Epidemiology and trends in the uptake of refractive error services in Harare, Zimbabwe: a hospital-based retrospective study

Aim The study aimed to determine the epidemiology and evaluate the trends in the uptake of refractive error services in Harare. Methods A clinic-based retrospective study at the Greenwood Park Eye Centre and its three subsidiaries was conducted from January 1, 2015 to December 31, 2020. Results 12,216 patients' records were retrieved, out of which 1074 (8.79%) had refractive error cases. The prevalence of visual impairment at presentation was 5.80% [95% CI: 5.39 ­ 6.23]. Among those with refractive error, the sample prevalence of visual impairment before correction was 41.30% [CI: 38.3 ­ 44.3, 95%], and 2.20% [95% CI: 1.4 ­ 3.3] after correction. There was inconsistency in the percentage utilization of refractive error services, with the highest being 42.60% in 2015. Refractive error types were related to age, employment position, and type of visual impairment prior to refractive error treatment. Conclusion There was a low percentage of refractive error services uptake in urban Zimbabwe.

Fréquence des amétropies aux cliniques universitaires du graben en République Démocratique du Congo

Introduction : Les amétropies sont des troubles de la vision dus à un fonctionnement défectueux du système optique formé par la succession la cornée, le cristallin et la rétine. Les vices de réfraction (myopie, hypermétropie, astigmatisme, presbytie) donnent des images floues sur la rétine. L'Organisation Mondiale de la Santé (OMS) estime à 153 millions le nombre des personnes souffrant de la déficience visuelle due à des vices de réfraction non corrigés. Le présent travail a pour objectif de déterminer la fréquence et le profil des patients avec amétropies aux Cliniques universitaires de Graben. Méthodes : Notre étude était du type descriptif transversale ayant couvert une période allant du 01 Janvier au 31 Décembre 2020. Notre échantillon a été exhaustif, c'est-à-dire il a été constitué de toute la population d'étude. Résultats : La fréquence des amétropies a été de 11,47%. L'astigmatisme était l'amétropie la plus représentée avec 47,86 %suivi de la myopie avec 38,90% et de l'hypermétropie avec 13,24%. La tranche d'âge la plus touchée est celle des adultes, âge (21-60 ans) avec 73,9% et la moins touchée est de 0-10 ans avec 0,8%. Le taux des déficiences visuelles a diminué après la correction optique et les cas de bonne vision sont passés de 81,1% à 99,4% de bonne acuité visuelle. Conclusion. Les amétropies constituent un réel problème de santé publique. De ce fait, nous encourageons le check up volontaire, comme les amétropies sont souvent méconnues et indolores, pourtant une cause non négligeable de déficience visuelle facilement évitable.

Introduction: : Ametropia are vision disorders due to damage to the visual system caused by a various abnormality in the cornea, lens and retina. The refractive errors (myopia, hyperopia, astigmatism, presbyopia) cause a very weak capacity for the eye retina to properly watch images. The World Health Organization (WHO) estimates that 153 million of people could be suffering from visual issues due to untreated refractive deficiencies. This study aimed to determine the frequency et profil of patients with ametropia. Methods: Our study was of a kind of crosssectional descriptive which covered a time interval from January 01 to December 31, 2020. Our sample was comprehensive and was based on several cases. Results: The frequency of ametropia was 11.47%. Astigmatism was the most prevalent ametropia with 47.86% followed by myopia with 38.90% and hyperopia with 13.24%.The most affected people are adults aged from 21 and 60 years with 73.9% and the least affected are children aged from 0 to 10 years with 0.8%.However, the rate of eyes abnormalities started decreasing after optical treatment and consequently the cases of eyes issues recoveries was about from 81.1% to 99.4% of sight improvement acuity. Conclusion: Ametropia is a real public health problem. As a result, we encourage voluntary check-ups, as ametropia is often unrecognized and painless, yet a significant cause of easily avoidable visual impairment.

