Aim: To compare the endothelial cell loss between phacoemulsification and manual small-incision cataract surgery (SICS). Endothelial cell loss was also compared in phacoemulsification group by temporal clear corneal incision (CCI) and by superior scleral incision (SI) technique. Materials and Methods: A total of 200 eyes of 200 patients were included in the study. Cases were randomly divided into two equal groups. Group A had undergone phacoemulsification and Group B had under gone manual SICS. In Group A 50 cases were performed by temporal CCI and remaining 50 cases were performed by superior SI technique. Endothelial cell count was evaluated by using a noncontact specular microscope. Results: Mean endothelial cell loss (cells/mm ² ) in Group A was 307.80 (12.33%), 397.79 (15.93%), and 421.69 (16.89%) on 1 week, 6 week, and 3 month postoperative period, respectively. In Group B, it was 270.86 (10.63%), 385.22 (15.12%), and 413.68 (16.24%) on 1 week, 6 week, and 3 month postoperative period, respectively. There was no clinical and statistically significant difference (P > 0.05) between the two groups. The mean endothelial cell loss in Group A by CCI was 340.68 (13.61%), 427.80 (17.08%), and 448.70 (17.92%) and by SI was 274.92 (11.05%), 367.78 (14.78%), and 394.68 (15.83%) on 1 week, 6 week, and 3 month postoperative period respectively. There was statistically significant difference in endothelial cell loss at 1 week (P < 0.05) but it was not statistically significant on 6 week and 3 month postoperatively (P > 0.05). Conclusion: There was no clinically or statistically significant difference in endothelial cell loss or visual acuity between phacoemulsification and manual SICS at 3 month postoperative period.

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Introduction: Uncorrected refractive error (RE) is the most common cause of visual impairment (VI) in the world. It has significant effects on individuals and community, restricting some educational and occupational employment opportunities of the otherwise healthy individual. A significant percentage of the world population is visually impaired/blind from uncorrected RE. Aim: To determine the pattern of REs in ophthalmic outpatients in a teaching hospital. Materials and Methods: Records of consecutive patients attending a tertiary eye facility who were diagnosed with RE and/or presbyopia from January 2010 to December 2011 were retrieved. Data were analyzed using Statistical Package for the Social Sciences 20.0. Result: Presbyopia coexisting with other forms of RE 273 (40.4%) and presbyopia only was seen in 215 (31.8%). Myopia only was seen in 77 (11.4%), astigmatism only in 18 (2.7%), and hyperopia only in 13 (1.9%). Conclusion: In line with the objectives of VISION 2020, the data presented in this study will help in planning result-oriented intervention programs in the state.

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Objective: Update courses in ophthalmology are organized in Nigeria with the aim of improving understanding of the basics of ophthalmology and also enhance chances of pass at the part one fellowship examination. It is assumed that the desired effect should be achieved at the end of the courses. This study was conducted to assess the candidates' views on impact of the program. Methods: A descriptive study involving administration of semi-structured questionnaires to consultants and residents was carried out. Information was sought on how participation in the prepart one update courses influenced their success at the examination. Results: Together, 84 respondents filled and returned the questionnaires. 51 (60.71%) were consultants and 33 (39.29%) were resident doctors. 44 (94.12%) of the consultants and all resident doctors participated in the update courses. 30 (63.83%) of the 47 consultants agreed that they understood the topics better, after the course. 16 (34.04%) responded that it assisted them to some extent, but one person felt it was no use. 18 (54.55%) of the resident doctors felt the update courses gave them a clearer insight, 13 (39.39%) said to some extent, and 2 (6.06%) concluded it was of no effect. 27 (81.82%) of the residents and 44 (93.62%) of the consultants agreed that the course contributed a lot to their success in the examination. Conclusion: Update courses have been found useful by majority of persons who participated in the study and should continue. Reorganization may be very helpful, especially, for those who felt that the courses made little or no impact on them.

