Risk Factors for Corneal Blindness Following Corneal Ulceration in North West Nigeria: A Case-Control Study

Corneal blindness following infectious corneal ulceration remains a major preventable cause of monocular blindness in North West Nigeria, yet the specific risk factors predicting progression to corneal scarring and blindness in this setting are incompletely characterised. This study identifies the risk factors for corneal blindness following corneal ulceration through a case-control study conducted at National Eye Centre Kaduna and Usmanu Danfodiyo University Teaching Hospital Sokoto, North West Nigeria. Cases will be patients who developed corneal blindness (visual acuity less than 3 over 60) following corneal ulceration, and controls will be age and sex-matched patients who recovered from corneal ulcer with visual acuity better than 3 over 60. A total of 80 cases and 160 controls will be enrolled. Exposure variables will include prior use of traditional eye remedies, delay from symptom onset to ophthalmic consultation, type of causative organism, nutritional status, HIV status, and treatment adherence. Conditional logistic regression will identify independent risk factors. The role of traditional eye remedy application in converting a potentially treatable corneal ulcer into a blinding corneal scar is well-established anecdotally but poorly quantified in North West Nigeria. This study provides robust case-control evidence to support advocacy for banning harmful traditional eye treatments and strengthening public health messaging. Recommendations will address regulatory action, patient education materials in Hausa, and integration of corneal ulcer prevention into primary health care training. Keywords: corneal ulcer, corneal blindness, risk factors, traditional eye remedies, North West Nigeria