The need to highlight the dangers to the eye and visual status in couching has become necessary in order to discourage its patronage. This was a bi-center clinic-based prospective descriptive study about new cases of couched eyes which were seen over a two-year period. Oral interviews, eye examinations, refractions, and perimetry tests were used to obtain the information. SPSS version 16 was used for the descriptive analysis. Twenty-five patients and 30 eyes of 15 (60%) males and 10 (40%) females were studied. The age range was 34–90 years with a mean age of 67.87 years (SD 11.27). Presenting versus (vs) corrected visual acuity (VA) for normal vision was 6.7% vs 23.3%, visual impairment was 16.7% vs 26.3%, and blindness was 76.7% vs 50%. A significant number still remained blind after corrections (P = 0.014). The most common presenting complaint was “poor/blurred vision” in 24 (80.4%) and the most frequent duration of couching before presentation was 7–12 months (46.7%). Subjects with a cup:disc ratio > 0.6 had intraocular pressures (IOPs) of > 21 mmHg, and 50% of those patients had IOP > 40 mmHg (P = 0.001). Glaucoma (13.3%) and corneal opacity/retinal detachment/couching maculopathy/optic atrophy (10%) were the most common complications. Couching causes visually-disabling complications, and is therefore strongly condemned. Increasing public awareness and putting a policy in place for affordable and accessible cataract services in government hospitals would gradually phase out its patronage.

PURPOSE: There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determine the causes and circumstances surrounding these occurrences and their effects on the eye and vision in a pediatric population. METHODS: A 3-year study of consecutive cases of ocular features that presented to an eye clinic following a history suggestive of child abuse along with any associated eye injury was carried out. Socio-demographic characteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eye examination was also done. RESULTS: Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the mean age was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The most common ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocular pressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normal vision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairment in 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most common injurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstances predisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications were cataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). CONCLUSIONS: Injuries commonly resulted from canes and sticks used during beatings, as well as from child labor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negative psychosocial and economic impacts on the child, family and country as a whole.
Africa, Western ; Blindness ; Canes ; Cataract ; Child ; Child Abuse* ; Child* ; Conjunctiva ; Corneal Opacity ; Employment ; Eye Injuries ; Female ; Humans ; Hyperemia ; Intraocular Pressure ; Jurisprudence ; Male ; Nigeria ; Punishment ; Retinal Detachment ; Rupture ; Sclera ; Vision Disorders ; Visual Acuity

AIM: To determine the ocular biometric measurements and central corneal thickness(CCT)in Nigerian children so as to have a reference database.

METHODS:A hospital-based observational study of a cross-section of children seen consecutively between November 2017 and January 2018. The socio-demographic data of patients, visual acuity(VA)was assessed with LogMAR charts and Lea charts according to age group. Examination under anesthesia(EUA)was carried out for children eight years and below. Anterior and posterior segments examination through dilated pupil were done. Corneal diameters(CD)were assessed using calipers. Intraocular pressures(IOP)were examined using hand held tonometer, CCT and axial length(AL)were measured using the ultrasonic pachymeter. Cycloplegic refraction was carried out after clinical examination. Data were entered into and analysed using SPSS version 17 to generate results through descriptive statistics. Frequencies and cross tabulations of variables were done(P<0.05).

RESULTS:Sixty-six children with 132 eyes, of ages between 3-16(mean: 9.13±3.70)years were studied. Male with female ratio was 1:1.7. The modal age group range was 6-10 years(42.4%). Most of them were primary school students 36(54.5%). The predominant parents' occupation was traders/unskilled workers(51.6%)and the professionals/civil servants(30.3%). The mean right and left VA were 0.45±0.46 and 0.45±0.44(LogMAR)respectively. The mean right and left horizontal corneal diameters(HCD)were 10.5±1.6 mm and 10.37±1.45 mm respectively. The mean right and left vertical corneal diameters(VCD)were 9.7±1.2 mm and 9.7±1.3 mm respectively. The mean right and left CCT were 556.71±2.61 μm and 556.47±45.53 μm respectively. Myopia 23(34.8%), myopic astigmatism 18(27.3%)and simple astigmatism 16(24.2%)were the commonest types refractive error. No significant associations were observed between CCT and HCD(P=0.739), VA(P=0.058)and refractive error(P=0.199). However, CCT slightly significantly correlated with the age groups(P=0.055).

CONCLUSION: Mean values for CCT, IOP and CD are known for the first time in Nigerian children. No significant association was seen between CCT and VA, CD and refractive errors. Further studies are required to ascertain findings.