The Nation Newspaper

Tag: blindness

  • Blindness in a child can now be prevented

    Blindness in a child can now be prevented

    Parents can now heave a sigh of relief over early blindness in children thanks to RetCam, an equipment just acquired by the Delta State University Teaching Hospital. OYEYEMI GBENGA-MUSTAPHA reports.

     

    When their baby came less than 32 weeks of gestation period, Mr and Mrs Pius Godwin were told it was a preterm. The hospital took care of the baby and it survived. The hospital, however, had no equipment to examine the baby’s eyes. As the baby grew, the parents noticed that it was not opening its eyes. They took the baby boy back to the hospital and were referred abroad, where they were told the boy had gone blind.

    A neonatologist, Mrs Laura Ade, said that was a preventable development, assuming there was a RetCam in the hospital, where the baby was born.

    The equipment would have screened for Retinopathy of Prematurity (ROP), because the current international screening guidelines suggest that premature babies and those less than 1500 grams at birth should be screened for ROP. Larger sick babies may also be screened, if the neonatologist believes there is high risk to develop ROP.

    According to Mrs Ade, ROP is the single leading cause of childhood blindness in the industrialised and developing countries. “Over the last decade, both the detection methods and treatment protocols have evolved significantly. Advanced technologies, such as the RetCam, is part of the tools physicians need to properly screen for ROP,” she said.

    Mrs Ade, the Nursing Manager covering Neonatal and Paediatrics at the Delta State University Teaching Hospital (DELSUTH), said: “ROP is a blinding eye disease of premature babies and very low birth weight infants and that is why Governor Emmanuel Uduaghan and the Chief Medical Director (CMD), Dr Leslie Akporiaye went all out to get RetCam for the teaching hospital, the only one in the country at the moment.”

    RetCam is a wide angle paediatric retinal imaging system useful for screening ROP. It is a non stressful way to screen premature babies and is easier to perform when compared to indirect ophthalmosocopy by ophthalmologists.

    Mrs Ade said: “RetCam can be easily performed by nurses, technicians in the Intensive Care Unit (ICU) or operating room.The RetCam is an advanced, wide-field digital imaging system that delivers the next generation of ophthalmic visualisation, photo documentation and ease of use. This wide-field ophthalmic imaging camera captures brilliant, full colour images that can be used for immediate evaluation of pediatric ocular pathology. Stunning digital images are captured and can be shared electronically with an ophthalmologist for immediate evaluation and tracked longitudinally over time. The RetCam is equipped with a family of interchangeable lenses that provide the user with a wide range of image options that allow the physician to view both anterior and posterior ocular pathology.”

    On the benefits of the tool, the CMD said: “The hospital is a teaching, service provider and a research institute. With RetCam in Neonatal Unit, it would allow clinicians to screen premature infants who are at risk of ROP. It has also been shown to be an invaluable tool in resident training, parent education and photo documentation of ROP, as an experienced user can quickly and safely obtain images of an infant’s eyes, allowing physicians to view the images and better evaluate the status of the ROP disease.

    “The eyes of premature babies can be screened and if detected early can be treated in time. Lack of ROP screening and timely laser treatment can lead to advanced ROP and poor prognosis. ROP is an important cause of blindness in developing countries.

    “As a teaching and research centre, it would improve the hospital because the RetCam allows for the use of remote imaging as a method of obtaining and evaluating images. Physicians around the world have been successful in using the remote imaging approach.

    “To the neonates and the hospital, the equipment has the following advantages to offer us- the physician can be remote from the facility where the images are being obtained. This eliminates the cost to physically transfer babies and family members to the physician’s location. Healthcare delivery becomes more timely and efficient. There is no need to wait until a physician can be on site to screen a baby or the need for physicians to spend their time and expense traveling to other sites.

    “It has been demonstrated that healthcare professionals other than physicians can be trained to effectively perform digital imaging, further reducing the time the physician needs to spend in the neonatal intensive care unit. Our Neonatal Unit is definitely one of the best in the country as we have RetCam which is part of the standard examination protocol for neonates.”

  • ‘Glaucoma, cataract may lead to blindness’

    ‘Glaucoma, cataract may lead to blindness’

    Dr. Imade Agbunorh is the Optometrist attached to the primary health centre at Ikotun, where she attends to patients who have eye problems. She explained some of the conditions that can lead to blindness and measures that can be taken to prevent loss of sight.

    IS it possible to go totally blind mid-age? What are the conditions that can lead to blindness?

    Of course yes. Some people are born blind and some develop conditions that lead to blindness as they grow older. Sometimes eye injuries, which occur as a result of accidents, road traffic accidents and even domestic accidents, can also cause blindness. Dangerous chemicals like acid splashed in the eyes could also lead to loss of sight. Blindness is common, not only in children or among the aged but even at middle age. For example, if you have an eye-condition like glaucoma, which is symptomless, and if you’re not someone that goes for regular eye checks, then you’re not likely to know until some damage have been done to your eyes. There are two major types of glaucoma: the closed-angle glaucoma and the open-angle glaucoma.

