Eye surgery, also known as ocular surgery, is a medical procedure that aims to correct or improve various eye conditions, such as cataracts, glaucoma, refractive errors, retinal detachment, squint and others. Eye surgery can restore or enhance vision, prevent further complications and improve the quality of life of patients.
However, eye surgery is not without challenges, especially in a developing country like Nigeria. According to the World Health Organization (WHO), Nigeria has one of the highest rates of blindness and visual impairment in Africa, with an estimated 4.25 million people affected. The main causes of blindness and visual impairment in Nigeria are cataracts (43%), glaucoma (16.7%), trachoma (5.5%), corneal opacities (5.3%) and refractive errors (4.9%).
Eye surgery can address some of these conditions, but it requires adequate post-operative care to ensure optimal outcomes and prevent complications. Post-eye surgery care involves regular follow-up visits, medication adherence, wound care, eye protection, hygiene and lifestyle modifications. However, many patients in Nigeria face barriers to accessing and adhering to post-eye surgery care, such as:
1. Lack of awareness and education: Many patients are not aware of the importance and benefits of post-eye surgery care, or they have misconceptions and fears about it. Some patients may not understand the instructions given by their eye doctors or may not be able to read the prescription labels. Some patients may also have cultural or religious beliefs that hinder their acceptance of post-eye surgery care.
2. Cost and affordability: Post-eye surgery care can be expensive for many patients in Nigeria, especially those who live in rural areas or have low incomes. The cost of post-eye surgery care may include transportation fees, consultation fees, medication fees, eye drops, glasses and other supplies. Some patients may not have health insurance or may not be covered by the National Health Insurance Scheme (NHIS). Some patients may also face financial difficulties due to loss of income or productivity during their recovery period.
3. Availability and accessibility: Post-eye surgery care may not be readily available or accessible for many patients in Nigeria, especially those who live in remote areas or have limited mobility. There is a shortage of eye care facilities and personnel in Nigeria, especially in rural areas where 70% of the population lives. According to the Nigerian Optometric Association (NOA), there are only about 4,000 optometrists and 300 ophthalmologists for a population of over 200 million people. This means that many patients have to travel long distances or wait for long hours to access post-eye surgery care. Some patients may also face challenges in accessing transportation, communication or internet services.
4. Compliance and adherence: Post-eye surgery care requires compliance and adherence from the patients, which can be influenced by various factors such as motivation, self-efficacy, social support, side effects and satisfaction. Some patients may not comply with their post-eye surgery care regimen due to forgetfulness, inconvenience, discomfort, lack of motivation or perceived ineffectiveness. Some patients may also face social pressure or stigma from their family, friends or community members who may not understand or support their post-eye surgery care.
These challenges can affect the outcomes and complications of eye surgery in Nigeria. According to a study by Okeke et al. (2019), the rate of post-operative complications after cataract surgery in Nigeria was 18%, which was higher than the global average of 10%. The most common complications were corneal edema (6.8%), posterior capsular opacification (4%) and endophthalmitis (1%). The study also found that poor post-operative follow-up was associated with a higher risk of complications.
Therefore, there is a need to address the unique challenges of post-eye surgery care in Nigeria and improve the quality and accessibility of eye care services in the country. Some possible solutions are:
5. Increasing awareness and education: There is a need to increase awareness and education among patients and the general public about the importance and benefits of post-eye surgery care, as well as the risks and complications of neglecting it. This can be done through mass media campaigns, community outreach programs, patient education materials and counselling sessions. There is also a need to dispel myths and fears about post-eye surgery care and encourage positive attitudes and behaviours towards it.
6. Reducing cost and improving affordability: There is a need to reduce the cost and improve the affordability of post-eye surgery care for patients in Nigeria, especially those who are poor or uninsured. This can be done through subsidizing or waiving fees for post-operative consultations, medications, eye drops and other supplies; expanding health insurance coverage or introducing social health protection schemes; providing financial assistance or incentives for transportation or accommodation; and supporting income-generating activities or vocational rehabilitation for patients.
7. Improving availability and accessibility: There is a need to improve the availability and accessibility of post-eye surgery care for patients in Nigeria, especially those who live in rural or hard-to-reach areas. This can be done by increasing the number and distribution of eye care facilities and personnel; providing mobile or outreach services; using telemedicine or digital platforms; and strengthening referral systems and coordination among different levels of eye care providers.
8. Enhancing compliance and adherence: There is a need to enhance compliance and adherence to post-eye surgery care among patients in Nigeria, which can be influenced by various factors such as motivation, self-efficacy, social support, side effects and satisfaction. This can be done through providing reminders, feedback, reinforcement, counselling and education; addressing side effects and managing expectations; involving family, friends or community members in post-eye surgery care; and ensuring patient satisfaction and quality of care.
Post-eye surgery care is an essential component of eye care that can improve the outcomes and prevent the complications of eye surgery. However, many patients in Nigeria face unique challenges in accessing and adhering to post-eye surgery care, which can affect their vision and quality of life. Therefore, there is a need to address these challenges and improve the quality and accessibility of post-eye surgery care in Nigeria.
