Ophthalmology

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5-flourouracil vs. beta-aiiadiation in the prevention of pterygium recurrence
(Blackwell Publishing Limited, 2004) Bekibele, C. O.; Baiyeroju, A. M.; Ajayi, B. G. K
Aim: The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the prevention of pterygium recurrence. Materials and methods: A retrospective non-randomised review of cases of fleshy pterygium treated with bare sclera excision and adjuvant 5-FU were compared with similar morphologically appearing ptervgia, marched for age and sex, treated with bare seleral excision and adjuvant beta-irradiation. All surgeries were carried out at the university college hospital and Ojulowo eye hospital, Ibadan, Nigeria. Results: Twenty-seven eyes of 24 patients who had pterygium excision with adjuvant treatment with 5-FU were compared with 31 eyes of 24 patients who were treated with excision and beta-irradiation. The mean age for the 5-FU group was 46.1 years while that for the beta-irradiation group was 46.9 years. Both sexes were equally represented, 12 males and 12 females. There were seven (25.9%) initial recurrences in the 5-FU group but four of these became atrophic, and therefore, cosmetically acceptable leaving three eyes (11 %) with unacceptable recurrent pterygium. The beta-irradiation group, however, had seven (22.5) initial recurrence but five of these became atrophic and fell short of the cornea, leaving two (6.5%) with clinically unacceptable recurrence. The difference was, however, nor statistically significant (Zc = 0.74 and p > 0.1). The associated complications were mostly mild in both groups and included cornea opacitv of 10 (37%) complications, conjunctivitis of three (11 %) complications, sclera granuloma of three (11%) complications and conjunctiva necrosis of one (3.7%) complication for the 5-FU group, and while the beta-irradiation group had corneal opacity of one(3.7%) complication and conjunctivitis of three (11%) complications. Conclusion: The non-statistical significance of a lower pterygium recurrence rate with use of beta-irradiation for the treatment of fleshy pterygium compared with 5-FU may have been partly due to the small number of patients studied. A randomised-controlled study using a larger sample size is therefore proposed. However, the fact that over half of those with initial recurrence in the 5-FU group became atrophic (and therefore cosmetically acceptable) over rime as well as less cost implication in the purchase of 5-FU relative to Strontium-90 association with few and mild complications makes it a desirable adjuvant therapy in depressed economics. However, beta-irradiation still has a place when cost issue is not an inhibiting factor in view of its clinically superior outcome
Adie's syndrome as a cause of amblyopia
(Slack Incorporated, Medical Publisher, New Jersey, 1987) Agbeja, A. M; Dutton, M. D.
Adie's syndrome comprises a tonic pupil, which may be associated with impairment of accommodation, in the presence of diminished or absent deep tendon reflexes. We report a case of a 4-year-old boy with Adie's syndrome in which latent hypermetropia was made manifest by accommodative paresis and resulted in reversible amblyopia
Advantages of simultaneous bilateral trabeculectomy over consecutive bilateral trabeculectomy in lbadan
(1996-09) Baiyeroju-Agbeja, A. M.; Ajewole, J. F.
A retrospective study of 26 patients who underwent simultaneous bilateral trabeculectomy over a 5year period was reviewed. Advantages of simultaneous bilateral trabeculectomy include a shorter stay in hospital compared to consecutive bilateral trabeculectomy, as well as a single general anaesthetic if required and this reduces the risk of exposure to anaesthetic agents within a short time. The turn-around time in theatre is also improved compared with separate operations. Preoperatively, 20 of the patients (77%) were on two or more antiglaucoma therapy. 69% of the patients (18patients) spent 7days in hospital, from admission to discharge, the normal duration of hospital stay for unilateral trabeculectomy. Only 31% spent over one week, none stayed in hospital beyond two weeks. Post operative complications occurred in 8 eyes (15.4%) but none led to blindness. Visual outcome was good in these patients as none had reduced vision postoperatively compared to preoperatively, 3eyes had an improvement in visual acuity postoperatively.
Astigmatism in post-operative cataract patients
(1994-12) Agbeja-Baiyeroju, A. M.; Oko, H. O.
The aim of the study was to find out the various degrees of post-operative refractive astigmatism in our cataract patients, causes of the astigmatism and ways of minimising this problem. The total number of post-operative refractive astigmatism was determined in patients following cataract surgery. 22% of the patients had an astigmatism of greater than 2 diopters although only 1.9% had the more intolerable astigmatism of greater than 4 diopters. Associated causes for the astigmatism included intraoperative vitreous loss, wound dehiscence, pterygium and corneal scars. With the advent of microsurgery and better magnification, suggestions are made as to how to minimise this condition which, if high proves very intolerable for the patient.
