Dr. A. O. Adeoye
Department of Surgery
Dr. A. O. Adeoye’s Articles
1. Adeoye, A. Survey of blindness in rural communities of South-western Nigeria. Tropical Medicine and International Health. 1996; 1 (5): 672-676.
A population based survey of rural communities in the Akinlalu-Ashipa ward of Ife North Local Government in Osun State, Nigeria, was conducted to determine the prevalence and causes of blindness. 2921 inhabitants were screened by a random cluster sample technique, out of which 27 were blind in both eyes. The overall prevalence rate of blindness (best corrected visual acuity less than 3/60 in the better eye) was found to be 0.9% (95% confidence interval 0.84-0.96%). The rate of blindness increased with age, especially from age 60. The major causes of blindness were cataract and its sequelae (48.1%), onchocerciasis (14.8%), primary open angle type glaucoma (11.1%), corneal scar/phthisis bulbi (7.4%) and optic atrophy (7.4%). About half of the blindness is potentially curable through cataract surgery, and a third preventable through health education, early diagnosis and prompt treatment.
2. Ojofeitimi, E.O., Adelekan, D.A., Adeoye, A., Ogungbe, T.G., Imoru, A.O., Oduah, E.C. Dietary and lifestyle patterns in the aetiology of cataracts in
Nutrition and Health J. 1999;3:61-68.
The objective of the study was to assess the dietary and lifestyle habits of patients with cataracts. A food frequency questionnaire was used to collect information on the consumption of a wide variety of food items especially fruits, vegetables and animal and dairy products. A structured questionnaire was used to collect information on smoking and alcohol consumption habits. The study was conducted on 62 subjects made up of 31 patients with cataracts attending the Ophthalmology clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria and 31 control subjects without cataracts. There were 20 males and 11 females in each group.
The study showed that higher percentages of controls than patients had adequate intakes of fruits and vegetables. Vitamin supplement usage was also higher in controls than patients. There was a strong negative association between past history of smoking, alcohol consumption and cataract. We could not demonstrate a relationship between body mass index (BMI) and cataract in the present study.
3. Adeoye, A.O., Olateju, S.O., Soetan, E.O. Communal conflict-related ocular trauma.
Nigerian Journal of Clinical Practice. 2002;5(1):1-4.
Purpose: To determine the cause, morbidity and visual outcome of ocular injuries sustained during the Ife/Modakeke communal conflict which occurred between August 1997 and December 1998.
Method: We conducted a retrospective study of all patients with eye injuries resulting from the conflict, treated at Obafemi Awolowo University Teaching, Hospital, Ile-Ife and 2 private eye clinics in Ile-Ife and Modakeke.
Results: Fifty-five eyes of 54 patients were injured. The mean age was 32 years with a male preponderance of 96.3%. Forty-two eyes (76.4%) were injured by gunfire through direct impact, backfire or stray bullet. Thirty-one eyes (56.4%) sustained closed-globe injuries while 24 (43.6%) had open-globe injuries. Thirty-five eyes (63.6%) were blind, out of which 9 eyes (16.4%) required primary enucleation.
Conclusion: Civilian conflict with the use of firearms is associated with severe ocular morbidity. Maintenance of peace is essential.
4. Ajaiyeoba, A.I., Isawumi, M.A., Adeoye, A.O., Oluleye, T.S. Prevalenceand causes of blindness and visual impairment among school children in south-western Nigeria.
International Ophthalmology. 2005;26:121-125.
The aim of the study was to assess the prevalence and identify the causes of blindness and visual impairment in school children of Ilesa-East Local Government Area of Osun State, Nigeria. A total of 1144 school children in primary and secondary schools were selected using a 2-stage random sampling method and examined to determine the prevalence and causes of blindness and visual impairment. A total of 17 (1.48%) children were blind or visually impaired. These comprised 11 (0.96%) children who were visually impaired and 4 (0.3%) who were severely visually impaired. Only 2 (0.15%) school children were blind. The causes of visual impairment were refractive error 10 (0.87%) and immature cataract 1 (0.08%), causes of severe visual impairment included corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and 1 cataract 1 (0.08%). The causes of blindness in school children were corneal scars presumed to be due to vitamin A deficiency 1 (0.08%) and keratoconus 1 (0.08%). Causes of blindness and visual impairment in children attending regular schools in Nigeria were treatable. Prevention, early recognition and prompt treatment of these diseases by regular screening of school children would definitely reduce unnecessary visual handicap in Nigerian school children so that they can attain their full potential in the course of their education. Also, information from this study is relevant for the purpose of planning eye care programmes for the prevention of blindness in Nigerian school children. This will go a long way in the prevention of unnecessary blindness and visual impairment in school children.
