Neurofibromatosis (NF) is a relatively common disease with multisystemic manifestation. It is incurable and may be associated with learning difficulties and tumors such as optic nerve gliomas, brain tumors, and malignant peripheral nerve sheath tumors. This review seeks to increase awareness among physicians, surgeons, and ophthalmologists of the prevalence and manifestations of NF in the Nigerian environment, consequently, improving recognition, facilitating early diagnosis, follow-up, and treatment of the disabling complications of this disorder. The databases of “MedLine/PubMed,” “African-Journals-On-Line (AJOL),” “Google scholar,” and “UpToDate” were searched using the keywords Von Recklinghausen disease, familial NF, schwannomatosis, vestibular schwannoma, acoustic neuroma, meningioma, classical NF, central NF, neurofibroma, and other synonyms for NF were mapped to the key phrases “Nigeria,” “neurological,” and “complications.” Relevant MeSH terms were used alone and in combination, adding Boolean operators and wildcards to broaden, restrict, and modify the search, as required. This scoping review describes the historical origins, classification, diagnostic criteria, and clinical presentation of the three major types of NF, with a focus on neurologic complications. Thereafter, it reviews the literature on NF in Nigeria (Nigerians), discussing the implications for ophthalmologists and suggesting guidelines for multidisciplinary team management and follow-up in light of current advances in NF research. Neurologic complications of NF include epilepsy, headaches, learning difficulties, cranial and peripheral neuropathies, and intracranial tumors. Screening, early recognition, long-term monitoring, and rehabilitation by a multidisciplinary team, is required to enhance the quality of life of patients with NF. There are currently very few published studies describing the neurologic complications of NF among Nigerians. However, Nigerian physicians, surgeons, and ophthalmologists should be aware that patients with NF may develop these neurologic complications and should seek to identify them early, in the management and follow-up of patients with NF.

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Background: Vision is critical to optimal educational development. About 12 million children are affected with undetected visual impairment from refractive error and are mostly in Asia and Africa, hence the need to determine the prevalence of refractive error and the impact of its correction on academic performance (AP) in a representative cohort of African children in Ilorin, Kwara State, and Nigeria. Few published studies have looked at the impact of refractive error on AP in Nigeria. This study will afford the children to have vision screening and correction of their refractive errors. It will also reinforce the importance and need for vision screening among primary school pupils and increasing teachers and parents awareness. Methodology: This was a quasi-experimental study carried out among 2124 primary school pupils aged 5–15 years. Eye examination and refraction were carried out during the first term of the school academic calendar. Children with visual acuity worse than logMar 0.2 (6/9.5), which improves with pinhole, had refraction and were dispensed free eyeglasses. The AP of pupils with refractive error was assessed at the end of the first term before the use of eyeglasses and at third term after wearing eyeglasses for 6 months using the mean academic score for all subjects. Result: The prevalence of refractive errors among primary school pupils aged 5–15 years was 2.8%. Myopia was the most common refractive error with a prevalence of 1.2%. The change in mean academic score of pupils with refractive errors was statistically significant as it improved to 61.1 ± 13.4 from 56.5 ± 13.9 following the use of eyeglasses. The improvement in AP was more significant in pupils with hypermetropia and astigmatism following the use of eyeglasses. Conclusion: The average AP of pupils with refractive errors was good, but nevertheless correcting for refractive errors had a positive impact, especially in pupils with hypermetropia and astigmatism.