Fréquence des vices de réfractions chez les enfants et adolescents âgés de 5 à 18 ans à l'Institut d'ophtalmologie tropicale d'Afrique, au Mali

Contexte et objectif. Les vices de réfraction, constituent un problème de santé publique sur le plan social et scolaire, mais leur ampleur dans les pays d'Afrique subsaharienne est peu connue. La présente étude avait pour objectif de déterminer la fréquence et décrire des vices de réfractions chez les enfants et adolescents en âge scolaire. Méthodes. Dans étude transversale et descriptive, les enfants âgés de 5 à 18 ans ; ont subi un examen oculaire, entre janvier 2017 et février 2018, dans le service d'optométrie de l'institut d'ophtalmologie tropicale d'Afrique (Iota). Les paramètres d'intérêt comprenaient les données sociodémographiques, optométriques et ophtalmologiques. Résultats. 220 sujets ont été examinés. Leur âge moyen était de 11 ans avec un sexe ratio de 1,8/1 en faveur des filles. La fréquence hospitalière du vice réfractif a été de 46,8%. Dans l'ensemble, il s'agissait : l'astigmatisme 55,53%, l'hypermétropie 27,18% des cas et la myopie 2,91%. Les emmétropes représentaient 14,38% des cas. Conclusion. Près de la moitié d'enfants en âge scolaire présentent des vices de réfraction, en particulier l'astigmatisme (avec risque d'amblyopie si non corrigé). Des études ultérieures à la recherche des facteurs de risque de cette pathologie sont à envisager

Ocular comorbidities in children with strabismus in Benin city

Background: Strabismus is the misalignment of the visual axis. Certain comorbidities have been found to be associated with strabismus.These must be identified and treated. Objective: The aim of this study was to determine the ocular comorbidities associated with strabismus in children 15 years and below presenting to the eye clinic of University of Benin Teaching Hospital, Benin City, from January 2014 to December 2014. Patients and Methods: This is a prospective hospital­based observational study of consecutive patients seen in the eye clinic. Results: Fifty­five children presented with strabismus accounting for 2.6% of the total number of 2112 new cases. There were 30 males (54.5%) and 25 females (45.5%) giving a male­to­female ratio of 1:0.83. The age range was from 5 months to 14 years. The mean age was 4.7 years with a standard deviation of ± 3.4 years. Thirty­seven (67.3%) of the patients were under 5 years of age. Forty­seven (85.5%) patients had esotropia, six (10.9%) had exotropia, and two (3.6%) had hypertropia. Vision­impairing comorbidities included refractive error in 33 (64.7%) patients, cataract in 9 (17.6%) patients, corneal opacity in 1 (2.0%) patient, and retinopathy of prematurity in 1 (2.0%) patient. Nonvision­impairing disorders were microcornea, conjunctivitis,and nasolacrimal duct obstruction. The relationship between ocular comorbidity and types of strabismus was not statistically significant (P > 0.05). Conclusion: Detailed assessment to identify the comorbidities associated with strabismus is recommended.This could improve the management of this condition

Cataract surgery in Ibadan, Nigeria: Visual outcome and post-operative refractive error

Background: Cataract is the leading cause of blindness worldwide and can be treated by various surgical techniques with good visual outcome.Objective: To describe the visual outcome and post-operative refractive status among patients who had cataract surgery in a tertiary centre.Methods: In a retrospective study, the demographic data, type of cataract, surgical procedure and complications, visual outcome and post-operative refractive status of the treated eye were retrieved from the hospital records of all adult patients who had cataract surgery.Results: Four hundred and sixty eyes of 456 patients (mean age 61.2 ± 17.3 years, Male: Female = 1.1: 1) had cataract surgery during the study period January 2012 and December 2014. The pre-operative visual acuity was < 3/60 in 415 (90.2%) eyes. All the surgeries were performed under local anaesthesia with 331 (72%) eyes undergoing extracapsular cataract extraction while 129 (28%) had small incision cataract surgery. Visual outcome in those who had a minimum of six weeks follow-up revealed unaided visual acuity of ≥ 6/18 in 185 (56.9%) eyes. Following refraction, 237 (72.9%) eyes had acuity of ≥ 6/18. Post-operative spherical refractive error ranged from ­6.75D to +4.50D (mean -1.61 ± 1.41D) while cylindrical error ranged from 0.00DC to 6.00DC (mean 2.33 ± 1.80DC). Pre-existing ocular problems contributing to poor post-operative visual outcome included glaucoma (50; 15.4%), and age-related macular degeneration (10; 3.1%). Conclusion: Extracapsular cataract extraction gave better visual outcome compared with small incision cataract surgery, but a higher incidence of post-operative cylindrical error was observed

