Nigeria builds on 2007 eye survey to plan eye care in 2021

ELIMINATION of blindness in Nigeria could be a mirage if Nigeria continues to build on its National Blindness and Visual Impairment Survey, conducted 14 years ago, in 2007, to plan eye care services in 2021 despite the country’s population increasing by more than 66 million.

Worldometer elaboration of United Nations data estimates the population of Nigeria in 2007 and 2021 at 146.3 million and 212.7 million respectively.

From 2005 to 2007, the “National Blindness and Visual Impairment Survey” was conducted to measure sight in Nigeria.

This first survey, intended to calculate the vision data of people over 40 in the country, estimated that about 0.78% of Nigerians are blind and that more than 80% of this blindness is preventable.

Among people aged 40 and over, the prevalence of blindness is 4.2%; and many people’s vision could be improved with glasses.

Furthermore, he calculated that approximately 1.13 million people aged 40 are currently blind; while 4.25 million adults are visually impaired or blind, 2.7 million moderately visually impaired and another 400,000 severely visually impaired adults.

In addition, blindness is associated with increasing age, more than doubling that in people aged 60 and over.

The number of blind people varies across the six geopolitical zones (GPZs), with the northwest having the highest proportion at 29% due to high prevalence and large population.

Refractive errors, cataracts and glaucoma are the main preventable causes of vision loss.

The main causes of childhood blindness are cataracts, congenital glaucoma, harmful eye medications (traditional and non-traditional), and the interaction between measles and vitamin A deficiency.

Nigerian Minister of Health, Dr Osagie Ehanire, during the commemoration of World Sight Day 2021, putting the prevalence of blindness in Nigeria at 0.78%, said the government plans to make eye care more accessible to the majority of Nigerians to reduce the burden. of blindness.

Ehanire, in a remark through the Permanent Secretary of the Ministry of Health, Mr. Mamuda Mamman, said, “Fortunately, the Ministry has made this a priority through measures to integrate primary eye care into the primary health care, thereby increasing accessibility to eye care. and encourage preventive eye health, especially in rural areas served by the PHC.

The group’s medical director, Eleta Eye Institute, Dr. Gboyega Ajayi, said that without international agencies funding the survey, Nigeria may not have data on the prevalence of blindness and visual impairment and the country is waiting. already another survey to support the eye care service. Planning.

“I am particularly worried about glaucoma. Unlike educated people, while many educated people, businessmen and professionals can see and are able to do their job, they don’t take the time to check their eye until they are almost blind.

In a study of 1881 patients screened at 24 health centers in southwestern Nigeria, of whom 120 glaucoma cases/suspects were identified, 56 (46.7%) of glaucoma patients were aware of glaucoma and only 39 (32.5%) patients could correctly answer at least one knowledge question.

Additionally, the study indicated that health workers surveyed cited cost and lack of knowledge as the main reasons why glaucoma patients frequently attended free screening events rather than seeking definitive care.

Dr Ajayi said the future for eye care services in Nigeria is bleak as it is very expensive to be blind in Nigeria and there are few doctors interested in training to become eye specialists in Nigeria. Nigeria.

“What they have lost in terms of not being able to go to work and the cost of an attendant to accompany them to the clinic for care, who would also be unemployed at the time, is sometimes much more than the cost of eye care service access.

“The situation is getting worse because we don’t even have enough doctors to train in ophthalmology. For example, at the Eleta complex, we needed 10 new doctors to train in ophthalmology and we only had two.

“Some of those we have trained have moved on to greener pastures and that means the ophthalmology training program in Nigeria could collapse very soon as we have no new people to train. It’s bleak for medical care in general, but especially for eye care. If others need three people and they have one, they can cope, but that’s not the case with ophthalmology,” he said.

While people often equate the brain drain in medical care with money, Dr Ajayi said its cause goes deeper than money.

According to him, brain drain problems in ophthalmology are linked to unduly long duration of training, poor reward system in the workplace and poor facilities in hospitals.

Professor Folasade Akinsola, Consultant in Ophthalmology at the University Teaching Hospital, Lagos (LUTH), remarked at the 21st Annual Faculty Conference of the National Postgraduate Medical College of Nigeria, Faculty of Ophthalmology in Lagos, that the burden of Visual impairment and avoidable blindness is heaviest on low and middle income countries like Nigeria and especially rural communities as well as the elderly.

According to her, the country should not have a prevalence of blindness, just as she called for more work on public education, government involvement and the training of specialists.

Ms Abosede Akinola, a nurse at the Ibadan Eye Health Centre, however, said the response to eye awareness services in the community is low as people are often skeptical of the facilities free eye awareness would provide.

According to her, “some of them know that they have vision problems, but they will want to go to their place of work before coming. They only start to happen when someone has probably left the place of awareness with free glasses or medicine. When you expect around 160 people to come from a community, you might only see 60.”

Dr Friday Oke, an optometrist, said Nigeria was barely doing enough for people with eye problems, adding: “Nigeria has less than 10,000 people to cater for its population of over 200 million. It is totally inadequate even if we ask people to have their eyes checked once a year. »

Former President of the Society of Ophthalmologists of Nigeria, Dr. Bade Ogundipe said that as individuals age, the chances of experiencing vision problems increase due to the increased possibility that they have developed diseases such as diabetes, cataracts and macular degeneration which affect sight as well as physiological changes. in the eyes.

He said: “If an individual, for example, was nearsighted as a child, he cannot use reading glasses when others use glasses. But the general rule is that there may come a time in life when you may need glasses.

“When it is physiological, you will only need to wear glasses to read. It is not a disease in itself while the others can be considered as diseases.

Additionally, Dr Ogundipe said whether a person wears glasses will also depend on the individual’s occupation, adding that a farmer may not see the need for glasses, but a teacher who reads often will ask. definitely help early.

While some people do not seek eye care early because they are careless with their eyes, he said others cannot afford the cost of eye care and some, due to myths and misconceptions wrong about glasses and surgery, would refrain from going to the hospital.

According to him, “some will say there is no need to go to the hospital, they will only give glasses. But there are some who will need eye surgery. There are different types of surgery. For example, after a cataract operation, you will see well. Glaucoma surgery is also simple, but it will not improve vision but will help reduce pressure in the eye.

“But people will say don’t let them operate on you, when they operated on me I couldn’t see any better even though they had glaucoma. Thus, many negative reports affect people’s willingness to seek help when they have eye problems.

However, Dr Ogundipe urged Nigerians to love their eyes, get regular eye checks and not wait to notice any signs or symptoms.

He said that by the time there is a loss of vision in some cases the individual is almost blind.

“Cataract can increase the inability to see, but always go to the hospital. You don’t wait until there is a catastrophe. If, for example, it is due to glaucoma at the time there is loss vision, at least 70% of the optic nerves would have been damaged and this is irreversible. So, it is better to be proactive; get your eyes checked regularly before you notice any symptoms,” he warned.

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