Browsing by Author "Ugalahi, M. O."

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Age at detection and age at presentation of childhood cataract at a tertiary facility in Ibadan, Southwest Nigeria
(2020) Olusanya, B. A.; Ugalahi, M. O.; Adeyemo, A. O.; Baiyeroju, A. M.
Background: To describe factors which influence the age at detection and age at presentation of patients with childhood cataract at a tertiary eye care facility in Southwest Nigeria. Methods: A retrospective review of children who presented with cataract between 2011 and 2015. Case notes were reviewed and data on age at detection and presentation as well as other clinical information was collected and analyzed using Stata 12 statistical software. Results: A total of 164 cases were reviewed, 52.4% of them were boys. Median age at presentation was 48 months while the median age at detection was 13.5 months. Seventy-four (45.1%) children had congenital cataract, 31.1% had developmental cataract, and 21.3% had traumatic cataract. The child’s mother detected the cataract in 116 (70.7%) of the patients. Median age at presentation for patients with congenital cataract was 18 months and 84 months for developmental cataract. The median age at presentation for congenital cataracts that were noticed by the mother was 17 months compared with 72 months for those noticed by other caregivers (p = 0.0085). The median age at presentation for developmental cataracts that were noticed by the mother was 72 months compared with 114 months for those noticed by other caregivers (p = 0.0065). Gender of the child did not significantly influence the age at detection or presentation. The source of referral and the location of domicile did not significantly affect the time interval between detection of the cataract and presentation to hospital. Conclusion: The average age of children presenting with cataracts in our setting is older than in high income countries. Detection of the cataract by the mother increases the likelihood of early presentation; thus, focused maternal education may promote earlier detection and presentation. Keywords: Childhood, Cataract surgery, Access, Nigeria, Sub-Saharan Africa
Bilateral congenital anophthalmia: a report of two cases and a case for increased anomaly ultrasound scans coverage in pregnancy in Nigeria
(Nigerian Association of Resident Doctors (NARD), 2022-02) Onebunne, E. O.; Ugalahi, M. O.; Olusanya, B. A.; Baiyeroju, A. M.
This is a report of two cases of patients with bilateral congenital anophthalmos who presented to a tertiary hospital, in Ibadan Southwest Nigeria, with the aim of highlighting the need for increased implementation of fetal anomaly scans coverage during pregnancy in Nigeria. Information on patients’ sociodemographic data, clinical features, and management are described. Both patients presented because of the inability of the parents to view the globes after delivery. Ophthalmic examination and ocular ultrasonography confirmed bilateral absence of the eyeballs in both patients and the parents were counseled on the anomaly including its treatment and prognosis.
Common forms of strabismus in a tertiary eye clinic in Southwest Nigeria
(Wolters Kluwer - Medknow, 2019-12) Olusanya, B. A.; Ugalahi, M. O.; Ayeni, O.; Fawole, O. I.; Baiyeroju, A. M.
Background: Strabismus occurs worldwide and is associated with undesirable psychosocial impact and negative social prejudice. However, there is a dearth of information on the different subtypes of strabismus in Nigerian patients. The aim of this study is to describe the common forms of strabismus among patients of an eye clinic in southwestern Nigeria. Methods: We retrospectively reviewed all new patients seen at the eye clinic of our hospital between January 1999 and December 2008. Patients with a diagnosis of strabismus were identified from the clinic registers and their case records were reviewed. Information on age, gender, cause, and type of squint as well as associated ocular/systemic disease was retrieved from the case records. Results: A total of 240 patients had strabismus, giving a relative frequency of 1.2%. Mean age of patients with strabismus was 19.8 (±19.7) years while male-to-female ratio was 0.98:1. Esotropia (53.8%) was more common than exotropia (44.2%). The mean age of patients with esotropia was 12.8 years compared with 27.9 years for patients with exotropia (P < 0.001). Sensory strabismus was the most common form of strabismus, occurring in 83 (34.5%) patients, while accommodative esotropia was found in only 5.8% patients. Conclusion: The relative frequency of strabismus in this study is fairly similar to other reports from Nigeria and Africa. Secondary strabismus was quite common whereas primary forms of strabismus such as accommodative esotropia appear to occur less frequently among our patients in comparison to Caucasian populations.
