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January-June 2015
Volume 23 | Issue 1
Page Nos. 1-30
Online since Friday, September 4, 2015
Accessed 40,204 times.
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ORIGINAL ARTICLES
The knowledge, perception, and attitude of patients living with glaucoma and attending the eye clinic of a secondary health care facility in South-East, Nigeria
p. 1
Eberechukwu Ogbeanu Achigbu, Chimdi Memnofu Chuka-Okosa, Kingsley Ihedioha Achigbu
DOI
:10.4103/0189-9171.164498
Background:
In the developing countries, most patients present with advanced disease or glaucoma blindness. This has been attributed to lack of awareness and poor knowledge as major contributing factors. The outcome of glaucoma management, however, depends largely on the understanding and perception of the illness by the patients.
Objectives:
This study aims to determine the knowledge, perception, and attitude of patients living with glaucoma and attending the Eye Clinic of the Imo State Specialist Hospital Owerri Imo State, Nigeria. The information obtained can be utilized by the health authorities in planning eye health education programs.
Subjects and Methods:
This was a cross-sectional study involving all previously diagnosed glaucoma patients attending the eye clinic of the hospital during the study period. Data were collected on knowledge, perception, and social disclosure attitude of the subjects using a structured questionnaire.
Results:
Twenty-nine males and 25 females participated in this study. The majority (42.6%) had only primary school education with petty trading accounting for 38.9% of the different occupations. The mean age at presentation was 60.9 years. The majority (88.8%) identified their eye problem as glaucoma, 46.3% knew it caused a progressive, irreversible loss of vision, and most (68.5%) did not know glaucoma to be familial. Approximately 67% of the subjects rated their management as satisfactory, 37% considered the drugs expensive, 70% and 13%, respectively had no, and negative perception of glaucoma surgery while 87.0% had a poor disclosure attitude.
Conclusion:
The subjects had a good knowledge of their diagnosis but a poor knowledge of the disease process. There was also an appreciable poor disclosure attitude and a negative perception of glaucoma surgery. Education and interaction with eye care personnel and other glaucoma patients using focal groups may bring about the desired change.
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Comparison of intraocular pressure reduction of initial and adjunct selective laser trabeculoplasty for primary open angle glaucoma in Nigerians
p. 7
Adeola O Onakoya, Temiloluwa M Abikoye, Onyinye M. A Onyekwelu, Abimbola O Olowoyeye
DOI
:10.4103/0189-9171.164494
Objective:
The objective was to compare the intraocular pressure (IOP) lowering effect of selective laser trabeculoplasty (SLT) as initial and adjunct therapy in primary open angle glaucoma (POAG).
Subjects and Methods:
Retrospective chart review of POAG patients who had SLT either as initial or adjunct therapy over a period of 1-year. Each patient had SLT done in 360° of the anterior chamber angle. IOP measurement with the Goldmann applanation tonometer was done at baseline, 60 min post procedure, days 1, 7, 30, 90, and 180.
Results:
Mean baseline IOP was 15.4 ± 3.5 mmHg and 17.5 ± 5.5 mmHg for initial and adjunct, respectively (
P
= 0.153); not significant. Mean IOP at 90 days was 10.5 ± 1.8 mmHg and 16.2 ± 6.3 mmHg for initial and adjunct, respectively (
P
= 0.013); statistically significant. Records at 180 days revealed mean IOP of 14.1 ± 3.9 mmHg and 15.7 ± 7.7 mmHg (
P
= 0.465) for initial and adjunct, respectively; not significant. The maximal mean IOP reduction in both groups was at 7 days. 70% of patients in the initial had IOP reduction of >20% compared to 63.5% of adjuncts throughout the study period. Initial sustained mean reduction of ≥3 mmHg from day 1 to 90, while the adjunct was till day 30.
Conclusion:
Initial SLT showed a sustained reduction in IOP, compared to adjunct with marginally lower measurements.
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Types of glaucoma in a University Health Centre in Al-Ahsa, Saudi Arabia: A pilot study
p. 12
Abdullatif Sami Al Rashed, Hamad Abdulaziz Al Subaie, Hisham Sameer Al Hathloul, Khalid Abdullah Al Shehab, Mansour Abdullah Al Naim, Kaberi Feroze Kaliyadan, Ansari Mukhtar Aleem
DOI
:10.4103/0189-9171.164495
Objective:
The objective was to assess the profile of different types of glaucoma in a University Health Centre in Al-Ahsa, Saudi Arabia.
Materials and Methods:
It is a retrospective study in which the files of the patients at King Faisal University Health Centre were reviewed. The data collected included: Age, sex, race, visual acuity, the slit lamp examination findings, the intraocular pressure (IOP) as the average of 3 readings, the cup-to-disc ratio (CDR), the visual field changes, and the details of treatment received.
Results:
Eighty glaucomatous eyes from 50 patients were included in the study. The mean age was 54.8 ± 12.7 years, and the mean IOP was 19 ± 3.9 mmHg that ranged from 11 to 28 mmHg. The mean CDR mean was 0.48 ± 0.16 that ranged between 0.3 and 0.9. Ninety-one percent of the visual field defects were arcuate scotomata. Primary open-angle glaucoma (POAG) (60%) was the most predominant type of glaucoma, followed by primary angle closure glaucoma (ACG) (21.3%), secondary OAG (7.5%), and secondary ACG (6.3%). As for the anti-glaucoma medications, 88% of the studied patients were on more than one medicine.
