₦airaland Forum

asamaigho:
howcome u guys turn a blind eye to Jonathan's maladministration and at dsame time expect a sane nigerian to vote for him? what do u guys take nigeria for?

change has come and u beta lick it wounds asap move in d direction of change.

Do you still hold these same views or shall I give you another year to ponder on?

The Boring Stuff
[s]Glaucoma is a group of ocular disorders with a multifactorial etiology, that has a characteristic pattern of retinal cell death often associated with increased eye pressure (Intraocular pressure, IOP).[/s]
From the simplified definition, you should know that increased IOP is not glaucoma, acute increased IOP doesn't cause glaucoma. The glaucoma damage occurs at the optic nerve head. This simply means that glaucoma is not just a simple disease, it has many causes, most times there is increased pressure and it cannot be cured!

If you have increased IOP without a glaucomatous appearance of the optic nerve head, then it is regarded as ocular hypertension.
To diagnose glaucoma, the pressure, the appearance of the nerve head and the visual field findings are relevant. The patient must have at least 2 of these 3 signs. The visual field finding is an important confirmatory test. someone with the nerve head changes but without either of the other two criteria is classed as a glaucoma suspect.

The damage caused is irreversible, the drugs given are to halt or decrease the rate of progression of the disease. The drugs cannot return lost vision. However, the progression is not always observable, an acute condition can cause glaucomatous nerve death and when that condition is resolved, the nerve death would not progress. So I like to describe glaucoma as potentially progressive. So we don't wait to see progression, instead we start treating right away.
Most (or all) classes of glaucoma drugs focus on reducing the pressure , because reduction can attenuate or halt the progression of normal tension and high pressure glaucoma.

Real life Questions

1. I'm taking my glaucoma drugs but my vision is still decreasing. Why?
Explanation
Glaucoma has an average age of onset of late 30s to early 40s. This period is also the age of onset of presbyopia. Secondly the part of vision that it affects is your peripheral vision, the part that you use to see objects on the sides. Therefore glaucoma damage cannot be observed by the patient except in the advanced stage. The patient's complaint is often due to presbyopia or something optoms call hyperopic shift or due to development of cataract. So you must never stop your drugs because you think they are not working or because your vision (esp near) is getting worse.
Another part of vision that may be affected is contrast sensitivity. This is why we see lots of patients that can read up to the bottom line on the charts but complain of always bumping into objects or inability to drive at night. Glaucoma reduces contrast sensitivity. Hence doctors should often check CS for patients with complaints in spite of normal acuity.

2. If drugs cannot return the vision, what about Surgery?
Explanation
Most of the drugs decrease pressure either by reducing production of aqueous or increasing outflow of aqueous humour. Surgery on the other hand puts a hole on the point of outflow to make aqueous leave faster, and pressure lower in turn.

3. The doctor says I have glaucoma and cataract too. That it is somehow..
Explanation
Cataract and glaucoma present a huge challenge for the clinician. First of all he has to ascertain the health of the retina and estimate the potential vision after cataract extraction. secondly the nature of the glaucoma would determine if the cataract can be extracted. Over maturity of the cataract can trigger an acute angle closure attack.

4. What causes glaucoma?
Explanation

#nowplaying God only knows - The beach boys

But seriously , no one knows. we only know some factors associated with it such as Intraocular pressure, elevated nitrogen oxide synthase, monosodium glutamate ( that stuff in indomie seasoning and Maggi cubes), unusual apoptotic activity if the RGC, prior use of steroids etc I assure you that all of the above are boring stuff, very boring! But we know there is a genetic factor...

5. Can I get glaucoma from kissing or sharing sharp objects?
Explanation
Yes, but only during public holidays. Nope just kidding.

