The History of the Nigerian Paediatric Ophthalmology & Strabismus Society (NIPOSS)
The Nigerian Paediatric Ophthalmology and Strabismus Society (NIPOSS) is the society for all Paediatric Ophthalmologists in Nigeria. It is committed to advocating and ensuring the good overall eye health of the NIGERIAN child. Nigeria, located in West Africa, is the most populous country in Africa with a population of 216 million. The country also has a very large youthful population with 94 million individuals under the age of 15 years.1
Nigeria currently has about 500 ophthalmologists, of these, there are 32 Paediatric Ophthalmologists and Paediatric oriented Ophthalmologists working in 21 eye care centres in the 36 states of Nigeria.
Paediatric Ophthalmology and Strabismus as a sub-specialty group of the Ophthalmological Society of Nigeria (OSN) started in 2004 during the annual conference of OSN in Calabar, Cross Rivers State. The first meeting of the sub-specialty group, the Paediatric Ophthalmology working group (POWG) held in Calabar, Cross River state, with a few interested ophthalmologists coming together with Professor Marilyn Miller in attendance and a facilitator who provided support for the organization from thereon.
On 7th September 2004, Prof Aderonke Baiyeroju was elected as the first chairperson of the POWG. Prof. Baiyeroju was the first Paediatric Ophthalmologist and Strabismologist in Nigeria after she returned to Nigeria in 1987 after her training in Scotland. Dr Roseline Duke was elected as the Vice Chairman and secretarial assistance was offered by Dr. Dupe Ademola-Popoola with Dr Mildred Ulaikere as treasurer. Steadily, under their leadership, paediatric ophthalmology clinics were set up in different hospitals across the country while the interest in paediatric ophthalmology and strabismus gradually gained momentum with an increase in the number of members in the specialty.
To guide the subspecialty group for the period between 2006 and 2008, leadership was handed over to Dr Roseline Duke as the Chairman, supported by Dr Ibrahim Achi as Vice Chairman and Dr Dupe Ademola-Popoola as secretary in 2006.
Prof Oseluese Dawodu became the Chairman in 2008 at a meeting held at Ijebu-mushin in Ogun state. Dr Dupe Ademola-Popoola was elected as the secretary while the treasurer was Dr Mildred Ulaikere. The executive led the subspecialty group from 2008 to 2014. The POWG rapidly developed into a society under the leadership of Prof Dawodu.
The name Nigerian Paediatric Ophthalmology and Strabismus Society (NIPOSS) was coined at the Ophthalmological Society of Nigeria Meeting in Lagos in 2011 as suggested by Prof Ose Dawodu. A constitution and set of by-laws were subsequently developed and NIPOSS was registered with the Corporate Affairs Commission in 2015. The following elders, late Prof Marilyn Miller, Prof Hannah Faal, Dr Linda Lawrence, Dr Kunle Hassan played a very supportive role in the growth of NIPOSS.
A board of trustees was set up with members as follows :
- Prof Elsie Samaila
- Prof Aderonke Baiyeroju
- Prof Oseluese Dawodu
- Dr Dienye Apiafi
- Dr Dupe Ademola-Popoola
The patrons were Dr Hannah Faal and the late Prof Marilyn Miller.
2014 - 2018
Chairperson – Dr Dupe Ademola-Popoola
Vice Chair – Dr Modupe Idris
Secretary – Dr Adedayo Adio
Treasurer – Dr Patricia Wade
2018 till date (2022)
Chairperson – Dr Adedayo Adio
Vice Chair – Dr Chinyelu Ezisi
Secretary – Dr Olubunmi Bodunde
Treasurer – Dr Aminat Hassan-Wali
Development of Training in Paediatric & Strabismus Subspecialty Program in Nigeria
The initial set of Paediatric Ophthalmologists in Nigeria was trained abroad in the United Kingdom, India, Canada, Pakistan, South Africa and the United States of America. These fully trained foreign trained ophthalmologists returned and established Paediatric Ophthalmology & Strabismus services across the country, mostly in government-owned tertiary hospitals.
A Child eye health course was held in Calabar, Cross River state in 2006. During this course, there were discussions on the need to commence a training program and curriculum development. The training curriculum development for Nigeria, based on international best practices began with Dr Roseline Duke as Chairman, in consultation with Prof Marilyn Miller and Prof Hannah Faal and was completed during the tenure of Prof Oseluese Dawodu as Chairman. The process was supported by a grant for a retreat and development of training modules obtained by Professor Ronke Baiyeroju from the World Health Organisation(WHO). The curriculum was also adopted by the West African College of Surgeons (WACS).
As of 2022 in Nigeria, there are 10 centers for training in Paediatric Ophthalmology and Strabismus nationwide namely:
- University College Hospital, Ibadan
- University of Ilorin Teaching Hospital
- University of Benin Teaching Hospital
- University of Jos Teaching hospital
- Eye Foundation Hospitals, Lagos
- Calabar Childrens Eye Centre, University of Calabar Teaching Hospital, Calabar
- University of Port Harcourt Teaching Hospital
- National Eye Centre, Kaduna
- Osun State University Teaching Hospital, Oshogbo
- University of Nigeria Teaching Hospital
This National training program in Paediatric Ophthalmology and Strabismus, awards the NIPOSS fellowship. Training commenced in 2012 and the first NIPOSS fellows were Dr Valentina Okeigbemen (trained by Prof Ose Dawodu in Benin) and Dr Olubunmi Bodunde (trained by Prof Dupe Ademola-Popoola in Ilorin).