Vision Screening to Detect Efractive Errors in Three Selected Secondary Schools in Birnin Kebbi; North West; Nigeria

Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi; Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart; while students with subnormal vision (VA = 6/9) were examined using pinhole; and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8 (n = 312) males and 48.2 (n = 302) females. Refractive error in either eye was present in 30 (4.8) children. Of these; myopia was diagnosed in 18 (60) children; and then hyperopia in 7 (23.3); and astigmatism in 5 (16.7) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi; and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment

Refractive Errors in Presbyopic Patients in Kano; Nigeria

"Background: The study is a retrospective review of the pattern of refractive errors in presbyopic patients seen in the eye clinic from January to December; 2009. Patients and Methods: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age; sex; and types of refractive error. Unaided and pin hole visual acuity was done with Snellen's or ""E"" Charts and near vision with Jaeger's chart in eng or Hausa. All patients had basic eye examination and streak retinoscopy at two third meter working distance. The final subjective refractive correction given to the patients was used to categorize the type of refractive error. Results: There were 5893 patients; 1584 had refractive error and 644 were presbyopic. There were 289 males and 355 females (M:F= 1:1.2). Presbyopia accounted for 10.9 of clinic attendance and 40 of patients with refractive error. Presbyopia was seen in 17 ; the remaining 83 required distance correction; astigmatism was seen in 41; hypermetropia 29 ; myopia 9 and aphakia 4 . Refractive error was commoner in females than males and the relationship was statistically significant (P-value = 0.017; P 0.05 considered significant). Conclusion: Presbyopia is common and most of the patients had other refractive errors. Full refraction is advised for all patients."

Prevalence; Distribution and Determinants of Myopia in Owerri; Nigeria

Background: Uncorrected myopia is a significant cause of visual impairment and avoidable blindness. Incidence of open-angle glaucoma has been shown to occur more often in myopia. This cross-sectional analytical study determined the prevalence; distribution and determinants of myopia in the adult population of Imo State; Nigeria with a view to establish a reference data for research purposes and future intervention in this locality. Materials and Method: A total of 3451 adults living in Owerri consisting of 2606 persons as test group and 845 persons as controls were randomly selected using standard optometric methods including subjective refraction. Results: Refractive error (ametropia) was found in 79.5 study and 76.8 control. Myopia was found in 23.4 study and 19.6 control. Highest prevalence of myopia was observed in females aged 40-49 years. Fifty percent of study and 68.1 of control group had myopia of -0.50DS to -3.00DS while 4.0 and 2.4 of study and control group respectively had myopic astigmatism. In all; 27.7 study and 16.2 control had myopia 5.00DS. The highest degree of myopia found in this study was - 24.00DS. Conclusion: This study provided information on the prevalence; distribution and determinants of myopia in Owerri; Nigeria and the data could be a basis for improved visual health care in the south-eastern sub-region of Nigeria

Pattern of Eye Disorders among Inmates of a Nigerian Prison

Aim:To determine the prevalence of eye disorders among the inmates of a Nigerian prison with a view to providing eye health care for the prisoners. Methods: A cross sectional survey of the ocular health status of the prisoners in a Nigerian prison was carried out using a pretested protocol designed for the study. Data was obtained on bio-data as well as anterior and posterior segment examinations. These were analyzed using EPI-INFO version 6.0. Results: Two hundred and sixty-nine (26.8) out of the 1005 prisoners examined had eye disorders. The commonest ocular problems noted were presbyopia (21.5); pterygium (19.3) refractive error (15.6) and allergic conjunctivitis (12.5). One inmate (0.1) was blind; 12 (1.2) had monocular blindness while 5(0.5) had low vision. Cataract was the commonest cause of monocular blindness and also the only cause of bilateral blindness. Conclusion: The prevalent eye diseases in the prison community are similar to the findings in the general population. There is a need to train the staff of the medical clinics in Nigerian prisons as integrated eye health workers to enable them meet the basic eye health needs of the prisoners

