Ophthalmology

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Spare the rod or spoil the eye? corporal punishment- related eye injuries among children presenting to tertiary hospital in South West Nigeria
(2018-06) Monye, H. I.; Ugalahi, M. O.; Olusanya, B. A.; Baiyeroju, A. M.
Objective: To determine the burden of corporal punishment in the aetiology of ocular injuries among children, to inform evidence-based advocacy measures to curb this trend. Methodology: This study was a retrospective review of cases of punishment-related ocular injuries among children aged 16 years and less who presented to the Eye Emergency of the University College Hospital, Ibadan, between 2010 and 2016. Data on proportion of paediatric ocular trauma due to corporal punishment, patient demography, circumstance surrounding, and nature of injury, management and visual outcome were descriptively summarised. Results: There were 109 cases of paediatric eye injuries during the study period of which 18(16.5%) were due to corporal punishment. The mean age was 10.3 years (SD 2.7). Males comprised 61.1 % (11) of cases. Place of injury was at school in 10 (55.6%) and at home in 8 (44.4%) cases. All injuries were unilateral. Sixteen (88.9%) of these injuries were of the closed globe type and management was conservative in 15 (83.3%) children. Twelve (66.7%) children had visual acuity less than 3/60 at presentation while 8 (44.4%) had 6/18 or better vision as at time of last follow up. Conclusion: Punishment-related eye injuries are important in the aetiology of paediatric ocular trauma in our locality especially as relates to poor visual outcome. There is therefore the need for targeted sensitization of parents, care givers and teachers, as well as creation of awareness of alternative methods to corporal punishment and legislation in order to effectively tackle this problem.
Simultaneous versus sequential surgery for bilateral congenital cataracts in a resource-limited setting
(2018) Ugalahi, M. O.; Olusanya, B. A.; Monye, H. I.; Baiyeroju, A. M.
Background: To compare simultaneous surgery with sequential surgery for the treatment of bilateral congenital cataracts in children younger than three years at a tertiary hospital in a resource-limited setting in order to facilitate informed decision making by parents and healthcare providers. Methods: A retrospective review of medical records of children below three years who had bilateral surgery for congenital cataracts between 2010 and 2016 at the paediatric ophthalmology unit of a university teaching hospital in Nigeria. Data on demographic characteristics, type of surgery, delays in care, time interval between surgery and optical rehabilitation, direct cost of care, systemic associations and surgical complications were retrieved, descriptively summarized and compared for both groups. Results: There were 40 eligible patients, 25 (62.5%) of which were males. Age at presentation ranged from 4-128 weeks with a median of 28 weeks. Twenty-four (60%) patients had simultaneous bilateral cataract surgery. Patients who underwent sequential cataract surgery had higher direct costs and accumulated hospital stay, and were more likely to experience delays in accessing second procedures as well as post-operative optical rehabilitation. No anesthetic or other serious ocular complications such as endophthalmitis were noted in either group. Conclusion: Although there were similarly low complication rates in both groups, we observed higher direct costs of care, longer duration of hospital stay, as well as longer intervals before second surgeries and visual rehabilitation in the sequential group. Therefore, simultaneous cataract surgeries may be the preferable option in resource-limited settings like ours, where health care financing is mainly through out-of-pocket expenses.
Indications for surgery amongst new patients presenting to the paediatric ophthalmology unit of the University College Hospital, Ibadan
(Wolters Kluwer - Medknow, 2021-03) Ugalahi, M. O.; Monye, H. I.; Olusanya, B. A.; Baiyeroju, A. M.
Objective: The objective of the study was to determine the proportion of children requiring ocular surgery amongst new patients presenting to the Paediatric Ophthalmology Unit of the University College Hospital, Ibadan, over a 2‑year period, to enhance planning and improve the efficiency of service delivery. Methods: The study was a retrospective review of records of all new patients aged 0–16 years who presented to the Paediatric Ophthalmology Unit of the University College Hospital, Ibadan, over a 2‑year period (May 2015–April 2017). Information on age and gender, clinical diagnosis and indications for surgery and type of surgery scheduled were retrieved from the diagnosis register of the unit, and a descriptive analysis was performed. Results: Of the 1240 children who presented to the clinic within the study period, 142 (11.5%) needed surgical interventions. Their ages ranged from 1 month to 16 years, with a mean age of 6.4 ± 4.7 years. Seventy‑nine (55.6%) of these were males. The most common indications for surgery were cataract and catara t‑related indications (n = 122, 85.9%), followed by glaucoma and strabismus. Other less common indications for surgery were nasolacrimal duct obstruction and epibulbar dermoid. Conclusion: Paediatric cataract, the leading cause of childhood blindness in this environment, presents the greatest surgical burden in our unit. It should, therefore, be a major focus of personnel training and equipment procurement for paediatric ophthalmology services in our environment.

Ophthalmology

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