IGP Idris viral Transmission video; the Medical explanation - By Dr Egharevba Osagie

On 20/May/2018 / In Articles

Nigerians have been treated to an overdose of humour, subsequent to the Inspector-General of Police's trending 'Transmission' video coming to light. I cringed every time I watched it, though hard to feel vicarious embarrassment for a Nigerian Policeman, he is still human like the rest of us, with the same limitations and shortcomings. There is nothing special about his condition, it affects us all. 
The IGP Idris Kpotun is not dyslexic as has been claimed on twitter, neither was the video doctored (I have seen the parallel version too) and it was not a spiritual attack [sic] because I have seen similar reading performances in a Bible believing church. There are instances where church members find it difficult to read passages from the Bible; skipping words and reading a line twice... Most of us can recall the presidential election results collation exercise, there was a particular returning officer who found it difficult to read a result he prepared, and local lighting had to be provided. These are not spiritual attacks, our village people are not that sophisticated! Brief analysis. Straight to the point. The IGP started well, though reading protocol that he is probably familiar with by heart. Looking at his facial expression, it is obvious from the video that he is almost squinting as he read. 
The initial nine word sentence is taken well (“I AM DELIGHTED- TO- MAKE- THIS- REMARK- AT- THE-), stops short as he moves to the next line (“OFFICIAL COMMISSIONING-OF-THE-CORPORATE-TRASMISSIONâ€), and the next four lines. He struggles as he read multisyllabic words but trudges on gently. (“...AS-IT (RE) MARKS-YET-ANOTHER-MILESTONE-IN THE EFFORTS OF THIS ADMINISTRATION TO COMMISSION THE NIGERIAN POLICE FORCE TO MAKE AN IMPORTANT EFFECTIVE ??? AND RESPONSIVE ___ IN THE ART OF POLICING IN NIGERIAâ€). The above statement does not make any sense. 
He struggles to find his place as he reads and it is obvious that a line was skipped towards the end of the statement. A line is also skipped later on in the speech (... ON THE 22ND OF JUNE, 2016, I PROMISED TO MAKE THE NIGERIAN POLICE FORCE A HIGH LEVEL _____ WILL TO BE MORE ACCOUNTABLE, EFFECTIVE AND TRANSITION TO AVAILABLE _____ WITH A COMPREHENSIVE ______ ON CORRUPTION). 
From this point onwards there is complete breakdown, I mean, close to complete breakdown as he tries to isolate the line he reads. Discussion.   The video we watched, that made most of us deliriously happy, is most likely as a result of age-related near visual inadequacy or PRESBYOPIA. It is not a a disease. It affects and will affect everyone of us at some point in our lives. 
The human eye, like a camera, has a lens that helps us produce sharp images of objects around us. To see clearly at varying distances, the lens changes its focus. In cameras, there is a dial for adjusting the focus (though newer cameras have autofocus), in the human eye, the focusing and refocusing is automatic. Since the human lens is in a fixed position in the eyes, it alters its focusing power by changing its shape. To see objects which are closer, the lens generates more focusing power by becoming 'fatter'. The fatter, the more focusing power. To see objects which are farther away, the lens returns to its default 'thin' relaxed state. This process called ACCOMMODATION, takes around 1second. The problem is that, with progression in age, the lens fibres become stiffer. 
The lens does not change shape or become as fat as it used to. And the lens does not change shape as quickly as it used to. From adolescence to old age, the focusing (accommodative) power of the eye is gradually lost as the lens gets stiffer in its thin relaxed state. And when we are around 40 years, the loss of elasticity is significant enough to impact on our functional ability. Â It becomes increasingly difficult to read small print, load an airtime voucher, thread a sewing machine needle, pick dirt from beans, tighten small screws with a screw driver, and other tasks done relatively close to the eyes. We find relief by holding the task at arms length, or by increasing the lighting, or when possible, increasing the size of the task. 
The IGP could not afford to move the paper backwards because it was on a lectern, neither could he increase his height from the paper obviously. These would have made reading easier. In the video, he is seen bending the sheet of paper towards light to improve visibility. When you force yourself to read, a pulling sensation is felt in the head, with production of tears and headache after a while. Usually, individuals with mild impairment start reading, after a few minutes, the letters appear jumbled and mixed up. This is most likely what we witnessed. Â As we advance in age, the lens gets even stiffer, more focusing power is lost and our symptoms get worse. Meanwhile, there is often no complaint with distance vision. This is presbyopia. 
It is a normal ageing process like hair greying.   The remedy is corrective lenses or near visual aids. This is an extra lens in the form of spectacles, to supplement the remaining focusing power in the human lens. This would enable individual read comfortably at his desired distance. The few minutes an examination takes would save you years of embarrassment and being the butt of jokes among your peers. 
