Traditional couching for cataract treatment: a cause of visual impairment.

Background: Cataract is the most common cause of blindness both in Nigeria and in the world over. Couching as an ancient method of treatment usually practiced by traditional healer is discouraged and has been abandoned as a result of the attendant complications and also because of the availability of better techniques in the treatment of cataract.

Study Design: Records of 9 eyes of 6 patients (4 males, 2 females) who presented at the eye clinic of the University of Ilorin Teaching Hospital following traditional treatment of cataract known as couching between April 1999 and December 2001 were reviewed retrospectively.

Result: The male: female ratio was 2:1. The age range was from 43 years to 80 years. The period between couching and presentation was between 3 months and 10 years. All the patients presented as a result of poor vision in the couched eyes. The complications recorded include glaucoma, optic atrophy and panuveitis. None had previous spectacle correction. Couching was done biocularly in 3 patients and uniocularly in 3 patients. The visual acuity at presentation was less than 3/60 in 8(88.8%) eyes. The patients received treatment, ranging from surgical, medical to optical as indicated. Their visual acuity improved to between 6/36 and 6/18 in 6 (66.6%) eyes, while the remaining 3 (33.3%) eyes remained blind.

Conclusion: Scientifically proven atrocities performed by those who practice medicine without any medical knowledge often referred to as "traditional doctors" as shown here are reasons enough to discourage such practices as they exist at present.