BusinessDay 04 Mar 2018
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Sunday <strong>04</strong> <strong>Mar</strong>ch <strong>2018</strong><br />
Interview<br />
C002D5556<br />
25<br />
‘Glaucoma is the commonest cause<br />
of irreversible blindness in Nigeria’<br />
Adeola Onakoya is a Consultant Ophthalmologist, at the Lagos University Teaching Hosiptal LUTH. She is also the Head of Department, Guinness Eye<br />
Centre at LUTH Idi-Araba. She is involved in clinical work – running general clinics as well as glaucoma specialist clinics at the Guinness Eye Centre in<br />
her capacity as a consultant ophthalmologist. Onakoya is a member of Ophthalmological Society of Nigeria and International Council of Ophthalmology<br />
(ICO) and the Chairman of the Glaucoma Society of Nigeria. In this interview with BDSUNDAY, she bares her mind on Nigeria’s healthcare sector, especially<br />
eye care services and diseases like glaucoma, and how the Guinness Eye Clinic is leading the charge against preventable blindness.<br />
Can you tell us about your role<br />
within the Guinness Eye Hospital<br />
and other responsibilities<br />
you handle within LUTH?<br />
As the head of department,<br />
I oversee the<br />
general running of<br />
the centre, take responsibility<br />
as the<br />
leader and accountable to the<br />
management of the Lagos University<br />
Teaching Hospital. My<br />
primary responsibility and assignment<br />
are to render quality<br />
eye care to patients accessing<br />
care at the centre. I also train<br />
and mentor resident doctors,<br />
medical students and nurses in<br />
comprehensive ophthalmology.<br />
Research is another vital part<br />
of my responsibility, to contribute<br />
to the body of knowledge.<br />
Outside of the Guinness Eye<br />
Centre (GEC), as a professor<br />
in the university, I serve in various<br />
committees towards the<br />
advancement of medical knowledge<br />
and smooth running of the<br />
institution. Beyond the confines<br />
of the hospital, I am the current<br />
chairman of the Faculty of<br />
Ophthalmology of the National<br />
Postgraduate Medical College<br />
of Nigeria, a body responsible<br />
for the regulation as well as the<br />
training and certification of specialist<br />
doctors in Nigeria.<br />
Businesses have a long history<br />
of providing support via building<br />
of infrastructure, massoriented<br />
initiatives and funding<br />
of research works, to the<br />
healthcare sector. A case in<br />
point is Guinness Nigeria Plc’s<br />
funding of eye clinics across<br />
the country, dating back to the<br />
1960s, including the Guinness<br />
Eye Hospital in LUTH that you<br />
oversee. Can you briefly tell us<br />
GN’s level of involvement in<br />
this hospital?<br />
Right from inception of the<br />
initiative of GN PLC to provide<br />
the infrastructure, the organisation<br />
has been very supportive<br />
in ensuring that GEC renders<br />
quality eye care services to<br />
people of Lagos and others from<br />
neighbouring states. This was<br />
achieved through the award of<br />
regular subvention in support<br />
of ophthalmic equipment purchase,<br />
infrastructure maintenance<br />
and the general running of<br />
GEC .GN Plc, in the last 10 years<br />
has been quite supportive in ensuring<br />
that GEC acquire cutting<br />
edge technology equipment<br />
for ophthalmic care, e.g LASER<br />
machines, slit lamps and other<br />
diagnostic equipment.<br />
Judging by the size of the Guinness<br />
Eye Hospital and the high<br />
patronage level of LUTH,<br />
would you say that the hospital<br />
has enough capable hands,<br />
especially specialised medical<br />
Onakoya<br />
personnel in-house?<br />
Guinness Eye Centre houses the<br />
Department of Ophthalmology<br />
of both the College of Medicine<br />
and Lagos University Teaching<br />
Hospital. In addition other<br />
stakeholders in eye health care,<br />
nurses, optometrists, pharmacist,<br />
medical records officers<br />
and other ancillary staff work<br />
in the centre. These comprise<br />
of eight consultant ophthalmologists<br />
with sub-specialist<br />
in glaucoma, peadiatric ophthalmology,<br />
vitreoretina and<br />
public health ophthalmology.<br />
Currently, there are 24 resident<br />
doctors undergoing specialist<br />
training, 39 ophthalmic trained<br />
nurses, two optometrists, six<br />
medical records officers, four<br />
pharmacists, and 16 ancillary<br />
support staff. In essence, the<br />
Guinness Eye Centre renders<br />
specialist and subspecialist<br />
services in addition to training<br />
of resident doctors, medical<br />
students and nurses. The infrastructures<br />
and the equipment<br />
available allows the GEC Lagos<br />
to render a comprehensive and<br />
subspecialty tertiary eye care<br />
in addition to the conducting of<br />
academic researches thereby<br />
making remarkable contributions<br />
to the existing body of<br />
knowledge in ophthalmology.<br />
The centre also serves as the<br />
examination centre for specialist<br />
in ophthalmology for the<br />
national postgraduate college<br />
of Nigeria, and international<br />
council of ophthalmology examination<br />
for which I serve as<br />
the coordinator in Nigeria.<br />
The eye care field is very wide<br />
though many hardly know<br />
this, which is why many who<br />
visit eye clinics erroneously tell<br />
you they have gone to see their<br />
Right from<br />
inception of the<br />
initiative of GN<br />
PLC to provide<br />
the infrastructure,<br />
the organisation<br />
has been very<br />
supportive in<br />
ensuring that GEC<br />
renders quality<br />
eye care services<br />
to people of Lagos<br />
and others from<br />
neighbouring<br />
states<br />
optician, even when it was an<br />
ophthalmologist or optometrist<br />
they saw. Briefly explain<br />
the differences between these<br />