5. Adeoye, A.O., Durosinmi, M.A., Adeodu, O.O., Kagu, M.B., Olateju, S.O.,Olowu, W.A., Salawu, I.L., Kazeem, O.D. Ocular manifestation of
Burkitt’s lymphoma: experience in Ile-Ife, south western Nigeria.
West African J Med. 2007;26(1): 48-52.
Background: Burkitt’s lymphoma is the most common childhood tumour in subSaharan Africa that typically affects the jaws and abdomen. Ocular involvement with blindness has been documented in some studies.
Objective: This was to evaluate the role of Burkitt’s lymphoma (BL) as a cause of blindness in Nigerian children.
Methods: Cases of BL seen in the hospital between 1986 and 2003 were studied retrospectively. Some of the patients with orbital disease at presentation underwent ultrasonographic examination of the eyes.
Results: Forty-three (16.5%) of the 260 patients seen presented with orbital tumours; 29 (67.4 %) of the 43 patients had full ophthalmic examination. The patients studied comprised 22 males and 7 females with a M: F ratio of 3:1, and median(age range) of 7(3-15) years. Orbital tumours occurred concurrently with jaw masses on the same side in 19(65.5 %) of 29 patients; the eye diseases were unilateral in 23 (79.3%) and bilateral in six (20.7%) of the cases. Proptosis was the ocular presentation in 27(93%) of patients and it was associated with conjunctival injection in nine, chemosis in 11 and exposure keratopathy in five. Fourteen (48.3%) patients had associated blindness; 12 (85.7%) remained blind in the affected eye(s) and one regained vision to 6/36 after chemotherapy. The patients underwent Cyclophosphamide-Oncovin-Methotrexate (COM) regimen with intrathecal therapy. Eight (27.6%) patients had concomitant CNS disease; these included cases of 6th and 7th nerve palsies, one case of intra-cerebral extension of tumour and another case of total ophthalmoplegia.
Conclusion: Burkitt’s lymphoma is an important cause of childhood blindness in Nigeria and the orbital disease ismainly extra ocular.
6. Oladehinde, M.K., Adeoye, A.O., Adegbehingbe, B.O., Onakoya, A.O. Visual functions of commercial drivers in relation to road accidents in Nigeria.
Indian J. Occupational & Environmental Medicine 2007;11: 71-75.
Objective: To determine the effects of the visual functions on the occurrence of road traffic accidents (RTA) amongst commercial drivers in Ife central local government area (LGA) of Osun state of Nigeria. Design: A cross-sectional study. Settings: Four major motor parks located at Ife Central LGA. Materials and Methods: Of the estimated 270 commercial drivers in the four major parks of the LGA, 215 consecutive drivers were interviewed and had their eyes examined. Structured questionnaires were administered by an ophthalmologist. Results: The prevalence of visual impairment (visual acuity < 6/18) in the better eye without correction was 3.3% ± 2.4 and there was a significant association between uncorrected visual acuity impairment in the better eye and RTA (P = 0.0152). Refractive error was seen in 8.4% of the drivers, but none of these wear corrective glasses. Visual field defect, abnormal stereopsis and color vision impairment did not have any significant association with RTA. Conclusion: Poor visual acuity is strongly associated with RTA amongst Nigerian commercial drivers as opposed to visual field defect, abnormal color vision and stereopsis. A significant proportion of visual impairment was due to uncorrected refractive errors.
