title: Couching techniques for cataract treatment in Osogbo, South west Nigeria.
abstract: BACKGROUND
  Couching is still being practised in developing countries including Nigeria despite its adverse effects on vision.
  
  
  OBJECTIVE
  To find out the different techniques of couching, highlight the unacceptable poor visual sequelae and assess knowledge, attitudes, and practices of subjects.
  
  
  METHODS
  Clinic based and prospective observational study.
  
  
  METHODS
  Structured interview and clinical examination of consecutive patients was used to obtain information.
  
  
  RESULTS
  Fifteen subjects and 20 eyes of 9(60%) males and 6(40%) females were studied. Age range 60 -90 years and mean 72.4±8.0. Commonest presenting complaints were "I cannot see properly/clearly" 4(26.7%) and "I want to do my second eye so I can see better" 3(20%). Presenting Versus (vs.) Corrected visual acuity (VA) was75% vs 60% blind, 55% vs 45% low vision, and 0% vs 10% normal vision, p= 0.032. Friends and neighbours mostly introduced subjects to couching (26.7% each). Commonest methods involved using sharp objects/needling 45% and blunt/grooving/rocking methods (30%). Subjects assumed "supine" position 75% of time. Eighty five percent of eyes were done at the coucher's. Procedure was painful in 73.3%. Only 5 eyes (25%) maintained vision for >10years. Thirteen (86.7%) said "no" to a repeat procedure and 93.4% would advice against couching.
  
  
  CONCLUSIONS
  Couching methods used were very crude and archaic with attendant poor quality of vision and dissatisfaction. Public education, affordable and accessible cataract surgical services taken to the rural communities could gradually phase out couching.
authors: Department of Ophthalmology, College of Health Sciences, Ladoke Akintola University of Technology and Teaching Hospital, Osogbo, Nigeria. misawumi@gmail.com
authors: M A
authors: MA
authors: Isawumi
authors: O U
authors: OU
authors: Kolawole
authors: M B
authors: MB
authors: Hassan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D061646:Operative Time; D010146:Pain / Q000209:etiology; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity
keywords: Couching; Methods; Nigeria; Visual sequelae
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