An estimated 24 million people are dealing with vision loss in Nigeria, of which 1.3 million became blind in 2020. Juliet Jacob Ochenje highlights factors contributing to the rise of visually impaired Nigerians in this informative article.
39-year-old Ibaralanyon Ogoniba narrates his close shave with blindness to African Health Report correspondent. What started as a ‘mere’ complication from a smallpox episode, he recalled, landed him in an operating theatre abroad, he said, with an expression of disbelief.
“When the problem started, I was 37 years old, which was two years back,” he said. ”It all started with chicken pox all over my body which I thought was a minor problem until after treating it with some medication, it cleared off but after a month or so, my eyes started to itch.
“I went to the hospital to for check up and treatment but was told that it is a mere issue and I had nothing to worry about. They gave me some medications like eye drop and the rest but after using them, I still didn’t feel better. The itching continued and aggravated to pains and red eyes. Then I had to go to different hospitals, about three of them, seeking for solutions and hoping it will get better. The doctors even made me believe it was going to be okay but unfortunately for me, it developed into what they called cataract. Then, I was told that my cornea was affected too and I needed a cornea transplant, so I went for the transplant outside the country.”
Ogoniba said he opted for the transplant to be done abroad because he was advised to do so by people who had had the same medical condition. He said the reasons given include low success rate of the surgery, which may mean repeating it or having complications. Another thing he considered was that the cornea is not available in Nigeria and has to be imported into the country.
“Most times, it is either from India or the United States, so I told myself that instead of getting it transported all the way from overseas, it would be much better if I get done there. I spent over 3.5 million naira to get it done abroad – from my flight tickets, accommodation and feeding with the treatment and since then, my vision has improved,” he explained.
Regular checkup, early detection key in maintaining good vision, treatment of diseases
“My advice for people is that once they notice any changes in their eyes, they should go for check up immediately because early detection really helped me and also, the doctors that were taking care of me then did a lot of work and also make sure you’re referred to the doctors for the specific ailment,” Ogoniba added.
Mr Joseph Kadiri also had a similar experience with Ogoniba. He said “around the young age of 26, I had a problem with my sight. It started with short sightedness and later magnified to cataract. The cataract surgery for the two eyes cost almost 350, 000 (three hundred and fifty thousand naira). It then developed to glaucoma where further surgery was carried out that cost almost one million naira on various visits to the eye clinic.”
He advised: The “eye is not something to play with. As such, we need to really take care of it. Not to eat too much of carbs to avoid a situation of been diabetic, which mostly causes eye problems. If you notice issues with your eyes early enough, start going for check up at the eye clinic or visit an ophthalmologist and optometrists. Also, start to eat food and fruits that can correct the eye immediately.”
Cataract, most common cause of severe visual impairment, blindness in Nigeria
According to the Nigerian Journal of Basic and Clinical services (2021 data), cataract is the leading cause of blindness worldwide. The Nigeria National Blindness survey cited in the journal reported that cataract is the most common cause of severe visual impairment and blindness in the country, at 45.3% for the former and 43% for the latter, respectively.
Globally, cataract surgery has been shown to be one of the most cost-effective health-care interventions. The implantation of an intraocular lens in the affected eyes through surgery is highly effective and results in immediate visual improvement, the journal added.
Refractive errors, glaucoma also leading avoidable causes of vision loss
Apart from cataracts, other main causes of blindness include congenital glaucoma, harmful eye medication (traditional and non-traditional) and the interplay between measles and Vitamin A deficiency, especially in children.
In 2021, Nigeria’s Minister of Health, Dr. Ehanire, put the prevalence of blindness in Nigeria at 0.78 per cent, said that the government planned to make comprehensive eye care more accessible to the majority of Nigerians to reduce the burden of blindness.
A report from BMC Ophthalmology survey of the prevalence and types of glaucoma in Nigeria based results from the Nigeria National Blindness and Visual Impairment Survey, in 2015, reported that the disease is the leading cause of irreversible blindness worldwide. The prevalence and types of glaucoma in Nigeria among adults aged 40 years and above. It found that Nigeria has a high prevalence of glaucoma, which is largely open-angle glaucoma and a high proportion of those affected are blind. Secondary glaucoma was mostly as a consequence of procedures for cataract.
