How relevant is current Nigerian postgraduate ophthalmic training to needed practice skills?

Objectives • To determine the pattern of referrals to an ophthalmic department • To determine the scope of other sub-specialty knowledge required of the practicing ophthalmologist • To determine the impact of referral pattern on the needed practice skills in ophthalmology.Method: A study of one hundred consecutive in-patients with visual complaints referred from different departments of the University College Hospital, Ibadan to the ophthalmology department was done. Their age, sex, source of referral, working diagnosis of the referring physician, definitive ocular diagnosis, investigations requested, ophthalmic management and outcome were analyzed.Results: Forty-eight percent of the subjects studied were aged below 20 years. Almost half of the patients (47%) were referred by neurosurgeons, while physicians had referred 20%, half of whom were from the endocrine unit. Optic atrophy and papilloedema represented 18% and 12% respectively of the ocular findings in the referred patients. Eleven percent of the patients had no discernible ocular abnormality. The investigation most frequently requested by the ophthalmologist was roentgenological examination (25%), followed by ultrasound scan (9%) and visual field analysis (7%). The most frequently prescribed medications by the ophthalmologist were antibiotics and antihistamines (27%). More than half of the patients (57%) did not require any medication but were counseled. Fifty-six percent of the patients had no ocular problem and were therefore discharged. Nine percent lost the vision in one or both eyes. Eight percent of the patients died while 27% was lost to follow up.Conclusions: The need for the ophthalmologist to have adequate knowledge of some diseases affecting medical and surgical sub-specialties is emphasized. This study justifies the current postgraduate curriculum of the various colleges that requires rotation through some specialized medical and surgical units by ophthalmology residents. Specifically, knowledge about vision-threatening intracranial space-occupying lesions, head injury and hydrocephalus must be updated. Diagnostic skills for recognition and investigation of optic disc oedema and optic atrophy also need to be reviewed constantly. Nigerian Journal of Ophthalmology Vol. 14(1) 2006: 5-