professionals and the services<br />
you render at Guinness Eye<br />
Hospital.<br />
An ophthalmologist is the head<br />
of the team, a fully trained medical<br />
doctor. They perform complete<br />
and comprehensive eye<br />
evaluation and provide treatment<br />
for all eye diseases, including<br />
those with endogenous<br />
origin, in addition to treating the<br />
associated medical conditions.<br />
He/she performs laser surgery<br />
and conventional eye surgery<br />
and also prescribes medication,<br />
glasses, and contact lenses.<br />
Optometrists perform eye examination,<br />
tests for glasses and<br />
ocular alignment; prescribe and<br />
fits glasses. He teaches eye exercises<br />
and refers patients with<br />
ocular diseases to the ophthalmologists<br />
for appropriate management.<br />
Opticians grind lenses<br />
and make glasses. At GEC, we<br />
render comprehensive eye care<br />
in addition to subspecialist eye<br />
care for glaucoma, paediatric eye<br />
services, vitreoretinal services,<br />
and refraction and low vision<br />
services. Surgical interventions,<br />
either conventional or LASER<br />
surgical services, are available.<br />
The Nigerian healthcare sector<br />
has been under severe strains<br />
in the last decade or more due<br />
to poor funding, lack of fresh<br />
investments, dearth of personnel,<br />
brain drain etc. How<br />
has the Guinness Eye Hospital<br />
coped with these challenges?<br />
The Guinness Eye Centre, over<br />
the years has managed to stay<br />
above board with regards to<br />
brain drain and dearth of personnel.<br />
The facilities and infrastructures<br />
available at the<br />
centre provide an enabling environment<br />
for comprehensive<br />
training that matches international<br />
standard, in addition to<br />
mentoring. These have over<br />
the years equipped the personnel<br />
and given us visibility in the<br />
international community and<br />
linkages formed with reputable<br />
institutions abroad whom we<br />
collaborate with. These collaborations<br />
have helped over<br />
the years to stabilise the training<br />
and human resources at GEC<br />
because of the vast opportunity<br />
and exposure through the international<br />
partners.<br />
What other challenges do you<br />
currently face and how are you<br />
resolving those?<br />
Ophthalmic practice is quite<br />
equipment-intensive and there’s<br />
a continuous demand for equipment<br />
as new and more advanced<br />
technology becomes available.<br />
These are not cheap; this is a major<br />
challenge we face. Through<br />
the support of Guinness Nigeria<br />
Plc, Vision 2020, collaboration<br />
with London School of Hygiene<br />
and Tropical Medicine and LUTH<br />
management, we managed<br />
to purchase some. However,<br />
there’s always a continuous need<br />
to upgrade the equipment to<br />
provide high quality care and<br />
treatment to our patients.<br />
Experts in eye care services<br />
have identified glaucoma as<br />
the leading cause of blindness<br />
in Nigeria. Why, in your<br />
opinion, is the disease so widespread?<br />
Glaucoma is the commonest<br />
cause of irreversible blindness<br />
in Nigeria. About 5.02 percent<br />
of people above 40 years suffer<br />
from Glaucoma, especially the<br />
open angle type. This in absolute<br />
numbers translates to two<br />
million and out of these, only 5<br />
percent are aware of the disease<br />
with about 20 percent blind in<br />
both eyes. Lack of awareness,<br />
poor knowledge about the aggressive<br />
nature of the disease<br />
in black people is also a major<br />
problem. Lack of symptoms at<br />
the early stages of the diseases<br />
lead to late presentation in our<br />
environment where regular eye<br />
examination is not part of our<br />
culture. Research has shown<br />
that 80-90 percent of patients<br />
with Glaucoma in Nigeria seek<br />
medical attention at the late<br />
stages of the disease with loss<br />
of vision in one eye in 40-50<br />
percent of them. In addition,<br />
first degree relatives of sufferers<br />
are also at a higher risk of<br />
the disease because it runs in<br />
families .The widespread nature<br />
in Nigeria is due to the fact that<br />
being black is a major risk factor<br />
coupled with increase in prevalence<br />
as one advances in age.<br />
What other eye defects are<br />
prevalent in Nigeria, from your<br />
experience, and how can they<br />
be prevented or managed?<br />
The other eye defects prevalent<br />
in Nigeria are refractive errors,<br />
cataracts, diabetic retinopathy<br />
and allergic conjunctivitis in<br />
children. For refractive errors,<br />
simple eye test with provision<br />
of spectacles will solve this huge<br />
problem. Cataract surgery with<br />
lens implant will reduce blindness<br />
from cataract being the<br />
commonest cause of blindness<br />
in Nigeria.<br />
At Guinness Eye Hospital, how<br />
do you define success, is it by<br />
the number of eye-related issues<br />
you are able to solve or<br />
the preventive measures you<br />
put in place for early detection<br />
and correction?<br />
Our successes span preventive,<br />
treatable and rehabilitative arms<br />
of care. Health education is given<br />
at the start of business each day<br />
in the clinic by nurses on common<br />
eye conditions and recognitions<br />
of the complications.<br />
Definitive treatments are offered<br />
for established conditions<br />
and the complicated cases are<br />
offered rehabilitative services.<br />
We have heard about the importance<br />
of regular checkups.<br />
In your opinion, how regular<br />
should we do a comprehensive<br />
eye checkup?<br />
For the eyes, it is once in 2 years.<br />
However, for people with family<br />
members who suffer from<br />
glaucoma, it should be done on<br />
a yearly basis. Entire body check<br />
up is advised on a yearly basis.