FACULTY OF CLINICAL SCIENCES
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Item Comparison of clinical outcome between 23G and 25 G vitrectomy in diabetic patients.(Oman Ophthalmic Society, 2017) Taleb, E. A.; Nagpal, M. P.; Mehrotra, N.; Bhatt, K.; Goswami, S.; Babalola, Y. O.; Noman, A.PURPOSE: To compare the clinical outcomes and complications between 23 G and 25 G vitrectomy in patients with diabetic vitreous hemorrhage (VH). MATERIALS AND METHODS: A retrospective comparative study comprising 69 eyes (36 eyes in 23 G group and 33 eyes in 25 G group) of 65 patients who underwent vitrectomy with air tamponade for diabetic vitreous hemorrhage (VH) with at least 6 months of follow up was conducted. RESULTS: There were no significant differences between the two groups in age, gender, bilaterality, type of diabetes, presence of hypertension, lens status, and previous argon laser photocoagulation state (P > 0.05). Best corrected visual acuity (BCVA) of both groups at postoperative 1 month logarithm of the minimum angle of resolution (logMAR) (1.06 ± 0.99, 0.90 ± 0.96), 3 months logMAR (1.07 ± 0.93, 0.83 ± 0.85), and 6 months logMAR (1.03 ± 0.89, 0.83 ± 0.85) significantly improved from the preoperative BCVA logMAR (2.03 ± 0.83, 2.15 ± 0.99) for 23 G group, 25 G group, respectively (P < 0.0001). There was no significant difference in BCVA between the two groups preoperatively and at 1, 3, and 6 months postoperatively (P = 0.566, 0.506, 0.333, and 0.445, respectively), incidence of intraoperative wound suturing (21.4%, 15.2%), postoperative hypotony (0.0%, 0.0%), early postoperative VH (POVH) (11.1%, 15.2%), late POVH (5.6%, 0.0%), retinal detachment (2.8%, 6.1%), neovascular glaucoma (92.8%, 9.1%), and endophthalmitis (0.0%, 0.0%) for 23 G group, 25 G group, respectively (P > 0.05). CONCLUSION: 25 G vitrectomy is as effective for PDR as 23 G vitrectomy.Item Optic disc coloboma in two Nigerian siblings; Case report & Review of Literature(Wolters Kluwer ‑ Medknow, 2017) Babalola, Y. O.; Olawoye, O. O.; Idam, P.We report two cases of bilateral asymmetric optic disc coloboma (ODC) in siblings. The index patient is a 9 year old Nigerian girl with severe cognitive deficit who presented with a poor vision of 3 years’ duration. She had a history of childhood febrile convulsions and delayed developmental milestones. Her visual acuity could not be assessed because she had a cognitive deficit and expressive aphasia. Ocular examination revealed a very large excavated right optic disc with only a strip of remnant neuro retinal rim superiorly, and a smaller left optic disc with inferior disc excavation, superior wedge of the pink neuro retinal rim as well as a temporal optic disc pit. No systemic features of syndromes associated with ODCs and intellectual disability were present in both patients. The younger sibling an 8 year old girl later presented to the eye clinic with a 5 month history of poor vision in the left eye. Ocular examination revealed visual acuity of 6/6 in the right eye and counting fingers in the left eye. Dilated binocular indirect ophthalmoscopy revealed a right large excavated colobomatous disc and a left small disc with infero temporal disc coloboma.Item Iridoschisis in a Nigerian patient; A case report(Wolters Kluwer - Medknow, 2016) Olawoye, O. O.; Babalola, Y. O.We report iridoschisis in a female who presented at the age of 85 years with a ten year history of complaints of gradual and progressive deterioration in vision in both eyes (left eye worse than the right eye). The examination was notable for the presence of peripheral anterior synechiae inferiorly and few loose iris fibrils some of which were adherent to the corneal endothelium in both eyes while others floated within the aqueous humor. The anterior chamber was shallow and there was marked inferior/inferotemporal sectoral iris atrophy with splitting of the anterior layer of the iris. The pupils were slightly irregular in but reactive in both eyes and there were lenticular opacities in both eyes.Item Chloroquine retinopathy: pattern of presentation in Ibadan, Sub-Sahara Africa(Macmillan Publishers Limited, 2016) Oluleye, T. S.; Babalola, Y. O.; Ijaduola, M.Background: Self-medication with chloroquine is common in Ibadan, Sub-Sahara Africa. Retinopathy from chloroquine is not uncommon. The aim was to determine the pattern of presentation. Methodology: Cases of Chloroquine retinopathy seen at the Retina and Vitreous Unit of the University College Hospital, Ibadan between 2008 and 2014 were reviewed. Information on age, sex, duration of chloroquine use, and visual loss were retrieved. Visual acuity at presentation, anterior, and posterior segment findings were documented. The results were analyzed using proportions and percentages. Results: Fourteen cases were seen during the study period. Mean age was 50.7 years. Male to female ratio was 3.5: Average duration of visual loss before presentation was 2.7 years. Average duration of self-medication with chloroquine