Friday 8 July 2016

DEADLY MIX: Hypertension plus cataract...


Mrs Ann Valentina Ideh, a renown ophthalmologist in Edo State,  Is the  proprietor of Prime Opticals and Eye Clinic in Benin City. Every year,  Ideh embarks on free eye treatment which includes surgery for indigent patients.
Over 2,000 people have benefited. This year’s  treatment  took place penultimate week. In this interview, Ideh gives an insight into  how the project started and why blindness  keeps increasing in Nigeria. Excerpts: Can we know how this free eye treatment started? An ophthalmologist is basically the head of the eye care team. This means I’m a trained medical doctor who, after Youth Service and my house job,  has done extra five years minimum course to do ophthalmology which is a course  to  treat people with eye challenges through the use of  glasses, drugs or  surgery. I trained at the University of Ibadan for my medical course and, for my post graduate program, I was at the Morfeild Hospital, the University of Benin and I also spent six years in India just to update myself. When I finished from the University of Benin, I knew after my post graduate program that I didn’t want to work  in  government service. I was a bit frustrated as a resident because of the strikes and  not being able to get things done. If you needed to get something done like surgery, you had to wait because there was  lack of basic things like light and water.  But  going out on my own, I wanted to establish the kind of hospital that would be different. I wanted a clinic that would  be an alternative to the government hospital and, 27 years later, I’m happy and proud to say that  I have a big private practice. I get respect from  teaching hospitals, from my friends  here and there. I feel fulfilled because  people come to learn new procedures from me. My mother was into  community development. At that time, we  would go out to the villages where they had events and we used to have a lot of people coming to stay with us. Anytime my mother, a Permanent Secretary,  brought some of these people from the villages, I knew that they were very different, everything that seemed like we took for granted was not what they were used to and she always used to say there was dignity in labor and she also used to  help  them financially. Then I realized  that sometimes God places you in a situation where  He wants to use you. So, when I was fifty, I had this clinic a long time ago, but I realized that  people would  come into the clinic and, when they come, maybe they would be told consultation was five thousand naira and,  because they might not have enough money, they would  walk away. So I thought why didn’t  we have a time when we could  open the clinic and people could be treated free of charge? But, first of all, we had to have enough staff and then you had  to have a big  clinic, otherwise  you wouldn’t be able to cope. So I talked to some charity organizations like  Charilove. When  I  checked fifty, I decided not to have a party. I said  I was going to raise  money to open a home for the handicapped, I raised N1million for them and  everyone was so happy. Then the question came. How are we going to keep this up? I thought I could  give back from the skill that I have and that is  ophthalmology. So I sat down with my staff and  told them  we should do something for the community.  So we went out to the morning show on ITV and we sent messages to churches. That was how we started the first eye clinic. It was successful, everyone just walked  in, then we categorized the patients. We had  old patients who we charged consultation and  professional fees but, this time, we went  straight to  drug sales. And then for blind patients, we have card charts. For  three children who had been categorized for surgery in the last camp, they were  born blind but unfortunately we can’t attend to them  this week because  we are doing like seven or eight patients a day. The children need to be put to sleep;  so they are going to have to wait till next week when we are free. We need to have time for them, we need to bring anaesthetics to put them to sleep and they were children brought in by good Samaritans. I have about 30 people who work with me but they  can’t deal with the number of people we have here; so we have volunteers. Every year, we  see about 2,000 new patients. But we  probably see about 100 in a day because we see between 600 and 700 in a week. We categorize them, some are free, some are marked down, but everyone has a discount on what we charge. After the patients have all come in, we can now distinguish between those who would get free glasses from those who need  free drugs and  free surgery. This year’s free medical treatment, how long is the exercise going to last? It lasts for one week, it starts on  Monday and goes on till Friday. What we do is we get people registered between 8am and 3pm so that we can attend to all the people in one day, we don’t want  spill over to the next day. The surgery you do, how is it arranged? Yesterday, we did eight surgeries. I don’t know how many have been  lined up for tomorrow. Some of them are  free, some are marked down  but  are discounted. There was a woman we saw yesterday, she was diabetic, blind, you could see the husband  was in need, those are the kind of people that we give free treatment. Those ones are not hard to identify; so, we just pick them  and tell them we help  with one eye, ‘what we want to do is to help you to be able to see’. What is actually responsible for blindness which seems to be rampant today? Diabetes  comes due to the fact that we take too many sugary things and we take a lot of food that we should  not normally take. You are going out to parties, you don’t know what they  cooked. They give you  salad with a lot of sugar and you  eat  without knowing the consequence.  