Pyramid Journal of Medicine 2019; volume 2:37

Prevalence and types of eye (40.4%), Allergic conjunc- diseases identified by routine tivitis (18%), and (3.0%).3 A Study Correspondence: Usman Abubakar in Sokoto on prevalence of blindness Mijinyawa, Department of , screening of medical reported that cataract was the leading cause Murtala Muhammad Specialist Hospital practitioners in Kano, of unilateral blindness accounting for Kano, Nigeria. Northwestern Nigeria 53.8%, non-trachomatous corneal opacity Tel.: +234.8035558591. in 12.9%, and uncorrected in E-mail: [email protected] 4 1 10.5%. In Imo Nigeria, an outreach pro- Key words: Ocular screening, Refractive Usman Abubakar Mijinyawa, gram identified that common causes of ocu- error, Blindness. 2 2 Lawan Abdu, Musbahu Sani Kurawa, lar morbidity were refractive error 31.6%, 3 Contributions: The authors contributed equally. Zayyad Farouq 23.5%, 17.0%, and 1Department of Ophthalmology, Murtala cataract 12.5%.5 There were 27.7% glauco- Conflict of interest: The authors declare no potential conflict of interest. Muhammad Specialist Hospital Kano; ma suspect, and refractive error accounted 2Department of Ophthalmology, Faculty for 29.6% of those with Funding: None. 2 of Clinical Sciences, College of Health in a study reported from Benin. In ECWA Received for publication: 10 January 2019. Sciences, Bayero University Kano; eye hospital Kano, most common causes of Revision received: 17 October 2019. blindness were cataract 40.5%, glaucoma 3Department of Ophthalmology, Aminu Accepted for publication: 17 October 2019. 29.3%, and corneal opacity 14.3% of cases Kano Teaching Hospital, Kano, Nigeria This work is licensed under a Creative of bilateral blindness.6 Screening done dur- Commons Attribution NonCommercial 4.0 ing world glaucoma week in Osun reported License (CC BY-NC 4.0). that 91.9% had normal disc, 7.3% had cup ©Copyright: the Author(s), 2019 Abstract disc ratio >0.6, pale disc non cupped in 0.8%, while 98.8% had normal macula.7 Licensee PAGEPress, Italy Ocular screening can identify both non- Medical doctors most times don’t have Pyramid Journal of Medicine 2019; 2:37 doi:10.4081/pjm.2019.37 blinding and potentially blinding condi- time to go for screening as such asympto- only tions. Asymptomatic eye conditions could matic eye conditions could be detected be detected early and be refer for further early and be refer for further reevaluation if were referred to the participating based hos- reevaluation if identified during screening. identified in screening. pitals. Data obtained included age, gender, Programmed Data generated during CME refractive status, anterior segment findings, in Kano were collated and analyzed. Visual use and vertical cup disc ratio which were all acuity was done, and near vision was tested documented. Data was analyzed using a with N-chart. All the participants that need- Materials and Methods computer based statistical package for the ed the screening had slit lamp examination, This was a cross sectional study of social science (SPSS) version 16.0 fundoscopy, and refraction. A total number Medical doctors that attended the 1st quarter (Chicago, USA). The qualitative variables of 92 participants were examined. Age Continuous Medical Education (CME) are presented as bar charts, pie charts, and ranges from 20 to 70 years with mean age of Program in Kano 2018. Ethical approval percentages. The non-parametric test χ2 was 45±2SD, and male to female ratio of (M:F = obtained from the Ethical Review Board of used appropriately to compare proportions. 