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Objective: To assess the pattern of ocular presentation in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma in Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh. Methods: This prospective observational study was conducted over 6 months in a glaucoma department of a tertiary eye institute in Bangladesh. All patients diagnosed with pseudoexfoliation glaucoma and pseudoexfoliation syndrome were recruited for the study. Clinical and demographic variables, pattern of presentation of pseudoexfoliation glaucoma and pseudoexfoliation syndrome, location of pseudoexfoliation deposit on the lens surface, and pupillary abnormalities observed with slit lamp examination were analyzed. Results A total of 46 eyes of 27 patients with pseudoexfoliation deposit were studied. There were 24 (88.9%) males and the mean age of the patients was 67.0 (±10.8) years. There was peripheral ring of pseudoexfoliation deposit observed on the anterior lens capsule of 12 eyes (n = 12 eyes). However, pseudoexfoliation deposits on the pupillary ruff were the most common pattern of presentation (n = 42 eyes). Poor pupillary dilation was observed in only one eye (n = 1 eye). Open-angle glaucoma was the commonest glaucoma (96.3%) associated with pseudoexfoliation syndrome and the patients had baseline intraocular pressure on the right and left eyes of 22.7 (±12.7) mmHg and 17.5 (±8.0) mmHg, respectively. Bilateral pseudoexfoliation was the most common presentation among patients with pseudoexfoliation glaucoma (n = 20). Conclusion Peripheral ring of pseudoexfoliation deposit was the classical deposit on the anterior lens capsule, whereas the central disk was absent in most cases. Poor pupillary dilation was rare.

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Aims and objectives: To determine the predictors of clinical outcome of ulcerative keratitis at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Methods: This was a hospital-based study of 61 patients with ulcerative keratitis. Participants’ sociodemographics and clinical information were obtained. Outcome measures included treatment outcome (categorized into good treatment outcome and poor treatment outcome) and posttreatment visual outcome (categorized into visual acuity 6/60 or better and visual acuity worse than 6/60). Results: A total of 61 patients were recruited for the study. Of these, 44 (72.1%) were males and 17 (27.9%) were females. Although majority 55 (90.1%) of the ulcers healed, many developed complications such as perforation with evisceration − 3 (11.5%), panopthalmitis with evisceration − 3 (11.5%), healed perforated ulcers with visually significant adherent leukoma − 5 (19.2%), visually significant corneal opacities from ulcers that healed without perforation − 6 (23.1%), corneal vascularizattion − 7 (26.9%), and anterior staphloma − 2 (7.7%). Predictors of poor treatment outcome included duration of symptoms of more than 1 week, use of harmful traditional eye medictions (TEMs), size of ulcer ≥4mm, and presence of hypopyon. Significant predictors of poor posttreatment visual outcome included age 40 years and above, size of ulcer ≥4 mm, and duration of symptoms ≥1 week. Conclusions: Majority of the corneal ulcers healed. However, many also had complications that led to significant visual impairment and ocular morbidity. These are largely due to late presentation and indiscriminate use of TEMs. Effective eye health education and promotion are recommended to encourage early presentation, prevention, and reduction of visual and ocular morbidity from ulcerative keratitis.

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Blindness rates especially avoidable ones still remain high despite various interventions in developing countries. Vision 2020 was therefore unattainable. Once a person goes irreversibly blind, the costs of rehabilitation and educating such a person dramatically rises. The response of government has been to send them to blind schools which has the distinct disadvantage of isolating them from their peers and causes them to lag behind educationally due to teaching methods not commensurate with modern standards. Recently, visually impaired people are encouraged to be schooled alongside their peers in an inclusive manner. For this to be successful, they need to be (re)habilitated first, then empowered with appropriate assistive devices. This communication highlights how this can be done so it can improve the current deplorable statistics of successful blind young people in developing countries such as Nigeria.

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Objective: To identify the barriers to the uptake of cataract surgical services among patients with cataract attending the eye clinic in Irrua Specialist Teaching Hospital (ISTH), Edo State, Nigeria. Materials and methods: The study was a descriptive hospital-based study of patients with cataract attending the eye clinic of the ISTH, Irrua, Edo State. An interviewer-administered questionnaire designed to identify the barriers to the uptake of cataract surgical services was used for this study. Responses to questions on willingness to have cataract surgery, reasons for unwillingness, and the factors which made willing participants end up not having surgery or delaying their surgery were obtained, collated and analyzed. Data were analyzed with IBM SPSS Software, version 21. Results: Four hundred patients made of 217 (54.3%) males and 183 (45.8%) females in a ratio of 1.2:1 were participated in this study. One hundred and eighty-eight (47%) of respondents did not know that cataract surgical services were available at ISTH, 34 (15%) had surgery within a week, whereas 189 (80.4%) respondents had surgery more than a week after being told they were eligible for surgery. Fear of poor outcome and lack of finance ranked high in the list of reasons for the delay in surgery. Women were 1.5 times more likely to have surgery than men. Education and distance from health facility had no role to play in the uptake of cataract surgery. Conclusion: Fear of poor surgical outcome, lack of finances, and lack of knowledge of the availability of surgical services are impediments to access cataract surgery at ISTH and improving surgical outcome and education about available surgical services may improve the uptake of cataract surgery.