The number of blind people is mind-boggling. According to the Nigerian Optometric Association in data released in 2020, nearly seven million Nigerians under the age of 40 are blind, and 50 million persons have some form of visual disability or the other, limiting their ability to work, learn or play.
Similarly, statistics by Sightsavers, an international development organisation, indicate that there are an estimated 24 million people with vision loss in Nigeria. 1.3 million of this number became blind in 2020. Vision loss is losing the ability to see well without some sort of vision correction such as eyeglasses, contact lenses, permanent artificial lenses, or surgical correction to the eye.
According to Ehanire, up to 0.78 percent of the country’s population suffer from blindness, with up to 84 percent from avoidable causes including cataract, glaucoma, refractive errors, uncorrected aphakia, harmful traditional eye practices, corneal opacities and neglected tropical diseases (NTDs) like trachoma and onchocerciasis.
These figures makes one wonder: what could Nigerians be doing to ramp up these numbers?
Harmful practices, Diet, Finances, Other Factors Contributing to Spike in Vision Loss
– Use of brake oil, urine, breastmilk, others, for treatment of eye infections
Many things contribute to the prevalence of blindness and vision loss among Nigerians. For one, people do not appropriate the kind of priority that eye care requires to it. The eyesight is one of the most important senses in the body as 80% of what humans perceive comes through the sense of sight.
This underscores the importance of visiting an eye doctor at least once a year, but that is not the case for many. Citing expensive cost of eye visits as a discouragement, many Nigerians have removed routine checkup from their budgets.
Certain personal habits are harmful to one’s eyes, including smoking and spending long periods on computers or phones.
Long periods spent glaring at electronic screens could lead to Computer Vision Syndrome (CVS) which has been contributing to the growing cases of eye-related issues among Nigerians. It has a 74 percent prevalence rate in Nigeria.
While it is understood that some people need to use computers for their daily work, the doctor advised that the light should not be very bright, but dimmed. Symptoms of CVS include eyes irritation, blurred vision, headaches, backaches, neck aches and muscle fatigue. However, it has not been found to cause any permanent eye damage.
Diet also plays a big role in eye degeneration. Consumption of foods rich in lutein benefits eye health and maintains them in old age. It is mostly found in green vegetables and fruits.
More importantly, medical experts have urged Nigerians to embrace the culture of periodic eye check-up as as a means of reducing growing cases of eye related infections, diseases and defects. Dr. Chukwuemeka Obianyo Mokwue, who was the pioneer Resident Ophthalmic Surgeon and Head of Clinical Services at St Mary’s Catholic Hospital, Gwagwalada, Abuja from 1997 to 2010, emphasised that the earlier the detection and treatment of eye disease, the higher the success rates.
In an interview with African Health Report (AHR), he explained that there have been improvements in eye healthcare services in Nigeria, so the need to go abroad for treatment is not as high as before. He added that there is assistance by non-governmental organisations to reduce the high cost of surgery on the struggling Nigerian, adding that successes have been recorded in the treatment of glaucoma, cataract and river blindness.
Dr. Mokwue stated: “For river blindness, which is an infection, it is preventable. The earlier the treatment, the higher the success rates. By the use of Mectizan in Nigeria, it has almost been eradicated….treatment of eye diseases are very affordable. Many NGOs working with different state governments and faith based organisations since 1990 ensured the affordability and access to the services.
“Previously in 1990s to 2010, it was (people used to travel abroad for eye treatment) because of some specialised areas like retinal diseases that we didn’t have the requisite manpower and equipment for. Dr. Goodluck Jonathan’s administration changed all that, building on Obasanjo’s commitment. Now people travel for tourism and personal choices, which many at times, are ill-informed or ill-advised. They need to have a follow up after surgery and sometimes, they cannot afford to go back to India or Europe for the follow up. The services in the country since 2010 have been excellent and improved tremendously.”
Need for Implementation of National Eye Health Policy To Provide Quality Eye Health Services For Nigerians
The Federal Government launched its first national eye health policy in February 2022 to tackle growing problems of avoidable blindness and vision impairment in the country. The policy created in conjunction with Sightsavers sets out guidance and commitments needed to reduce the eye health crisis and provide quality eye health services for all Nigerians, as well as reduce the social and economic impact of vision impairments.
The priority areas of the new policy include rolling out the policy to the 36 states, creating state eye health coordination teams to lead on implementation, advanced training for eye health professionals, and ensuring affordable service is accessible.