1:0.2). Emmetropia was seen in 34.8%, the State Hospitals Management Board and A confidence interval of 95% was used, and while presbyopia was seen in 23.9% of adhered to the tenants of Helsinki declara- a P-value of ≤0.05 was considered statisti- cases. Findings were corneal opacity, tion. Permission was granted by the cally significant. cataract, and allergic . Vertical Nigerian Medical Association (NMA) Kano cup disc ratio of ≥0.5 was seen in 12.0% Branch. Programmed Data generated dur- and 9.8% of cases in right and left eye ing the CME were collated and analyzed. respectively, while 1.1% of the eyes had All Medical doctors with registered phone Results macula hole. Refractive error for distance, contact from the database of the association A total number of 173 doctors that were presbyopia and some anterior andNon-commercial posterior were informed via text messages on the registered by the NMA attended the CME segment findings were identified. Majority need for voluntary eye screening exercise. program, and 92 (53.2%) participants were had normal vision in both eyes with visual Screening was done in a nearby room which examined during the screening program. acuity of 6/6 to 6/18. ensured smooth flow of participants from Age ranges from 20 to 70 years with mean the waiting area to first stage assessment age of 45±2SD. There were 76 male and 16 and refraction, then to the ophthalmologist females: (M: F=1:0.2). Of 184 eyes, 1 for further examination and provision of (1.1%) had macula hole, 3 (3.3%) eyes Introduction any available intervention where needed. could not be accessed due to cataract, and Screening is often aimed at detecting The Ophthalmic nurses carried out the 88 (95.7%) were normal. diseases some of which are asymptomatic. unaided and pinhole visual acuity using the It could lead to early disease recognition Snellen’s lettered chart and near vision that needed an immediate form of interven- using the N-Chart after informed verbal tion or prompt referral for further manage- consent. The Optometrist refracted all the Discussion ment. Eye conditions such as cataract, participants using manual retinoscope, Ocular screening can identify both non- refractive errors, allergy, changes while the Ophthalmologist carried out the blinding and potentially blinding condi- that are suspicious of glaucoma were iden- slit lamp examination and fundoscopy tions. Despite the wide age range, most of tified in other studies.1,2 In an outreach pro- (Welch-Allyn). Those found to have minor the participants are in the third to fourth gram conducted in Abuja, it was found that treatable eye conditions were treated in the decade of life (Table 1). At these age people major causes of ocular morbidity were venue, while those that needed reevaluation are more energetic. Few were in the sixth to

[Pyramid Journal of Medicine 2019; 2:37] [page 49] Article seventh decade, perhaps as older doctors presbyopia. In Imo refractive error account- normal macula. In our screening only one have retired and need not to attend the CME ed for 31.6% of cases, while presbyopia case of macular hole was identified, and in activity. There were more male doctors than accounted for 17.0% of cases.5 Refractive 3.3% of cases the macular could not be females that attended the program in line error accounted for 29.6% of those with accessed due to cataract. Uniocular blind- with the general educational trend in the visual impairment in a study reported from ness was only seen in 2.2% of right eye, part of the country the study was conducted Benin.2 The age of the participants could while 97.8% had normal vision in the right partly due to cultural reasons. Due to the have accounted for the variation between eye. In the left eye 96.7% as well had nor- relatively young age of the participants, one the studies. More than half of the partici- mal vision, while 2.2% had uniocular blind- third were emmetropic and only one fourth pants examined had normal anterior seg- ness. Moderate visual impairment was seen had presbyopia (Table 2). Distant ments. Our study showed that allergic con- in 1.1% of cases (Table 5). Refractive