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GLAUCOMA, A Leading Cause of Blindness

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Dr. Gemma Henry Ibe performing her usual Rural Free Eye Medical check-up

Dr. Gemma Henry Ibe performing her usual Rural Free Eye Medical check-up

Glaucoma is the 2nd leading cause of blindness in the world after cataract.  World Glaucoma week is celebrated from 10th to 16th of March, every year and 12th of March is usually recognized as World Glaucoma day.

From the free eye project we have carried out in various parts of Imo State; we discovered that the prevalence of glaucoma is very high in Imo State.

Glaucoma has been called the silent “thief of sight” because the loss of vision often occurs gradually over a long period of time and symptoms only occur when the disease is quite advanced.  And once vision is lost, it cannot be recovered, so treatment is aimed at preventing further loss.

Before glaucoma is defined, we need to understand some terms.

 

Optic nerve:

Also known as cranial nerve 2.  Is a sensory nerve composed of nerve fibers that carry visual information from the retina to the brain.  Any damage on it causes visual loss.

 

Intraocular Pressure (IOP):

The fluid pressure inside the eye.

 

Visual Field:

The total area in which object can be seen in the side (peripheral) vision while you focus your eyes on a central point.

 

Glaucoma:

Is a disease of the eye that causes damage to the optic nerve with an increase in intra-ocular pressure (IOP) and a characteristic visual field loss.

Glaucoma steals sight without warning.  In the early stages of the disease, there may be no symptoms at all.  Experts estimate that more than half of the people affected by glaucoma may not know they have it.

It was once thought that high intraocular pressure is the main cause of this optic nerve damage.  Although IOP is clearly a risk factor, but we now know that other factors must also be involved because even people with “normal levels of eye pressure can also experience vision loss from glaucoma.

 

TYPES OF GLAUCOMA

There are several classifications/types of glaucoma but the two main types are open-angle glaucoma and angle closure glaucoma.

 

1. Open-angle glaucoma:

Sometimes called chronic glaucoma.  It happens when the eyes drainage canals become clogged overtime.  It is the most common type of glaucoma and typically occurs in patients over the age of 50 years, and the risk increases with age.  Open-angle glaucoma is often referred to as “thief in the night” because it can develop gradually and go unnoticed for years, slowly robbing the victim of his/her eye sight.  Because there is usually no pain experienced over these years of development and no apparent symptoms, the victim is unaware of the existence of this serious eye disorder until it is too late.

 

2. Angle-closure glaucoma:

Also called acute glaucoma.  It is caused by blocked fluid in internal eye structures, creating a spike in the eye pressure.  It affects less than 10% of all patients diagnosed with glaucoma.  It is the most serious form of glaucoma and in some cases comes on progressively in just a matter of hours or days.  It is often inherited and more common in women and elderly people especially those who are far-sighted.  It can appear suddenly and is often very painful, visual loss can progress quickly and the discomfort often leads patients to seek medical attention quickly.

 

3. Cogenital glaucoma:

Also called developmental glaucoma.  It is evident at birth or within the first few years of life.  It affects both eyes in babies and caused by a defect in the channel through which aqueous humor normally exits the eye.  It is discovered in babies before the age of 6 months.

 

4. Secondary glaucoma:

Caused by something such as injury, inflammation, tumor or in advanced cases of cataract or diabetes.  It can also be caused by certain drugs such as steroids.  This form of glaucoma may be mild or severe.

 

5. Absolute glaucoma:

This is considered the end-state in which there is blindness.  It is associated with primary angle-closure glaucoma and is treated by enucleation (surgical removal of the eyeball).

 

SYMPTOMS OF GLAUCOMA

The symptoms are experienced based on the type of glaucoma one has.  In cases of chronic glaucoma, there are usually no noticeable symptoms at all because the condition develops slowly.

Symptoms of Angle-closure glaucoma:

·           Intense pain

·           Redness of the eye

·           Headache

·           Tender eye area

·           Seeing halos or rainbow-like rings around lights

·           Misty vision

·           Loss of vision in one or both eyes that progresses very quickly.  These symptoms are not constant.  They can last for one or two hours before disappearing again.  But each time the symptoms occur, vision is damaged a little more.

