Tayo Bogunjoko

Aims: To report a comparison of clinical features, visual and anatomic outcomes between patients with retinal detachments from giant retinal tears (GRTs) and those from other types of holes and tears undergoing retina reattachment surgery in the same institution within the same time period in sub-Saharan Africa. Materials and Methods: A retrospective noncomparative case series of patients undergoing primary retina detachment (RD) repair for rhegmatogenous retina detachment (RRD) at Eye Foundation Hospital Retina Institute between January 2014 and December 2018 was done. Results: A total of 275 eyes of 275 patients met the inclusion criteria. Ages ranged from 7 to 87 years. And 81 (29.4%) eyes had giant tears were categorized as group A and 194 (70.6%) eyes had other types of tears were categorized as group B. At presentation Visual acuity in 66 eyes (79.6%) in the group A was worse than 3/60, compared to 117 eyes (60.3%) in group B. Primary anatomic success was achieved in 73 eyes (92.4%) in-group A and 157 eyes (86.7%) in group B. Final anatomic success was achieved in 75 eyes (94.9%) in group A and 164 eyes (93.2%) in group B. Good visual outcomes were achieved in 48 eyes (59.3%) in group A and 126 eyes (65.6%) in group B. Conclusion: Good anatomic and visual outcomes can be achieved after surgery for RRD secondary to giant tears in a sub-Saharan Africa setting in this era of small gauge vitrectomy and perflourocarbon use, these outcomes are comparable to those from surgery for RRD secondary to other types of holes and tears.

Objective: To assess the knowledge, attitudes and practices regarding Diabetic Retinopathy (DR) among Medical Officers (MO) and diabetic patients in Ogun State of Nigeria. Design: This was a cross-sectional study. Setting: Diabetic clinics based in three hospitals in Ogun state. Methods: Medical officers in all the general hospitals were interviewed via telephone while one teaching hospital and two state hospitals were randomly selected to conduct face-to-face interviews with diabetic patients. Data obtained from these interviews was filled into a structured questionnaire. Results: All the medical officers in the general hospitals were aware that DM affects the eyes while 43% believed that diabetic patients need a monthly eye examination. About 36% examined the eyes of diabetic patients on each visit. All medical officers would refer a diabetic with poor vision to an ophthalmologist. Majority (75%) of the patients recruited were female. Fifty-one per cent of patients were not aware that diabetes affects the eyes while only 35% had ever had a fundoscopy. Conclusions: The medical officers in the general hospitals in the state are all aware that diabetes can cause DR but don’t have eye clinics. Less than half of them (43%) screen for DR. Known diabetics are not having regular eye examination. Key words: Medical Officers, Diabetic retinopathy, Ogun State, Screening

Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over the years. A private / public partnership together with private health /education partnership have strengthened government health systems, developing a sustainable model for delivery of eye services to the most indigent. Over the last four years, in Ogun state, screening for cataract alone has increased in fourfold and the number of cataracts surgeries performed, threefold. However, ongoing subsidising of surgeries may be needed until local health insurance schemes or other ways of financing eye care become reliable. Tackling health beliefs about eye care remain one of the main barriers to uptake of services.

Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation Centre Ijebu, Nigeria in a 5 year period for planning purposes.Methods: Data was collected from patients’ case notes from January 2006 to December 2011. A systematic sampling of 468 patients from 1173 case notes of patient with (PSEDs) was done. Information retrieved was: age, sex, state of residence and diagnosis. All patients were examined by the glaucoma and the vitroretinal specialist as the case may be. They had visual acuity, refraction, slit lamp examination (including intraocular pressure (IOP) with Goldman applanation tonometer), and dilated fundoscopy with (bilateral indirect ophthalmoscopy) BIO, slit lamp using 20 D, 78 D and 90 D respectively. The glaucoma patients in addition had central visual field (CVF), Central cornea thickness (CCT), fundus photograph and in some cases optical coherence tomography (OCT) done in addition to the above.Results: The mean age was 59.98 years...

Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its progress towards vision 2020 goals in Ogun state of Nigeria. Study Design: A descriptive cross-sectional study. Place and Duration of Study: 21 eye care facilities in Ogun state between November and December 2014. Methodology: Data was collected with an adapted questionnaire developed by WHO and IAPB. The questionnaire was filled by telephone interview to key officials of registration boards for ophthalmologists, optometrists and ophthalmic nurses and public and private institutions employing these professionals in the state. Sources of population data was from census, state website and estimated rate of annual population. Each of these targets graded to show if vision 2020 target was met in 2014. Results: There were 21 eye care facilities in Ogun state. 7 (33%) are government owned, 2 (9.5%) Original Research Article Bogunjoko et al.; BJMMR, 19(10): 1-9, 2017; Article no.BJMMR.31702 2 ar...

Background: The objectives of the study were to review the training and assess the impact of middle level eye care personnel (community ophthalmic technician) with skills to complement the services of the ophthalmologist for efficient eye care system and fulfilling vision 2020 goals.Methods: The collaboration between 2010 and 2015 was reviewed with an institutional questionnaire for both Eye Foundation Centre and College of Health Technology in Ijebu, Nigeria: structure of 2 year training Programme and one year internship, community ophthalmic technicians (COT) as assistants to ophthalmologists, hierarchy/career options and challenges and ensuring clinical quality and their strength in the Eye Foundation Eye Health System were appraised.Results: From 2010 to 2015, a total of 72 COTs have graduated, 41(57%) of them employed by the Eye Foundation Hospital Group. Apart from this, 28 did their internship in 2015, 19 (68%) out of this at Eye Foundation establishments in southwestern and ...

Ophthalmology in Nigeria has developed over the decades with contributions from several personalities. Many events and institutions have served to shape the emergence of good care, from the establishment of ECWA Eye hospital in 1943 as one of the premiere indigenous dedicated Eye Hospitals, to the establishment of the National Eye Centre as well as the University College Hospital Ophthalmology department, the specialty of Ophthalmology has grown to enviable heights. The formation of the Ophthalmological Society of Nigeria in 1969 and the establishment of the National Postgraduate College and The West African College of Surgeons equally stand out as landmark events in History. The Nigerian National Survey of Blindness and Visual Impairment (2005 to 2007) was the biggest ever survey in Africa, no national level estimates existed in Nigeria before the survey. This gigantic task took more than three years to complete including 30 months of rigorous fieldwork and was only possible becaus...

Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its progress towards vision 2020 goals in Ogun state of Nigeria. Study Design: A descriptive cross-sectional study. Place and Duration of Study: 21 eye care facilities in Ogun state between November and December 2014. Methodology: Data was collected with an adapted questionnaire developed by WHO and IAPB. The questionnaire was filled by telephone interview to key officials of registration boards for ophthalmologists, optometrists and ophthalmic nurses and public and private institutions employing these professionals in the state. Sources of population data was from census, state website and estimated rate of annual population. Each of these targets graded to show if vision 2020 target was met in 2014. Results: There were 21 eye care facilities in Ogun state. 7 (33%) are government owned, 2 (9.5%) Original Research Article Bogunjoko et al.; BJMMR, 19(10): 1-9, 2017; Article no.BJMMR.31702 2 are non-governmental organization (NGO)/mission owned and 12 (57.2%) are private for profit. There were 77 eye care workers in active service made up of 27 ophthalmologists, 31 ophthalmic nurses and 19 optometrists in 2014. Most eye care workers in Ogun state work in government establishments (66%), 26% in private for profit and 7.8% in NGO/mission. Vision 2020 targets had only been achieved for ophthalmologists in 2014. The Ogun state ratio for ophthalmologist was 5.4 per million populations, 3.8 for optometrists and 6.3 for ophthalmic nurses. The percentage of each of the eye care workers average 25% in the capital city and 75% outside capital. Practitioner per million population specific for capital and outside capital is worse outside capital city. Conclusion: The HReH was above the vision 2020 target for ophthalmologists. The ophthalmic nurses are above average and optometrists very low. There is need for a targeted investment for these two categories of practitioners and the need to address maldistribution of eye care workers.

