Couching in Nigeria: Prevalence, Risk Factors and Visual Acuity Outcomes

Abstract

Couching is still widely practiced in Nigeria and visual outcomes are very poor. The population needs to be made aware of the risks associated with the procedure, and services for high quality, affordable cataract surgery need to be expanded, particularly in rural areas and in the north of the country.

Blindness and visual impairment due to uncorrected refractive error in sub-Saharan Africa: review of recent population-based studies

“…The high prevalence of uncorrected aphakia in Nigeria may have been due to couching, an antediluvian treatment of cataract, which is still commonly practiced in Nigeria and other areas of SSA. Couching in Nigeria is associated with poor visual outcomes, and adherence to aphakic correction is poor; even with aphakic correction 42.6% of patients surveyed with aphakia were blind 18. Moreover, in the same study, the most common cause of a poor outcome following cataract surgery was URE in eyes with IOLs, and uncorrected aphakia in non-IOL eyes 19…”

Quality of life and visual function in Nigeria: findings from the National Survey of Blindness and Visual Impairment

“…Couching, a common practice in the northern administrative regions and rural areas of Nigeria,22 had statistically significant associations with low VF and QOL scores. Furthermore, evidence from Nigeria and Mali emphasised poor visual outcomes after couching 22 23.…”

Prevalence and causes of ocular morbidity seen among rural adult population of Osun State, southwest Nigeria

“…Almost 50% of cataracts were found to be couched from the Nigerian national survey results. [12] Further community survey is required to ascertain this.…”