Ten-year rural experience of surgical eye removal in a primary care center south-eastern Nigeria

Introduction: Surgical removal of the eye usually reflects the pattern of severe ocular diseases and the level of development and socio-cultural dynamics in each specific setting. In Nigeria there have been several reports of causes of surgical eye removal in urban tertiary eye-care centers. This study determined the pattern of surgical eye removal in a rural primary eye-care facility (hospital) in South-eastern Nigeria. Methods: A retrospective chart review was performed for all patients who had surgical removal of the eye between January 2002 and January 2012 at the eye unit of the Presbyterian Joint Hospital, Ohaozara, Ebonyi State, South-eastern Nigeria. Data collected included age, sex, diagnosis and the eye affected. The diagnosis was further categorized into degenerative lesions, infections, trauma and neoplasm. The statistical package for social sciences was used for data analysis. Results: Two hundred and twenty-six eyes from 226 patients were surgically removed within the study period from 52.2% (n=118) males and 47.8% (n=108) females (ratio: 1.1:1; p=0.5). The mean age of the cohort was 47.6 +/- 20.2 years (range 2-82). Children aged 0-10 years were 8.4% while those over 60 years comprised 23.4% of the study population. The three most common causes of surgical removal of the eye were severe eye infections 60.6% (n=137), degenerative eye diseases (staphyloma) 13.3% (n=30) and severe eye injury 11.5% (n=2 6). Retinoblastoma 6.2% (n=14) was the commonest tumour type seen. Conclusion: The most common cause of surgical eye removal was severe ocular infections followed by degenerative eye diseases. More males than females had their eyes surgically removed. Over half of those who had their eyes removed were aged 51 to over 60 years. The commonest cause of eye removal among children was retinoblastoma. These causes are largely preventable and avoidable. With intensive eye health education and the provision of adequate eye-care facilities this trend can be reversed.