The training program is open to both International and Local trainees and has received trainees from the West African subregion and from all the geopolitical zones of the country.
The NIPOSS Fellowship training programme has the advantage of running in a modular format in various NIPOSS training centres giving a trainee the best exposure available in all areas of paediatric ophthalmology and strabismus within the country.
However, the core clinical exposure occurs at the primary hospital assigned for the training.
NIPOSS landmark achievements
Achievements over the last 18 years include :
- Registration of the society with the Corporate Affairs Commission
- Documented membership guidelines
- Documented aim and objectives of NIPOSS
- Corporate Affairs Commission approved By-laws and Constitution
- Defined leadership structure and succession plans
- NIPOSS Bank Accounts opened – Local and domiciliary accounts
- Establishment of a NIPOSS Post Residency Subspecialty Fellowship training in Paediatric Ophthalmology. 7 Fellows have been trained so far.
- Registered training centres in 10 locations. With one Nigerian fellow currently in training and 2 foreign fellows about to start training.
- Yearly subspecialty/midyear meetings started 2012
- NIPOSS quarterly webinars started in 2019 – before the outbreak of Covid 19 and was primarily to help members to still have access to medical and surgical updates from the comfort of their homes without having to spend a lot on travelling. The partnership with Cybersight has greatly enhanced its visibility on the international stage. These lectures are all domiciled in the Cybersight online library and our NIPOSS website as our contribution to the repository of knowledge.
- NIPOSS educational pamphlets distributed across the country from 2019
- NIPOSS website www.niposs.org online from 2021
- At the yearly subspecialty meetings, Organized by NIPOSS executives, hard and soft copy brochures and mementoes are distributed/couriered to financial members.
- Usually a Theme and subtheme are required with scientific papers and training updates around this topic invited. Following this, an Annual general meeting holds to discuss business-related topics and financial matters along with yearly reports. A yearly communique is released at each meeting. Due to the covid outbreak, the last subspecialty was completely virtual.
- Zoom subscriptions are made to ease arrangements for meetings in line with present-day realities.
- The very first paediatric subspecialty lecture was given by Prof Marilyn Miller in 2011. Subsequently, it was decided that it should hold yearly by an invited guest expert on a chosen theme for that year and be called the yearly Marilyn Miller guest lecture. The prestigious yearly Marilyn Miller lecture has been delivered by ten (10) eminent scholars from all over the world on various topics of interest. In the last 2 or 3 years, we have been able to record and keep these vast resources of information online.
Gains by NIPOSS in 18 years
- Twenty-one (21) public hospitals centres and 1 private tertiary eye hospital in Nigeria where specialized child eye care services are provided.
- At least 8 paediatric eye centers now have collaborations with paediatric oncology.
- At least 13 centres are now screening for ROP.
- ROP screening guidelines for Nigeria are now available.
- Squint surgery is being performed in many paediatric eye centres.
- Paediatric glaucoma care is better available.
- Low vision care is more readily available though still not much in the northern regions of the country.
- Paediatric Low vision training is available in the country at least once a year now.
- Orthoptic training is now available once a year in one centre in the country.
Some of our challenges
1. Infrastructure, Medicines and technology
- An inadequate number of centres with dedicated fully equipped child-friendly clinics and theatre spaces.
- Lack of vitrectomy machines for paediatric cataract surgery in younger children.
- Lack of Lasers for retinal pathologies including Retinoblastoma, in particular.
- Challenges with Retinoblastoma management in relation to the lack of radiotherapy and expensive chemotherapy medication.
2. Human Resources
- Few well-skilled Paediatric Glaucoma specialists.
- More skills are required in performing Anterior Vitrectomy.
- More centres are necessary for Orthoptic and Pediatric Low Vision Training.
- Training for a childhood blindness coordinator to link community events to tertiary hospitals and ensure follow-up is lacking.
Recommendations for the way forward
- The political will to implement already existing policies on the prevention of childhood visual blindness and visual impairment.
- Support to the development of comprehensive regional centres.
- Collaborate with national/international bodies (OSN, AOC) to develop a partnership for equipment purchase.
- Strategies towards developing programmes for the prevention of childhood blindness and visual impairment for states and zones in Nigeria.
- The review of the NIPOSS fellowship curriculum and training programme.
- Networks with international organizations and Institutions for cross-learning and linkages.
- Encourage trained exchange programs between already established paediatric eye care centres and developing paediatric eye care centres.
- Development of tele medicine for regional centres and corresponding feeder state paediatric eye care centres to link for clinical care and consultation. E.g. in Retinopathy of prematurity and training.
- Collaborations and networks are desired in the area of research, while ophthalmic residents and fellows and academicians are encouraged to carry out research in paediatric ophthalmology and publish in scientific journals to contribute to knowledge.
- A mentorship programme for young paediatric ophthalmologists and strabismologists.
- Continuous review of screening guidelines for paediatric eye conditions including ROP and development of preferred practice patterns(PPP) for specific common conditions frequently seen in our practice to encourage better management.
Appreciation: NIPOSS executive and members appreciate the invaluable support of Dr Rabiu by ensuring that Members of the Middle East Paediatric Ophthalmology and Strabismus Society (MEAPOSS) participate in our 2011 subspecialty day during the OSN meeting in Lagos, and getting some of their members participating at the short course held in Benin in 2013 for the first set of NIPOSS Post Residency Fellowship training for the first set of Fellows.
COMPILED BY PROF ADEDAYO ADIO
2018 – 2022