Ophthalmology
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Item Standard treatment guidelines(Federal Ministry of Health, Nigeria in Collaboration with WHO, EC, DFID, 2008) Federal Ministry of Health, NigeriaItem Standard treatment guidelines(Federal Ministry of Health, Nigeria in Collaboration with WHO, EC, DFID, 2008) Federal Ministry of Health, NigeriaItem Pterygium treatment using 5-FU as adjuvant treatment compared to conjunctiva autograft(Nature Publishing Group, 2008) Bekibele, C. O.; Baiyeroju, A. M.; Olusanya, B. A.; Ashaye, A. O.; Oluleye, T. S.Background The use of conjunctiva autograft, adjunct antimetabolite therapy has been shown to be effective in preventing pterygium recurrence. Objective To compare 5 fluorouracil (5-FU) to conjunctival autograft in the treatment of large, fleshy pterygium. Methods A randomised controlled prospective study of outcome of pterygium treatment using 5-FU as adjuvant treatment compared to conjunctiva autograft. Thirty-five eyes with large pterygium treated with bare sclera conjunctival excision plus 5-FU were compared with 33 eyes treated with excision and conjunctival autograft alone. Results Post-operative pterygium recurrence was observed in four (11.4%) eyes treated with 5-FU and 4 (12.1%) eyes treated with conjunctiva autograft (P40.05). The post-operative complications included, granuloma formation 11.4% for 5-FU and 3.0% for autograft and conjunctival discharge 5.7% for 5-FU group only. Conclusion 5-FU is marginally superior to conjunctival autograft in the prevention of pterygium recurrence but neither gives a more desirable single digit recurrence rate. Randomised studies combining both conjunctival autograft and 5-FU in pterygium treatment is advocated to further explore their effect.Item 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.Item Patency of the ductus arteriosus in newborns: experience in a special care baby unit(2001) Omokhodion, S. I.; Baiyeroju-Agbeja, A. M.; Adegboye, V. O.; Adeyemo, A.; Lagunju, L. A.A prospective cohort study of infants admitted into the Special Care Baby Unit, University College Hospital, Ibadan, has revealed a 24.5 per cent prevalence of patency of the ductus arteriosus (PDA) among 97 infants, who were admitted over a six-month period. The major factor predisposing to PDA was prematurity (p=0.014). A higher incidence of PDA (35 per cent) Was found among the preterm infants, and of these preterm infants, the very low birth weight (VLB'W') infants were found to be more highly susceptible to PDA (p=0.028). The mean birth weight of the preterm infants who developed PDA in the study was 1447g, while that of those without PDA was 1835g. There was no relationship between the sex of the infants and the development of PDA. A strong association was however, found between respiratory distress and PDA (p<0.0001). Nine of the hospital mortalities recorded occurred in the preterm infants and more than half of them (55.5 percent) had PDA Thus, prematurity is a risk factor for PDA and the presence of a PDA appears to increase the risk for mortality for such infants. Evidence for PDAshould be sought in all premature infants and prompt and aggressive management of those infants who show signs of decompensation from PDA is recommended to reduce mortality from this disease.Item Visual recovery after cataract surgery in children(2006-12) Olusanya, B. A.; Baiyeroju, A. M.; Fajola, A. O.Objective: To evaluate the visual outcome of cataract surgery in children aged 16 years and below at the University College Hospital (UCH), Ibadan. Methods: A retrospective review of the case records of patients aged 0-16 years who had cataract surgery at the UCH Ibadan between January 1995 and June 2006. Results: One hundred and fifty-one eyes of 101 patients were studied. Eighty-four eyes (55.6%) had congenital cataracts, 25.2% were developmental, while 13.9% were secondary to trauma. Seventy-one (70.3%) patients had bilateral cataracts. Eighty-nine (58.9%) of the eyes had an associated ocular pathology. Ninety-eight eyes (64.9%) had extracapsular cataract extraction without intraocular lens implant (ECCE), while 50 eyes (33.1 %) had extracapsular cataract extraction with posterior chamber intraocular lens implant (ECCE+PCIOL). Primary capsulotomy was performed on 34 eyes (22.5%). Postoperative complications were observed in 119 eyes (78.8%); with posterior capsule opacity occurring in 41.1%. Thirty-five eyes (38.9%) of those with objective visual acuity had a visual outcome ≥ 6/18. A visual outcome of 6/18 Dr better was significantly associated with increasing age (p =0.007) and the use of PCIOL implants (p =0.005), while poor visual outcome (≥ 6/24) was significantly associated with onset of cataract at birth (p =0.001); the presence of other ocular pathology (p =0.03); and a long delay between presentation and surgery (p= 0.02). Conclusion: The visual recovery of children who underwent cataract surgery in Ibadan is encouraging and the surgical results are likely to improve with increased proficiency in IOL implant surgery. The establishment of well-equipped and well-staffed paediatric ophthalmology centres would be beneficial in improving outcomes and would therefore help in achieving the goals of Vision 2020: The Right to Sight' .Item Hunter syndrome: case report and review of literature(2006-06) Ogunbiyi, A.; Adeyinka, A. O.; Ogah, S. O.; Baiyeroju, A. M.Hunter syndrome is one of the mucopolysaccharidosis, which are a rare group of genetic diseases, It is due to a deficiency in the enzyme Iduronate 2-sulphatase. This in turn leads to the accumulation of glycosaminoglycans, dermatan and heparan sulphate. The intra and extracellular accumulation of this substances lead to multisystemic organ abnormality. We present a patient with Hunter syndrome who presented with involvement of the skin, cardiovascular system, the eyes and musculoskeletal system. We have also included a literature review. As far as we know, it is the first case reported in a Nigerian.Item 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.Item A report of case of bilateral iris coloboma in a 9 year old boy(2009) Mosuro, A. L.; Baiyeroju, A. MItem Pattern of ophthalmic consult from the ear, nose and throat ward of a tertiary hospital(2009) Komolafe, O. O.; Adeosun, A. A.; Baiyeroju, A. M.Objective: To study the pattern and indications for ophthalmic referral of patients with otorhinolaryngology problems. Method: A retrospective study of patients who were admitted into the Ear, Nose and Throat (ENT) ward of the University College Hospital, lbadan and had ophthalmic referral between July 2000 and June 2004. The parameters evaluated were the demography of the patient, indication for ophthalmic consult, and the contribution of the ophthalmologist towards the management of the patient. Results: Reports on 26 patients on whom ophthalmic consults were sent were available for review. This accounted for 3% of the patients admitted during the period under review. Fourteen (53.8% ) of the consults were sent on account of proptosis and 7 (26.9%) for complaints of poor vision. In 12 (46.2%) of these patients, the otorhinotarfngological diagnosis was sinonasal tumour. The ophthalmologist made positive contributions to the management of 20 (76.9%) of the patients. These included the use of lubricants/protective shield (6 [23.1%]), tarsorrhaphy (3 [11.5%]), antiglaucoma medication (2{7.7%}) and cataract extraction (2[7.7%]). Conclusion: Proptosis milked highest for ophthalmic consult from the ENT ward in this review. Close collaboration between subspecialties should be encouraged when managing visllally-threatening conditions. There is also the need for a standard referral protocol.
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