Download Managing Ocular Disability In Nigeria

Managing Ocular Disability In
Nigeria
Gbemi Oworu FRCSEd, FWACS, MCMI
Huddersfield Royal Infirmary
Huddersfield
Managing Ocular Disability In Nigeria
• How big is the problem?
• What are the cause?
• How do we tackle the
problem?
What is visual disability?
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Visual Impairment (VI):
Mild VI:<6/12-6/18*
Mod VI:<6/18-6/60*
Severe VI:<6/60-3/60*
Blind: Vision of <3/60*
*(in the better eye)
Prevalence of blindness & VI
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Blind 4.2%
Severe VI: 1.5%
Moderate VI: 5.3%
Mild VI: 4.5%
• 4.25million adults
(>40yrs) are either
visually impaired or blind
The Nigeria national blindness & visual impairment survey
2005-2007
• Females : Males
(4.4%:4.0%)
• Illiterate: Literate
(5.8%:1.5%)
• North East: South west
(6.1%:2.8%)
Causes of visual disability
• Cataract
• Glaucoma
• Corneal scarring from all
causes
• Uncorrected refractive error
Causes of visual disability
• Cataract: Most common cause of
disability
- 43% of blindness
- 400,000 operable
- Increasing by 2020
to 600,000
• Glaucoma
• Corneal scarring
• Uncorrected refractive error
Causes of visual disability
• Cataract: • Glaucoma
- 2nd commonest cause
- 16.7% of blindness
• Corneal scarring
• Uncorrected refractive
error
Causes of visual disability
• Cataract: • Glaucoma
• Corneal scarring from all
causes:
 3rd commonest cause
 7.9% of blindness
- trachoma
- river blindness
Uncorrected refractive error
Causes of visual disability
• Cataract: • Glaucoma
• Corneal scarring
• Uncorrected refractive error
 Commonest cause of mild (77.9%) to
mod(57.1%) VI
 2.46 million
Managing visual disability
- uncorrected refractive error
• Preschool vision screening (or 1st year of
primary school)
• Identified during screening for glaucoma and
diabetes
Managing visual disability
- corneal scarring diseases
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Provision of portable water/good hygiene
Health education
Prompt treatment of eye infection
Prompt surgical treatment
Corneal graft surgery
Health and safety checks
Managing visual disability
- glaucoma
• Education
• Painless gradual blindness
• Risk of glaucoma in an
African >40 yrs
• Annual screening by
optician or
ophthalmologist
• Prompt effective
treatment once
diagnosed
(eye drops/operation)
Managing visual disability
- cataract
• Education
• Couching is not the
answer (46.1%)
• Affordable safe cataract
surgery+ lens implant
• Subtenon anaesthesia
one of the safest local
anaesthetic
Conclusion
• 84% of blindness is
avoidable or treatable
• Education
• Preschool eye test
• Good hygiene/water
• Annual eye test for
glaucoma
• Affordable safe cataract
surgery
The Nigeria national blindness & visual impairment survey 20052007