was 5.3 years. Presenting visual acuity showed 2(14%) cases of bilateral blindness(VAo3/60 in both eyes); 5(35.7%) cases of uniocular blindness; three cases of bilateral low vision(VA worse than 6/18 but better than 3/60). Anterior segment examination showed abnormal sluggish pupillary reaction in those with severe affectation. Dilated fundoscopy showed features ranging from mild macular pigmentary changes and bulls eye maculopathy to overt extensive retinal degeneration involving the posterior pole, attenuation of retinal vessels, optic atrophy, and beaten bronze appearance of atrophic maculopathy. Conclusion: Chloroquine retinopathy is not uncommon in Ibadan, Sub-Sahara Africa. Bulls eye maculopathy, extensive retinal, and macular degeneration with optic atrophy are the main presentations. Public health education is imperativeItem Health seeking behaviours of patients attending primary eye care centre in Nigeria.(OALib, 2015) Megbeleyin, E. O.; Babalola, Y. O.Purpose: To determine health seeking behaviour in relation to non-orthodox eye medication use among patients attending a primary eye health center in Nigeria. Materials and Methods: It was a cross-sectional study of consecutive respondents. Participants’ socio-demographic profile, types and pattern of harmful traditional eye medications (HTEMs) use were obtained using a pre-tested questionnaire. Data analysis was by SPSS version 20.0. Results: Of the 303 patients enrolled in the study, 153 (50.5%) were males and 150 (49.5%) were females. The age range was from 13 years old to 94 years old with a mean of 53.8 ± 17.05 years old. Majority of the subjects (74.3%) used orthodox medical outfits for their eye care needs. The prevalence of use of HTEMs was 11.9%. Common forms of TEMs used were herbs 24 (66.7%), sugar water 3 (8.3%), breast milk 3 (8.3%) and onions 6 (16.7%). There was statistically significant association between age and use of HTEMs (p = 604.27, 2 χ =< 0.001, 95% CI = 0.000 - 0.010), and health seeking behaviour (p = 808.70, 2 χ =< 0.001, 95% CI = 0.000 - 0.010). Conclusion: Eye care providers and health care managers must have good knowledge of the various factors that negatively influence utilization of eye care services and be responsive to them.Item Indications for intravitreal bevacizumab in Ibadan, Subsaharan Africa.(Bentham Science Publishers, 2014) Oluleye, T. S.; Babalola, Y. O.Background: Angiogenesis is a contributing factor in some retinal diseases, hence the role of vascular endothelial growth factor (VEGF) as a common pathway in proliferative retinopathies. Bevacizumab has been found to be effective in the treatment of these diseases. The aim of this study was to review all cases of intravitreal bevacizumab given in the retinal unit of the University College Hospital, Ibadan from July, 2010 to June 2012, pointing out the common indications. Methods: After obtaining ethical approval from the University College Hospital/University of Ibadan Review Board for the study, all cases of intravitreal injections of bevacizumab recorded in the retinal register during the study period (July 2010 to June 2012) were retrieved. Age, sex, diagnoses and indication for injection were recorded in the data sheet prepared for the study. Results were analyzed using proportions and percentages. Results: A total of one hundred and thirty four injections of bevacizumab were given in the study period. The most common indication was cystoid macular edema from retinal vein occlusion ([26(19.4%)] followed by wet age related maculopathy [23(17.1%)] and sickle cell retinopathy [(22(16.4)]. Emerging indications included idiopathic polypoidal choroidal vasculopathy [8(6%) and retinal macroaneurism with macular edema [6(4.5%)]. Conclusion: Cystoid macular edema from vascular occlusion and wet age related macular degeneration are the major indications for intravitreal bevacizumab injection in Ibadan.Item How satisfied are patients attending a Nigerian Eye Clinic in University of Calabar teaching hospital?(Educational Society for Excellence, 2014) Megbeleyin, E. O.; Babalola, Y. O.; Musbahu, S. K.; Ibienmo, O.; Okonkwo, S. N.Background: Satisfaction surveys are periodically necessary to evaluate services rendered to clients/patients as a means of quality assurance and service improvement. Aim: To determine satisfaction to services rendered to ophthalmic patients in an outpatient eye clinic. Material and methods: It was an observational study carried out with validated questionnaires complemented with a focused group discussion. Statistical Package for Social Sciences (version 15-0) was used for data analysis. Observation: A total of 251 questionnaires were analyzed comprising 139 males and 112 females (M: F= 1: 0-8). Age range and mean age were 17-92 years and 37-2 + 15-6 years respectively. Overall satisfaction with quality of services was 80-1%. Specifically, 95-6%, 92%, 80-9%, 70-9%, and 59-8% were satisfied with cleanliness of hospital premises, doctors' willingness to listen to