Congenital aniridia: clinical profile of children seen at the University College Hospital, Ibadan, South-West Nigeria
(SAGE Publishing, 2021) Ugalahi, M. O.; Ibukun, F. A.; Olusanya, B. A.; Baiyeroju, A. M.
Purpose: To describe the clinical features of patients younger than 16 years with aniridia presenting to the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital, Ibadan, Nigeria. Methods: The is a retrospective review of children with aniridia seen between May 2015 and April 2019 at the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital in Ibadan. Data on demographic characteristics, presenting complaints, ocular and systemic examination findings, and interventions were collected and descriptively summarised. Results: A total of 28 eyes of 14 patients were studied. The mean age was 6.37 ± 4.98 years. Seven (50%) patients were male. Aniridia was diagnosed in first-degree relatives of nine patients. The most common complaint at presentation was poor vision in 11 (78.6%) patients. Objective visual acuity assessment was obtained in 22 (78.6%) eyes. Presenting visual acuity was worse than 20/60 in all 22 eyes and worse than 20/400 in 8 (36.4%) eyes. Refraction was performed in 17 (60.7%) eyes and revealed a mean spherical equivalent of −3.93 ± 5.99 diopters. Twenty (71.4%) eyes had corneal opacities, and lenticular opacities were seen in 15 (62.5%) of 24 eyes. Mean intraocular pressure (IOP) at presentation was 21.62 ± 10.4 mmHg; 12 (41.4%) eyes had elevated IOP at presentation. Ten (35.7%) eyes had cataract surgery and six (21.4%) eyes had glaucoma surgery. Conclusion: Familial aniridia was common in this study, and most of the patients presented with moderate to severe visual impairment. The common ocular associations were refractive error, cataract, corneal opacity and glaucoma.
Delays in uptake of surgery for childhood cataract at a child eye health tertiary facility in sub-Saharan Africa
(SAGE Publishing, 2019) Ugalahi, M. O.; Olusanya, B. A.; Fagbemi, O. O.; Baiyeroju, A. M.
Background: Timely uptake of surgery is vital in the control of childhood blindness due to cataract. The aim of this study is to determine the uptake of surgery as well as the frequency and reasons for rescheduling of surgery for childhood cataract in a tertiary hospital in southwest Nigeria. Methods: A retrospective study of children with childhood cataract seen at the Paediatric Ophthalmology unit of the University College Hospital, Ibadan between 2011 and 2015. Demographic and clinical information was retrieved from case records. Caregivers of children who did not have surgery were contacted by telephone to elicit reasons why surgery was not done. Results: A total of 164 children were included in the study; 90 (54.9%) were male. The median age at presentation was 4 years with a range of 2–180 months. A total of 64 (39.0%) children had unilateral cataract. All patients were scheduled for surgery, but 123 (75%) underwent surgery. Surgery was rescheduled in 42 (34.1%) of those who had surgery. Reasons for rescheduling included financial constraints, illness, delay in paediatrician evaluation to ascertain fitness for anaesthesia and strike actions by health workers in the hospital. Conclusion: Three quarters of the children had surgery, though it had been rescheduled, at least once, in about onethird of them. Delayed uptake of surgery was mainly due to inability to afford treatment and strike actions. The need for improved coverage of health insurance especially for the paediatric age group in developing countries cannot be overemphasized. This is because good vision is an integral part of child development.
Familial cataracts: profile of patients and their families at a child eye care tertiary facility in a developing country
(2023) Ugalahi, M. O.; Onebunne, E. O.; Olusanya, B. A.; Baiyeroju, A. M.
