Ophthalmic services utilisation and associated factors in the Ashanti region, Ghana

Objective: This survey determined the utilisation of eye care services and associated factors among adults in the Ashanti region of Ghana. Design: A population-based cross-sectional descriptive study Method: Data for this study was collected from 1615 randomly selected individuals in the Ashanti region of Ghana, using a structured, pretested interviewer-guided questionnaire. Information regarding the accessibility and determinants of, and barriers to, eye care services was based on self-reports, using the WHO Eye Care Services Assessment Questionnaire. Inferential analyses were performed using the chi-square test for statistical significance, set at p=0.05.Setting: Ashanti Region, Ghana Participants: One thousand six hundred and fifteen randomly selected adults Results: Public eye care facilities were used by 58.2% of the participants for their last eye exam. Of the participants, 47.0% had travelled less than five kilometres for their last eye exam. Waiting time and service cost were participants' most frequently cited challenges in seeking care. No need felt (40.1%), self-medication (37.7%) and cost (22.2%) were the most frequently mentioned barriers to seeking ophthalmic services. Conclusion: The major challenges encountered in seeking eye care services were waiting time and cost of service. Major barriers to ophthalmic services utilisation were no need felt, self-medication and cost. Factors such as cost, lack of felt need and self-medication, which serve as barriers to utilising eye care services, should be addressed by stakeholders through eye health education and promotion

Eye care utilization among older subjects with visual impairment in Northwest Ethiopia

Purpose: To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North Western Ethiopia, 2021. Methods: An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted. Results: A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2­23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5­7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0­9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5­5.6), being blind (AOR = 2.9; 95% CI: 1.5­5.6), duration of visual impairment ≤1 year (AOR = 2.5; 95% CI: 1.3­4.9) were all significantly associated. Conclusion: In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

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.

Prevalence and causes of visual impairment among older persons living in low-income old age homes in Durban, South Africa

Background: Visual impairment (VI) increases with age and has been reported to be more prevalent among older adults living in old age homes than in the general population. Aim: To determine the prevalence and causes of VI among older adults living in low-income old age homes in Durban, South Africa. Setting: This study was conducted at low-income old age homes in Durban. Methods: This cross-sectional study of 118 residents aged 60 years and older, collected socio-demographic data, presenting visual acuities (VAs) for each eye, and binocularly. Anterior segment eye examinations were conducted with a penlight torch and a portable slit-lamp, while posterior segment evaluation was conducted with direct and indirect ophthalmoscopy. Objective and subjective refractions were performed, and the best-corrected distance and near VAs were measured in each eye. VI was defined as presenting VA < 6/18 and included moderate VI (< 6/18−6/60), severe VI (< 6/60 ­3/60) and blindness (< 6/120). Results: The mean age of the participants was 73.3 years and included 80.5% females and 19.5% males. The prevalence of VI and blindness was 63.6%. Optical correction significantly reduced the prevalence of VI and blindness by 19.5% (p < 0.05). The main causes of non-refractive VI and blindness were cataract (54.5%), posterior segment disorders (25.5%) and corneal opacities (20%). Conclusion: The prevalence of VI and blindness is high among residents in low-income old age homes living in Durban. Refractive correction and surgical cataract intervention can significantly reduce the burden of VI and blindness among the elderly residents

