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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.

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