Purpose: The aim of this study is to describe the clinical profile, pedigree charting, and management of children with familial cataracts at a child eye health tertiary facility in southwest Nigeria. Methods: The clinical records of children ≤16 years diagnosed with familial cataracts at the Pediatric Ophthalmology Clinic, University College Hospital Ibadan (Ibadan, Nigeria) from January 1, 2015, to December 31, 2019, were retrospectively reviewed. Information on demographic data, family history, visual acuity, mean refractive error (spherical equivalent), and surgical management was retrieved. Results: The study included 38 participants with familial cataract. The mean age at presentation was 6.30 ± 3.68 years, with a range of 7 months to 13 years. Twenty-five patients (65.8%) were male. All patients had bilateral involvement. The mean duration from onset of symptoms to presentation at the hospital was 3.71 ± 3.20 years, with a range of 3 months to 13 years. In 16 of the 17 pedigree charts obtained, at least one individual was affected in each generation. The most common cataract morphology was cerulean cataract, observed in 21 eyes (27.6%). The most common ocular comorbidity was nystagmus which was observed in seven patients (18.4%). Sixty-seven eyes of 35 children underwent surgery within the period of the study. The proportion of eyes that had best-corrected visual acuity ≥6 / 18 before surgery was 9.1%; this proportion had increased to 52.7% at the last postoperative visit. Conclusions: Autosomal dominant inheritance appears to be the major pattern among our patients with familial cataract. The most common morphological type found in this cohort was cerulean cataract. Genetic testing and counseling services are vital for the management of families with childhood cataract.
Indications for surgery amongst new patients presenting to the paediatric ophthalmology unit of the University College Hospital, Ibadan
(Wolters Kluwer - Medknow, 2021-03) Ugalahi, M. O.; Monye, H. I.; Olusanya, B. A.; Baiyeroju, A. M.
Objective: The objective of the study was to determine the proportion of children requiring ocular surgery amongst new patients presenting to the Paediatric Ophthalmology Unit of the University College Hospital, Ibadan, over a 2‑year period, to enhance planning and improve the efficiency of service delivery. Methods: The study was a retrospective review of records of all new patients aged 0–16 years who presented to the Paediatric Ophthalmology Unit of the University College Hospital, Ibadan, over a 2‑year period (May 2015–April 2017). Information on age and gender, clinical diagnosis and indications for surgery and type of surgery scheduled were retrieved from the diagnosis register of the unit, and a descriptive analysis was performed. Results: Of the 1240 children who presented to the clinic within the study period, 142 (11.5%) needed surgical interventions. Their ages ranged from 1 month to 16 years, with a mean age of 6.4 ± 4.7 years. Seventy‑nine (55.6%) of these were males. The most common indications for surgery were cataract and catara t‑related indications (n = 122, 85.9%), followed by glaucoma and strabismus. Other less common indications for surgery were nasolacrimal duct obstruction and epibulbar dermoid. Conclusion: Paediatric cataract, the leading cause of childhood blindness in this environment, presents the greatest surgical burden in our unit. It should, therefore, be a major focus of personnel training and equipment procurement for paediatric ophthalmology services in our environment.
Intraocular pressure elevation following the use of topical dexamethasone ointment after Squint surgery
(West African College of Surgeons, 2022-01) Ugalahi, M. O.; Ibukun, F. A.; Olusanya, B. A.; Baiyeroju, A. M.
Purpose: To describe the pattern of intraocular pressure (IOP) changes after squint surgery in eyes of black Africans at the University College Hospital, Ibadan, Nigeria. Materials and Methods: This was a retrospective review of the clinical records of patients who underwent squint surgery between 2010 and 2019. Data on demographic characteristics, preoperative and postoperative intraocular pressure values, coexisting ocular pathology, type of strabismus, surgery performed, frequency and duration of postoperative topical steroid use and treatment received for elevated intraocular pressure were collected and descriptively summarised. Results: Thirty-six (39.1%) out of 92 patients who had squint surgery during the study period met study inclusion criteria. Mean age was 20.5 ± 13.6 years. All patients were administered Maxitrol® ointment postoperatively. Baseline, peak and net change in IOP were 12.9 ± 2.6 mmHg, 21.3 ± 6.8 mmHg and 8.39 ± 7.2 mmHg respectively. Thirty-one (86.1%) patients had elevation in IOP from baseline; 21 (67.7%) of these had significant IOP elevation. Topical steroid therapy was tailed off rapidly for all patients with significant IOP elevation. Twelve patients were commenced on topical IOP lowering medications, with normalization of intraocular pressure in majority of them by three months after surgery. Conclusion: Elevated intraocular pressure with the use of topical dexamethasone ointment after squint surgery was common in this study and majority of the patients had significant elevation in intraocular pressure. Close monitoring of the intraocular pressure of black patients, especially children, on topical steroid medication after squint surgery is strongly recommended.