Retractive erros in school children in Onithsa; Nigeria

Objectives: To determine the incidence and pattern of ametropia among school children.Materials and Methods: Consecutive shcool children presenting at the Guinness Eye Center Onitsha between September 2001 and August 2002 with visual acuity of 6/9 or worse in at least one eye; complaints of visual blurring; eye strain; brow ache and or discomfort while reading were recruited into the study. Cycloplegic refraction on each child was performed using 0.5tropicamide eye-drops. Post-cycloplegic tests were performed within 72 hours.Results: Of the 306 children (M:F - 1:2) examined; 301 (98.4) had ametropia. Spherical errors were namely; hyperopia 23 (7.5); myopia 47 (15.4). Astigmatism occurred in 231 (75.5) namely hyperopic astigmatism 72 (31.2); myopic astigmatism 159 (68.8). Anisometropia was present in 80 (26.1) children; 16 of whom did not improve with refraction. Generally older children (12 - 17 years) were more likely to have refractive errors than younger children (95CI: 0.07; 0.31; p 0.005). But there was no difference in the incidence of myopia between younger children (aged 6 - 11 years) and older children (95CI: -0.08; 0.43; p 0.05). While 41 (13.4) had visual impairment in the better eye; 8 (2.6) other children had uniocular blindness at presentation.Conclusions: There is a high incidence of uncorrected refractive errors among school children; although many were of small degrees. The cooperation of parents and teachers is vital in identifying and treating this modifiable cause of poor academic performance and learning difficulties

Refractive Errors in School Children in Onitsha; Nigeria

Objectives: To determine the incidence and pattern of ametropia among school children. Materials and Methods : Consecutive school children presenting at the Guinness Eye Center Onitsha between September 2001 and August 2002 with visual acuity of 6/9 or worse in at least one eye; complaints of visual blurring; eye strain; brow ache and or discomfort while reading were recruited into the study. Cycloplegic refraction on each child was performed using 0.5) namely hyperopic astigmatism 72 (31.2 tropicamide eye-drops. Post-cycloplegic tests were performed within 72 hours. Results: Of the 306 children (M:F - 1:2) examined; 301 (98.4) had ametropia. Spherical errors were namely; hyperopia 23 (7.5); myopia 47 (15.4). Astigmatism occurred in 231 (75.5); myopic astigmatism 159 (68.8). Anisometropia was present in 80 (26.1) children; 16 of whom did not improve with refraction. Generally older children (12 - 17 years) were more likely to have refractive errors than younger children (95CI: 0.07; 0.31; p 0.005). But there was no difference in the incidence of myopia between younger children (aged 6 - 11 years) and older children (95CI: -0.08; 0.43; p 0.05). While 41 (13.4) had visual impairment in the better eye; 8 (2.6) other children had uniocular blindness at presentation. Conclusions: There is a high incidence of uncorrected refractive errors among school children; although many were of small degrees. The cooperation of parents and teachers is vital in identifying and treating this modifiable cause of poor academic performance and learning difficulties

A Survey of the prevalence of refractive errors among children in lower primary schools in Kampala district

Refractive errors are a known cause of visual impairment and may cause blindness worldwide. In children; refractive errors may prevent those afflicted from progressing with their studies. In Uganda; like in many developing countries; there is no established vision-screening programme for children on commencement of school; such that those with early onset of such errors will have many years of poor vision. Over all; there is limited information on refractive errors among children in Africa. Objective: To determine the prevalence of refractive errors among school children attending lower primary in Kampala district; the frequency ofthe various types of refractive errors; and their relationship to sexuality and ethnicity. Design: A cross-sectional descriptive study. Setting: Kampala District; Uganda. Patients: A total of 623 children aged between 6 and 9 years had a visual acuity testing done at school using the same protocol; of these 301 (48.3) were boys and 322 (51.7) girls. Results: Seventy-three children had a significant refractive error of +-0.50 or worse in one or both eyes; giving a prevalence of 11.6and the commonest single refractive error was astigmatism which accounted for 52of all errors. This was followed by hypermetropia; and myopia was the least common. Conclusion: Significant refractive errors occur among primary school children aged 6 to 9 years at a prevalence of approaximately 12. Therefore; there is need to have regular and simple vision testing in primary school children at least at the commencement of school so as to defect those who may suffer from these disabilities