7. Adeoye, A.O., Onakpoya, O.H. Indication for eye removal in Ile-Ife. Afr J Med & Med Sci. 2007;36(4):371-375.
The indication for surgical eye removal reflects the pattern of severe ocular diseases in a given community and gives insight into the causes of uniocular blindness. It is an unfortunate end to certain ocular morbidities. In instances where the fellow eye is already blind, it then becomes even more grievous. The aim of the study is to find out the reasons for surgical eye removal in Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife. Nigeria. Retrospective analytic study of records of all patients who had their eyes removed in the Ophthalmic theatre of OAUTHC Ile-Ife from January 1994 – December 2003 were reviewed without prejudice to method of such removal. A total of 94 eyes were removed during this 10 year period, out of which 92 records were available for inclusion in this study. 30.4% of the patients were below 10 years of age. The male to female ratio was 2.1:1. All cases of eye removal were uniocular. Trauma was the leading cause of eye removal (43.4%) while orbito-ocular tumour was next (30.4%). Tumour was the leading cause of eye removal in the paediatric age group (87.2%) with Retinoblastoma being the commonest indication. Six out of the 92 (6.5%) patients studied unfortunately were already blind in the second eye; in this group of individuals the reason for eye removal was preventable in 83.3%. Most of the indications for eye removal were avoidable. Eye health education is needful for the general populace and particularly for individuals with an ‘only’ eye
8. Ashaye, A.O., Adeoye, A.O. Characteristics of patients who drop out from a glaucoma clinic. Journal of Glaucoma. 2008;17(3): 227-232.
Purpose: To find the dropout rate and identify the clinical characteristics of patients who drop out in the first year of follow-up from a glaucoma clinic. Design: Descriptive hospital-based study at a tertiary hospital eye department.Methods: Clinical characteristics of consecutive patients newly diagnosed with glaucoma who dropped out (n=452) were compared with patients who did not drop out (n=295) within 12 months. Results: The rate of dropout from follow-up was 60.5% within 1 year; 43.1% of the study group dropped out after their first follow-up visit. The dropout rate was high in all age groups, but higher in the age groups 21 to 30 years, 41 to 50 years, and over 70 years. Males had a higher dropout rate than females (78.6% vs. 34.5%). Dropout rate was higher among those with mild/moderate glaucoma than those with severe disease (88.2% vs. 37.2%); those who lived further away from the hospital than those who lived nearer to the hospital (72.5% vs. 40.8%), those who were referred from screening clinics for nonblinding eye disease compared with those referred because of a blinding eye disease (72.2% vs. 58.9%). More patients (63.8%) unsure of their family eye disease history dropped out, compared with 34.3% of those with positive family history of glaucoma and other potentially blinding diseases. More patients who had no systemic disease dropped out, than those with systemic disease (54.6% vs. 39.6%); whereas patients on 2 medications or more had a higher dropout rate than those on less than 2 medications (68.1% vs. 52.1%). Of the study factors, those that were statistically significantly associated with dropping out of follow-up from the glaucoma clinic were age, sex, place of domicile, diagnosis at referral, severity of disease, family history, and polydrug use. Conclusions: The dropout rate from this glaucoma clinic in the first year was high (60.5%). Patients who were more likely to dropout were younger patients, male, those who travelled far distances to the clinic, those with mild to moderate glaucoma, those with no family history of blinding eye diseases, and patients taking 2 or more eyedrops. Patients who seem to perceive their problems as not serious dropped out of follow-up. These findings have great implications in planning future studies and intervention to improve the follow-up of glaucoma patients in the study area.
9. Onakpoya, O.H., Adeoye, A.O., Akinpelu, V.A. Cost-related antibiotic
dosage omissions – Challenges for orbital cellulitis management in resource poor
communities. Orbit.2009; 28: 147-152.
Background: Orbital cellulitis is a medical emergency with potential vision and life threatening complications. Aim: To highlight clinical presentation and challenges in the management of orbital cellulitis in resource poor communities of southwestern Nigeria. Method: Retrospective review of patients managed for orbital cellulitis at the Wesley Guild Hospital, Ilesa, Nigeria for biodata, socioeconomic status, clinical presentation, compliance to prescribed medications and treatment outcome. Data was analyzed using SPSS version 11. Result: Seventeen patients with mean age and standard deviation of 10 +/- 9.9 years were managed for orbital cellulitis. Thirteen (76.5%) females and 4(23.5%) males giving a male to female ratio of 1:3.3 (p = 0.03). Most patients (94.1%) belonged to low socioeconomic status and sinusitis was the most common predisposing factor. 10 (58.8%) had intravenous antibiotics only while 7(41.2%) had surgical drainage of abscess in addition. Delayed and irregular administration of antibiotics was observed in 9 (52.9%) patients due to lack of funds thus necessitating change of choice in antibiotics. Complication include ptosis 3(17.6%), corneal opacity 2 (11.8%), optic atrophy 1(5.9%) and 1(5.9%) meningitis and death 1(5.9%). Conclusion: Cost and affordability should be major determinants of choice of empirical antibiotics in resource poor communities to ensure timely and regular treatment and improve prognosis in management of orbital cellulitis.