Eye diseases in Akon payam, South Sudan

Objectives: To determine the prevalence and causes of blindness and visual impairment among patients in Akon payam, Warrap State, South Sudan.Methods and materials: This was a cross-sectional study of 862 patients conducted at Akon in the period 18 ­ 31 September 2015. The Snellen E chart was used to measure visual acuity, and all patients had a basic eye examination. Their vision status was categorized according to the World Health Organization classification. Data were entered and analyzed using SPSS version 22(IBM).Results: The age range of the study population was 3 - 86 years; 81.9% were aged 41-80 years. 50.8% were males and 49.2% were females. There were 1483 bilaterally blind eyes giving a prevalence of blindness of 86% (95% CI: 3.2497-3.3531) with prevalence of visual impairment of 3.9 %( 95% CI: 2.5001-3.0944.Cataract (59.7%) was the commonest eye disease, followed by glaucoma (15.1%), corneal dystrophy (9.3%), allergic conjunctivitis (5.5%), corneal scar (1.9%), refractive errors(1.8%) and others(6.7%). Among those who are blind cataract (66%) was the major agent with females affected more than males .It was followed by glaucoma (16.7%), corneal dystrophy (10%), corneal scar(1.8%) and the rest of agents(5.4%). The main age group affected by blindness was the 41- 80 years age group (87%) and the least was below 20 years (1.1%). There was a strong association between age and sex with the causes of blindness.Conclusion: There was equal sex preponderance with more blindness in those aged 41 years or above. Cataract and glaucoma still remained major cause of blindness in this payam. More effort is needed by the government to reduce the burden of these diseases

The prevalence of self-reported vision difficulty in economically disadvantaged regions of South Africa

Background: Vision impairment, resulting in vision difficulties, is a leading cause of disability, and hence one of the key barriers for people to access education and employment, which may force them into poverty. Objectives: The objective of this study was to determine the prevalence of self reported vision difficulties as an indicator of vision impairment in economically disadvantaged regions in South Africa, and to examine the relationship between self-reported vision difficulties and socio-economic markers of poverty, namely, income, education and health service needs. Methods: A cross-sectional study was conducted in economically disadvantaged districts to collect data from households on poverty and health, including vision difficulty. As visual acuity measurements were not conducted, the researchers used the term vision difficulty as an indicator of vision impairment. Data were collected from 27 districts (74 901 respondents). Logistic regression analysis and chi-square tests were used to determine bivariate relationships between variables and self-reported vision difficulty. Kernel density estimators were used for age, categorised by self-reported and not reported vision difficulty.Results: Prevalence of self-reported vision difficulty was 11.2% (95% CI; 8.7% - 13.7%). More women (12.7%) compared to men (9.5%) self-reported vision difficulty (p 0.01). Self-reported vision difficulty was higher (14.2%) for respondents that do not spend any money. A statistically significant relationship was found between the highest level of education and self-reporting of vision difficulty; as completed highest level of education increased, self-reporting of vision difficulty became lower (p 0.01). A significantly higher prevalence of self-reported vision difficulty was found in respondents who are employed (p 0.01), 17% (95% CI: 12.8% - 21.1%). Conclusion: The evidence from this study suggests associations between socio-economic factors and vision difficulties that have a two-fold relationship (some factors such as education; and access to eye health services are associated with vision difficulty whilst vision difficulty may trap people in their current poverty or deepen their poverty status). The results are thus indicative of the need for further research in South Africa

Research protocol: development, implementation and evaluation of a cognitive behavioural therapy-based intervention programme for the management of anxiety symptoms in South African children with visual impairments

Background: Childhood anxiety presents a serious mental health problem, and it is one of the most common forms of psychological distress reported by youth worldwide. The prevalence of anxiety symptoms amongst South African youth is reported to be significantly higher than in other parts of the world. These high prevalence rates become even more significant when viewed in terms of children with visual impairments, as it is suggested that children with physical disabilities may be more prone, than their non-disabled peers, for the development of psychological difficulties. Objectives: The main aim of this study is to develop, implement and evaluate a specifically tailored anxiety intervention programme for use with South African children with visual impairments. Method: A specifically tailored cognitive-behavioural therapy-based anxiety intervention, for 9-13 year old South African children with visual impairments, will be evaluated in two special schools. The study will employ a randomised wait-list control group design with pre- postand follow-up intervention measures, with two groups each receiving a 10 session anxiety intervention programme. The main outcome measure relates to the participants' symptoms of anxiety as indicated on the Revised Child Anxiety and Depression Scale. Conclusion: If the anxiety intervention programme is found to be effective in reducing symptoms of anxiety, this universal intervention will lay down the foundation upon which future contextually sensitive (South African) anxiety intervention programmes can be built

Visual Loss in HIV-Associated Cryptococcal Meningitis: A Case Series and Review of the Mechanisms Involved