 

Since secondary glaucoma is caused by other conditions or eye injuries, it is possible for the symptoms of glaucoma to be confused with the symptoms of the other conditions like painful eyes, headache and misty vision.

Recognizing the symptoms of developmental glaucoma (congenital) can be difficult due to the young age of the baby or child.  However, a child may display symptoms such as;

 

·           Large eyes

·           Being sensitive to light (photophobia)

·           Having a cloudy appearance to their eyes

·           Having watery eyes

·           Jerky movements of the eyes

·           Having a squint, which is an eye condition that causes one of the eyes to turn inwards, outwards or upwards while the other eye looks forward?

Don’t forget it is only your eye doctor that can examine you and confirm that you have glaucoma.  You can never know with all these symptoms.

 

PREVENTION OF GLAUCOMA

Most of the risk factors such as age, race and family history are beyond our control.  If you are under age 40 and have not known risk factors, examine your eyes and do glaucoma tests every 6 months but if you are above 40 years do that every 3 months.  If you are at increased risk, or already diagnosed with glaucoma, you need a regular eye examination every month to prevent blindness.

There is no discovered way of preventing glaucoma yet, but there are few recommendations for general physical wellbeing that can help a little like:

·           Eat a varied and healthy diet

·           Limit caffeine intake

·           Try to exercise daily

·           Maintain a healthy weight

·           Keep your blood pressure at a normal level

·           Do not smoke

·           Prevent over exposure of your eyes to sunlight by wearing sunglasses and hats.

·           Visit your eye doctor always.

RISK FACTORS OF GLAUCOMA

·           Increased intra-ocular pressure (IOP)

·           Age

·           Family history of glaucoma

·           High blood pressure

·           Myopia

·           Other medical condition like diabetes

·           Other eye conditions like uveitis

·           Long-term use of eye-drops that contain steroid-This is one of the reasons why we preach against self medication because you don’t know the contents and side effects of the eye-drop you buy from the drug store.

 

TREATMENT OF GLAUCOMA

There is no cure for glaucoma – yet, however the key to glaucoma management is diagnosing the disease at early stage and prescription of medication and eye drops are the most common early management.  If the condition worsens, then glaucoma laser treatment or glaucoma surgery (trabeculectomy) may be the only option to save the remaining vision.  If the vision is totally lost, it is not reversible again.

In my earlier article in THE LEADER, I explained some basic things on cataract, and if you are reading this one, you can now discover the difference between cataract blindness and glaucoma blindness.  If you have loss of vision as a result of cataract, with cataract extraction, you can still see again but if you loose your sight as a result of glaucoma, because it causes loss of retinal nerve fibres.  It is not reversible, so the case of glaucoma is strictly “PREVENTION IS BETTER THAN CURE”.

If someone’s glaucoma has advanced to an irreversible stage, the person usually has a fixed, widely dialated pupil and that is why the Igbo name for glaucoma is “ISI-ANYA-EKE”.

There is a burglar on the Prowl,  He is right around the corner, a slowly, painless deadly thief of sight, He will smash your precious window if you disregard the screen, He is slippery, dangerous felon and needs to be arrested quickly, but it is up to you to do it.  Please stop glaucoma, GET TESTED, CHECK YOUR EYE PRESSURE ALWAYS.  SAY NO TO… BLINDNESS.

______________________________________

Dr. Mrs. Gemma Henry-Ibe
Ophthalmology Department IMSUTH, ORLU – 08037776866 – gemmaibe@yahoo.com

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The Data of Forgiveness

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The Universal Character of Salvation

The most important ingredient in today’s media economy is data. The amount of data available determines how much and how long we can work or play on the internet. Currently, many of the service providers offer unlimited data plans but we know that those “unlimited” plans are not always unlimited. Sometimes, your download speed can get slowed down when you cross a certain point. Today, however, Jesus gives us the divine model of an unlimited plan. It is the unlimited bundle of compassion and forgiveness which never gets slowed downed shut down for maintenance. The theme for this week is that we must learn to forgive without limits no matter the injury committed against us.

