title: The dangers of couching in southwest Nigeria.
abstract: The need to highlight the dangers to the eye and visual status in couching has become necessary in order to discourage its patronage. This was a bi-center clinic-based prospective descriptive study about new cases of couched eyes which were seen over a two-year period. Oral interviews, eye examinations, refractions, and perimetry tests were used to obtain the information. SPSS version 16 was used for the descriptive analysis. Twenty-five patients and 30 eyes of 15 (60%) males and 10 (40%) females were studied. The age range was 34-90 years with a mean age of 67.87 years (SD 11.27). Presenting versus (vs) corrected visual acuity (VA) for normal vision was 6.7% vs 23.3%, visual impairment was 16.7% vs 26.3%, and blindness was 76.7% vs 50%. A significant number still remained blind after corrections (P = 0.014). The most common presenting complaint was "poor/blurred vision" in 24 (80.4%) and the most frequent duration of couching before presentation was 7-12 months (46.7%). Subjects with a cup:disc ratio > 0.6 had intraocular pressures (IOPs) of > 21 mmHg, and 50% of those patients had IOP > 40 mmHg (P = 0.001). Glaucoma (13.3%) and corneal opacity/retinal detachment/couching maculopathy/optic atrophy (10%) were the most common complications. Couching causes visually-disabling complications, and is therefore strongly condemned. Increasing public awareness and putting a policy in place for affordable and accessible cataract services in government hospitals would gradually phase out its patronage.
authors.affiliation: Department of Surgery, College of Health Sciences, Osun State University, PMB 4494, Osogbo, Nigeria ; Department of Ophthalmology, Ladoke Akintola University of Technology Teaching Hospital, PMB 5000, Osogbo, Nigeria.
authors.forename: Isawumi Michaeline
authors.initials: IM
authors.lastname: Asuquo
authors.affiliation: Department of Surgery, College of Health Sciences, Osun State University, PMB 4494, Osogbo, Nigeria.
authors.forename: Hassan Mustapha
authors.initials: HM
authors.lastname: Busuyi
authors.affiliation: Department of Ophthalmology, Ladoke Akintola University of Technology Teaching Hospital, PMB 5000, Osogbo, Nigeria.
authors.forename: Kolawole Olubayo
authors.initials: KO
authors.lastname: Umar
keywords: awareness; cataracts; complications; policy