A Review of Eye Removal (Evisceration) at Our Lady of Grace Hospital Breman Asikuma Central Region, Ghana 2012-2016

Abstract

Introduction: The World Health Organisation (WHO) - supported VISION 2020 is a global initiative that aims to eliminate avoidable blindness by the year 2020. To reduce and possibly eliminate the need to undertake evisceration in Ghana, there is the need to understand the causes of eviscerations. The Our Lady of Grace Hospital in the Asikuma–Odoben-Brakwa District of the Central Region of Ghana has for many years provided specialised eye care services. This study is a five-year review of eviscerations undertaken at this facility. Methodology: Using a standard tool, data was extracted from the records of patients who had undergone eviscerations at the hospital between January 2012 and December 2016. Data extracted included demographic records, the circumstances of eye injury and the indications for evisceration. Supplementary information was obtained from theatre logbooks. In-depth telephone and face-to-face interviews were conducted with nine patients with readily-available contact information. Data analysis was largely descriptive. Result: Eighty-one cases of eviscerations were conducted. This represented a rate of 27 per 1,000 eye surgeries at the facility. The mean age of patients was 50 years (range 50 to 59). The highest proportion of patients were 60 years and above. Right (51%) and left (49%) eyes were eviscerated in nearly equal proportion. The occupations of the majority of patients were farmers/fishers (55.6%) and trading (19.8%). The trauma-related indications for evisceration were stick/vegetal materials, stick eye injury and assault. The non-trauma-related indications for evisceration were endophthalmitis (45%) and ulcerative keratitis (27%). The underlining factor in most cases was occupation and most (55.6%) cases presented in complicated conditions. Conclusion: Late reporting to health facility and involvement of aged people in manual unprotected farm activities are common underlying causes of evisceration. Public education to encourage early reporting is needed. The aged should be discouraged from engaging in unprotected manual farm-related activities.