Is couching rare in the pediatric age group? a report of bilateral couching in a child
(Wolters Kluwer - Medknow, 2019-12) Ugalahi, M. O.; Ata, A. S.; Olusanya, B. A.; Baiyeroju, A. M.
Background: Couching, an ancient procedure for cataract surgery, is unfortunately still being practiced in many developing countries. There are several reports of couching in adult populations; however, literature is sparse on its occurrence in children. Case report: We report a case of a 10-year-old boy who had bilateral couching on account of congenital cataracts due to presumed congenital rubella syndrome. The patient had initially presented to our clinic during neonatal period and was scheduled for surgery. Unfortunately, surgery was not performed due to various reasons which were either patient related or health system related. He represented to the eye clinic 6 years post-couching with complaints of poor vision. Conclusion: This report aims to highlight the fact that couching is, indeed, being performed on children’s eyes, especially as a consequence of inefficiencies in the eye healthcare delivery system.
Ocular injuries in a paediatric population at a child eye health tertiary facility, Ibadan, Nigeria
(Elsevier, 2023) Ugalahi, M. O.; Adebusoye, S. O.; Olusanya, B. A.; Baiyeroju, A.
Purpose: To determine the pattern, causes and risk factors for ocular injuries amongst children presenting to a tertiary facility in Ibadan, southwest Nigeria Methods: A retrospective review of clinical records of patients aged 16 years and below who presented with ocular injuries to the eye emergency unit between May 2010 and April 2016. Information extracted includes patient’s demography, location and circumstances of injury, clinical findings, and management. Data was analysed using IBM SPSS Statistics for Windows, Version 26.0. Descriptive and inferential statis- tics were calculated. Odds ratio were derived from regression models adjusted for confounders. Significance was set at a P-value of 0.05. Results: A total of 109 children were studied. Majority were boys (male to female ratio = 2.9:1). The median age at presentation was 9 years. Injury occurred at home in 67 (61.5%) children, and at school in 30 (27.5%). More than half of the children were injured during play, 18 (16.5%) during corporal punishment, and 34 (31.2%) by accidents during domestic/schoolwork. Majority (73.4%) were closed globe injuries. The odds of injury with sharp objects and ocular trauma score of 4 or less was were 3.2 times (95% Confidence interval {CI}: 1.3–7.7) and 3.9 times (95% CI:1.4–11.4) higher in children aged 0–5 years respectively. The odds of open globe injury was 9.8 times (95% CI: 3.4–28.6) higher in injury from sharp objects. Wood/stick, cane, stone, broomstick and fist/palm/finger were the agents responsible for two- thirds of injuries. Conclusion: This study revealed that children predominantly sustain ocular injuries at home and younger children have greater odds of severe injuries with profound implications for visual disability. Health education, adult supervision and the application of appropriate measures necessary for reducing the incidence and severity of childhood ocular trauma are advocated.
Ocular morbidity among orphans and vulnerable children living in shelters in Ibadan metropolis
(Wolters Kluwer - Medknow, 2024) Ajetunmobi, B. S.; Ugalahi, M. O.; Uchendu, O. C.; Baiyeroju, A. M.
Globally, orphans and vulnerable children (OVC) represent a significant population at risk of poor health as well as a high risk of developing ocular disorders. These ocular disorders could lead to childhood visual impairment or blindness if left undetected or untreated. This study therefore focuses on ocular morbidity among OVC living in shelter facilities to provide relevant data for planning eye care interventions. Methods: A descriptive, cross-sectional study was conducted among OVC ages 5–16 years living within shelter facilities in Ibadan, Oyo State. Sociodemographic characteristics were obtained. Ocular examinations, including visual acuity measurements, colour vision test, Hirschberg test, anterior and posterior segments assessment, and cycloplegic refraction were conducted. Descriptive and inferential analysis was done with IBM SPSS Statistics version 24. All analyses were at 5% level of statistical significance. Results: A total of 497 eligible OVC participated in the study. The mean age was 11 ± 3.4 years, and 263 (52.9%) were males. The prevalence of ocular morbidity was 18.1%. The most common types of ocular morbidity were refractive errors 47 (9.5%) and allergic conjunctivitis 18 (3.6%), with more females affected by both conditions, 28 (59%) and 11 (61%), respectively. Ocular morbidity was most common (28.3%) among the 14–16 years age group (P=0.001). Conclusion: Refractive errors and allergic conjunctivitis, which are treatable ocular conditions, were the most common ocular morbidities among these children. Regular eye screening as well as the provision of quality and affordable eye care services is advocated for this vulnerable population of children.
