Ophthalmology
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Item Pattern of ocular disorders in patients with Diabetes Mellitus at an endocrinology clinic of a tertiary centre in Ibadan, Sub-Saharan Africa(The Nigerian Medical Association, Rivers State Branch, 2025) Babalola, Y. O.; Adebusoye, S. A.; Esan, A.; Akande, T. O.; Adeleye, J. O.; Olusanya, B. A.Background: Diabetes mellitus causes various systemic complications including ocular disorders. Diabetic retinopathy, diabetic macula oedema and ocular conditions such as cataract and primary open angle glaucoma may lead to blindness. This study determined the spectrum of ocular disorders associated with diabetes mellitus in patients attending a tertiary hospital in Ibadan, Nigeria. Method: This is a cross-sectional study of 270 consecutive diabetic patients attending the Endocrinology clinic at the the University College Hospital, Ibadan, Nigeria. Data analysis was by SPSS version 22. Result: Two hundred and seventy patients were recruited between January 2018 and December 2022. There were 77 (22.85%) males and 192 (71.7%) females. The age range was 18 to 85 years and mean of 59.5+_ 11.8 years. One hundred and nine (40.4%) had tertiary level education. Two hundred and twenty (81.5%) never had an eye examination; 41 (17.4%) had diabetic retinopathy and 25 (9.3%) had diabetic macula oedema. Uncorrected refractive error was the commonest ocular diagnosis in 79(14.6%) closely followed by visually significant cataract in 75 (13.9%). One hundred and sixty-six (61.5%) patients were unaware of the visually debilitating effect of DM while 50 (18.5%) had undergone ocular screening. Conclusion: Diabetic retinopathy, refractive errors and diabetic macula oedema are the ocular abnormalities with the highest frequency in our clinic population. There is paucity of awareness of ocular complications of diabetes mellitus in our populace and the vast majority had never had ocular screening. Creating awareness and screening for ocular disorders is key in preventing visual impairment.Item Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A.; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.Item Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.Item Learning styles of fresh clinical students in Ophthalmology at the University of Ibadan, Nigeria – A pilot study(Wolters Kluwer Medknow, 2020) Oluleye, T. S.; Babalola, Y. O.; Olusanya, B. A.; Majekodunmi, O. I.; Ijaduola, M. A.Background: The College of Medicine, University of Ibadan, Nigeria, is using a new curriculum for its learners. Therefore, knowing the learning styles of the learners will help the teachers formulate appropriate teaching strategies. The aim of the pilot study was to determine the learning styles of the 1st-year clinical students rotating through ophthalmology with a view to recommending appropriate teaching strategies to the teachers for the smooth running of the new curriculum. Methodology: The first fifty set of students sent to the department of ophthalmology for ophthalmology rotation was used as a pilot. A total of 47 students completed the study. Three students voluntarily did not participate in the study. Design: VARK questionnaire assisted testing of learning styles was used for the study. It consists of 16 questions with four options testing each domain of visual (V), auditory (A), write or reading (R), and kinesthetic (K) ways of learning. Multiple responses were allowed. The total responses were computed at the end to give an idea of the learning styles of the students. Results: A total of 1192 responses were received from 47 students (25 males and 22 females), with a male to female ratio of 1.1:1. The Auditory and kinesthetic ways of learning were responsible for 669 (56%) responses. There was no statistically significant difference among the sexes. Conclusion: The most preferred learning styles were the auditory and kinesthetic ways of learning. Teachers should consider direct instructions and more hands-on teaching of their students while formulating a teaching plan.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 pre maturity 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 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 Refractive amblyopia among children in Ibadan: the need for amblyopia screening programmes(2015) Olusanya, B. A.; Ugalahi, M. O.; Okoli, C. E.; Baiyeroju, A. M.Background: The prevalence and burden of amblyopia in developing countries is probably underestimated, and little is known about the pattern of amblyopia in West Africa. Aim: To determine the relative frequency and types of amblyopia among children with refractive errors seen in the eye clinic of a tertiary hospital over a 2 year period. Methods: A cross-sectional study conducted at the eye clinic of the University College Hospital, Ibadan, Nigeria between January 2012 