Bilateral orbital rhabdomyosarcoma mimicking burkitt's lymphoma
(1998) Falade, A. G.; Osinusi, K.; Baiyeroju-Agbeja, A. M.; Ogunbiyi, J. o.; Owoeye, J. F. A.; Thomas, J
Bilaterial orbital rhabdomyosarcoma mimicking Burkitt's lymphoma in an 11-year old girl is reported. The patient presented with bilateral proptosis and right cervical lymphadenopathy. Despite consultations at a number of hospitals, a definitive diagnosis was not made until presentation at the University College Hospital, Ibadan, where cytological examination of a fine needle aspiration biopsy specimen of the tumour and the lymph node revealed. changes that were consistent with those seen in rhabdomyosarcoma. This case emphasises the fact that rhabdomyosarcoma is an important differential diagnosis of orbital tumours in childhood, especially in Burkitt's lymphoma endemic areas.
Blepharoptosis in Ibadan, Nigeria
(2003-09) Baiyeroju, A. M.; Oluwatosin, O. M.
Objective: To look into the cases of blepharoptosis in our environment as well as find out the causes and effects of the ptosis. Design: Prospective clinic study and prospective cluster sampling method of school children. Setting: University College Hospital, Ibadan and 3 schools in Ibadan, Nigeria. Subject: Over a 5 year period, all patients who presented with blepharoptosis at the University College Hospital were recruited for the study. During the same period, a school survey was also done to find out the prevalence of blepharoptosis among school children. Results: Twenty five cases of blepharoptosis were found during the 5 year period. Fifty two percent of the patients were found to be less than 16 years of age while only 8% were over 50 years of age. There was a 1:1 male to female ratio with majority of them (68%) having only one eye affected. The most common cause of blepharoptosis was found to be congenital, accounting for 56% of the patients. The prevalence in the school survey was found to be 1.2% higher than the incidence of 0.5% found in the eye clinic. Conclusion: Blepharoptosis is not an uncommon ocular problem. A detailed assessment of the cause, amount of ptosis and levator functions helps to determine the most appropriate surgical technique which would give the best functional and cosmetic result
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.
Causes of removal of the eye In Ibadan
(1996-12) Baiyeroju-Agbeja, A.; Ajibode, H. A.
The aim of the study was to enumerate the causes of removal of the eye in our community and find out ways of reducing this. 139 eyes were removed at the University College Hospital, lbadan, over a 5 year period between January 1989 and December 1993. Only 100 of the cases were available for inclusion in this study. The age, sex, causes of removal of the eyes and final diagnosis were obtained. Most of the patients (64%) were below the age of 30 years, the youngest being 3 weeks of age. The most common cause of eye removal was found to be infective (endophthalmitis/panophthalmitis), although in the age group of 0-10 years, Retinoblastoma was the commonest cause of the removal of the eye.
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.
Congenital giant dermoid cyst of the orbit associated with microphthalmia and cataract
(1995) Baiyeroju-Agbeja, A. M.; Thomas, J.
A case of a giant dermoid cyst of the orbit associated with microphthalmia in a two-year old female child is reported. Clinical diagnosis of the condition was made when the child was two months old, although it had been observed at birth by the parents. Surgical excision of the tumour and the microphthalmic eye was undertaken when the child was two years old. Findings at the operation included a giant cyst that was partially intraorbital with a portion of it extending into the temporal fossa, a microphthalmic eye with cataract and non-closure of the zygomatico-frontal suture. Six months after surgery, there was no evidence of recurrence of the tumour.
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.
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.
Diagnosis of ocular disease in Ibadan by ultrasound
(1995-12) Baiyeroju-Agbeja, A. M.; Marinho, A. O.
15 patients with ocular disease, in whom views of posterior segment of the eyes could not be obtained underwent ultrasonography of the eyes to aid in the diagnosis and further management of the patients. In some cases the ultrasound was then compared with the histological diagnosis when the eye was removed and in other cases to the ophthalmoscopic examination when a better view of the posterior segment could be obtained. This was done as a pilot study to ascertain the level of accuracy of our ultrasonic diagnosis and how much it could be depended upon for the very important decision of removal of the eye when indicated.