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Introduction: Trachoma is the leading cause of infectious blindness worldwide and is targeted for elimination by the year 2020 by the World Health Organization (WHO). The aim of our study was to provide baseline data on trachoma for eight local government areas (LGAs) of Zamfara state, Nigeria to enable planning and control activities in affected communities. Materials and Methods: A population-based cross-sectional survey was conducted in the selected LGAs between October 2010 and July 2011 using a two-stage sampling with probability proportional to size. The WHO guidelines for trachoma control were used in planning the survey, while the risk factors assessment was based on a recommendation from another WHO publication. Results: Trachomatous inflammation - follicular prevalence in children 1-9 years was 0.04-18%; while trachomatous trichiasis (TT) prevalence in persons ≥ 15 years was 0-1.4% across the LGAs. Access to improved water sources was worst (>40%) in Bakura and Maradun LGAs. Latrine accessibility was the highest (64%) in Bakura and Bukkuyum LGAs. Awareness of trachoma as a disease was 7-92% across the LGAs, whereas knowledge of trachoma prevention is poor (1-8%). Chi-square analysis shows access to latrine, knowledge of trachoma as a disease, and its prevention was significantly protective for active disease (odds ratio [OR] <1, P < 0.05). A regression analysis, however, showed that only access to latrine and knowledge of trachoma prevention remained significantly protective (OR < 1, P < 0.05). Conclusion: The risk factors for trachoma are endemic in the study areas, and active control measures are needed. The burden of the disease is, however, clustered with most LGAs having a low burden of both the active and blinding disease.

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Multifocal choroiditis is a vision-threatening disease causing inflammation at the level of retinal pigment epithelium and outer retina. We present a unique case of unilateral multifocal choroiditis in a young nonmyopic male and its subsequent course. The patient developed visual loss due to the sub-retinal neovascular membrane (SRNVM) in macula due to multifocal choroiditis. The SRNVM regressed with repeated intra-vitreal injection of bevacizumab and the visual acuity improved from 6/24 at presentation to 6/12 after repeated intra-vitreal injections of bevacizumab.

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Purpose: To assess the best method to prescribe spectacles in children. Source of Data: References have been collected from a MEDLINE search from 1975 to 2014. Older articles deemed not to be very contributory and those with foreign languages without any translation were omitted. The search was done using the words - spectacles, children, glasses, and prescription. Study Selection: To help and decide a proper prescription of glasses in children. Data Extraction: Internet for indexed PubMed articles. Conclusions: Children have visual needs that differ from adults, and therefore, the prescription of glasses has to be given with utmost care. They are interested in their near world and the eyes are going through a process of emmetropization. A cycloplegic refraction cannot be avoided. Many guidelines have been given based on the experience of pediatric ophthalmologists/optometrists. The basic principles, however, remain the same and should be adhered to the treatment of myopia, hypermetropia, astigmatism, and anisometropia. It is equally important to look at the spectacle frame and lenses to ensure that the prescription is used by the child.

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Lamellar ichthyosis is a rare congenital disorder with ocular manifestation resulting from the cicatrization of anterior lamella of eyelids. Early diagnosis and management of ectropion can prevent the most severe complications such as severe dry eyes, corneal perforation, and possible loss of the eye. This case report highlights a case of lamellar ichthyosis with mild ectropion which was managed conservatively.

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Xeroderma Pigmentosum (XP) presents in early childhood with photophobia, photosensitivity, cutaneous pigmentary changes, and a predisposition for malignancy in sun-exposed mucocutaneous areas and ocular structures. Ocular diseases are evident in at least 40% of XP patients and often cause visual impairment. Eight-year-old male child, a diagnosed case of XP at the age of 6 years, came to ophthalmology outpatient department with watering, redness, photophobia and gradually increasing mass on nasal side in the left eye for the last 6 months. In the left eye, almost the entire cornea was involved with a grayish-white, irregular, and limbal mass of 10 mm × 12 mm in size. Excision biopsy of the growth in the left eye was performed under general anesthesia. Cryotherapy application was done over the excised area. Histopathology report revealed well-differentiated squamous cell carcinoma. Ophthalmologist's role in early detection and excision of suspected lesions, counseling as well as prompt referral to the dermatologist and oncologist are vital in the management of such cases.

