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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?. Visual Impairment (VI):

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Managing ocular disability in nigeria

Managing Ocular Disability In Nigeria

Gbemi Oworu FRCSEd, FWACS, MCMI

Huddersfield Royal Infirmary

Huddersfield


Managing ocular disability in nigeria1
Managing Ocular Disability In Nigeria

  • How big is the problem?

  • What are the cause?

  • How do we tackle the problem?


What is visual disability
What is visual disability?

  • 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
Prevalence of blindness & VI

  • 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
Causes of visual disability

  • Cataract

  • Glaucoma

  • Corneal scarring from all causes

  • Uncorrected refractive error


Causes of visual disability1
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 disability2
Causes of visual disability

  • Cataract: -

  • Glaucoma

    - 2nd commonest cause

    - 16.7% of blindness

  • Corneal scarring

  • Uncorrected refractive error


Causes of visual disability3
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 disability4
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
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
Managing visual disability- corneal scarring diseases

  • 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
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
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
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 2005-2007