The University Of Benin added another inaugural lecture series at the Akin Deko Auditorium Ugbowo Campus on the 8th of May, 2017 which made it the 191st inaugural lecture series of the University Of Benin. Present at the event , the vice chancellor of the university represented by , DVC Administration Prof. Ehirobo prof E.P Iribhogbe, the DVC Academic, the school LibrarianDr. Evelyn Idiodi, Deans Directors, Professor, Emeritus Professors , staff, student CMD
UBTH Prof Mike Ibadan, and Family members.
The lecture with unaccustomed attendance had the Topic: “That no Nigerian Becomes Blind Needlessly”: the burden of avoidable blindness in Nigeria” by Professor (Mrs.) Adesuwa Itohan Osahon Professor of Ophthalmology (Public Health/Community Ophthalmologist)
The eye is the light of the body. Blindness, therefore, implies living in perpetual darkness.
In Matthew 6:22, Jesus asserts that the eye is the lamp of the body “if your eye is bad, your whole body will be full of darkness”. The importance of good vision cannot, therefore, be overemphasized
The eye also is the window to the rest of the body as we can recognize a number of systemic diseases by examining the fundus (the inside of the eye), that is, the retina, blood vessels, and optic disc. Some conditions that might require a lot of elaborate tests to diagnose can be picked up by a thorough examination of the fundus. Provision of Ophthalmic care to the populace is based on teamwork. The members of the team include:
- The Ophthalmologist: A medically qualified eye doctor who possesses a postgraduate qualification in ophthalmology after a residency training program of 6 years. He is the leader of the team. The job of the Ophthalmologist is to render TOTAL eye care: medical, surgical (eye operations) and optical (prescribing of glasses)
- The Optometrist: A non-medically qualified university graduate whose job it is to test the patient’s refractive state and prescribe appropriate optical correction for them; also provides treatments for low vision and help with low vision rehabilitation. He also has the doctor of Optometry degree (OD)
- The Dispensing Optician: Responsible for cutting the lenses and fixing the glasses and is usually a non-University graduate
- The Ophthalmic Nurse: Is specially trained after general nursing to provide ophthalmic nursing care. Their duties include vision testing, basic eye procedures like removal of superficial foreign bodies from the eye, instillation of eye drops, and assist in theater sessions and clinics. They give eye health education and are involved in patient counseling.
- The Primary Eyecare worker: Is in the community, at the grassroots and they are trained in vision testing and recognition of minor eye problems. They also counsel patients.
The need for cooperation among members of this team cannot be overemphasized in order to provide an efficient Ophthalmological service to the populace. The 10th Edition of the World Health Organization (WHO) International Classification of Diseases (ICD 10) defines blindness as best corrected Visual acuity (BCVA) worse than 3/60 (20/400) in the better eye OR a visual field less than 10 degrees from fixation(WHO, 1992), The occurrence of blindness in an individual can have a devastating impact on his socio –economic life. It affects the performance of activities of daily living, making him almost totally dependent on others. The economic losses arising from blindness, both at the individual and community levels are therefore enormous. Hence, any effort expended in preventing the problem of blindness is always highly rewarding both to the individual and the community. The Nigeria National Blindness and Visual Impairment Survey (NNBVIS) conducted from 2005 -2007 was the first and only truly national survey of blindness and visual impairment in Nigeria so far, The overall prevalence of blindness was 0.78% from the survey, the absolute number blind in Nigeria was about 1.1 million with over 3 million having a visual impairment. About 84% of causes of blindness was avoidable (preventable and treatable); The major avoidable causes included Cataract, glaucoma, aphakia, corneal opacity, trachoma, refractive error, onchocerciasis, and diabetic retinopathy. The prevalence of blindness due to glaucoma is higher in Nigeria at 16.7% compared with 8% globally; this emphasizes the fact that the burden of blindness from glaucoma in Nigeria is high which makes glaucoma a major public health problem. The international community intends to fight avoidable blindness through
- Disease Control and Prevention
- Training of personnel
- Strengthening of the existing eye care infrastructure
- Use of appropriate and affordable technology and resource mobilization
- Vision 2020 has yielded positiveresults since it was launched in 1999 as evidenced by a reduction in the incidence of Trachoma, Onchocerciasis and eye complications of Vitamin A deficiency. Nigeria belongs to the group with one to less than 4 (1:3.99) ophthalmologists per million populations This poor ratio is compounded by the fact that most of these ophthalmologists (80%) live in urban areas leaving the rural areas underserved. In Nigeria, about 70% of the population lives in rural areas.
TREATMENT OF CATARACT-The only known treatment for cataract is surgical removal. With advances in technology, cataract surgery can now be performed in about half an hour or less with the insertion of an intraocular lens which restores the eye to almost near normal vision. It is possible to do it as a day case without hospitalization. Sometimes, the procedure is sutureless resulting in rapid visual rehabilitation. This was not the case about three decades ago prior to the advent of microsurgery with intraocular lens implant in Nigeria. In the last decade a more modern form of cataract surgery known as phacoemulsification has also become available in Nigeria. The surgery is very quick, requires a very small incision and an ultrasonic device is used to break up the cataract and the fragments are then aspirated out of the eye. This is then followed by the insertion of a foldable intraocular lens. In our study on eye care outreach program to rural communities in Edo and Delta states of Nigeria carried out during a one-week period in September 2001, 104 patients were operated upon for various eye diseases, the commonest being cataract– 78 patients. This surgical output in one week was what most teaching hospitals in the country were able to achieve in six months Due to high cost of cataract surgery nationwide, some patients, especially in the rural areas and also in the Cities resort to the traditional method of treatment referred to as—COUCHING, She defines Glaucoma as an optic neuropathy in which raised intraocular pressure is a significant risk factor usually associated with characteristic visual field defects. It is the leading cause of irreversible blindness worldwide, Globally, there were 60.5 millionpeople with glaucoma in 2010 and this will increase to 79.6 million by 2020 out of which 11.2 million will be bilaterally blind. There are different types of glaucoma, but in Nigeria, the commonest adult type is Primary open angle glaucoma; the acute closed angle type is more common in Caucasians. In Sub-Saharan Africa, glaucoma presents at a much younger age, and at a later stage, progresses more rapidly so there is increasing lifetime risk of blindness By the WHO definition of blindness, many people that move around unaided with visual field of fewer than 10 degrees from fixation are actually blind and such people have tunnel vision. Note that by WHO definition, blindness is assessed by both the Snellen reading chart and visual fields ie the ability to see all around you. Efforts should be made to deploy eye medical doctors, ophthalmic nurses, and optometrists to work in the rural areas where we have the highest prevalence of needless blindness. They need to be encouraged to do so by granting them suitable incentives as part of their conditions of service. This will address the maldistribution of personnel. Universal Eye Health Care i.e. affordable, accessible and available eye health care for all should be practiced by all stakeholders rendering eye care services. Ministries of Health shouldestablish primary eye care units in all the primary health care centers in Nigeria. This will help reduce the practice of using destructive traditional eye medications and patronage of quacks. Quality Education, Economic empowerment, and poverty alleviation will no doubt also help in curbing the menace of needless blindness. Antenatal care for all pregnant women so that potentially blinding problems can be detected and treated early enough. DVC (administration) prof. J Ehirobo who represented The vice chancellor appreciated the lecturer for the research work and a well-delivered lecture. He thereafter decorated Prof. (Mrs.) Adesuwa Itohan Osahon with a medal to usher her into the honor roll of the University of Benin Inaugural Lecturer’s
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