Conclusion:
This pilot study has demonstrated that POAG may be the predominant type of glaucoma in Al-Ahsa, Kingdom of Saudi Arabia (KSA). A population-based study with a larger sample size is warranted to confirm the outcome and to provide a baseline data on the prevalence of types of glaucoma in this region of KSA.
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Post-operative complications and visual outcome in eye camp patients undergoing sutureless cataract surgery at a Base Hospital in Vijayapura District, South India
p. 16
Sushma Hosamani, K Vallabha, Vijaykumar Warad
DOI
:10.4103/0189-9171.164500
Background:
Cataract is the principal cause of blindness in India, accounting for 62.6%. This problem can be tackled, and the backlog of cataract blind can be reduced by performing cataract operations on a large scale. Base hospital approach with screening camps has shown good visual outcome with lesser complications.
Aim and Objectives:
To study the profile of postoperative complications and visual outcome in eye camp patients undergoing cataract surgery at the base hospital.
Materials and Methods:
In this cross-sectional study, 413 patients were included following screening at community screening camps. Patients underwent sutureless small-incision cataract extraction with intraocular lens implantation under local anesthesia at the base hospital. Postoperative complications and visual outcome were recorded.
Results:
Immediate postoperative complications were corneal edema (9.44%), striate keratitis (6.77%), expected uveitis (5.56%), secondary glaucoma (2.66%), residual lens matter (2.66%), iris prolapsed (0.48%) and shallow anterior chamber (0.24%), hyphema (0.24%) and iris incarceration (0.24%). Endophthalmitis was reported in 0.48% (one grew citrobacter, rarely reported). Late complications included posterior capsular opacification (3.87%) noted and retinal detachment (0.48%) later. Majority 83.39% of the patients had postoperative best corrected visual acuity (BCVA) between 6/6 and 6/18, 13.42% had BCVA between 6/18 and 6/60, 3.19% had BCVA < 6/60 as at 6 months follow-up visit (overall percentage is 100%).
Conclusions:
The overall vision-threatening complications after cataract extraction in the base hospital are low. Our study reflects the efficacy of the base hospital approach, in terms of visual and surgical outcome, as an important aspect from the public health point of view, which can help in clearing the cataract backlog in developing countries like India.
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CASE REPORTS
Diagnosis of tubercular brain abscess through ocular manifestation
p. 22
Smita Anand, Kumar Rajiv, Ranjan Ashis
DOI
:10.4103/0189-9171.164497
Central nervous system tuberculosis is a severe form of extra-pulmonary tuberculosis. It mainly presents as meningitis or tuberculoma. Tubercular brain abscess (TBA) is a rare manifestation of tuberculosis in an immunocompetent patient. We report a case of TBA who presented to us due to the defective vision and headache.
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Airbag related ocular injuries: A short case series
p. 24
Adeola O Onakoya, Chigozie A Mbadugha, Olufisayo T Aribaba
DOI
:10.4103/0189-9171.164499
Airbags are designed to protect occupants of motor vehicles from injuries in the event of a crash but have been implicated in some serious ocular injuries after road traffic accidents (RTAs). Diagnosis of airbag related ocular injuries requires a high index of suspicion. Using a retrospective hospital-based, noninterventional study design, we evaluated the frequency and severity of airbag-related ocular injuries in patients presenting with ocular trauma to the eye clinic over a 4 years period. The case notes of patients managed for varying degrees of ocular injuries over a 4 years period in an eye clinic were reviewed. Patient demographics, the cause of injury, type of vehicle, speed, specific ocular structures injured, visual morbidity, and visual outcome were assessed. An 150 cases were identified and enrolled in the study. Only 8 (5.3%) of them were victims of RTAs. Airbag deployment was the mechanism of injury in 2 (1.33%) patients. Details of these two patients are reported. There was bilateral involvement in the two patients that had airbag-related ocular injuries. Each of the patients sustained a ruptured globe in one eye, and one of them became bilaterally blind from airbag-related ocular injuries. Airbag-related ocular injuries can be very severe, and this mechanism of injury should be considered during the assessment of victims of RTAs with ocular injuries.
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Fundus autofluorescence features of optic disc pit related maculopathy
p. 27
Olufemi Oderinlo, Adekunle Hassan, Ogugua Okonkwo
DOI
:10.4103/0189-9171.164496
Fundus autoflorescence (FAF) is a new investigational tool used to identify lipofuscin distribution in the retinal pigment epithelium (RPE) cell monolayer. It has recently been used to analyze age-related macular degeneration, central serous chorioretinopathy, retina telangiectasia and diffuse and macula retina dystrophies. Our study reports its use to evaluate two different patterns of presentation in optic disc pit related maculopathy, and findings suggest that FAF as an investigational tool can give valuable information for evaluation of the RPE – photoreceptor complex and the metabolic condition of RPE in this disorder.
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© Nigerian Journal of Ophthalmology | Published by Wolters Kluwer -
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Online since 14 July, 2014