In Matthew’s Gospel, today’s teaching on unlimited forgiveness comes after Jesus had told his disciples the parable of the wandering sheep, so it is plausible that some would have wondered among themselves how many times a good shepherd should go after the same sheep if it keeps wandering away. In those days, people believed that forgiveness was limited to three times only – a fourth transgression was not to be forgiven. So, by asking Jesus how many times he should forgive his brother, Peter was probably aiming to increase the limit to seven times. And Jesus makes it clear that we are to forgive others, “not seven times but seventy-seven times” (Matt. 18:22).That means we must dispense an unlimited data bundle of mercy.

In Jesus Christ, we have the forgiveness of a debt we could never pay. Sin is an offence against God and a direct rebellion against his authority and creation. The debt of 10,000 talents mentioned in today’s parable symbolizes the magnitude of the offence that sin causes in God’s eyes, but he is always willing to forgive without limits. However, we can easily cut ourselves off from God’s river of mercy when we refuse to forgive others. We end up restraining God’s mercy and putting ourselves under strict justice. To unfold his mercy without compromising his justice, God leaves each person free to choose between the two. If we insist on strict justice when we are offended, we bring God’s strict justice upon ourselves. But if we offer an unlimited bundle of mercy to others, we draw God’s unlimited data of forgiveness upon ourselves.

The secret to forming a forgiving heart lies in recognizing the evil of our sin and the immensity of God’s goodness in forgiving us. Until we see the ugliness of our ingratitude and selfishness, we will never appreciate the generosity of God’s forgiveness. Let us examine ourselves now to see how much forgiveness we are giving. Is there someone we still cannot forgive even after they have expressed sorrow for their actions? Have we judged someone too harshly because of something they said or did that we did not particularly like? How many times have we failed to help somebody because we are still dwelling on an injury that we suffered many years ago? How many times have we treated someone differently based on preconceived notions or stereotypes? These are some of the factors that shackle us like chains and that disrupt the unlimited data of divine grace in our lives. When we close ourselves off to people or dismiss them based on our preconceptions, mistaken judgments, and prejudices, not only do we make them suffer, we suffer as well.

But it does not have to be that way. Jesus came to free us from and the burden of sin and unhappiness. Forgiveness is like mercury, which runs away when it is held tightly in the hand but is preserved by keeping the palm open. When we lose forgiveness, we lose the ability to give and to receive love because love is the foundation of forgiveness. And since God is the foundation of love, whoever refuses to forgive automatically rejects the love of God. This is the essence of today’s parable and it is highlighted by the contrast between what was owed by each man. The wicked slave owed his master some 10000 talents. In gold terms, that is 350 tons and at today’s price, he owed his master USD21.8 billion. This was way more than King Solomon made in a year which was 666 talents of gold or USD1.45 billion in today’s value (cf. I Kings 10:14). So, this unforgiving servant owed his master what no individual could never payback. In contrast, his fellow servant owed him the equivalent of one talent of gold or USD2.1 million; so a man who was forgiven $21.8b could not let go of $2.1m, and his wickedness landed him in the hands of torturers.

Dear friends, forgiveness is an act of compassion which is expressed in the free choice to pardon one another’s shortcomings every day, and to also pardon ourselves for own mistakes Forgiveness transcends the fear of being wounded again; it is a deliberate act in imitation of the redemptive work of Jesus, the advocacy of the Holy Spirit, and the loving kindness of the Father. The whole point of today’s parable is that our Father in heaven will do the same to anyone who refuses to forgive others. Whoever refuses to forgive is doomed to a life of bitterness, and as the ugly trend continues, the person ends up building invisible walls of resentment around themselves, thereby blocking off not just one’s relationships with other people but with God as well. Forgiveness is not just an emotional expression or a sense of righteousness; it means being merciful not only when there is an explanation or apology, or a promise of amendment from the offender, but even when the offence is deliberate, and the offender is adamant. Forgiveness is a precious gift of grace, which does not depend on the worthiness of the receiver. Forgiveness is what we called to do, and the Lord’s grace is sufficient for us in that regard. Amen.