6. I have been taking Timoptol and Slow-k. My new doctor placed me on Timolol but I think it doesn't work as good as Timoptol.
Explanation
In reality, timolol and timoptol contain exactly the same agent , Timolol maleate 0.5%. But timoptol is made by Med Reich in UK while timolol is made in India or Lagos. so I don't see why their efficacy should be different. I believe Pharmguru can help us understand this better, and also why Beecham amoxycillin seems better than Nigerian amoxil.
As for Slow-K , I don't understand the rationale of giving slow k to glaucoma patients. I believe an eye doctor in the house would shed light on this.

Glaucoma takes vision that cannot be recovered. That headache that starts from your eyes spreading up to your head, may be your saving grace. See a doctor tomorrow.

You can contribute, condemn or ask questions.


drsteriod
rexbuton
Optom
jauntty
optm
lademinus
algorithm

the sender obviously needs a better camera

picture 2

still poor quality

donodion:
As at when did the growth started? After application of the cipro or before?

Before

optm:
I do not have a good visual of it

Okay

walexsy:
Lol..it was actually man to man...1.A quite sharp object
2.No buh...
3.the lid is torn n a bit swollen
4.yes when I'm not just awakening
5.yea
6.not at all
7.doesn't feel so
8.yea,it was
9.no
10.definitely,only the eye tho
11.I can't tell
12.No
13.yea...

Possibly a lacerating injury, and the depth of involvement is a referral criteria in most countries.
A high velocity blow is high risk too.

For your vision to be reduced even after 5 days may indicate corneal injury (also considering your photophobia) or anterior chamber involvement as suggested by DeRay98.
You will need to go back to FMC tomorrow to see a doctor for complete evaluation, and as you'd need tetanus toxoid injection if the object was metallic only as a precaution.

If the pain is unbearable, then you can take a tab of Diclofenac with food.. as long as you don't have stomach wahala or ulcer

optm:
can't really get a good view of it . can't see anything hanging close to the caruncle i suspect it to b over the superior limbus . nevertheless from what was described , It's having the presentation of hordeolum. at the initial stage of the growth was there pain? can't really tell much Because I'm not having a Good visual of the growth. you may also need to rule out a chalazon too; but it having discharge is makin it a bit confusing . just makin judgements from what was written though #blind judgements lol

Can you see that reddish body on the medial side? it is a growth from under the upper eyelid.. very close to the canthus. it produces pus.
there was never pain. It is not a chalazion. a chalazion is hard/tough and nodular and under the skin. This one is a fleshy overgrowth

DeRay98 BraniacX drsteroid jauntty allycat donodion

homeboy205:
It's subconjuctival hermorrage

It is not subconj.

optm jaunty

A NL user emailed this case to. me a while ago, and he allowed me share it. What does the house think it is??

Presentation

Started a month ago as a small elevation, increased in size
No pain
No visual disturbance
Patient bought gtt cipro and had been using it for 2wks

Examination
The growth actually arises from the upper palpebral conj
There is also severe hyperemia in the lower palpeb. conj and fornix.
Bulb. conj is Normal
The growth actually hangs down next to the caruncle like a pendulum , the growth has a tip and produces a watery yellowish discharge (muco. p)

Vision is normal. There is no itch too

...especially in the area of antibiotics abuse.

DeRay98:
I don't know your field in eye care, but you have tried to handle this response very sensibly and professionally with some good research rather than rely on assumptions to define the three Eye related fields.kudos!
The topic can not be over-flogged as lots of Nigerians generally believe they can outsmart eye care professionals who have spent years of their lives to study to render this all sensitive care.
I'm in the eye care fields and i see these things frequently. people think that they can just get any one drop from the "chemist" when they have what they think is a minor eye problem and its over. Many believe its the eye professionals will charge lots of many for "simple" eye problems. eventually it becomes "penny wise, pounds foolish" because what they could have spent N5000 to fix in time will end up costing tens of thousands later due to "smart" choices.

Thanks for the feedback! Eye professionals need to do more in educating consumers. The information deficit is too large

Walexsy
And who gave you gentamycin? Did the person take a look at the eye?