Outcome of combined trabeculotomy-trabeculectomy in eyes of Nigerian children with primary congenital glaucoma
(West African College of Physicians and the West African College of Surgeons, 2023-08) Ugalahi, M. O.; Adeyemo, A. O.; Olusanya, B. A.; Baiyeroju, A. M.
PURPOSE: To report the outcome of combined trabeculectomy among children with primary congenital glaucoma at a child eye health tertiary facility in southwest Nigeria. METHODS: A retrospective review of children who underwent combined trabeculotomy-trabeculectomy (CTT) surgery on account of primary congenital glaucoma between 2016 and 2020 at the University College Hospital, Ibadan, Nigeria. All surgeries were performed by paediatric ophthalmologists. The main outcome measures were postoperative intraocular pressure, corneal clarity, and complications. RESULTS: A total of 21 eyes of 13 patients were included. Ten (76.9%) of the patients were males and 8 (61.5%) had bilateral disease. The mean age at presentation was 4.8 (± 3.6) months, while the mean age at surgery was 8.1 (± 5.9) months. The average waiting time between noticing symptoms and presenting to the clinic was 3.2 (±4.9) months. The mean horizontal corneal diameter was 13.2 (± 1.4) mm, while the mean pre-operative intraocular pressure (IOP) was 25.7 (± 8.6) mmHg. The surgical success (IOP<21 mmHg) rates at 3, 6, and 12 months were 86.7%, 64.3%, and 92.9% respectively. The Kaplan-Meier estimates of the probability that IOP remained below 21 mmHg up till 3, 6, and 12 months were 74%, 53%, and 53% respectively. Postoperatively, 85.7% of the eyes had complete resolution of corneal oedema. One eye had an intraoperative complication of vitreous loss. The post-operative clinic follow-up rate reduced to 52.4% by 1 year. CONCLUSION: Combined trabeculotomy-trabeculectomy is a relatively safe procedure that is associated with favorable success in Nigerian children with primary congenital glaucoma.
Outcome of glaucoma management in sturge-weber syndrome: case series
(Wolters Kluwer - Medknow, 2024-08) Ugalahi, M. O.; Onebunne, E. O.; Olayiwola, O. T.; Urom, C. O.; Olusanya, B. A.; Baiyeroju, A. M.
To report the clinical findings and outcome of treatment for developmental glaucoma from Sturge-Weber syndrome in four consecutive children managed at a child eye health tertiary facility in Ibadan, Nigeria. Methods: A retrospective case series of four children with Sturge-Weber syndrome (SWS) and developmental glaucoma who underwent surgical treatment for glaucoma over a 3-year period. Information on patients’ sociodemographic data, clinical features, and management are described. Results: Four male children, aged between 7 weeks and 11 years, with unilateral developmental glaucoma and varying extent of port-wine stain were included in the study. The primary surgery in three patients was trabeculectomy, while the fourth patient received a glaucoma drainage device. Shallow anterior chamber, choroidal effusion, and cataract were complications of glaucoma surgery observed. Secondary surgeries performed include anterior chamber reformation, suturing of leaking peritubular scleral channel, sclerotomy and fluid drainage, bleb needling, cataract surgery, and scleral buckle surgery. At the 1-year follow-up visit, one eye had complete success, one eye had qualified success, while the other two had treatment failure. Conclusion: The outcome of management of glaucoma associated with Sturge-Weber syndrome is modest. Though rare, SWS can cause significant ocular and systemic morbidity. Complications of therapy may be encountered, and multiple surgical interventions may be required for optimal management.
Outcome of surgery for traumatic cataract in children in a child eye health tertiary facility, Ibadan, Nigeria
(SAGE Publishing, 2021-03) Ugalahi, M. O.; Olusanya, B. A.; Aremu, O. O.; Baiyeroju, A. M.