Effectiveness of trabeculectomy on glaucoma patients in Ibadan
(2001) Agbeja-Baiyeroju, A. M.; Omoruyi, M.; Owoaje, E. T.
This study was designed to determine the effectiveness of trabeculectomy on African patients. All patients who underwent trabeculectomy over a 10-year period, January 1987 to December 1996 were included in the study. Information extracted from their case notes included age, sex, type of glaucoma, number of years of glaucoma before surgery, eye involved, and visual acuity pre-operatively and postoperatively. Intraocular pressures at presentation, preoperatively and post operatively (2 days, 1 week, 3 months, 6 months, 12 months and last clinic visit) were also recorded. Other data collected included pre-operative anti glaucoma therapy, additional techniques at surgery, complications of surgery, presence of a filtering bleb and follow-up period post operatively. A success rate of 91.2% was obtained from 433 eyes operated upon, The most significant outcome was the presence of a filtering bleb which had a better success rate than the absence of a bleb. High success rates were recorded in the age groups “>60 years and 20-40 years", the lowest success rate was in the “less than 20 years of age". All the patients with developmental glaucoma had a successful outcome (100%) while only 50% of the secondary glaucoma were successful. Patients with open angle glaucoma had 92% success rate. Complications of surgery were mostly transient. It was concluded that the presence of a bleb was a good indication of the control of intraocular pressure and that early surgery gave a more successful outcome than late surgery.
Eye changes in Nigerian patients with Alopecia Areata
(1997-03) Baiyeroju-Agbeja, A. M.; Ogunbiyi, A. O.
Eye changes have been reported in patients with Alopecia Areata. There are no local reports of this association. We decided to find out the prevalence and to document the various eye changes in patients presenting with Alopecia Areata in this environment. We examined 13patients presenting with clinical features of Alopecia Areata. A structured questionnaire was administered to gather relevant biodata, duration of illness and previous drug history. Nine of them showed eye changes, some of which had been previously described which include lens opacities, refractive errors and retinal abnormalities. Unlike what had been previously described. 4 of our patients had definite early posterior subcapsular cataracts. We suggest that patients with Alopecia Areata should have ophthalmological examination as part of their initial assessment.
Eye diseases among drivers In the University College Hospital and College of Medicine, University of lbadan, Nigeria.
(2009-07) Bekibele, C. O.; Fawole, O. I.; Adekunle, L. V.; Bamboye, A. E.; Ajayi, R.; Baiyeroju A.M.
Objective of this study is to determine the pattern of eye diseases amongst drivers of College of Medicine, University of Ibadan (UI) and the University College Hospital (UCH) Ibadan. Cross sectional study of (99) drivers employed by the two institutions using a semi structured questionnaire and through eye examination at the eye clinic of UCH. Our results show that age range of respondents was from 39-60 years , mean 50.1+/- 4.78 years. Driving experience ranged from 5 to 43 years, mean 27.9years. +/- 6.24. Causes of ocular morbidity were pterygium 14.1 %, pingueculum 8 %, optic atrophy 8%, glaucoma 4%, and pathological myopia 1%. Risk of developing anterior segment disease increased with number of years spent driving. (OR2.4, 95% C! 1.1-6.2; P=O.05). We conclude that periodic eye examination of drivers can help to identify potential blinding eye diseases such as glaucoma and cataract and allow prompt treatment to prevent blindness and ensure safe driving. Drivers may be redeployed to an administrative job after a prolonged period of driving and when visual impairment ensures.
Eye disorders
(The Federal Ministry of Health, 2008) Baiyeroju-Agbeja, A.
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.
Fuch's heterochromic iridocyclitis in Ibadan
(1995) Baiyeroju-Agbeja, A.
An uncommon form of uveitis, Fuch's heterochromic iridocyclitis is presented in 8 patients seen at the eye clinic of the University College Hospital. The spectrum of the disease is discussed in the African eye.
Granuloma pyogenicum of the palpebral conjunctiva in an African child
(1998-12) Agbeja-Baiyeroju, A. M.; Fafowora, O. F.
We report a case of granuloma pyogenicum involving the upper palpebral conjunctiva in a male child with the histopathological features found after excision. This has not been previously reported in an African and there was no history of previous trauma or inflammation of the eyelid. The lesion was associated with an indolent corneal ulcer which took 7 months to heal completely even though no recurrence of the lesion occurred after a complete excision.