandatory for oculoplastic surgeon to attend both local and international oculoplastic seminar and conferences yearly.

A training center in the West African subregion for the subspecialties, including oculoplasty, would go a long way in reducing the cost (both quantifiable and unquantifiable) of training. Furthermore, sponsorship of oculoplastic surgeon for annual meetings and international conferences should be encouraged by training institutions.

Promotion of public awareness about oculoplastic services through media (electronic and others) and seminar is also important. Furthermore, awareness modules on oculoplasty should be incorporated into ophthalmology residency program in Nigeria.

Linkage of OPSAN to other oculoplastic associations such as Asia Pacific Society of Ophthalmic Plastic and Reconstructive Surgery and American Society of Ophthalmic Plastic and Reconstructive Surgery will also help in the rapid development of this important subspecialty.

 Conclusion



Oculoplastic subspecialty as a career is an important part of ophthalmology, though it is still in its infancy in Nigeria. Every effort should be made to develop this important specialty so as to reduce medical tourism abroad.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Oculoplastics. Available at https://en.wikipedia.org/wiki/Oculoplastics. Accessed February 17, 2021.
2Norris JH, Gale RP, Nkumbe H, Backhouse OC, Bernadin P, Chang BY. Oculoplastic surgery in Madagascar: a review. Community Eye Health 2009;22:3-4.
3Global Oculoplastic Surgery Market (2020 to 2025) − Growth, Trends, and Forecast. Available at https://www.businesswire.com. Accessed May 2, 2021.
4Patel BC, Anderson RL. History of oculoplastic surgery (1896–1996). Ophthalmology 1996;103:S74-S95.
5Monsudi KF, Ayodapo AO. Oculoplastic training and its role in eye care services in a Nigeria Tertiary Hospital. Sierra Leone J Biomed Res 2018;10:40-6.
6Edak E. Secretary Ophthalmic Plastic Surgery Association of Nigeria. Personal communication February 20, 2021.
7Odugbo P. Secretary Faculty of Ophthalmology WACS. Personal communication March 2, 2021.