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Item Conjunctival incisions for trabeculectomy and their relationship to the type of bleb formation-A Preliminary Study(1987-04) Agbeja, A. M.; Dutton, G. N.The bleb which develops following trubeculectomy may be diffuse or cystic in nature. Cystic blebs can he complicated by infection, leakage of aqueous, astigmatism and problems related to contact lens wear, whereas diffuse blebs are not associated with such problems. We report a preliminary prospective photographic evaluation of bleb formation following each of three types of conjunctival incision: (a) fornix bascd (b) straight limbus based and (c) curved limbus based. The vascular patterrn and morphology of the drainage bleb formed was dependent upon the type of conjunctival incision made. The fornix based flap was found most likely to give rise to a diffuse bleb with a normal vascular pattern.Item Non-cardiac surgery and anaesthesia in children with congenital heart disease(1996-06) Soyannwo, O. A.; Baiyeroju, A. M.Children with Congenital Heart Disease (CHD) presenting for non-cardiac surgery have various physiological and functional abnormalities and thus pose great challenges to the anaesthetist. This one year prospective study was undertaken to determine the incidence of CHD in children presenting for noncardiac surgery, the type of lesions and anaesthetic course. Five patients (1.5%) out of a total of 324 children aged from birth to twelve years who had surgery during the study period were found to have CHD, ventricular septal defect (VSD) being the commonest cardiac lesion. Surgery was for cataract extraction and herniorrhaphy. Although all the children had been previously treated or were on current treatment for additional medical problems, surgery under closely monitored balanced general anaesthetic technique was found to be safe.Item Ocular complications of head injury in children(Springer-Verlag, 1991) Shokunbi, T.; Agbeja, A.Ocular complications occurred in 28%, of children with head injury. Neuro-ophthalmological lesions made up one-third or these complications, mostly involved the optic nerve, and were associated with other focal neurological signs more frequently than non-neural ocular complications. Lesions or the posterior visual pathways were rare but tended to be permanent.Item A comparison of visual function scores in hydrocephalic infants with and without lumbosacral myelomeningocoele(Nature Publishing Group, 2002) Shokunbi, M. T.; Odebode, T. O.; Agbeja-Baiyeroju, A. M.; Malomo, A. O.; Ogunseyinde, A. O.; Familusi, J. B.Purpose: The cerebrum is frequently malformed in children with myelomeningocoele. This anomaly renders them potentially susceptible to cerebral visual impairment. In these patients, hydrocephalus is an important and frequent complicating lesion which compromises intellectual function and may also cause cerebral visual impairment. In this study, we determined whether hydrocephalic patients with lumbar myelomeningocoele (HLM) are at a greater risk of visual impairment than hydrocephalic patients without this lesion (H). Methods: In this prospective study, we assessed five parameters of visual function in 20 hydrocephalic children with lumbar myelomeningocoele and compared the total visual function scores (TVFS) obtained with those from hydrocephalic children without overt spinal dysraphism, but similar in age, sex and ventricular size. The parameters, which were assessed with the aid of a quantitative grading scale, were papillary size and reaction, optic atrophy, visual fixation and tracking. Results: The age and sex distributions of the patients in the two groups were similar. The anterior and posterior dimensions of the lateral ventricles were also similar. The mean (SD) of the TVFS were 24.25 (3.63) and 24.20 (3.47) respectively for the two groups (P = 0.90). Conclusions: The results suggest that, in hydrocephalic infants with lumbar myelomeningocoele, visual function is not further diminished by the associated dysraphism and that ventricular dilatation is the major determinant of visual impairment.Item Patency of the ductus arteriosus in newborns: experience in a special care baby unit(2001) Omokhodion, S. I.; Baiyeroju-Agbeja, A. M.; Adegboye, V. O.; Adeyemo, A.; Lagunju, L. A.A prospective cohort study of infants admitted into the Special Care Baby Unit, University College Hospital, Ibadan, has revealed a 24.5 per cent prevalence of patency of the ductus arteriosus (PDA) among 97 infants, who were admitted over a six-month period. The major factor predisposing to PDA was prematurity (p=0.014). A higher incidence of PDA (35 per cent) Was found among the preterm infants, and of these preterm infants, the very low birth weight (VLB'W') infants were found to be more highly susceptible to PDA (p=0.028). The mean birth weight of the preterm infants who developed PDA in the study was 1447g, while that of those without PDA was 1835g. There was no relationship between the sex of the infants and the development of PDA. A strong association was however, found between respiratory distress and PDA (p<0.0001). Nine of the hospital mortalities recorded occurred in the preterm infants and more than half of them (55.5 percent) had PDA Thus, prematurity is a risk factor for PDA and the presence of a PDA appears to increase the risk for mortality for such infants. Evidence for PDAshould be sought in all premature infants and prompt and aggressive management of those infants who show signs of decompensation from PDA is recommended to reduce mortality from this disease.Item Visual recovery after cataract surgery in children(2006-12) Olusanya, B. A.; Baiyeroju, A. M.; Fajola, A. O.Objective: