scholarly works
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Item 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.Item 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.Item 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.Item 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 AfricaItem West African College of surgeons basic ophthalmology resource: development and initial evaluation(2024) Abdulsalam, S.; Ademola-Popoola, D.Purpose: To describe the process of development of the West African College of Surgeons (WACS) Basic Ophthalmology Educational Resource and to report the feedback from the first five cohorts to utilise the resource at the commencement of their training in ophthalmology. Methods: After initial meetings topics considered essential foundations for training in ophthalmology were identified. Faculty members subsequently searched the internet to identify suitable online open source learning materials relevant to each topic, which were then collated and cataloged. Where suitable quality learning materials could not be identified, materials were created or re-used from existing WACS courses. Following the creation of the resource, questions were developed for a summative assessment, taken by learners upon completion of the resource. Results: The resource went 'live' on 10th July 2019. As of March 2024, a total of 203 learners in 5 cohorts had completed the course. The feedback responses of 150 (74%) learners from the first 5 cohorts are described in this report. Regarding their overall assessment of the course, 64 (43%) learners rated the resource as very good', 63 (42%) as 'good', and 23 (15%) as 'satisfactory’. Most (>98% respondents reported that the course met their expectations and that the content was relevant to their learning needs. Conclusion: The WACS Basic Ophthalmology Resource appears to be a valuable opportunity for acquiring foundational knowledge.Item 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.Item 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.Item 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.Item Optic disc drusen and a constellation of other features of retinitis pigmentosa: a case report(Science Publishing Group, 2021) Babalola, Y. O.; Baiyeroju, A. M.Aim: We describe a case of optic disc drusen in retinitis pigmentosa with a myriad of other ocular associations of retinitis pigmentosa coexisting in our patient. To the best of our knowledge, this is the first case reported in a Nigerian. Method: This is a case report of a 16 year old who presented top our eye clinic with a 2 year history of poor night vision with an associated history of difficulty seeing far since childhood. The best corrected visual acuity was 6/18 and 6/12 respectively in the right and left eye. Slit lamp biomicroscopy revealed bilateral grade 1 posterior subcapsular cataracts. Binocular indirect ophthalmoscopy of both eyes revealed vitreous opacities, pale, cupped discs with nasalization of the vessels and yellowish, crystalline deposits at the inferior and superior disc margins. The retina was pale with attenuated vessels, bone spicule pigmentation, atrophic maculopathy and epiretinal membranes bilaterally. Results: An assessment of optic disc drusen, glaucoma, atrophic maculopathy with epiretinal membrane in retinitis pigmentosa was made. The diagnosis of optic disc drusen was confirmed by characteristic ocular B-scan findings. He was commenced on guttae betaxolol BD in both eyes and counselled on the nature of the eye pathology. Conclusion: Optic disc drusen co-exists with retinitis pigmentosa. Though uncommon, optic disc drusen may occur in Africans as seen in our patient. Other ocular associations including myopia, glaucoma and macula lesions like epiretinal membrane and atrophic maculopathy may also be present. The central visual field changes in a patient with retinitis pigmentosa, optic disc drusen and glaucoma may be attributable to all three ocular entities and not just the glaucoma. Prompt diagnosis, follow –up and adequate patient counselling is essential in the management of these patients.Item Immunization of children in Africa: strides and challenges(Wolters Kluwer - Medknow, 2023-06) Olawuyi, D. A.; Esanju, D. O.; Olowolayemo, S. A.; Asogwa, C. S.; Salako, O. O.; Kolajo, A. E.; Akano, O. S.; Ibekwe, J. P.; Mbey, A. N.; Raji, A. H.Background: The African continent is behind by a wide margin in the childhood vaccination race which contributes significantly to the high childhood morbidity and mortality rate from vaccine-preventable diseases in the continent. Some African countries are still struggling to achieve routine immunization coverage for all recommended expanded program on immunization vaccines. Aim: In this study, we aimed to identify the barriers hindering childhood immunization in Africa and to identify the remarkable progress made so far. Materials and Methods: Peer-reviewed articles published in English that focused on the barriers to childhood immunization in Africa and the progress made so far was reviewed. This was achieved by searching relevant search terms in PubMed, Google Scholar, Wiley Online Library, and CINAHL databases dating back from January 2000 to June 2022. Result: A total of 30 papers were reviewed. The barriers include parents’ education status, economic status, and gender/age; place of birth and place of residence; cultural beliefs and religious affiliations; fear of contracting diseases and lack of trust in health public institutions; vaccine awareness and delivery; and dose-specific delays. The achievements include international support and oriented actions, plans for technological integration and its implementation, and domestic immunization-oriented actions and research work. Conclusion: Childhood immunization is still low in Africa with the majority of the countries yet to realize the global immunization targets. Technologies and immunization-related interventions have been implemented to support Africa but more concerted effort and aid are required to reduce vaccine-preventable deaths to the bare minimum.