Practice of external ocular photography among ophthalmologists in Nigeria, sub-saharan Africa

Background: External ocular photography (EOP) has become an essential tool in the day-to-day practice of ophthalmology as it entails the imaging of the external eye, ocular adnexa, face, and the anterior segment of the eye. The aim of this study was to assess the practice of EOP among ophthalmologists in Nigeria with a view to providing baseline information that will be useful in the advancement of ophthalmic practice. Materials and Methods: An online cross-sectional survey among practicing ophthalmologists in Nigeria. Information regarding reasons for external photography, type of camera, ownership of camera and barriers to external photography were obtained. The data obtained were analysed using IBM Statistical Package for the Social Sciences version 22.0 software for Windows (IBM Corp., Armonk, NY, USA). Results: A total of 183 out of 355 ophthalmologists completed the survey (51.5% response rate), with a mean age of 43.9 ± 8.1 years. Of the respondents, 84.7% use EOP in their practice with 53.6% making use of smartphones. Indications for the use of EOP were documentation (71.0%), teaching purposes (54.2%), patient’s communication (47.1%), and surgical/treatment planning (45.8%). Among the users of EOP, 87.1% obtained consent and only 5% use written informed consent. There is an association between obtaining consent and younger years in practice (P = 0.005). Conclusion: The use of EOP is high among ophthalmologists in Nigeria and with its increasing popularity comes the need for ethical and medicolegal considerations, especially in oculoplastic practices. Most importantly, whenever the effective concealment of patient’s identity and privacy cannot be guaranteed during clinical photography, the use of oral consent may be inadequate.