    The closed-angle is an ocular emergency and it is painful. And that is when the patient is compelled to immediately seek medical attention. But the open-angle glaucoma, also called chronic glaucoma or adult onset glaucoma, has no symptoms whatsoever. We also have the congenital glaucoma, which children are born with. That also leads to blindness if nothing is done as intervention. Now the open-angle glaucoma is also described as the silent thief of sight. Silent, because it does not cause any pain, and by the time the patient starts experiencing any symptoms, the damage has already been done. The only remedy would, therefore, be to preserve the existing vision, and not to recover the lost vision. There are some other conditions like infections that could reduce your visual acuity temporarily; but unlike glaucoma, when such conditions are properly treated with medications, the visual acuity becomes normal again. And glaucoma damages not only your central vision but most times the peripheral visual fields and could lead to what is called tunnel vision. In some types of glaucoma, medical interventions like using eye-drops and other oral medications don’t really have significant impact and that patient usually has to recourse to ocular surgery, (e.g. trabeculectomy). And even that does not bring back any lost vision, as I earlier said, but only preserves existing vision. Another condition that could lead to blindness at middle age is cataract.

    How dangerous is cataract?

    Both glaucoma and cataract can lead to blindness, but the difference is that blindness due to cataract is reversible, all other factors being equal. What happens is that the transparent crystalline lens in the eyes which helps to transmit light to the back of the eyes ( the retina), from where it is taken to the optic nerve and to the brain becomes cloudy; therefore, light rays cannot easily penetrate it. But when you go for cataract extraction surgery, the cloudy lens is removed and it is replaced with an intraocular lens and vision may be restored almost to normal.

    A lot of people are afraid of eye surgery, and that it’s so delicate that doctors may not be able to couple everything back in place.

    That’s not true. With modern technology that obtains today, the rate of success is much higher than it used to be. The important thing is to get the right specialist.

    How available are these right specialists, and how affordable?

    The specialists in charge of eye surgery are the ophthalmologists. The ratio of ophthalmologists vis a vis the Nigerian population is still low; which literally means that they have a lot of patients to attend to, especially in cities like Lagos. But they are still available.

    Affordability varies from one specialist to the other; but blindness is far more expensive than what you pay for qualitative eye care services.

    What are the factors that can lead to glaucoma and cataract?

    A major cause of blindness at old age is age-related macula-degeneration. The macula is the part of the retina that sub serves central vision. Most of the tasks we do like reading, writing, driving and all that; we use our central vision to co-ordinate it. Age-related macula-degeneration most times is not found in every old person as the name implies; but it is more common in people who spend a larger proportion of their time outdoors, and do not protect their eyes from the harmful rays of the sun. People who do not have periodic eye checks regularly are also at a higher risk. The chances of such people having eye problems that could lead to blindness is higher than in those who are well-informed and seek periodic eye-checks , while also maintaining a healthy lifestyle. They are also expected to be pro-active and protect their eyes from UV rays and generally maintain a good standard of eye-care.

    For the UV rays, what do you recommend?

    The number one thing to do is protect your eyes from the sun. You’re likely to find some different degrees of cataract in about one out of every three persons above 60 and the number one implicating factor is excessive exposure of the eyes to UV rays. So you’ll be doing yourself a great deal of good if you protect your eyes with good poly carbonic lenses with high sun protective factor that stop the UV rays from penetrating your eyes. Your diet also matters a lot. For example, researchers have found a very low rate of age-related macula-degeneration or cataract amongst vegetarian; and that is because they tend to go more on fruits and vegetables which are very good for the eyes because they are very rich in anti-oxidants; Anti-oxidants include vitamins A, C and E, which protect the eyes and the body from free radicals that cause aging and also boost immunity. You don’t just wait until you have a problem or begin to have a problem before you go for an eye test. And avoid self-medication.

    Is there a chance of people having reading problems and delaying in seeing an optometrist going blind?

    No. When you are approaching late 30s to 40 years and above, presbyopia sets in. What that simply means is that the eyes can no longer focus on near objects like before, because as you grow older, you start losing the accommodative power. Power of accommodation is what enables you to look at objects or print material at near. However, it does not lead to blindness. The only problem is reading close objects become burdensome; and if you insist, you develop eye strains, headache, fatigue and all that.

    And for those who work permanently with the computer?

    I’ll expect that they protect themselves with computer screen protectors to shield their eyes from the electro-magnetic waves coming out of the computer. I think the onus lies on employers to make sure that all office computers are protected as part of the welfare packages, at least in the interest of their staff. Also, you’re likely to have eye strain; what we call computer eye syndrome; and these include headache, itching, searing pain. And my advice is that anybody that works on computers should not stay glued to the computer for a long stretch of time. Work about 30 minutes and look away for at least five to 10 minutes. And then you make sure that where you are working is well-illuminated. And then there are lenses meant for computer use even if you don’t have refractive errors. They are called anti-reflective lenses.