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Imo Deputy Governor’s giant strides towards revitalizing agriculture

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Imo Deputy Governor's giant strides towards revitalizing agriculture
By Joy Opara

The increasing cost of Agricultural products in Imo State in recent times has continued to be a major source of concern to the citizens of the state.

A critical appraisal of the development of Agriculture in this state reveals that successive governments had neglected this major sector of the economy, over three decades now, and this has adversely affected the revenue of government.

In line with the vision of the “shared prosperity” government of the Hope Uzodinma administration, the revolution of agriculture is among its cardinal programmes for which a high powered committee (on agricultural master plan for Imo State) has been set up.
For the purpose of resuscitating all moribund agricultural industries and facilities in the state, it is not surprising that this committee is headed by a world class Professor of Agriculture and Deputy Governor of Imo State, Prof. Placid Njoku.

The need to diversify the economy cannot be over-emphasized. It is a well known fact that there is no better and more sustainable means of diversifying the economy than through agriculture. It would be recalled that after the inauguration of his committee, the deputy governor went into action, first by visiting all moribund agricultural facilities in the state, which included Adapalm in Ohaji/ Egbema LGA, Avutu Poultry farm in Avutu, Obowo LGA, Songhai farms, Okigwe road, Owerri, ADP farms in Nekede, Owerri West. Others are Acharaubo farms in Emekuku, Owerri North, Imo Rubber Plantation in Obiti, Ohaji/ Egbema, amongst others.
Prof. Njoku in one of his speeches during the tour described agriculture as the economic base of most countries of the world. Considering the dwindling oil revenue, he said it should be a source of worry to people of good conscience that the vision of our founding fathers to generate revenue, food security, economic advancement, industrialization, employment and eradication of poverty was destroyed by successive governments.
The Deputy Governor, who not only is acknowledged as one of the greatest professors of Animal Science, a renowned Agriculturist and former Vice Chancellor of a leading University of Agriculture, the Federal University of Agriculture, Umudike, made it clear that the present government led by Governor Hope Uzodinma is desirous to return agriculture to its former glory.

The Ikeduru-born technocrat and farmer per-excellence said that the 3R Mantra of this administration namely: Reconstruction, Rehabilitation and Recovery is a base for making the dream of Imo State as the food basket of the nation come true.

Noting that government is a continuum, the deputy governor promised that his committee will build upon what is already on ground by rehabilitating the ones that could be rehabilitated and bringing in new facilities where necessary to ensure that the passion of the governor towards agricultural revival is achieved.

Meanwhile, in most of the establishments visited by the committee, it was discovered that indigenes of the communities had badly encroached into the lands and converted them to personal use. Investigations by the committee revealed that agents of some past governments in the state connived with the communities to make it possible, for their personal aggrandizement.

The deputy governor, whose humility has become legendary pledged his total support to the Governor, Senator Hope Uzodinma whom he described as God sent to right all that were done wrong by the previous administrations in the state. He called on all to give this administration the needed support to rewrite the history of Imo State in gold, especially the agricultural sector.

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Child Abuse: A case of betrayal of reciprocal trust

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Child Abuse: A case of betrayal of reciprocal trust
By Christian Uzoukwu

Some years ago, while as a kid, I fell out with my father due to an occasion of sheer disobedience and on that very day, I was given no food and was ultimately battered by hunger. Child abuse includes both acts of commission and omission on the part of parents, guardians as well as care-givers.

These acts have led to a lot of actual and threatened harm meted out on countless number of children. In 2014, the WHO made an estimate of 41,000 children (under the age of 15) that are victims of homicide and other related offences. This estimate, as expounded by this world body is grossly below the real figures due to the views of the society in relation to corporal punishment experienced by children. Girls are always most vulnerable to different forms of child abuse during unrests and in war-thorn territories.

Cases of child abuse can be established in some deadly human vices such as child trafficking, child labour, forced adoption as seen in the one-child policy prevalent in China. In the Asian country, women, by law are only allowed to have one child. Local governments would sometimes allow the woman to give birth and then they would take the baby away stating the mother violated the one child policy. Child traffickers, often paid by the government, would sell the children to orphanages that would arrange international adoptions worth tens of thousands of dollars, turning a profit for the government.