To evaluate the visual outcome of cataract surgery in children aged 16 years and below at the University College Hospital (UCH), Ibadan. Methods: A retrospective review of the case records of patients aged 0-16 years who had cataract surgery at the UCH Ibadan between January 1995 and June 2006. Results: One hundred and fifty-one eyes of 101 patients were studied. Eighty-four eyes (55.6%) had congenital cataracts, 25.2% were developmental, while 13.9% were secondary to trauma. Seventy-one (70.3%) patients had bilateral cataracts. Eighty-nine (58.9%) of the eyes had an associated ocular pathology. Ninety-eight eyes (64.9%) had extracapsular cataract extraction without intraocular lens implant (ECCE), while 50 eyes (33.1 %) had extracapsular cataract extraction with posterior chamber intraocular lens implant (ECCE+PCIOL). Primary capsulotomy was performed on 34 eyes (22.5%). Postoperative complications were observed in 119 eyes (78.8%); with posterior capsule opacity occurring in 41.1%. Thirty-five eyes (38.9%) of those with objective visual acuity had a visual outcome ≥ 6/18. A visual outcome of 6/18 Dr better was significantly associated with increasing age (p =0.007) and the use of PCIOL implants (p =0.005), while poor visual outcome (≥ 6/24) was significantly associated with onset of cataract at birth (p =0.001); the presence of other ocular pathology (p =0.03); and a long delay between presentation and surgery (p= 0.02). Conclusion: The visual recovery of children who underwent cataract surgery in Ibadan is encouraging and the surgical results are likely to improve with increased proficiency in IOL implant surgery. The establishment of well-equipped and well-staffed paediatric ophthalmology centres would be beneficial in improving outcomes and would therefore help in achieving the goals of Vision 2020: The Right to Sight' .Item Hunter syndrome: case report and review of literature(2006-06) Ogunbiyi, A.; Adeyinka, A. O.; Ogah, S. O.; Baiyeroju, A. M.Hunter syndrome is one of the mucopolysaccharidosis, which are a rare group of genetic diseases, It is due to a deficiency in the enzyme Iduronate 2-sulphatase. This in turn leads to the accumulation of glycosaminoglycans, dermatan and heparan sulphate. The intra and extracellular accumulation of this substances lead to multisystemic organ abnormality. We present a patient with Hunter syndrome who presented with involvement of the skin, cardiovascular system, the eyes and musculoskeletal system. We have also included a literature review. As far as we know, it is the first case reported in a Nigerian.Item Congenital poikiloderma with unusual hypopigmentation and acral blistering at birth(Elsevier, 1999) Ogunbiyi, A. O.; Ogunbiyi, J. O.; Baiyeroju-Agbeja, A. M.Congenital poikiloderma is an uncommon hereditary disorder. It has been reported in association with various synuromes. No case has previously been reported from this environment. We report a case of congenital poikiloderma in a two and a half year old female Nigerian associated with unusual generalised hypopigmentation and acral blisters at birth. The child subsequently developed macular hyperpigmentation on an erythematous background and atrophy of the skin. Although he had some features which were suggestive of Rothmund-Thomson syndrome (RTS), the presence of nypopigmentation at birth along with acral blistering, was noted to be peculiar to this child. We, therefore, feel that this case presents a distinct variant of congenital poikiloderma that has not been described previously.Item The relationship between ventricular size and visual function in children with hydrocephalus(1998) Odebode, T. O.; Shokunbi, M. T.; Malomo, A. O.; Familusi, J. B.; Agbeja-Baiyeroju, A. M.; Ogunseyinde, A. O.We examined the relationship between ventricular size and visual function in 50 children (36 males and 14 females) with hydrocephalus. The third and lateral ventricular sizes and the visual function scores did not significantly differ between the sexes. Ventricular enlargement was most pronounced at the trigones and least at the level of the foraminae of Monro. The visual function score correlated inversely with the size of the lateral ventricle measured at the levels of the anterior horn and the trigone and expressed as coronal diameter and "Modified" Evans' ratio (r = 0.49; P = 0.001 and r = - 0.38, P = 0.01 for the anterior horn; r = 0.48, P = 0.00 I and r = -0.35, P = 0.001 for the trigone). The size of the third ventricle did not correlate with visual function score. A "modified" anterior Evans ratio of 0.60 and a trigonal Evans ratio of 0.73 were associated with very low visual function score. Furthermore, there was significant inverse correlation between occipitofrontal circumference (OFC) and visual function (r = -0.6379, P = 0.001), but OFC was not valuable for predicting visual function before the onset of head enlargement.Item Focal dermal hypoplasia: a case report and review of literature(2003-12) Ogunbiyi, A. O.; Adewole, I. O.; Ogunleye, O.; Ogunbiyi, J. O.; Ogunseinde, O. O.; Baiyeroju-Agbeja, A.A 14 year old girl was seen in the clinic with a huge vulvar wart, and warts on both tonsils. She also had poikiloderma. She had bony abnormalities, which included lobster claw abnormality of the right foot, a right cervical rib, and the right clavicle was lower than the left. There were fine parallel vertical radio-opaque lines in the distal femoral tibial metaphyses bilaterally (osteopathla striata). A diagnosis of Focal dermal hypoplasia was made. The huge vulvar wart and the warts on the tonsils were excised. She recovered promptly and she was discharged home.