@ Walexsy
I'm sorry about the domestic violence, I hope you finally showed her who's her daddy!!

For your eyes, giving you a drug over the internet is closer to quackery than common sense. Could you please answer the following questions.
1. What was the nature of the object that hit the eye
2. Was the eye open on impact?
3. Is the lid torn or swollen or filled with blood?
4. Can you open the eye normally?
5. Can you move the eye in all directions?
6. Do you feel like vomiting?
7. Does it feel like there's something inside the eye?
8. Was the blow high velocity?
9. Are you seeing double?
10. Do you think your vision is reduced? check both eyed individually
11. Ask someone to shine a torch in your eye and tell if the small black hole becomes smaller
12. Were you vaccinated against Tetanus?
13. Does your vision look tinted?

I'm really sad right now.. From our discussions I wasn't sure he'd found God, he claimed to be a philosopher! If I knew he was that young I should have been assertive ! I pray he was saved. RIP Freemanan

There is another angle to this issue.
Before Optometry became a 6 year course it was a 4 year BSc program... After the upgrade a two year conversion course was set up, but many of the old optoms have not converted. These optoms are not trained to prescribe drugs and handle some diseases but today a lot of them have blended into the game without looking back.

Another problem is the apparent weakness of the ODORBN especially in the aspects of fishing out defaulters and stamping out community screening done by quacks. If the board can tackle quackery then Nigerians and expatriates would be safer..

This thread was previously posted as a comment on an earlier thread but I feel we could disprove some myths address more issues



PS. This is not a thread to discuss Lucrativeness or clinical/social superiority of any group. Posting such could be treated as thread derailment.



Per the optician, optometrist, ophthalmologist dilemma, I'd
like to discuss it using the Nigerian situation because
information found on the internet may not be wholly
applicable to our case.
Also, I'd like to point out that the levels and extent of basic
healthcare provided in a domain is set and limited by
legislature. Two individuals with the same qualification in
different countries may offer differing level of care. And if the
act establishing these professions is amended tomorrow,
this discourse becomes a history leSSON
OPTICIANRY


An optician is a professional who is trained in dispensing
optics, and is capable of receiving, interpreting and
supplying ophthalmic lenses ; spectacles, contact lenses and
low vision aids. An optician can independently sell frames,
sunglasses, artificial eyes, cosmetic contact lenses and even
Oculus Rift. Dispensing optics is a two or three year
programme done Diploma-style in optometry schools. Their
regulatory board is the ODORBN- Optometry and dispensing
optician regulatory board etc.


OPTOMETRY
An optometrist is an individual who has completed a 6yr
optometry programme and awarded doctor of optometry. He
is expected to complete a single year internship programme.
The course has its own fellowship and post graduate
schools and a newly inaugurated residency programme.
An optom as I prefer to call them is capable of handling
ocular emergencies, infective cases, refraction leading to
prescription of glasses and contact lenses, treats eye
ailments, low vision rehab and orthoptics.
In Nigeria, refraction, LV and orthoptics are their exclusive
preserve. LV and orthoptics are specialty areas, saying
every optom can do them is like saying every MD can do a
cardio bypass shunt surgery or neurosurgery.
I'd like to point out that the ailments treated have a limit ,
however this should not concern the layman as optometrist
are involved in the co-managment of every case. At their set
limits, they are expected to refer. Common cases referred
are cataract surgery, deep penetrating/perforating corneal
injury, laser trabeculoplasty, photo coagulation and ocular/
orbital tumours. Optom also do dispensing optics in school,
herein lies a problem that would be seen later.


OPHTHALMOLOGY
An ophthalmologist is a medical doctor that after completing
his MBBS, went on to specialize in ophthalmology. From his
MBBS experience, he is able to carry out surgery, though
most of the special skill is learnt at the post graduate level.
So, he can practice general medicine and do ocular work
too. Considering the fact that he is often in a general
hospital, most patients get to meet him first thus bypassing
the optom. And at the limit of his powers, he refers refractive
cases to the optom, and this fuels the stereotype that optom
only does glasses. And economically it is more viable to
employ ophthalm considering their versatility in general
practice. And moreover there are just five or six optom
schools in Nigeria.


