Causes and incidence of destructive eye procedures in north-eastern ghana

To determine the causes and incidence of destructive ophthalmic procedures as seen at a major reference eye centre in northern Ghana

Retrospective case series involving a review of surgical records of all evisceration and enucleation procedures done between January 2002 and December 2006 at the Bawku Hospital Eye Department. Information collected included basic demographic data, diagnosis, visual acuity at diagnosis and the eye affected. The aetiology responsible was determined from history, clinical examination and investigations as contained in the existing records. The primary clinical indications for evisceration were categorized into degenerative lesions, infections, trauma, neoplasms, and others. Statistical analysis was done using the Epi Info software.

A total of 337 eyes of 336 patients made up of 217 (64.6%) males and 119 (35.4%) females were removed during the study period. Mean age was 36.4 with a range of 1-90 years. Children under 15 years constituted 25.1% of whom 9.3% were under 5 years. The elderly (>/=60 years) comprised 26.3%. The most common cause of destructive procedure was endophthalmitis /panophthalmitis (47.9%), ocular injuries (23.2%), degenerative lesions (8.9%) and neoplasms (5.1%). Regarding neoplasms, females were more likely to be enucleated while the reverse was so for traumas (p=0.04 and p=0.02, Chi(2) test, respectively). Compared to the total number of surgeries done each year the crude incidence was computed at 26.6% per 1000 cases per year.

Most causes of destructive procedures in this part of Ghana are preventable and serious preventive strategies are needed to reverse this trend.