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Practicing in a low-resource environment presents unusual challenges with the management of even the simplest conditions when physicians must choose between investigating their patients and proceeding to intervention with patients' limited resources. Failure to perceive light, inaccurate light projection, or sonographic evidence of retinal detachment are all reasons to avoid cataract surgery, as there is no hope of visual recovery. However, when a patient already accepts a blind eye, but wants cataract surgery to remove the cosmetic blemish of leukocoria, they may question the necessity of preoperative ultrasonography because of the additional expense involved. Market forces can be defined as the economic factors affecting the price, demand, and availability of a commodity. In recent times, market forces have played increasingly significant role in the accessibility of standard healthcare in Nigeria; as Medical Services in Public Hospitals are no longer free, and the majority of Nigerians fund their healthcare through out-of-pocket expenditure, which places a burden on the economically challenged and uninsured. The main objective is to emphasize the importance of ultrasonography in a blind eye for the purpose of determining the position of a suspected retinal detachment, and to introduce the black occlusive intraocular lens (IOL). This is a report of cosmetic cataract surgery performed in a blind eye, with failure to achieve desired results, due to anteriorly displaced retinal detachment. This case describes the difficulties encountered with cosmetic cataract surgery in a low resource setting and discusses the use of occlusive IOL to improve cosmetic outcome. Cataract surgery is to be avoided in the presence of total retinal detachment. However, black occlusive IOL implantation may provide a cosmetically acceptable outcome.

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Background: Ocular injuries comprise a group of disorders with a wide variation in clinical presentation, causes, and visual outcome. Penetrating injury is defined as a single full thickness laceration of the eyeball usually caused by a sharp object. Aims: The purpose of this study was to know the causes, clinical features, and visual outcome of various penetrating ocular injuries in the pediatric age group. Settings and Design: It was a hospital based longitudinal study. Subjects and Methods: In this hospital based longitudinal study, 50 consecutive patients in the pediatric age group (up to 14 years) presenting to the ophthalmic OPD or casualty with penetrating ocular injuries were studied during a period of 2 years (August 1998-July 2000). Results: The present study showed the highest incidence (48%) of penetrating ocular injury in the age group of 6-10 years. Incidence of penetrating eye injury was found to be more in males (74%) as compared to females (26%). Wooden stick (34%) injuries are the most commonly observed penetrating eye injuries. Final visual outcome of more than 6/36 was seen in 79.31% of those patients in which only anterior segment was involved as against it was seen in only 23.08% of those in which posterior segment was involved. Conclusions: Penetrating ocular injuries are the most common cause of mono-ocular preventable blindness in pediatric age group. The three most important factors determining the final visual outcome were size and site of injury, as well as the time interval, between the injury and the presentation.

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Introduction: Congenital glaucoma is an uncommon ocular condition affecting about 1/15,000 live births. About two third of cases are bilateral with a higher prevalence in males. The definitive treatment requires surgery which could be trabeculectomy, trabeculotomy, goniotomy, drainage tubes or a combination of trabeculotomy and trabeculectomy. Aim: To determine the outcome of trabeculectomy in patients with congenital glaucoma seen at the University College Hospital Ibadan between 2007 and 2013. Methods: The medical records of all patients with congenital glaucoma seen between the years 2007 and 2013 were retrieved. Inclusion criteria were patients who had trabeculectomy with or without anti-metabolites within this period. The main outcome measures assessed were postoperative intraocular pressure (IOP) and corneal clarity. Data was analyzed with the statistical Package for Social Sciences version 21. Results: Thirty-four eyes of 18 patients were reviewed out of which 16 patients had bilateral trabeculectomy while two had unilateral trabeculectomy. The mean preoperative IOP was 26.31 mmHg while the mean IOP in the immediate postoperative period, at 3 months after surgery and at last follow-up visit were 13.31 mmHg, 12.78 mmHg and 15.89 mmHg respectively. IOP was <21 mmHg in 81.82% of the eyes as at last clinic visit. All eyes had cloudy corneas preoperatively while 38.24% had minimal residual corneal opacity (Haab's striae) as at last follow-up visit. Conclusion: In the absence of equipment for other surgical options, trabeculectomy is an effective surgical approach in the management of congenital glaucoma in the short term.

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