Purpose To evaluate the pattern of ocular and visual complications of head injury. Method A prospective study of 225 headinjured patients managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. For the purpose of extracting vaisual complications, a Neurosurgeon and an Ophthalmologist examined each patient and appropriate investigations were carried out. Patients with ocular morbidity were analysed for age, sex, cause of injury, admission Glasgow coma score, and associated injuries in addition to findings at ophthalmic and neurosurgical evaluations. Results Two major types of ocular and visual complications were observed in 57 (25.3%) of 225 head-injured patients studied. Soft-tissue injury to the globe and adnexae included periorbital ecchymosis, subconjuctival haemorrhage, lid laceration, or rarely globe rupture in 29 patients. Neuro-ophthalmic ocular cranial nerve palsies occurred in 28 patients, while orbital fracture was encountered in two patients. Ocular injuries were multiple in 60% of cases. The patients, comprising 37 male and 20 female subjects, were aged 9 months to 57 years (mean ¼ 28 years). Traffic accident was the leading cause of head injuries (84.2%), while fall from height (7%), assault (7%), and gunshot (1.8%) were miscellaneous causes. Conclusion Injury to the globe and adnexae and ocular cranial nerve palsies constitute the most common oculovisual complications following head injury in our centre.

AbstractsBackground: Health care providers are expected to have the skills and knowledge relevant to their field and should also be familiar with the ethical and legal expectations that arise out of the standard practices. Objectives: To elucidate the practice of the health care providers in relation to healthcare ethics in Nigeria. Methods: A self-administered structured questionnaire was devised and distributed to staff of two tertiary health care facilities in Northern Nigeria. The questionnaire comprised of detailed questions regarding day-to-day aspects of Medical ethical issues. Results: A total of 307(76.2% ) out of 403 health care providers responded to the questionnaire. The median age of the respondents was 34 years. More than half 168(54.7%) of the respondents disagreed as to whether "Ethical conduct is important only to avoid legal action. Many respondents 135 (44.0%) agreed to adhering to "patient's wishes", on the other hand over two-third of the respondents 211 (68.7%) agreed that "doctor should do what is best" irrespective of the patient's opinion. There were significant differences (p<0.05) between the perception of physicians and non-physicians on many ethical issues. Conclusion:This study has shown gap in knowledge and practice of healthcare ethics among health care providers. There is a need for periodic education on clinical ethics in our hospitals.

Knowledge of the presentation pattern of glaucoma helps in providing more understanding of the disease, leading to better control. The aim of this study was to determine the presentation pattern among newly diagnosed glaucoma patients in Lagos, Nigeria. This was a multicenter cross-sectional survey of newly diagnosed glaucoma patients, recruited over a four-week period. Socio-demographic characteristics, presenting history, awareness and perception on glaucoma, and basic examination findings were obtained. A total of 208 patients, including 90 (43.2 %) females with a mean age of 53.9 years were recruited. One hundred and forty-three (68.7 %) were self-referred patients with a mean duration of symptoms of 2.6 years. Fifty-five (26.4 %) patients gave a history of glaucoma in at least one family member. Ninety-five patients (45.7 %) were aware that glaucoma can cause visual loss, but 69 (72.6 %) out of these believed the visual loss is reversible. Seventy (33.7 %) patients had been previously diagnosed with glaucoma elsewhere. From the 208 patients, 35.5 % had visual impairment (presenting visual acuity [VA] of <6/18 in the better eye), while 15.5 % were blind (presenting VA in better eye <3/60). Lack of glaucoma awareness, positive family history and illiteracy were associated with late presentation of glaucoma. Late presentation is still a major concern among glaucoma patients in Southwest Nigeria, and there is a need to intensify present efforts aimed at increasing public awareness, emphasising the irreversible nature of the disease, as well as encouraging at-risk groups such as first-degree relatives to go for screening.

BackgroundAlthough a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community.MethodsA retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007.ResultsA total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%).ConclusionsAdequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.

Emphasis should shift to team building and ensuring available workers perform optimally rather than meeting the absolute numbers of some cadre, which does not guarantee improved output. Issues of equitable distribution, appropriate staff mix, filling identified gaps in human resources, and addressing poor service uptake should be the focus to reach the goals of Vision 2020: The Right to Sight.