Aims: To review the trends in glaucoma procedural treatments from January 2009
to December 2017. Methodology: A retrospective search was carried out from the
operating theater and laser room records of the Eye Foundation Hospitals in Lagos,
Abuja, and Ijebu‑Imushin. Consecutive glaucoma procedures for each year from
January 2009 to December 2017 were recorded in the data sheet prepared for the
study. Data were analyzed using SPSS version 25. Results: From 2009 to 2017,
trabeculectomy had been decreasing in frequency from 117 to 65 (44%), except for
2015. The frequency of use of glaucoma drainage device (GDD) has been steadily
increasing from 1 in 2013 to 26 in 2017, but this is not statistically significant.
The frequency of cataract extraction with trabeculectomy reduced drastically from
20 in 2009 to 3 (566%) in 2014. Bleb review (BR) increased from 2 in 2009 to
18 (800%) in 2015, however, it dropped to 6 in 2017 (66%). Among the laser
procedures, transscleral cyclophotocoagulation (g‑probe) is commonly done. It
increased from 40 procedures in 2009 to 98 in 2014 (145%). There has been an
increase in laser trabeculoplasty from 15 in 2009 to 44 in 2013 (193%). Laser
iridotomy increased from 12 in 2009 to 26 in 2015 (116%). From 2009 to 2015,
there was an increase in glaucoma procedures and surgeries – 206 to 325 (58%)
but this declined by 27% from 2015 to 2017. Conclusion: Trabeculectomy is the
most performed procedure at our centers. This is followed by g‑probe and laser
trabeculoplasty. The rate of trabeculectomy is on the decrease, while the rate of
GDD is increasing. The laser procedures are also on the increase.
Keywords: Eye Foundation Hospital Group, glaucoma surgeries, trends, types

INTRODUCTION According to recent estimates, the major global causes of moderate to severe vision impairment are: age-related macular degeneration 4%, glaucoma 2%, and diabetic retinopathy 1% after uncorrected refractive error (53%) and un-operated cataract (25%). 1 The first three diseases are posterior segment in location. They are diseases of the retina, choroid and optic nerve and primarily include: glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). 2 With an increasing population of older people, more people will be at risk of vision impairment due to chronic eye diseases. In totality, the prevalence of vision impairment worldwide has decreased since early estimates in the 1990s. This decrease is associated with: massive socioeconomic development; increased public health action; availability of eye care services more than before; awareness of the general population about solutions to the problems related to vision impairment. 1 ABSTRACT Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation Centre Ijebu, Nigeria in a 5 year period for planning purposes. Methods: Data was collected from patients' case notes from January 2006 to December 2011. A systematic sampling of 468 patients from 1173 case notes of patient with (PSEDs) was done. Information retrieved was: age, sex, state of residence and diagnosis. All patients were examined by the glaucoma and the vitroretinal specialist as the case may be. They had visual acuity, refraction, slit lamp examination (including intraocular pressure (IOP) with Goldman applanation tonometer), and dilated fundoscopy with (bilateral indirect ophthalmoscopy) BIO, slit lamp using 20 D, 78 D and 90 D respectively. The glaucoma patients in addition had central visual field (CVF), Central cornea thickness (CCT), fundus photograph and in some cases optical coherence tomography (OCT) done in addition to the above. Results: The mean age was 59.98 years (SD 17.67) and the age range is 5-95 years. Males outnumbered females by 63% to 37%. The diseases were more common in age group 61 to 80. Patients' attendances were mostly from Ijebu division of Ogun state (57%). Glaucoma is the commonest cause of attendance 262 (56%) followed by diabetic retinopathy 29 (6.2%) and age-related macular degeneration (ARMD) 28 (6.0%). Conclusions: Glaucoma, diabetic retinopathy and ARMD were noted as the commonest PSEDs in Ijebu division in Southwestern Nigeria.