Permanent visual loss is a devastating yet preventable complication of cryptococcal meningitis. Early and aggressive management of cerebrospinal fluid pressure in conjunction with antifungal therapy is required. Historically; the mechanisms of visual loss in cryptococcal meningitis have included optic neuritis and papilloedema. Hence; the basis of visual loss therapy has been steroid therapy and intracranial pressure lowering without clear guidelines. With the use of high-resolution magnetic resonance imaging of the optic nerve; an additional mechanism has emerged; namely an optic nerve sheath compartment syndrome (ONSCS) caused by severely elevated intracranial pressure and fungal loading in the peri-optic space. An improved understanding of these mechanisms and recognition of the important role played by raised intracranial pressure allows for more targeted treatment measures and better outcomes. In the present case series of 90 HIV co-infected patients with cryptococcal meningitis; we present the clinical and electrophysiological manifestations of Cryptococcus-induced visual loss and review the mechanisms involved

Making a Difference with Vision 2020: The Right to Sight? Lessons from two States of North Western Nigeria

Settings and Aim: The World Health Organization launched in 1999 an initiative to eliminate the global avoidable blindness and prevent the projected doubling of avoidable visual impairment between 1990 and 2020 (Vision 2020: The Right to Sight). The World Health Assembly (WHA) adopted resolutions WHA 59.25; WHA 56.26 urging member states to adopt the Vision 2020 principles. More than 90 nongovernmental development organizations; agencies; and institutions; together with a number of major corporations; are now working together in this global partnership. Two neighboring states in North Western Nigeria provide eye care services using different approaches; one state uses the principles of Vision 2020; the other uses a different strategy. The aim of the study was to assess awareness and utilization of eye care services in two Nigerian states. Design: A population-based cross-sectional interview of households was conducted in two neighboring states using a structured questionnaire. Data analysis was performed using SPSS version 21 and a P 0.05 was considered as significant. Findings: Participation rate was 97 in the two states. The population in the Vision 2020-compliant state were significantly more aware about general eye care services (80 vs. 44; P 0.0005); had less proportion of households unaware of any eye care service (55 vs. 69; P 0.0005); and have a significantly higher felt the need to utilize eye care services (47 vs. 5.9; P 0.0005). The service utilization rate was however low in the two states. Conclusion: The principles of Vision 2020: The Right to Sight is adaptable to different cultures/societies and has demonstrated a potential to increase awareness and a felt need for eye care in poor resource settings

Presbyopia: Prevalence; Distribution and Determinants in Owerri; Nigeria

Background: Presbyopia causes blurring and impairment of vision at near. It is the most common physiologic change in the adult eye with advancing age. Good near vision is a necessity for domestic activities; office work and near vision tasks other than reading and writing; especially among adults in a resource-limited economy. The study determined the prevalence; distribution and determinants of presbyopia; presbyopic spectacle coverage; and provided data for ready-made near vision spectacles in Imo State; Nigeria. Materials and Methods: A total of three thousand; four hundred and fifty-one adults consisting of 2606 persons as study group and 845 persons as controls were randomly selected for the study. Structured questionnaire was administered to the subjects. Their visual acuity at far and near including tonometry; ophthalmoscopy; perimetry; retinoscopy and subjective refraction were done. Subjects who could not read N6 and emmetropes; who are 40 years and above were considered as presbyopic. Results: The prevalence of presbyopia was 70.9 and 75.0 of study and control groups respectively. Females aged 40-49 were in the majority (57.1 and 51.9 of females in the study and control groups respectively). Subjects requiring additions at near of ?+1.50DS to 2.00DS were in the majority (39.0 and 46.4 of study and control groups respectively). Amongst the presbyopes 61.3 and 78.7 of study and control groups respectively did not have presbyopic correction. The subjects were also ignorant of corneal inlay technology in treatment of presbyopia. A higher prevalence exists among rural dwellers and the contributory factors were environmental influences; poor nutrition and irrational use of chloroquine for treatment of malaria. Conclusion: Over seventy-percent of presbyopia was found in this study. The determinants were age; gender; nutrition and drug use. Majority of the presbyopes were domicile in the rural area and did not have corrective spectacles. We recommend visual health education; regular vision screening and intervention to achieve the targets of vision 2020 in low-and-medium-income countries