GREY AREAS AND HOTSPOTS
The optician and optom have overlapping points and it
breeds conflict often. Most optom send their jobs to
opticians but this doesn't stop the optician from engaging in
illicit behaviour such as refracting patients and giving drugs.
I ran a screening programme for a multinational a few years
back, and we had men from every group on our team- we
even have hype men and bouncers at times [sic] … I
observed that my optician was jotting like ManUtd manager,
when I got closer after a while, I saw she had written
complaints and drugs given.. That's how they start. We
also see lots of optom and ophthalmol that practice beyond
their scope. Lots of!
Another issue is that of employment in the civil service. I
don't want to discuss those issues but to appeal to all
parties to act on the philosophy of mutual respect and
human dignity. I hope I remained impartial throughout .

An0nimus:
Rexbuton can you create another thread with that explanation on difference between opticianry, opthamology and co? it's an educative piece that many others need to read. Great job you're doing

I appreciate the feedback. God bless you.
I'm scared the thread would easily be derailed by unnecessary arguments. Let's give it a try!

crackhaus:
Seems Chinese.

I don't think I have come across that particular name though...but I've read 'a little' on the Ming, Han, and Qing dynasties as well as some of the famous Tea ceremonies and masters of the time.
Mao Tse Tung I found particularly interesting.


I really should read up on The Art of War by Sun Tzu, I've postponed it too long.

He was the last Chinese emperor.. A really sad tale

crackhaus:
I think I sensed the sarcasm, but I honestly felt like talking about the Ethiopian... I like his story

Have you read about Pu Yi?

I wish I could discuss him with someone

Onegai:
Good one. I've only self-medicated for my eyes once (I had a burn) and I looked up past cases to know that I needed Corticosteroid drops for about 3 days max.

Could you also explain to everyone on the thread, the difference between an Ophtamologist and Optometrist or Optician? A lot of people don't know and some unscrupulous medical practioners will see some patients who need Opthamologists and insist on treating them (because they're chasing money).

Thanks for the positive feedback and apologies for the delay.
Per the optician, optometrist, ophthalmologist dilemma, I'd like to discuss it using the Nigerian situation because information found on the internet may not be wholly applicable to our case.
Also, I'd like to point out that the levels and extent of basic healthcare provided in a domain is set and limited by legislature. Two individuals with the same qualification in different countries may offer differing level of care. And if the act establishing these professions is amended tomorrow, this discourse becomes a history leSSON

OPTICIANRY
An optician is a professional who is trained in dispensing optics, and is capable of receiving, interpreting and supplying ophthalmic lenses ; spectacles, contact lenses and low vision aids. An optician can independently sell frames, sunglasses, artificial eyes, cosmetic contact lenses and even Oculus Rift. Dispensing optics is a two or three year programme done Diploma-style in optometry schools. Their regulatory board is the ODORBN- Optometry and dispensing optician regulatory board etc.

OPTOMETRY
An optometrist is an individual who has completed a 6yr optometry programme and awarded doctor of optometry. He is expected to complete a single year internship programme. The course has its own fellowship and post graduate schools and a newly inaugurated residency programme.
An optom as I prefer to call them is capable of handling ocular emergencies, infective cases, refraction leading to prescription of glasses and contact lenses, treats eye ailments, low vision rehab and orthoptics.
In Nigeria, refraction, LV and orthoptics are their exclusive preserve. LV and orthoptics are specialty areas, saying every optom can do them is like saying every MD can do a cardio bypass shunt surgery or neurosurgery.
I'd like to point out that the ailments treated have a limit , however this should not concern the layman as optometrist are involved in the co-managment of every case. At their set limits, they are expected to refer. Common cases referred are cataract surgery, deep penetrating/perforating corneal injury, laser trabeculoplasty, photo coagulation and ocular/orbital tumours. Optom also do dispensing optics in school, herein lies a problem that would be seen later.