error occurred about equal as junctivitis, opacity, and corneal opacity were the frequent anterior segment findings Table 1. Age distribution of 92 participants. (Table 3). Similarly, in an outreach program conducted in Abuja, it was found that major Conclusions Age (years) Frequency, n (%) causes of ocular morbidity were refractive From the study, eye conditions such as 20-30 16 (17.4) error (40.4%), (18%), refractive error for distance, presbyopia and 3 5 31-40 38 (41.3) and cataract (3.0%). In Imo cataract was some anterior segment findings (corneal 41-50 16 (17.4) responsible for 12.5% of cases which was opacity, cataract and allergic conjunctivitis) 51-60 18 (19.6) nearly similar to our findings (Table 3). In were identified. Some of the participants ECWA eye hospital Kano, most common 61-70 4 (4.3) had a vertical cup disc ratio of ≥0.5. while causes of blindness were Cataract 40.5%, uniocular blindness was seen in 2.2% of Total 92 (100) glaucoma 29.3%, and corneal opacity cases, and about 90% of the participants had 6 14.3% of cases of bilateral blindness. Most normal vision in both eyes. Of the 184 eyes Table 2. Refractive status. of the participants had vertical cup disc examined, only 1.1% had macula hole. ratio of ≤0.4 (Table 4), comparable to a Refractive status Frequency, screening study done in Osun were 91.9% only n (%) had normal disc, 7.3% had cup disc ratio 7 Presbyopia only 22 (23.9) >0.6. In Imo glaucoma was identified in References 5 Presbyopia with Distance refraction 18 (19.6) 23.5% of cases. In Benin, 27.7% cases of 1. Ogwurike S, Pam V. Pattern of eye dis- visual impairment were found to be glauco-use eases in Kaduna State, a rural commu- Distance refraction only 20 (21.7) 2 ma suspects. In this study normal macular nity outreach experience. Nig J Ophthal Emmetropia 32 (34.8) was seen in 95.7% of cases, similarly to the 2004;12:1-5. Total 92 (100) 7 study in Osun were 98.8% of cases had 2. Osaguona VB, Ukponmwan CU, Kayoma DH, Okojie OH. Ocular health Table 3. Anterior segment findings. status of patients seen at the screening Anterior segment findings Right eye Left eye Centre of the University of Benin Frequency, n (%) Frequency, n (%) Teaching Hospital Benin city, Nigeria – A preliminary report. J Biomed Sci Normal 52 (56.5) 50 (54.3) 2012;11:44-50. Corneal opacity 1 (1.1) 1 (1.1) 3. Babalola OE, Babalola IB, Esuga M, et Cataract 10 (10.9) 10 (10.9) al. Finding in an eye care outreach pro- Allergic conjunctivitis 29 (31.5) 29 (31.5) gramme in Abuja. Nig J Ophthal 2003; Other findings 0 (0) 2 (2.2) 11:12-5. 4. Muhammad M, Mansur RM, Dantani Total 92 (100) 92 (100) AM, et al. Prevalence and causes of Non-commercial blindness and visual impairment in Table 4. Vertical Cup Disc in 184 eyes of 92 participants. Sokoto state, Nigeria, Baseline data for Cupp disc ratio Right eye Left eye Vision 2020: The right to sight eye care Frequency, n (%) Frequency, n (%) programme. Mid Est Afr J Ophthalmol 2011;18:123-8. ≤0.4 79 (85.9) 82 (89.1) 5. Achigbu EO, Dike KC, Uwakwem AC, ≥0.5 11 (12.0) 9 (9.8) et al. Ocular morbidity in rural commu- No red reflex 2 (2.2) 1 (1.1) nities in Imo state, south east Nigeria. Total 92 (100) 92 (100) Open J Ophthalmol 2016;6:184-90. 6. Olatunji FO, Kirupananthan S, Table 5. Vision status of 92 participants. Ayanniyi AA, Abuh S. Causes of adult blindness at ECWA eye hospital Kano, Cupp disc ratio Right eye Left eye Nig J Ophthalmol 2008;16:51-4. Frequency, n (%) Frequency, n (%) 7. Isawumi MA, Hassan MB, Asekun- Normal vision 90 (97.8) 89 (96.7) olarinmoye EO, et al. Prevalence and Moderate visual impairment 0 (0) 1 (1.1) causes of ocular morbidity seen among rural adult population of Osun state, Blindness 2 (2.2) 2 (2.2) south west Nigeria. Ann Trop Med Pub Total 92 (100) 92 (100) Health 2013;6:465-71.

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