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Objectives: To identify the various means by which patients overcome barriers to cataract surgery in a tertiary hospital. Materials and methods: This was a descriptive hospital-based study of the barriers to the uptake of cataract surgical services in Irrua Specialist Teaching Hospital and how patients overcome them. Four hundred patients who presented to the eye clinic participated in this study. Patients, who had surgery within the study period at least more than a week from counseling and when a clinical decision to have surgery was made, were asked to describe the ways they overcame their barriers to surgery and the responses were collated and analyzed using the IBM SPSS version 21. Results: The study recruited 400 consecutive patients attending the eye clinic who had a cataract or were yet to have cataract surgery. There were 217 males (54.3%) and 183 females (45.8%), a ratio of 1.2:1. One hundred and eighty-five (84.5%) participants had delayed cataract surgery during the study period with finance (51.4%) and a lack of felt need (28.6%) playing a major role in delaying surgeries. Fear of outcome (12.4%) also played a role in delaying surgery. Free cataract surgical services helped sort out the economic constraint among some participants, whereas support from relations, as well as motivation from relatives and other people who had good outcome from surgeries, helped overcome other barriers such as fear of outcome and lack of escort to the hospital. Conclusion: Motivators may play a huge role in improving the uptake of cataract surgery. These motivators may be cataract evangelists or relatives themselves. Economic constraints may be tackled by free eye surgeries, reduced cost of eye care, and/or improving efficiency in the course of providing eye-care services.

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Introduction: In spite of the comparatively high rate of blindness and other visual impairments in Nigeria, access to orthodox eye care remains low. Religion has been shown to have important effects on health behavior but such effects as regards access to eye health care remains insufficiently explored in local research. Objective: This study aims to assess the knowledge and attitudes as regard eye care and health, among religious leaders in Calabar, Cross River State, Nigeria. Methods: Using a qualitative design, the study was conducted among 15 religious leaders from the Christian religion in Calabar. A focus group discussion was conducted which lasted about 90 minutes and was moderated by trained staff. Audio recordings were made and transcribed for qualitative content analysis. Results: Participants exhibited some basic knowledge of eye disease and causes of blindness. They found yearly eye-checks acceptable and generally agreed that they would encourage their church members to see a doctor when they had eye symptoms. There was also the opinion that the need to go to the hospital was dependent on the church member’s faith and the spiritual understanding of illness etiology. Conclusion: There is a need to further engage religious leaders to improve their knowledge and attitudes to eye health and care. Due to the strong influence of religious leaders in a religious country such as Nigeria, they could influence their congregations positively and improve the general resort to orthodox care for eye symptoms.

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Background: There are currently two versions of rapid assessment of avoidable blindness (RAAB) method in use: RAAB5 and RAAB6. While RAAB5 uses visual acuity (VA) of 6/18 as cutoff for visual impairment (VI), RAAB6 uses VA of 6/12. Aim: The aim of the study was to determine the average additional time it will take to test from 6/18 to 6/12 VA levels and to compare the causes of VI across these VA cutoffs. Methods: It was a cross-sectional study of patients aged 50 years and above attending a tertiary hospital in Jos between April and September 2016 (6 months). RAAB6 methodology was used to test presenting VA of all participants. The time taken to obtain a VA of 6/18 and to test from 6/18 to 6/12 was recorded separately for each eye. Those with VA worse than 6/12 in one or both eyes had their eyes examined to determine the cause of VI. The data collected were analyzed using the Statistical Package for Social Sciences for windows software, version 20. Results: The average additional time taken to test VA from 6/18 to 6/12 was 42.11 seconds (95% confidence interval: 32.86–51.35). Cataract was the major cause of VI with both VA cutoffs with no significant difference in its proportion (P = 0.924). Uncorrected refractive error and glaucoma were the next important causes of VI with 6/12 (P = 0.041) and 6/18 (P = 0.041) cutoffs, respectively. Conclusion: The spectrum of disease causing VI may not differ significantly between the two RAAB versions, but survey duration will likely be prolonged with RAAB6.

