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    Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria
    (Springer, 2010) Bekibele, C. O.; Baiyeroju, A. M.; Ajaiyeoba, A.; Akang, E. E. U.; Ajayi, B. G. K.
    Background: Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. Objective; To identify symptoms and surface abnormalities associated with dry eyes. Materials and methods: One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer's 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Results: Mean tear meniscus height, Schirmer's test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer's test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer's values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher's exact test) and 95.8% of dry right eyes compared to 61.1 % of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). Conclusion: A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.
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    Syndromatic hepatic ductular Hypoplasia (Alagille syndrome) in a Nigerian: A Case Report
    (1998) Akinyinka, O. O.; Akang, E. E. U.; Agbeja-Baiyeroju, A. M.; Osifi, B. O. A.||; Thurham, D.
    We report what, as far as we are aware, is the first documented case of Alagille syndrome which is characterised by chronic cholestasis, characteristic facies, pulmonary stenosis and defects at the vertebral arch, in a Nigerian girl who presented at the age of two days and was followed up interminently for a period or 10.5 years. The biochemical indices suggestive of choiestasis in the patient improved with age while the height and weigh remained suboptimal. The patient had two percutaneous iiver biopsies with the second biopsy being consistent with paucity of interlobular biie duet syndrome. The characteristic facia features suggestive of the Alagille syndrome and clinical and echocardiographic evidence pulmonary stenosis were first observed at the age or 58) months. This syndrome although rare, should be considered in the differential diagnosis of conjugated hyperbilirubinaemia in Nigerian children.
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    Tear function and abnormalities of ocular surface: relationship with subjective symptoms of dry eye in lbadan, Nigeria
    (2008-03) Bekibele, C.O.; Baiyeroju, A. M.; Ajaiyeoba, A. I.; Akang, E. E. U.; Ajayi, B. G. K.
    Objective: To determine the relationship between tear function and ocular surface abnormalities with subjective symptoms of dry eye. Methods: Patients with various ocular irritation symptoms suggestive of dry eye were examined for tear break up time (TBUT), Schirmer's test 1, and Rose Bengal staining pattern. They were compared with a group of asymptomatic healthy subjects. Results: There were 63 subjects, mean age 43.8 years (+/-14.7 years) with various complaints of dryness presenting as having irritation or foreign body sensation. A group of 17 asymptomatic subjects, mean age 42.1 years (+/-12.7 years) were studied as controls. There were 22 (34:.9 %) males and 41(65.1%) females in the symptomatic group while the control group had 4 (23.5%) males and 13(76.5%) females. Ocular irritations included itching 38(60.3%), pricking and itching 10 (15.9%). Mean Shirmer's test value were lower for symptomatic, subjects (mean 14.5mm +/-12.3 right eye; 14.9mm+/-12.4 left eye), compared to the controls (23.0mm +/-13.4 right eye; 17. 9mm +/-13.4 Ieft eye) P=0.02, for right eye and 0.4 for left. The mean TBUTwere also lower amongst the symptomatic subjects (10.5 seconds, right eye and 10.1 seconds left eye), while for controls mean TBUT was 12.7.,seconds right eye and 12.1 seconds left eye (P=0.2). Fifty -six out of 126 (46.8%) eyes of all symptomatic subjects compared to 7 out of 34 (20.6%) eyes of asymptomatic subjects had positive staining of conjunctiva with rose Bengal (p=0.06). For subjects with itching as the primary symptom 44.7% of them as opposed to 23.5% of the controls were likely to stain positive with rose Bengal, (sensitivity of itching as screening tool for dry eye was 81%, specificity 38.2%). Itching and pricking sensation together (sensitivity 46.2% and specificity improved to 65%). Rose Bengal grades were also inversely correlated with mean Schirmers values (Pearson correlation -0.429; P = 0.001) and TBUT (Pearson correlation -0.316, P=0.005). Conclusion: Itching and other ocular irritation symptoms may be indicative of underlying abnormal tear function and ocular surface damage, their presence calls for further examination for tear deficiency and prompt institution of treatment for dry eye