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About two million Nigerians suffer open angle glaucoma — Onakoya

Onakoya

Prof. Adeola Onakoya is a Consultant Ophthalmologist and Head of Department, Guinness Eye Centre at the Lagos University Teaching Hospital (LUTH). She is a member of Ophthalmological Society of Nigeria and International Council of Ophthalmology (ICO), as well as the Chairman of the Glaucoma Society of Nigeria. In this interview, she discusses the Nigeria healthcare sector; state of eye care services and prevalent eye diseases in the country.

What are the different branches of eye care?
Ophthalmologists are heads of the team. They are fully trained medical doctors. They perform complete and comprehensive eye evaluation and provide treatment for all eye diseases, including those with endogenous origin, in addition to treating the associated medical conditions. They perform laser surgery and conventional eye surgery, as well as prescribe medication, glasses and contact lenses.

Optometrists perform eye examination, tests for glasses and ocular alignment, as well as prescribe and fit glasses. They also teach eye exercises and refer patients with ocular diseases to the ophthalmologists for appropriate management.
On their part, opticians grind lenses and make glasses.

At Guinness Eye Centre (GEC), we render comprehensive eye care in addition to subspecialist eye care for glaucoma, paediatric eye services, vitreoretinal services, and refraction and low vision services. Surgical interventions, either conventional or Laser surgical services are also available.

Glaucoma has been identified as the leading cause of blindness in Nigeria. Why is the disease so widespread?
Glaucoma is the commonest cause of irreversible blindness in Nigeria. About 5.02 percent of people above 40 years suffer from glaucoma, especially the open angle type. This in absolute numbers translates to two million and out of these, only five percent are aware of the disease with about 20 percent blind in both eyes. Lack of awareness and poor knowledge about the aggressive nature of the disease in black people are also major problems. Also, lack of symptoms at the early stages of the diseases leads to late presentation, because regular eye examination is not part of our culture.

Research has shown that 80 to 90 percent of patients with glaucoma in Nigeria seek medical attention at the late stages of the disease with loss of vision in one eye in 40 to 50 percent of them. In addition, first degree relatives of sufferers are also at a higher risk of the disease because it runs in families. The widespread nature in Nigeria is due to the fact that being black is a major risk factor coupled with increase in prevalence as one advances in age.

What other eye defects are prevalent in Nigeria. How can they be prevented or managed?
The other prevalent eye defects in the country are refractive errors, cataracts, diabetic retinopathy and allergic conjunctivitis in children. For refractive errors, simple eye test with provision of spectacles will solve this huge problem. Cataract surgery with lens implant will reduce blindness from cataract being the commonest cause of blindness in Nigeria.

Our operations span preventive, treatable and rehabilitative arms of care. At the start of business each day, health education is rendered by nurses on common eye conditions and recognitions of the complications. Definitive treatments are offered for established conditions and the complicated cases are offered rehabilitative services.

How often should people go for a comprehensive eye checkup?
For the eyes, it’s once in two years. However, for people with family members who suffer from glaucoma, it should be done on a yearly basis. Entire body check up is advised on a yearly basis.

Guinness Nigeria is funding eye clinics across the country. What’s the company’s level of involvement in this hospital?
Right from inception of Guinness Nigeria’s initiative to provide infrastructure, the organisation has been very supportive in ensuring that GEC renders quality eye care services to people of Lagos and those from neighbouring states. This was achieved through the award of regular subvention in support of ophthalmic equipment purchase, infrastructure maintenance and the general running of GEC. In the last 10 years, Guinness Nigeria has been quite supportive in ensuring that GEC acquires cutting edge technology equipment for ophthalmic care, e.g. laser machines, slit lamps and other diagnostic equipment.

Guinness Eye Centre houses the Department of Ophthalmology of both the College of Medicine and Lagos University Teaching Hospital. In addition to other stakeholders in eye health care, nurses, optometrists, pharmacist, medical records officers and other ancillary staff work in the centre. These comprise eight consultant ophthalmologists with sub-specialist in glaucoma, peadiatrae ophthalmology, vitreoretina and public health ophthalmology. Currently, there are 24 resident doctors undergoing specialist training, 39 ophthalmic trained nurses, two optometrists, six medical records officers, four pharmacists, and 16 ancillary support staff.

In essence, the Guinness Eye Centre renders specialist and subspecialist services in addition to training of resident doctors, medical students and nurses. The infrastructure and the equipment available allow GEC Lagos to render a comprehensive and subspecialty tertiary eye care in addition to conducting of academic researches, thereby making remarkable contributions to the existing body of knowledge in ophthalmology. The centre also serves as the examination centre for specialist in ophthalmology for the National Postgraduate College of Nigeria, and International Council of Ophthalmology Examination, where I serve as the coordinator in Nigeria.

What other challenges do you currently face and how are you resolving them?
Ophthalmic practice is quite equipment-intensive and there’s a continuous demand for equipment, as new and more advanced technology becomes available. These are not cheap. And this is a major challenge we face. Through the support of Guinness Nigeria Plc, Vision 2020, collaboration with London School of Hygiene and Tropical Medicine and LUTH management, we have managed to purchase some. However, there’s always a continuous need to upgrade the equipment to provide high quality care and treatment to our patients.

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