Other striking examples of child abuse are the various forms of violence against the girl-child which involves infanticide, sex-selective abortions, female genital mutilations (FGM), sexual initiation of virgins in some African cultures, breast ironing in some parts of Cameroon – involving the vicious use of hot stones and other tools to flatten the breast tissue of girls who have attained the age of puberty. As if those were not enough, female students are also subject to maltreatments in countries like Afghanistan and Pakistan. This is not to talk of recurring kidnapp of female students in some parts of Nigeria, as we saw in the case of Dapchi and Chibok schoolgirls.

Based on simple analysis, child abuse can be defined as “all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”.

This definition by WHO also falls in line with the definition propounded by the United States Centres for Disease Control and Prevention, which says that child abuse are acts of commission. This commission includes “words or overt actions that cause harm, potential harm, or threat of harm to a child”, and acts of omission (neglect), meaning “the failure to provide for a child’s basic physical, emotional, or educational needs or to protect a child from harm or potential harm.

In Nigeria, most cases of child abuse have become cumbersome due to the fact that these acts of abuses are regarded as mere punishments to unruly young ones and by so doing, should be justified and doesn’t call for any further discussion and/or scrutiny. According to various statistical studies and researches, child abuse is a vast societal cankerworm and has four profound tentacles viz:

Physical Abuse: this involves undue hitting, beating, kicking, shaking, biting, burning, strangling, insertion of pepper into the eyes and pubic regions of children, maltreatments from house-help(s) and seniors at boarding/day schools, suffocating and forcing children to live in unwholesome conditions.

Sexual Abuse also includes persuading a minor into acts of sexual intercourse, exposure of the child’s private parts, production of child-related pornographic contents and actual sexual contacts with children.

Psychological Abuse of children can be seen in cases of excessive scolding, lack of proper attention that children should be receiving from their parents and guardians, destructive criticisms and destruction of a child’s personality.

Neglect of children can also lead to children dropping out of schools, begging/stealing for food and money, lack of proper medical care for minors and realities of children looking like ragamuffins.

Consequently, the causes of child abuse can be judiciously related to sex, age, personal history, societal norms, economic challenges, lack of Rights’ Protection Agencies, parents battling with traits of alcoholism and family size. These causative agents of child abuse can bring untold effects upon the society at large and these effects can be emotional, physical and psychological as the case may be, giving rise to individuals with dissociative lifestyles.

Furthermore, the treatment of individuals who have been malformed with respect to the abuses they experienced abinitio, can be a long process because it involves behavioral therapy and other forms of neoteric therapies. Treatments of psyche-related problems are not just a one-day process due to the long-lasting effects of abuses on various conscious mental activities. It is also noteworthy to point out that, prevention is always better than cure and holding fast to this true reality, entails that agencies who have the responsibility of protecting the rights of children must continue to do the needful which requires proper oversights of parent-child relationships.

To conclude this piece therefore, we must agree that untold hardships have been a great challenge for children especially in Africa and some parts of Asia. Children with long histories of abuses turn out to become societal misfits. To this end we encourage that: Children should be given a free platform to express themselves on many topical issues and issues relating to their existence.

Children should also be allowed to freely ask questions on any issue, no matter, how weird it seems to be.

Governments should make regulations outlawing societal norms and values that might amount to child abuses.

Corporal punishments by parents, guardians and care-givers should be discouraged at all levels, thereby making parents/guardians/care-givers who seem to be incorrigible, to face the full weight of justice enshrined in the law of the land.

Education system (both conventional and unconventional) in Nigeria should be able to train up young ones into becoming critical, analytical and evaluative individuals with a view of defending the vulnerable.

And again, since children are said to be leaders of tomorrow, it is pertinent to note that to secure their future, their present existence must be cherished and protected.

Christian Chimemerem Uzoukwu
08100029867 / 09025760804
Admin Critical Thinkers’ Forum.

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