Aims:To determine the prevalence of orbito-oculoplastic diseases and thereby contributing a data base to the emerging orbito-oculoplastics subspecialty in the sub-Saharan region.Settings and Design:A tertiary eye care centre.Materials and Methods:A descriptive prospective study was done in a tertiary eye care center. Demographic and clinico-pathological diagnoses of 269 patients presenting to the oculoplastics clinic over a 4-year period (January 2008 -December 2011) were collected at entry and during follow-up visits. These were patients referred from the general ophthalmology clinics of the study center, secondary eye care centers within and from neighboring states. Patients were categorized based on the primary diagnosis after examination by the oculoplastics surgeon. Ethical issues were considered though data collection did not involve direct patient participation.Statistical Analysis Used:Microsoft Excel 2007 software.Results:Two hundred and sixty-nine patients were seen with 141 (52.4%) females. Leading etiological factors were trauma; 81 (30.0%), congenital anomalies 55 (21.0%) and tumors 44 (16.0%). Eyelid diseases were the most frequent 115 (42.8%), with ectropion 36 (31.0%) and ptosis 33 (29.0%) being the most common. Orbital and peri-orbital lesions 44 (16.4%) were mainly dermoids 12 (27.3%) and capillary heamangioma 4 (9.1%) in the pediatric age while thyroid orbitopathy 11 (25.0%) was predominant in adults. Ocular and degenerative diseases were retinoblastoma in 4 (16.7%) and phthisis bulbi in 10 (33.3%). Contracted socket was 22 (84.0%) of socket pathologies. Primary conjunctival diseases occurred less often, rather Stevens-Johnson syndrome in 9 (30.0%) and its ocular complications were more frequent.Conclusions:It is expected that this survey will provide a database for oculoplastics surgeons and ophthalmologists in an emerging subspecialty and thus enhance training focus and equipment acquisition.

Purpose:Oxidative stress has been implicated in the pathophysiology of glaucoma, cataract, and many degenerative diseases. The purpose of this study is to evaluate the systemic oxidative stress in black-African patients diagnosed with primary glaucoma or age-related cataract (ARC) and compare these indices to normal control patients and between the two conditions.Methods:This was a descriptive cross-sectional study of consecutive recruited subjects attending a tertiary care facility. One hundred adults were enrolled and sub-grouped into: Normal controls (n = 20), patients with primary glaucoma (n = 40), and patients with cataract (n = 40). The data were collected on patient demographics and clinical information. Ten milliliters of the venous blood was taken from each subject for the evaluation of serum biochemical indices of oxidative stress. Laboratory measurements of enzymatic and nonenzymic anti-oxidants, as well as lipid peroxidation, were conducted using established and validated spectrophotometric methods. The systemic oxidative stress was measured by the serum levels of anti-oxidant enzymes and lipid peroxidation, and compared between the groups and to a control group of patients.Results:Statistically, significantly reduced serum levels of glutathione, glutathione-S-transferase, superoxide dismutase, catalase, and ascorbic acid were found in the patients with glaucoma or cataract when compared with controls (P < 0.05 for all). Differences in serum lipid peroxidation levels across or between the groups were nonsignificant. Serum protein levels were significantly higher among the subjects with cataract or glaucoma than in controls.Conclusion:Our results concur with findings in Caucasian study cohorts. This indicates that in black-Africans, primary glaucoma, and ARC are associated with increased systemic oxidative stress. This supports the existing evidence on the role of oxidative stress in these ocular disorders and reinforces the rationale for the use of anti-oxidants in the management and possible prevention of these conditions.

Purpose:To determine the prevalence of patient refusal of glaucoma surgery (GSR) and the associated factors in Lagos, Nigeria.Materials and Methods:A multicenter cross-sectional survey was conducted in Lagos state, Nigeria. Twelve centres were invited to participate, but data collection was completed in 10. Newly diagnosed glaucoma patients were recruited and interviewed from these sites over a four week period on prior awareness of glaucoma, surgery refusal, and reason(s) for the refusal. Presenting visual acuity was recorded from the patient files. The odds ratio and 95% confidence intervals (CI) were calculated.Results:A total of 208 newly diagnosed glaucoma patients were recruited. Sixty–five (31.2%) patients refused surgery. Fear of surgery (31 (47.7%) patients), and fear of going blind (19 (29.2%) patients) were the most common reasons. The odds ratio of surgery refusal were marital status – not married versus married (2.0; 95% CI, 1.02–3.94), use of traditional medication – users versus non users (2.4; 95% CI, 1.1–5.2), perception of glaucoma causing blindness – no versus yes (3.7; 95% CI, 1.3–10.5), type of institution - government versus private (5.7; 95% CI, 1.3–25.1), and visual acuity in the better eye - normal vision versus visual impairment (2.3; 95% CI, 1.1–4.9). Age, gender, level of education, family history of glaucoma, and prior awareness of the diagnosis of glaucoma, were not significantly associated with surgery refusal. Perception of patients concerning glaucoma blindness was the strongest factor on multivariate analysis.Conclusion:GSR was relatively low in this study. Unmarried status, use of traditional medications, perception that glaucoma cannot cause blindness, government hospital patients, and good vision in the better eye were associated with GSR. These factors might help in the clinical setting in identifying appropriate individuals for targeted counseling, as well as the need for increased public awareness about glaucoma.

The aim of this study was to investigate the types and presentation pattern of congenital defects of the eye and adnexia in our center. This is a retrospective review of congenital defects of the eye and adnexia over a 20-month period at a tertiary referral center in Lagos, Nigeria. Records were analyzed for age at presentation, laterality, gender, vision assessment, and type(s) of abnormality. Out of 412 pediatric patients, 40 (9.7 %) were seen to have congenital abnormality of the eye and/or its adnexia during the study period. There were 17 (42.5 %) males. Twelve patients (30.0 %) presented with involvement of the right eyes, nine (22.5 %) with left eyes, while 19 (47.5 %) had bilateral involvement. Twenty-eight patients (70.0 %) were aged 1 year or less at the time of presentation. A total of 69 entities were recognized as some children had two or more malformations. The common congenital defects identified were cataract (39.1 %), ptosis (17.4 %), glaucoma (8.7 %), and cornea opacity (7.2 %). Other less common congenital defects include: microphthalmos, anophthalmos, coloboma (lid and iris), dermoid cyst, and aniridia. All of the patients with available visual acuity documentation had visual impairment. A high proportion of the patients were lost to follow-up. Cataract, ptosis, and glaucoma were the commonest congenital defects of the eye and adnexia in our center and were associated with visual impairments. The significant loss of the patients during follow-up needs urgent investigation and attention to forestall this trend.