Objective: The objective of this study was to describe the outcome of surgery for traumatic cataract and associated factors in children aged 16 years and below operated in a tertiary facility. Methods: This was a retrospective review of records of children who had surgery for traumatic cataract between August 2015 and August 2019. Information on biodata, preoperative visual acuity, surgical methods, complications, and postoperative visual acuity were retrieved. Data were analyzed using IBM SPSS Statistics 20.0. Results: Traumatic cataract accounted for 87 (14.7%) of 593 eyes operated for childhood cataract during the period. Of these, a total of 79 records were available for review. There were 56 (70.9%) males with a mean age of 10.11 (±3.39) years. All injuries were unilateral; closed globe injuries accounted for 70 (88.8%) of the cataracts and the left eye was affected in 42 (53.2%) patients. Fifty-two (67.09%) eyes had other ocular injuries apart from cataracts. The morphology of the cataract was membranous in 44 (55.7%) eyes, and 76 (96.2%) eyes had cataract surgery with intraocular lens (IOL) implantation; 39 (51.3%) of these IOLs were implanted within the capsular bag. The preoperative best corrected visual acuity was worse than 6/18 in all 79 (100%) eyes and improved to 6/18 or better in 32 (40.5%) eyes at 3 months postoperatively. Conclusion: Traumatic cataract accounted for less than a quarter of all childhood cataracts in our center. Majority of the eyes had successful IOLs implantation during surgery, and the best corrected visual acuity improved in a moderate proportion of these patients.
Pattern of refractive error among children attending the eye clinic of a tertiary hospital in Ibadan, Nigeria
(Wolters Kluwer - Medknow, 2014) Olusanya, B. A.; Ugalahi, M. O.; Ogunleye, O. T.; Baiyeroju, A. M.
Refractive amblyopia among children in Ibadan: the need for amblyopia screening programmes
(2015) Olusanya, B. A.; Ugalahi, M. O.; Okoli, C. E.; Baiyeroju, A. M.
Background: The prevalence and burden of amblyopia in developing countries is probably underestimated, and little is known about the pattern of amblyopia in West Africa. Aim: To determine the relative frequency and types of amblyopia among children with refractive errors seen in the eye clinic of a tertiary hospital over a 2 year period. Methods: A cross-sectional study conducted at the eye clinic of the University College Hospital, Ibadan, Nigeria between January 2012 and December 2013. Case notes of children with refractive errors seen during this period were retrieved and information including socio-demographic data, presenting visual acuity and visual acuity with correction were recorded. Amblyopia was defined as best corrected visual acuity worse than 6/9 or a difference of >2 Snellen chart lines between both eyes in the absence of any ocular pathology that could explain the visual impairment. Results: A total of 250 eligible patients who had refractive errors were included in the study. Visual acuity was corrected to 6/9 or better in 224 (89.6%) children while 26(10.4%) of them had amblyopia. Among the 26 children with amblyopia, 21 (80.8%) children had amblyopia in both eyes and majority (65.4%) had isoamctropic amblyopia. Of the 47 amblyopic eyes, 36 (76.6%) eyes had moderate amblyopia while 11 (23.4%) eyes had severe amblyopia. Conclusion'. There is a high relative frequency of amblyopia in this study and we recommend preschool eye examinations for all children to ensure early detection and management of amblyopia, thereby reducing the burden of amblyopia in our populace.
Refractive errors among children attending a tertiary eye facility in Ibadan, Nigeria: highlighting the need for school eye health programs
(Association of Resident Doctors (ARD), University College Hospital (UCH), Ibadan, Nigeria, 2019) Olusanya, B. A.; Ugalahi, M. O.; Ogunleye, O. T.; Baiyeroju, A. M.
