THE YEAR 2018 IS HALF way gone and, in another 5months, it will become history. A lot of of water has passed under the bridge. Have we learnt any lessons? History has shown that people seldom learn from history and to fail to learn from history is to allow history to repeat itself! In order to deal meaningfully with the present, it is a worthwhile exercise to analyse the past and see how well we have fared. Unfortunately, while the rest of the world is moving forward in all aspects of development including eye care, Nigeria has been relatively static in many areas and actually moving backwards in others. The old age practice of cattle grazing is still unfortunately, a major source of concern and should qualify for one of the leading causes of death in the first half of 2018. Incredible!

Cataract remained the leading cause of blindness in 2017. We still have a backlog of over two million persons with blinding cataract in need of surgical intervention. Sadly, we haven’t even started to tackle this! Added to this, new cases are coming up at the rate our human resources and available facilities cannot cope with. The result is that couching (an ancient practice which is over 2000 years old like open grazing) is still widely practised, converting reversible blindness into irreversible blindness! Is anyone surprised? Why should we make progress if we are applying the solution of yesteryears to the challenges of today? What can we expect? What hope do we have in a country that cannot find a lasting solution to a road that is just 120km long? Rebuilding the expressway and adding more lanes is no solution to the recurring anguish, nightmares and several hundreds of deaths on that road for over 50 years without addressing, simultaneously, the issue of alternative means of mass transportation. I am told there is a train being built between Lagos and Ibadan. I am a doubting Thomas and except I see the signs and the route, I would not accept that it is happening.

Similarly, a pragmatic, well-co-ordinated approach must be taken to tackle the challenge of blinding cataract. With judicious use of the available human and financial resources, Nigeria can conquer cataract blindness. Special thanks and appreciation to several Nigerians and organisations who contributed to our fight against cataract blindness in 2017. Through them, several hundreds have had their sight restored. The government can provide subsidy for private hospitals so they can offer free cataract surgeries to our people.   

   If the problem of cataract is receiving a little bit of attention, to my knowledge, many Nigerians are still largely unaware of the potential danger of irreversible blindness from glaucoma. Those that are aware are not responding to our call for pre-emptive measures to prevent blindness from this scourge. While cataract blindness is reversible, glaucoma blindness is irreversible. While cataract calls attention to its presence from the onset by gradually increasing impairment of vision, glaucoma causes no visual impairment in the early stages and only announces its presence when blindness is knocking at the door. And what are these pre-emptive measures that can help prevent blindness from glaucoma? Yearly visit to an ophthalmologist who has the knowledge and instruments to recognise its early signs; compliance with treatment and follow up appointments once the diagnosis is made.

Two conditions, however cause me a lot of heartache. They remind me of the two occasions that I knew a fatal accident was going to happen and could not stop it. On each occasion, a young man was at the wheel driving. I was driving in the same direction at a speed of about 100km/hour. This young man overtook me at a speed of about 140km an hour. Knowing that about half a kilometre ahead, there was a sharp bend to the left, I was certain an accident was inevitable. It happened and sadly, I was there only to play the role of an undertaker! The second happened in similar circumstances but this time the occupants of the vehicle were luckier. They escaped with varying degrees of injury but no life was lost.

Blindness from gonococcal conjunctivitis and Chloroquine are avoidable and caused by utter recklessness akin to what has been described above. Gonococcal conjunctivitis occurs when an infected, usually, own urine is used as eye drops for a simple eye irritation or infection. With every epidemic of Apollo, many cases of gonococcal infection of the eyes are coming up and quite a few end up with blindness. Blindness from Chloroquine arises from an excessive use of the medicine.

What do we expect during the remaining half of 2018? The omen is bad! More people will need cataract surgery and will not be able to afford the cost. They will end up having their cataract couched and eventually become irreversibly blind. More patients with glaucoma will remain unrecognised until blindness sets in. Those with glaucoma without the financial resources to buy medications or have surgery will continue to go blind. Fewer Nigerians will visit the ophthalmologists before their problems become serious and those who succeed in consulting an ophthalmologist will find it difficult to buy their medicines because of increasing costs and non-payment of salaries and pensions. Consequently, blindness from all causes will increase by the end of 2018. What can the government do? Just wonder if the Federal government could not put to better use the $350million Abacha fund returned to it. Instead of giving cash gift to 300,000 “poor” Nigerians! In a country where we don’t manufacture even tooth picks, all the money will be “return to sender.” The poor will become poorer because nothing kills initiatives and worsens poverty than free meals.

   History has shown it all. It is the science of progress.

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