and December 2013. Case notes of children with refractive errors seen during this period were retrieved and information including socio-demographic data, presenting visual acuity and visual acuity with correction were recorded. Amblyopia was defined as best corrected visual acuity worse than 6/9 or a difference of >2 Snellen chart lines between both eyes in the absence of any ocular pathology that could explain the visual impairment. Results: A total of 250 eligible patients who had refractive errors were included in the study. Visual acuity was corrected to 6/9 or better in 224 (89.6%) children while 26(10.4%) of them had amblyopia. Among the 26 children with amblyopia, 21 (80.8%) children had amblyopia in both eyes and majority (65.4%) had isoamctropic amblyopia. Of the 47 amblyopic eyes, 36 (76.6%) eyes had moderate amblyopia while 11 (23.4%) eyes had severe amblyopia. Conclusion'. There is a high relative frequency of amblyopia in this study and we recommend preschool eye examinations for all children to ensure early detection and management of amblyopia, thereby reducing the burden of amblyopia in our populace.Item Trabeculectomy for congenital glaucoma in University College Hospital, Ibadan: a 7 year review of cases(Wolters Kluwer - Medknow, 2015-12) Olusanya, B. A.; Ugalahi, M. O.; Malomo, M. O.; Baiyeroju, A.Introduction: Congenital glaucoma is an uncommon ocular condition affecting about 1/15,000 live births. About two third of cases are bilateral with a higher prevalence in males. The definitive treatment requires surgery which could be trabeculectomy, trabeculotomy, goniotomy, drainage tubes or a combination of trabeculotomy and trabeculectomy. Aim: To determine the outcome of trabeculectomy in patients with congenital glaucoma seen at the University College Hospital Ibadan between 2007 and 2013. Methods: The medical records of all patients with congenital glaucoma seen between the years 2007 and 2013 were retrieved. Inclusion criteria were patients who had trabeculectomy with or without anti-metabolites within this period. The main outcome measures assessed were postoperative intraocular pressure (IOP) and corneal clarity. Data was analyzed with the statistical Package for Social Sciences version 21. Results: Thirty-four eyes of 18 patients were reviewed out of which 16 patients had bilateral trabeculectomy while two had unilateral trabeculectomy. The mean preoperative IOP was 26.31 mmHg while the mean IOP in the immediate postoperative period, at 3 months after surgery and at last follow-up visit were 13.31 mmHg, 12.78 mmHg and 15.89 mmHg respectively. IOP was <21 mmHg in 81.82% of the eyes as at last clinic visit. All eyes had cloudy corneas preoperatively while 38.24% had minimal residual corneal opacity (Haab’s striae) as at last follow-up visit. Conclusion: In the absence of equipment for other surgical options, trabeculectomy is an effective surgical approach in the management of congenital glaucoma in the short term.Item Delays in uptake of surgery for childhood cataract at a child eye health tertiary facility in sub-Saharan Africa(SAGE Publishing, 2019) Ugalahi, M. O.; Olusanya, B. A.; Fagbemi, O. O.; Baiyeroju, A. M.Background: Timely uptake of surgery is vital in the control of childhood blindness due to cataract. The aim of this study is to determine the uptake of surgery as well as the frequency and reasons for rescheduling of surgery for childhood cataract in a tertiary hospital in southwest Nigeria. Methods: A retrospective study of children with childhood cataract seen at the Paediatric Ophthalmology unit of the University College Hospital, Ibadan between 2011 and 2015. Demographic and clinical information was retrieved from case records. Caregivers of children who did not have surgery were contacted by telephone to elicit reasons why surgery was not done. Results: A total of 164 children were included in the study; 90 (54.9%) were male. The median age at presentation was 4 years with a range of 2–180 months. A total of 64 (39.0%) children had unilateral cataract. All patients were scheduled for surgery, but 123 (75%) underwent surgery. Surgery was rescheduled in 42 (34.1%) of those who had surgery. Reasons for rescheduling included financial constraints, illness, delay in paediatrician evaluation to ascertain fitness for anaesthesia and strike actions by health workers in the hospital. Conclusion: Three quarters of the children had surgery, though it had been rescheduled, at least once, in about onethird of them. Delayed uptake of surgery was mainly due to inability to afford treatment and strike actions. The need for improved coverage of health insurance especially for the paediatric age group in developing countries cannot be overemphasized. This is because good vision is an integral part of child development.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.