complaints, nursing care; doctors' following-up on treatment, and time nurses administered treatments respectively. However, only 37-8%, 38-6%, 39-8%, and 47-4% were satisfied with drug costs, cost of transportation to hospital, laboratory charges, and record keeping profile respectively. Conclusion: Costs of uptake of eye care services and record keeping profile were key sources of dissatisfaction in this study.Item Knowledge, attitudes and practices of pharmacists attending to ophthalmic patients in Nigerian public hospitals(International Organization of Scientific Research, 2013) Megbeleyin, O. E.; Babalola, Y. O.; Opubiri, I.; Adenuga, O.; Akinyemi, A.; Megbeleyin, F. A.Pharmacists' instructions at the time of dispensing ophthalmic medications are crucial in terms of patient compliance and efficacy of therapy. The aim of this study was to appraise knowledge, attitude and practices (KAPs) of pharmacists attending specifically to ophthalmic patients with regards to ophthalmic dispensing. It was a prospective, non-randomized study based on fully consented consecutive respondents. There were 30 respondents, 16 (53.3%) were males and 14 (46.7%) were females. The average age of the study group was 32 years +/- 8.36.Majority, 23(76.7%) were either unaware or disagreed with the potential benefit of puctal occlusion following eye drop application. Less than 50% of the respondents got the order of applying various forms of topical preparations and know eye ointment should mostly be applied at bed time to avoid blurring patients’ vision. The waiting interval between topical medications were found to vary significantly with as much as 8(26.7%) giving no specific interval. No respondent knew other forms of local routes of ophthalmic drug administration aside topicals. It is concluded that pharmacists in these institutions will benefit from education related to ophthalmic dispensing and drug administration.Item Pattern of presentation of Idiopathic choroidal polypoidal vasculopathy in Ibadan, Sub-saharan, Africa(Dove Medical Press Ltd., 2013) Oluleye, T. S.; Babalola, Y. O.Background: Idiopathic polypoidal choroidal vasculopathy is an abnormal choroidal vascular pathology similar to age-related macular degeneration. It may present with sudden visual loss from hemorrhagic retinal pigment epithelial detachment and breakthrough vitreous hemorrhage or with chronic recurrent episodes. The condition is not uncommon in the retina clinic at the University College Hospital, Ibadan, Sub-Saharan Africa. This study presents the pattern of presentation in Ibadan. Methods: We review all cases of idiopathic polypoidal choroidal vasculopathy seen from 2007 to 2012 in the retina clinic at the University College Hospital, Ibadan, to determine the major pattern of presentations, available treatment modalities, and visual outcomes. Results: Ten cases were seen during the study period. Their mean age was 58 years, with a male to female ratio of 1:4. The most common presenting complaint was sudden visual loss. Major examination findings were retinal pigment epithelial detachment, orange subretinal lesions, and breakthrough vitreous hemorrhage. The modalities of treatment available included vitrectomy to clear vitreous hemorrhage. Intravitreal bevacizumab reduced the height of the pigment epithelial detachment and cleared vitreous hemorrhage. Thermal laser was applied for extrafoveal lesions. Two patients with subfoveal lesions were referred abroad for photodynamic therapy. Visual outcome showed significant improvement in vitrectomized patients who presented with vitreous hemorrhage. Presenting vision of hand motion and light perception improved to vision ranging from counting fingers to 6/12 after vitrectomy. Conclusion: Idiopathic polypoidal choroidal vasculopathy may not be uncommon in Sub-Saharan Africa. A high index of suspicion is warranted in the diagnosis so as to provide timely intervention.Item Pre-Consultation waiting time in a Nigerian public eye facility - a source of patient dissatisfaction(Standard Research Journals, 2013) Megbeleyin, E. O.; Ibienemo, O.; Babalola, Y. O.In order to determine subjective responses of ophthalmic patients to pre-consultation waiting time, a cross-sectional study was carried out with pretested questionnaires. Statistical Package for Social Sciences version 15.0 was used for descriptive analysis. In the research a total of 251 patients were analyzed comprising 139 males (55 percent) and 112 females (45 percent), in the ratio of 1: 0.8 respectively. Their ages ranges from 17 to 92 years with a mean of 37.2 years + 15.6 Satisfaction with overall quality of services was 80.1 percent; only 25.5 percent were satisfied with waiting time. Bivariate analysis (validated by multiple logistic regressions of confounding variables) of waiting time and overall satisfaction showed a result of X 2 =44.586 and p-value = 0.0001. It is thus concluded that Pre-consultation waiting time is a major source of patient dissatisfaction to our facility.