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Objectives: Various risk factors for age-related macular degeneration (ARMD) have been postulated and identified. This study seeks to identify risk factors for cases with ARMD in our environment and proffer appropriate recommendations on ways to reduce the risk of its development and progression. Methods: This was a case–control hospital-based study conducted in the out-patient eye clinic of the Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Nigeria. The cases were patients attending the eye clinic, with a diagnosis of ARMD and the controls were patients without a diagnosis of ARMD for a period of 7 months, all 50 years and above. Chi-squared and Fisher exact analyses were used to explore variables. Logistic regression (unadjusted and adjusted) were used to determine possible risk factors and their interactions. Results: A total of 240 respondents made of 120 cases and 120 controls participated in the study. A higher proportion of the respondents in both study groups was in the age group 60 to 69 years; cases 48 (40.0%) and controls 49 (40.8%) years. Adjusted odds ratio (OR) for risk factors for ARMD includes male sex [OR: 3.07; 95% confidence interval (CI): 0.92–10.23], those who resided in urban areas (OR: 3.08; 95% CI: 0.13–73.14), those who were employed (OR: 1.45; 95% CI: 0.46–4.54), alcohol use (OR: 1.86; 95% CI: 0.21–16.61), regular consumption of fast foods (OR: 1.43; 95% CI: 0.00–2355.87), obesity (OR: 1.39; 95% CI: 0.46–4.16), use of nontinted glasses (OR: 0.43; 95% CI: 0.14–1.35), and diabetes (OR: 1.31; 95% CI: 0.30–5.63). Conclusion: In this study, increasing age, the female gender, increasing body weight, and myopia were positively associated with ARMD. Tertiary education, weekly consumption of fruits, and the use of tinted spectacles were protective against ARMD. Identifying these risk factors in our environment will be a major step in planning health awareness programs geared toward management of progression of ARMD.

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Conjunctival nevi are the most common melanocytic tumors of the eye. The benign conjunctival nevus typically harbors conjunctival inclusion cysts that are detectable both clinically and histopathologically, which differentiates it from the other pigmented conjunctival lesions. They commonly affect teenagers and young adults. In our case, we have performed excision of the nevus with amniotic membrane grafting in which we have procured and processed the amniotic membrane ourselves.

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Objective: The aim of the study is to determine the changes in refraction that occur amongst healthy pregnant women in South-Eastern Nigeria. Materials and methods: This was a hospital-based prospective longitudinal study. Forty-six healthy pregnant women and an equal number of healthy nonpregnant women, designated as cases and controls, respectively, were recruited from the antenatal clinic (ANC) of Federal Medical Centre Owerri and followed up from the first trimester of pregnancy to 6 weeks postpartum. All participants underwent ocular examinations and intraocular pressure measurement using Perkins handheld applanation tonometer and refraction (subjective and objective). These examinations were repeated and recorded during the second trimester, third trimester, and 6 weeks postpartum follow-up visits. Data obtained were entered and analyzed using the Statistical Package for Social Science version 21. P < 0.05 was considered statistically significant. Results: A myopic shift in the mean refraction of the pregnant women as the pregnancy advanced was observed. This change in the refractive state was however not statistically significant (P = 0.14) and it did not have any significant effect on their distance visual acuity (P ≥ 0.11) and near visual acuity (P ≥ 0.10). Conclusion: Normal pregnancy is associated with changes in refraction; nonetheless, these change maybe innocuous and gradually resolves following delivery. Clinicians may need to delay spectacle correction for pregnant women who experience visual symptoms from physiological changes in refraction unless it is deemed necessary.

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