Yes, a lot of us claim we know elderly people who read without glasses, yes I agree. I will give two instances in which it is possible and why it does not apply in this case. There is something called myopia, or shortsightedness. Individuals who are shortsighted find it difficult to see distant objects clearly, because their natural lens is too strong or their eyeball is too long. But they can read something close without any problems. 
But to see distance clearly, they need glasses. When they get to presbyopic age (40+), the more severe the shortsightedness, the less likely they would need glasses for reading, because that extra strength in the lens would enable them read clearly. Those with mild shortsightedness would need glasses when their shortsightedness can no longer compensate for the lost focusing power. Overall, they would start using glasses later than their normal eyed age mates. So presbyopia occurs, but the myopia (shortsightedness) compensates for it, depending on the myopia severity and lens focusing power remaining.
Secondly, there are cases of individuals who have been using glasses for reading and near work, then dramatically they begin to read without glasses. Some claim the glasses corrected their eyes, others may claim they finally received their healing. The truth is that, as the lens becomes stiffer, its central part is becomes thicker and harder. The increased hardness (Nuclear sclerosis) would make it possible for the patient to read clearly once again without glasses. Though as this happens, the distance vision declines gradually. Most patients do not notice this distance decrement in vision until they are tested. As the thickening and hardness continues, distance vision would continue to decline, then near vision follows, and finally complete lens opacity blindness. Blindness from senile cataract. Fear not! It is treatable. 
Like we observed, the IGP was not wearing glasses and he is 59 years old. Rough calculations based on the maximum expected focusing power for his age, the distance from his eye to the paper and the visual criteria for appointment into the NPF makes it nearly impossible for him to see normal sized typed print at that distance without glasses. I think he should have had a pair of glasses on. Like some of us, he probably see glasses as a badge of disability or a crack on his veneer of invincibility. But like I have suggested severally, glasses for reading, should be seen as a mark of maturity. And I am willing to get the IGP two pairs at no cost. The IGP does not fall into the first category of people who can read without glasses, if he was moderately to severely shortsighted, would not have gained entrance into the police academy. 
He could not function as a police chief in charge of Police Mobile Force if he was even moderately myopic. Neither does he have immature cataract.   Considering the above, it is necessary that he wears spectacles when reading at least.  Not just him, but most of us that fall into his category. I understand that there are misconceptions concerning the use of spectacles. And I'll will address a few of them, now and afterwards. Firstly, it is popular belief, that when you start using glasses, you would become dependent on them, and unable to function without them. 
The truth is, with or without correction, the problem is there. Your glasses would supplement your focusing power and help you read clearly. The reason why that statement is rife, is because, on wearing your glasses, you are presented with perfect vision, and when you take it off, the defect becomes obvious to you because you can see the difference. Presbyopes who do not wear glasses do not know what better vision they are missing. The glasses that are given is just to supplement the remaining focusing power of the human lens. Thus, as that focusing power decreases, it would be necessary to update the glasses. This is usually 2-3 years, as long as the eye is healthy. There is no one-off solution. 
Purchase of reading glasses from roadside vendors is strongly discouraged. Often times, the reading glasses powers are wrongly labelled, and the power is the same for both eyes. But in reality, our two eyes do not always have the same error. In fact, aside this age related presbyopia, a lot of us have preexisting refractive errors such as myopia (shortsightedness), astigmatism etc. The standard of practice is that, these errors are corrected first, before correction is given for presbyopia. And all the corrections are incorporated into one pair of glasses. 
A proper visual examination would not be aimed at changing glasses alone, but would screen for ocular diseases that could impact on vision devastatingly. The eyes are more valuable than the hundreds off naira spent on cheap plastic glasses from the marketplace. Â Secondly, there is no medication - vitamin supplement, drug nor eye drop that can treat presbyopia, just like there is no drug to prevent old age. Presbyopia is an avoidable cause of near visual disability. It is estimated that more than 40.7% of global population above 50 years have functional presbyopia. 
In reality, the figures are much higher. And Spectacles are a cheap, safe and readily available treatment. Optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which include refraction and dispensing, detection/diagnosis and management of disease in the eye, and rehabilitation of conditions of the visual system -World Council of Optometry. Please, see an optometrist today to avoid transition or transmission problems. 
Dr. Egharevba Osagie OD is a member of the Nigerian Optometric Association, he conducts free visual screening in North East Nigeria.
He can be contacted for comments and constructive criticism on 08130424136.

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