MUST READ......Every 40-year-old needs reading glasses — Expert

This is Dr. Valentina Ideh

A consultant ophthalmologist and Medical Director of Prime Opticals and Eye Clinic in Edo State, Dr. Valentina Ideh, speaks about eye related issues and  free medical outreach of the centre called Eye Camp with Fidelis Chidi blog

What is your assessment of eye care among Nigerians?

 

I think we can say some people are not literate, so they have a problem. Some people live too far from eye care practitioners. But even when we talk about our supposedly literate group, we have a problem. People don’t come until they have a problem and it’s not supposed to be like that. They say prevention is better than cure and I think that is aptly said. A person over 40 should visit an eye clinic every other year. An adult needs to change glasses every two years. Sometimes, you can see a patient who can read all the letters on the chart but have lost their visual field.

So, our culture of taking care of the eye is not really good enough. We spend a lot of money on clothes but when you are told to pay N4, 000 to see a doctor we complain. People also find themselves too busy.

Some people patronise road side vendors for eyeglasses. Is that helpful?

They (vendors) are doing more harm than good because the person buying from them thinks he is getting a cheap deal. But he does not realise that by buying from them, he is depriving himself of finding a problem which could be easily treated. By the time he visits a hospital, it might be a bit late.

How can the prevalence of glaucoma and cataracts in Nigeria be checked?

Cataract is the commonest cause of reversible blindness in this country; one can treat the patient and he gets vision. We only have a problem with the children; if they are not properly treated and the cataract is in one eye, they eye might become amblyopic. But glaucoma is the commonest cause of irreversible blindness and that is a big problem because when we make a diagnosis and you are blind, we cannot help you.

But with cataract, improving the number of surgeries can help. Ninety per cent of adults will need a pair of glasses including those over 40 years of age because our lens become presbyopic, our lens gets older. About 10 per cent of people suffer from glaucoma. There are doctors who have died from glaucoma because they were busy writing prescriptions while others were busy checking their eyes.

We, however, advocate healthy living so that one’s cholesterol and lip levels do not go up. If they do, the fats can be deposited in the ring around the eye or the back of the eye. It is like age-related macular degeneration. In such situations, we tell people not to eat a lot of oily food but vegetables and fruit and cut down on sugar.

Do you think government is doing enough to provide relevant facilities for the treatment of eye problems?

Definitely not. I get referrals from the teaching hospitals in Benin and in Oghara. Some teaching hospitals do not have equipment for laser therapy and optical coherence tomography. This situation makes the doctors not to function very well. That is why there are incessant strikes. But sometimes, it is difficult for the patient to understand because he is short-changed at the end of the day; he goes into the teaching hospital because he feels it is going to be cheaper but the doctors are on strike. He does not know why they are on strike. It’s very difficult and a lot more has to be done.

What do you think government can do to tackle to help those with eye problems?

I think government really needs to sit down and decide on what they want to do. If they have a teaching hospital, then a teaching hospital is supposed to be the tertiary centre and equipped with everything for health care. But we are always changing government so quickly and the commissioners that there is never enough time for new persons to settle down to work. One year is for politicking, the next they do some work and the third year, they are getting ready for the next election. That does not give them enough time to do things.

Why did you establish Eye Camp?

About 10 years ago when I turned 50, I was grateful to God. I had run my clinic for 16 years at the time and I thought about what I could do to impact the society in which I live. The first thing I did was to work with children with difficulties at Project Charilove, a non-governmental organisation that deals with the handicapped. I was then the chairman. We raised N1m donations from friends and family, instead of holding a birthday party and we gave the money to the NGO. After that, I saw that the need was great and I returned to medicine.

I found, overtime, that people would come into the clinic and as soon as they were told how much it would cost to see the doctor, they would it was too expensive and would leave.

During my next birthday, I organised a one-week free outreach in my clinic to avail the patients the opportunity to use every medical facility there. We started with our first Eye Camp in June, 2007. Some patients who were blind underwent free surgeries in one eye. It was free consultation, so they didn’t pay anything to see the doctor; we had widows, children and the indigent were treated free. Also, others got a discount for glasses and those who needed free treatment got it.

We hold the outreach twice a year in June and December, which happen to be my birthday and my husband’s, respectively. We have held it for a decade.

How has the attendance been since you started?

Under normal circumstances, we receive about 30 to 40 patients a day. But during the Eye Camp, we see 400 to 500 new patients at each camp and our normal old patients, who come in because they know they will get discounts. The consultations and professional fees are free so the patients only pay a little for their drugs. I have found it very rewarding. Usually, one has to pray and spiritually prepare oneself because if one is doing four to five surgeries in a week and it suddenly increases to between seven and 10 surgeries in a day for one week, it is quite a lot on the doctors.

How do you ensure there are enough professionals to manage the growing beneficiaries of the programme?

We have ophthalmologists, optometrists and ophthalmic assistants. We have opticians, nurses and other members of staff. So, everyone has to make some contributions. I also have colleagues who volunteer their time, just to help us for free and I think that says a lot. We start at 8am and normally finish at 5:30pm. But during the outreach, we are at the clinic till 7pm or 8pm and the workers give their time to it. We also have to provide lunch for them because they have no time to out. This is just a way of giving back to society. I do not come from Benin; I am from Delta State but I have worked in Edo for 27 years. I like the people and I feel the programme is part of our corporate social responsibility.

What are the areas you focus on during the free medical programme?

We tell the hypertensive and diabetic to come in for screening. People do not realise that hypertension and diabetes are now a big cause of eye problem. For diabetes, many of the problems are behind the eye. If you are diabetic and you do not get good treatment, you will get complications in the eye. One of them is cataracts. Another is called diabetic retinopathy; it is a kind of bleeding problem which can allow the retina, which is the film of the eye, to come off.  Retina detachment at that time is a bit late. So usually, if you have had diabetes for some time and it is not well controlled, you get a background diabetic retinopathy. But if you are not controlling your sugar level and not seeing a doctor, background retinopathy can become a big bleed; you can wake up one morning and lose your vision. We call it a cerebrovascular accident, when you wake up one morning and you discover that you don’t see with one eye, you have a big bleed and might not be able to restore vision.

For the hypertensive, the cerebrovascular accident is like a stroke; it means that one blood vessel either breaks open and blood comes out. The small vessels are also in the eyes and kidneys, that is why diabetics have complication with the eyes. It could be a CVA, which is a stroke in the brain and problems in the kidneys because the blood vessels in these areas are very small; we call them microangiopathy. There are also refractive errors; people need glasses. Everyone will need to see an ophthalmologist eventually. So, once you get to 40, unless you are short-sighted, you will find some difficulty reading and will need a pair glasses.

This is the age when the chronic simple glaucoma sets in. It is a disease with a quiet, painless and irreversible cause of blindness. It is something that you cannot tell that you have. If your pressure is high, you might have a bit of a headache but you would probably not think it is the eye. But if a doctor checks your pressure and looks into your eye, he can see that your disc has a problem, which needs to be treated. Because vision lost cannot be returned, it is important that you get a diagnosis on time and start treatment early, so that any vision remaining can be saved. Refractive errors can occur in all age groups.