Background: It is estimated that 19 million children aged below 15 years are visually impaired globally. Twelve million of these are due to uncorrected refractive errors. The aim of this study was to describe the pattern of refractive errors seen in children attending the eye clinic of the University College Hospital, Ibadan, Nigeria. Methods: A descriptive retrospective study of children with refractive errors seen between January 2011 and December 2012 was conducted. Information on the age, sex, type of refractive error, degree of error (spherical equivalent), presenting complaint, previous spectacle use and return for follow-up visit were retrieved and analyzed using SPSS version 20. Results: Three hundred and sixty-six children diagnosed with refractive errors accounted for 34.6% of all children seen. Of these, 267 (73%) records were successfully retrieved. The mean age was 10.58 (± 3.14) years, with 156 (58.5%) aged between 11 and 15 years. The male to female ratio was 1:2. The commonest refractive error was myopia, found in 124 (23.2%) of 534 eyes followed by simple myopic astigmatism and compound myopic astigmatism found in 117 (21.9%) and 111 (20.8%) eyes respectively. Majority, 229 (85.8%) had never worn spectacles previously and only 80(30%) children returned for a follow up visit. Conclusion: Refractive errors constitute a common diagnosis among children seen in our tertiary eye facility. Late presentation and poor follow up among our patients are a cause for concern. Public enlightenment, health education and school eye programs are recommended to reverse this trend.
Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme
(Paediatric Association of Nigeria, 2020) Olusanya, B. A.; Oluleye, T. S.; Tongo, O. O.; Ugalahi, M. O.; Babalola, Y. O.; Ayede, A. I.; Baiyeroju, A. M.
Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks. Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards developing country-specific screening guidelines.
Simultaneous versus sequential surgery for bilateral congenital cataracts in a resource-limited setting
(2018) Ugalahi, M. O.; Olusanya, B. A.; Monye, H. I.; Baiyeroju, A. M.
Background: To compare simultaneous surgery with sequential surgery for the treatment of bilateral congenital cataracts in children younger than three years at a tertiary hospital in a resource-limited setting in order to facilitate informed decision making by parents and healthcare providers. Methods: A retrospective review of medical records of children below three years who had bilateral surgery for congenital cataracts between 2010 and 2016 at the paediatric ophthalmology unit of a university teaching hospital in Nigeria. Data on demographic characteristics, type of surgery, delays in care, time interval between surgery and optical rehabilitation, direct cost of care, systemic associations and surgical complications were retrieved, descriptively summarized and compared for both groups. Results: There were 40 eligible patients, 25 (62.5%) of which were males. Age at presentation ranged from 4-128 weeks with a median of 28 weeks. Twenty-four (60%) patients had simultaneous bilateral cataract surgery. Patients who underwent sequential cataract surgery had higher direct costs and accumulated hospital stay, and were more likely to experience delays in accessing second procedures as well as post-operative optical rehabilitation. No anesthetic or other serious ocular complications such as endophthalmitis were noted in either group. Conclusion: Although there were similarly low complication rates in both groups, we observed higher direct costs of care, longer duration of hospital stay, as well as longer intervals before second surgeries and visual rehabilitation in the sequential group. Therefore, simultaneous cataract surgeries may be the preferable option in resource-limited settings like ours, where health care financing is mainly through out-of-pocket expenses.
Spare the rod or spoil the eye? corporal punishment- related eye injuries among children presenting to tertiary hospital in South West Nigeria
(2018-06) Monye, H. I.; Ugalahi, M. O.; Olusanya, B. A.; Baiyeroju, A. M.
Objective: To determine the burden of corporal punishment in the aetiology of ocular injuries among children, to inform evidence-based advocacy measures to curb this trend. Methodology: This study was a retrospective review of cases of punishment-related ocular injuries among children aged 16 years and less who presented to the Eye Emergency of the University College Hospital, Ibadan, between 2010 and 2016. Data on proportion of paediatric ocular trauma due to corporal punishment, patient demography, circumstance surrounding, and nature of injury, management and visual outcome were descriptively summarised. Results: There were 109 cases of paediatric eye injuries during the study period of which 18(16.5%) were due to corporal punishment. The mean age was 10.3 years (SD 2.7). Males comprised 61.1 % (11) of cases. Place of injury was at school in 10 (55.6%) and at home in 8 (44.4%) cases. All injuries were unilateral. Sixteen (88.9%) of these injuries were of the closed globe type and management was conservative in 15 (83.3%) children. Twelve (66.7%) children had visual acuity less than 3/60 at presentation while 8 (44.4%) had 6/18 or better vision as at time of last follow up. Conclusion: Punishment-related eye injuries are important in the aetiology of paediatric ocular trauma in our locality especially as relates to poor visual outcome. There is therefore the need for targeted sensitization of parents, care givers and teachers, as well as creation of awareness of alternative methods to corporal punishment and legislation in order to effectively tackle this problem.