Background: visual impairment is one of the commonest causes of disability globally. Uncorrected refractive error is the commonest and largely preventable cause of avoidable visual impairment worldwide. The objective of this study is to ascertain the distribution of refractive errors in the adult populations in Ogun state, southwestern Nigeria. Methods: This is a retrospective review of adults from 18 years and above. Data was collected from the patients' case notes from January 2008 to December 2012 from the record department of Deseret Community vision institute (DCVI) in Ogun state, Southwestern Nigeria. The diagnoses used are: myopia, hyperopia and astigmatism. A systematic sampling of 1000 patients from 6000 case notes was done. Specific information that was retrieved include: age, sex, town of residence, entry or unaided visual acuity, degree of refractive error and corrected visual acuity. Myopia is regarded as ≥-0.50DS, hyperopia ≥ +0.75DS, astigmatism ≥-0.25DC and emmetropia: >-0.50-< + 0.75. All statistical analysis was done by statistical software STATA 11.0. Results: Of the 446 with refractive error, 191(42.82%) were males, 255(57.18%) were females. Age range is from 18-88. Mean age was 48.2. Astigmatism is the commonest cause of refractive error 289(64.80%), followed by hyperopia 96(21.50%) and myopia 61 (13.70%). Females have more refractive errors than males. Age, sex and occupation are not statistically associated with refractive errors. Conclusion: Refractive errors are common eye conditions and astigmatism is the commonest type of refractive error in adults. Females have more refractive errors than male. Copyright©2017, Tayo Julius Bogunjoko et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.

Objective: To assess the knowledge, attitudes and practices regarding Diabetic Retinopathy (DR) among Medical
Officers (MO) and diabetic patients in Ogun State of Nigeria.
Design: This was a cross-sectional study.
Setting: Diabetic clinics based in three hospitals in Ogun state.
Methods: Medical officers in all the general hospitals were interviewed via telephone while one teaching hospital
and two state hospitals were randomly selected to conduct face-to-face interviews with diabetic patients. Data
obtained from these interviews was filled into a structured questionnaire.
Results: All the medical officers in the general hospitals were aware that DM affects the eyes while 43% believed
that diabetic patients need a monthly eye examination. About 36% examined the eyes of diabetic patients on
each visit. All medical officers would refer a diabetic with poor vision to an ophthalmologist. Majority (75%) of
the patients recruited were female. Fifty-one per cent of patients were not aware that diabetes affects the eyes
while only 35% had ever had a fundoscopy.
Conclusions: The medical officers in the general hospitals in the state are all aware that diabetes can cause DR
but don’t have eye clinics. Less than half of them (43%) screen for DR. Known diabetics are not having regular
eye examination.
Key words: Medical Officers, Diabetic retinopathy, Ogun State, Screening

Background: The objectives of the study were to review the training and assess the impact of middle level eye care personnel (community ophthalmic technician) with skills to complement the services of the ophthalmologist for efficient eye care system and fulfilling vision 2020 goals. Methods: The collaboration between 2010 and 2015 was reviewed with an institutional questionnaire for both Eye Foundation Centre and College of Health Technology in Ijebu, Nigeria: structure of 2 year training Programme and one year internship, community ophthalmic technicians (COT) as assistants to ophthalmologists, hierarchy/career options and challenges and ensuring clinical quality and their strength in the Eye Foundation Eye Health System were appraised. Results: From 2010 to 2015, a total of 72 COTs have graduated, 41(57%) of them employed by the Eye Foundation Hospital Group. Apart from this, 28 did their internship in 2015, 19 (68%) out of this at Eye Foundation establishments in southwestern and north central Nigeria. Others are employed by other government or nongovernmental agencies. From 2010 to 2015, outpatients‟ visits have increased from 42,962 to 104,239 at its peak, surgical volume from 3,999 to 18,350 at the Eye Foundation Hospital Group. The COT programme has been accredited by International Joint Commission on Allied health personnel in Ophthalmology (IJCAHPO). Conclusions: COTs with skills are required in large numbers to complement the services of ophthalmologists for efficient eye health system. Their contribution is very important to meet the vision 2020 human resources objectives for Sub-Saharan Africa. Keywords: Community ophthalmic technicians, Ophthalmologists, Eye foundation