Destructive ophthalmic surgical procedures in Onitsha, Nigeria

to determine the incidence, trend and causes for surgical removal of the eyeball at the Guinness Eye Center Onitsha, Nigeria.

Case files and theatre records of all patients who had eviscreration, enucleation or exenteration at the Guinness Eye Center Onitsha between 1995 and 2001 were reviewed. Information on age, sex, disease duration before hospital presentation, indication for surgery and the type of surgery were analysed.

56 eyes of 56 patients were surgically removed. Patients including some with penetrating eye injuries presented late for treatment; 37.5% and 53.5% had used traditional eye medicines (TEM) and eye drops possibly containing steroids, respectively, prior to hospital consultation. The indications for surgery were severe ocular infections, especially panophthalmitis; severe penetrating eye injuries and orbito-ocular tumours. The annual incidence ranged from 1.9 - 4.2% with an average of 3.4% . The downward trend observed in the later part of the study was associated with reduced incidence of ocular gunshot injuries, which in turn coincided with a reduction in violent crime in Onitsha and its environs.

In spite of the observed downward trend in the rate of destructive eye surgery, the incidence of such procedures could be reduced further by timely intervention with modern microsurgical techniques; intraocular antibiotics and radiotherapy. The public should be educated on the harmful effects of TEM and abuse of eye drops. Those with eye problems should seek early hospital treatment.