10. Onakpoya, O.H., Adeoye, A.O., Kolawole, B.A. Determinants of dilated eye examination among Type 2 diabetics in southwestern Nigeria. Eur J Int Med 2010; 21: 176-179.
Purpose: To assess the prevalence and factors influencing previous dilated eye examination in screening for retinopathy among type II diabetics. Methodology: Cross-sectional study of type II diabetic patients receiving treatment at a tertiary hospital in southwestern Nigeria was conducted with information on gender, age, duration of diabetes, current medication and previous dilated eye examination recorded. Eye examination included visual acuity, pen torch examination, applanation tonometry and direct ophthalmoscopy of the dilated eye in a dark room. Visual acuity was presented as classified by WHO while data was analyzed using SPSS version 11 and statistical significance inferred at P<0.05. Results: Eighty three type II diabetics with mean age 57.5+/-10.8 years and mean duration of diabetes of 6.6 years were studied. Visual impairment (<6/18 in the better eye) and blindness (<3/60 in the better eye) were recorded in 3.6% and 12% of the patients respectively while diabetic retinopathy was present in 21.6%. Only 24 [28.9%] diabetics had previous dilated eye examination; absence of eye symptoms [50.8%] and lack of referral [45.8%] were the main barriers to having previous dilated eye examination. Previous dilated eye examination was significantly influenced by the presence of visual impairment/blindness [P=0.002], longer duration diabetes mellitus [P=0.006], current insulin treatment [P=0.040] and presence of non-diabetic vision threatening eye diseases [P=0.016]. Conclusion: Dilated eye examination rate is low; inadequate knowledge about diabetic retinopathy as well as low referral rates is contributory. Massive health education on diabetic retinopathy as well as development of sustainable retinopathy screening protocol would be helpful.
11. Adeoye, A.O., Ashaye, A.O., Onakpoya, O.H.Perception and attitude of people towards Onchocerciasis in southwestern Nigeria.
Middle East African J Ophthalmol 2010; 17(4): 310-314.
Background: Onchocerciasis (river blindness) is a major cause of bilateral blindness with devastating socioeconomic consequences. Since Nigeria is the most heavily onchocerciasis endemic country in the world, the information on people’s knowledge about this disease is significant. This could influence their response to current preventive measures of the African Programme for Onchocerciasis Control. Aim: This study was designed to estimate the level of knowledge and attitudes of rural/semi-urban communities in Ife North Local Government Area of Osun State toward onchocerciasis. Materials and Methods: Cluster random sampling was used to select 500 adults for the study. Semi-structured questionnaires were administered to subjects. Data on knowledge of the local name, cause, mode of transmission, manifestation, severity, treatment, and prevention of onchocerciasis were collected and analysed. Statistical analysis included frequency distribution of the responses and a Chi-square test for comparison of variables with the P value for statistical significance set at 0.05. Results: Onchocerciasis was well known by its local name among 458 (91.6%) of the respondents. Only seven (1.4%) knew that it affects both the eyes and skin. The cause was commonly attributed to impure blood by 114 (22.8%), whereas transmission was thought to be through fomites by 161 (32.2%). Only 12 (2.4%) respondents attributed the disease to blackfly bites. The level of education and the association of onchocerciasis with a river were significantly associated (P = 0.001). Subcutaneous nodules were felt to contain water (85.4%), baby worms (3.2%), and fat (0.6%). There was a negative attitude toward sufferers of the disease. Conclusion: Adequate information transfer in simple local dialect by trained personnel to the communities at risk of onchocerciasis is essential for better uptake of all aspects of the onchocerciasis control programme.