OPHTHALMOLOGY
An ophthalmologist is a medical doctor that after completing his MBBS, went on to specialize in ophthalmology. From his MBBS experience, he is able to carry out surgery, though most of the special skill is learnt at the post graduate level. So, he can practice general medicine and do ocular work too. Considering the fact that he is often in a general hospital, most patients get to meet him first thus bypassing the optom. And at the limit of his powers, he refers refractive cases to the optom, and this fuels the stereotype that optom only does glasses. And economically it is more viable to employ ophthalm considering their versatility in general practice. And moreover there are just five or six optom schools in Nigeria.

GREY AREAS AND HOTSPOTS
The optician and optom have overlapping points and it breeds conflict often. Most optom send their jobs to opticians but this doesn't stop the optician from engaging in illicit behaviour such as refracting patients and giving drugs.
I ran a screening programme for a multinational a few years back, and we had men from every group on our team- we even have hype men and bouncers at times [sic] … I observed that my optician was jotting like ManUtd manager, when I got closer after a while, I saw she had written complaints and drugs given.. That's how they start. We also see lots of optom and ophthalmol that practice beyond their scope. Lots of!
Another issue is that of employment in the civil service. I don't want to discuss those issues but to appeal to all parties to act on the philosophy of mutual respect and human dignity. I hope I remained impartial throughout .

dominique:
Ok then. There was a time I had itchy redeye and the doctor prescribed some antibiotic eye drops which I got from a good chemist. If we are not to get eyedrops from chemists, where should we get them from then?

I failed to express my ideas clearly.. What meant was that we shouldn't self medicate or meet the chemist guy instead of a seeing a doctor first

Could you suggest a more appropriate title?

swaggzo:
ONE TIME, I BOUGHT TWO PRESCRIBED PACKS OF EYE DROPS FROM A VERY BIG/POPULAR PHARM OWNED BY ONE OF THOSE GREEDY POT BELLIED IGBO MEN, BASED IN KADUNA STATE..

FOR THE FIRST TIME IN YEARS, I WAS STUPID ENOUGH TO BE IN A HASTE.. ..I DIDN'T BOTHER TO CHECK FOR THE EXPIRY DATE.. . (OR I THOUGHT ITS GON BE AUTHENTIC BECAUSE THE SHOP LOOKED GOOD).


I BOUGHT THE DROPS FOR 1,000 EACH, BUT IT TOOK ME ABOUT 20,000 TO FIX THE DAMAGE THE SOLUTION DID TO MY EYES IN JUST 2 DAYS OF USAGE.. ...



YOU CAN FAKE ANYTHING, BUT IF YOU FAKE AROUND WITH ANYTHING REALATED TO HEALTH THEN LUCIFER IS A BETTER PERSON.


I CALLED THE NAFDAC ON THEM, I WAS 19 THEN.
I STILL CANNOT UNDERSTAND HOW NAFDAC LET THEM GO AFTER COLLECTING BRIBE!

That's true! There is no worse evil than fake drugs

Ioannes:
Yeah, well Americans refer to trousers as pants.

Yeah... I think the guy who made the reference first was just being silly

crackhaus:
Damn, why my man?...why?

You just trivialized the story of one of the greatest military strategists to ever come out of Africa.




Hint:
Ras Tafari

My signature is a famous Haile quote, actually what he told Churchill after they successful pushed Mussolini back, and it's not so common but the guy wanted to test my knowledge by asking me who was Haile , so I took him on. And sadly he never got my sarcasm and you almost missed it too.
I've got respect for Haile

lalasticlala please push this to front page

Anyone seen or heard from Jomo lately?

How do things like this make front page?? More like a mad man's graffiti