Onwubiko S N, Udeh N N, Nkwegu O, Ukwu D O, Nwachukwu N Z
Department of Ophthalmology, University of Nigeria Teaching Hospital, PMB 01129, Ituku-Ozalla, Enugu, Nigeria.
Int Ophthalmol. 2019 Oct;39(10):2385-2390. doi: 10.1007/s10792-019-01078-9. Epub 2019 Feb 1.
To investigate the current practice on glaucoma care with the aim of highlighting its poise to tackle this emerging sight-threatening disease in Nigeria.
This was a cross-sectional, descriptive, population-based survey involving 88 ophthalmologists. Information on their demographic characteristics, practice profile, challenges and prospects on glaucoma care was collected using a semi-structured, self-administered questionnaire in August 2016. Data were analysed using SPSS 20.
The participants are comprised of 46 (52.3%) males and 42 (47.7%) females, with a mean age of 42.2 ± 8.7 SD years. They were 45 (51.1%) consultants, 31 (35.2%) residents and 12 (13.6%) diplomates. Their years of practice were 8.8 ± 6.7 SD years. They worked mainly in government hospitals located at the southern part of Nigeria. The current practice was mainly comprehensive ophthalmology, 63 (71.6%). Only 2 (2.3%) had strict subspecialty practice. Others, 23 (26.1%), had combined practice. Eleven (12.5%) were glaucoma specialists and had combined practice. The majority of the participants, 57 (64.8%), were routinely diagnosed glaucoma properly. Sixty-three (71.6%) participants underwent trabeculectomy, 48 (54.5%) combined cataract surgery with trabeculectomy, 7 (8.0%) drainage implants, 5 (5.7%) laser trabeculoplasty, and 2 (2.3%) minimally invasive glaucoma surgery. Poor patients' acceptance and satisfaction, fear of complications, lengthy post-operative care and cost were the main deterrents to surgeries. Advocacy, public awareness, training of glaucoma specialists, provision of equipment and health insurance were the major recommendations on improving glaucoma care.
Given the meagre number of specialists and lack of strict subspecialty practice, optimal glaucoma care in Nigeria is still far from reality.
调查青光眼护理的当前实践情况，以突出其应对尼日利亚这种新出现的致盲性疾病的态势。
这是一项基于人群的横断面描述性调查，涉及88名眼科医生。2016年8月，使用半结构化自填式问卷收集了他们的人口统计学特征、执业概况、青光眼护理的挑战和前景等信息。数据采用SPSS 20进行分析。
参与者包括46名（52.3%）男性和42名（47.7%）女性，平均年龄为42.2±8.7标准差岁。他们中有45名（51.1%）顾问医生、31名（35.2%）住院医生和12名（13.6%）专科文凭持有者。他们的执业年限为8.8±6.7标准差年。他们主要在尼日利亚南部的政府医院工作。当前的实践主要是综合眼科，有63名（71.6%）。只有2名（2.3%）有严格的亚专科实践。其他23名（26.1%）有综合实践。11名（12.5%）是青光眼专科医生且有综合实践。大多数参与者，57名（64.8%），能正确常规诊断青光眼。63名（71.6%）参与者进行了小梁切除术，48名（54.5%）将白内障手术与小梁切除术联合进行，7名（8.0%）进行了引流植入物手术，5名（5.7%）进行了激光小梁成形术，2名（2.3%）进行了微创青光眼手术。患者接受度和满意度低、对并发症的恐惧、术后护理时间长和费用是手术的主要阻碍因素。宣传、公众意识、青光眼专科医生培训、设备提供和医疗保险是改善青光眼护理的主要建议。
鉴于专科医生数量稀少且缺乏严格的亚专科实践，尼日利亚的最佳青光眼护理仍远未实现。