Are you aware that when you go to fast food restaurants, they put a lot of sugar in the salad you eat to make it  sweet? That  is not the way we used to do it. Our diets have changed a lot. We  eat  a lot of processed food. Before, we were eating yam, garri, home grown rice but now we are eating polished rice, we do  not take enough vegetables or give them to our children. We have water bottles inside which we put  clean water for our children but now children  go  to school with  juice, soft drinks  and so on. Their diet from the beginning is already wrong. We are giving them  noodle  to eat and  what is  noodle? The spice used in it is  not healthy.  Many people  walking around  are hypertensive. What we do here is to screen people for blood pressure during which we find out a lot of things. You need to have your blood pressure and your blood sugar screened at least once a year. If you are told you are hypertensive or diabetic, it’s usually a lifelong thing. Our patients think that when you go to the hospital and your doctor says you are now controlled, it means you should stop the drugs. We have a lot of people with that, diabetes is one of the causes of cataract. Hypertension is also one of the causes of the problems at the back of the eye. We have people who come in like that because they do not know they are hypertensive. Diabetic  patients cannot have surgery if their blood sugar is not controlled. If they do, they might have infections which are bound to heal slowly. They are most likely to have complications after surgery. Most of our diabetic patients, their meals are majorly carbohydrate, which is mostly starch. Protein is richer than carbohydrate; so it’s difficult when you tell the patient to eat a lot of green plantain, amala made from plantain and wheat. Here we  eat a lot of rice, yam and so on. Carbohydrate is our main meal but it’s supposed to be protein and vegetables which would be the main meal. Children are also supposed to come in for a  check before going into primary school. This is to check their eyesight before it gets worse. Some children need glasses to correct their sight  on time but some parents say their children are too small to  wear glasses at that age. Babies wear glasses, the glasses are specially made with a band around the head. If  you postpone treatment for a yet unborn  until he is born, the vision is not going to be good. The development of the eye has to do with age,  the development of the eye is between birth and nine years. If  during  that period  you  do not  maximize the use of the eye, it might be too  late. So children have to be brought in when they are not seeing or if the parents notice their eyes are moving around like albino children. Such children have to have a test every year until they get to 21 and are fully grown at which stage we know we cannot improve their  vision anymore. Adults need to have at least a check  every  two years. If you are diabetic or hypertensive, you have to have  your eyes checked every year. Another problem is glaucoma, which  is a different and painless disease. It is the loss of vision over time. You cannot tell if you have glaucoma unless you go for eye test. It doesn’t give pain or happen rapidly. It is a disease which does not have a cure but can only be managed with treatment. And the stage which you walk in with the disease, we can manage it using drugs, laser and surgery. But most of our patients come in late and we help them manage the remaining 10% of  the vision they have. Patients most time do not admit they have the disease. It is a disease where you have to use drugs for the rest of your life and the drugs would not make the eye better and if you don’t use the drugs, your situation gets worse. It is usually hard to explain it to the patient. It is most rampant to black people and people over 40. We the blacks are very prone  because we have pigments and the pigments block where the eye is supposed to drain out. Due to that, pressure builds up in the eye and destroys the nerve over time. Cataract  can be treated by surgery, but glaucoma  cannot be fully cured. Then there is diabetes and hypertension which affect the back of the eye. Once you are 40, you need to get glasses because your lens get weaker. If you have a family history of eye problem, you need to get checked because there is a possibility you have it too. As our hair grows, so does our eyes. A healthy diet and a healthy lifestyle can prevent some eye problems even in  old age. If you are not taking care of your eyes, with age, your eye strength would degenerate. Taking care of your body also takes care of your eyes and having regular eye checks also help.

Read more at: http://www.vanguardngr.com/2016/07/deadly-mix-hypertension-plus-cataract/

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