Social Exclusion of Students with Visual Impairments at a Tertiary Institution in KwaZulu-Natal

Objectives: People with visual impairment experience exclusion and marginalisation from family; mainstream school; the community and university. The experience of social exclusion is multistructural; multidimensional and complex. This article is based on a study that aimed to describe the social exclusion of students with visual impairment at a tertiary institution where the authors are employed.Design: The study was qualitative. It used an exploratory design to provide compelling data on the insider perspectives of students.Setting and subjects: Fifteen students participated in the study; of whom nine were men and six women. Eleven students were partially sighted and four were blind. All the subjects were from the university where the authors are employed.Results: The study established that participants' exclusion from access to opportunities and development left them psychologically; socially; financially and emotionally scarred.Conclusion: The study established that visual impairment and poverty were related and that women experienced oppression on two counts. The first was because of their disabled status and the second was oppression by other female students at the university. Recommendations are for changes within families; schools; communities and universities

The Ocular Complications of an Envenomous Snakebite

An envenomous snakebite is an important public health problem that can lead to irreversible loss of vision. Snake venom neurotoxins mainly act on the peripheral nervous system at the neuromuscular junction; and result in the implication of the cranial nerves. Consequently; mild neurological symptoms that relate to cephalic muscle paralysis; including exotropia; ptosis; diplopia and ophthalmoplegia; can occur. This happens because the extraocular muscles are especially susceptible to neurological muscular blockage. Other neurological complications of snake venom include accommodation paralysis; optic neuritis; globe necrosis; keratomalacia; uveitis; and loss of vision due to cortical infarction. Haemostatic complications may include subconjuctival haemorrhage; hyphema; and vitreous and retinal haemorrhages. Another rare complication of a snakebite is ocular injury. Snakebite injuries are often accompanied by facial swelling; periorbital ecchymosis; massive subconjuctival haemorrhage; severe corneal oedema and exophthalmos in the affected eye. Unfortunately; such injuries result in permanent loss of vision; as early evisceration is deemed necessary to reduce the amount and effect of the venom in the affected eye. With such a variety of ocular complications as a result of a venomous snakebite; it is important for primary care physicians to have some basic knowledge of the management of these complications; as they may prove to be vital where patients present with a snakebite and possible venom injection in the eye

Pathologies ORL revelees par des complications ophtalmologiques : a propos de trois cas

Nous rapportons trois cas cliniques qui demontraient chacun une pathologie d'origine oto-rhino-laryngee (ORL) initiale; qui etait revelee par une atteinte oculo-orbitaire. Ces trois cas etaient differents de part leurs etiologies. Leur symptomatologie commune associait la baisse d'acuite visuelle et l'exophtalmie. Un examen ORL complet est indispensable devant toutes atteintes oculo-orbitaires pour la recherche d'un eventuel foyer primitif

Ocular disorders in children in Zaria children's school

BACKGROUND:The main causes of blindness in children change over time. The prevalence and pattern of eye diseases in children were studied in northern Nigeria 6 years ago. This study like the previous one was a school eye health screening conducted in Zaria children school located at the centre of Zaria, a city in northern Nigeria.AIMS AND OBJECTIVES:to determine the current prevalence and pattern of eye diseases affecting school children in Zaria. This is to serve as a current template for planning eye care for children in Zaria and environs.MATERIALS AND METHODS:a cross sectional study of 327 children who completed a pre-designed school eye screening format was conducted. Consent was obtained from the school authority and the parents before the screening exercise. It involved assessment of visual acuity, anterior and posterior segment examination and colour vision testing. Intraocular pressure measurement and refraction were done for those with indications.RESULT :A total of 327 children were examined, out of which 45.6% (n=149) were males and 54.4% (n=178) were females. M: F=1:1.2. Age range 5-17 yrs with mean of 9.6 ± 3.1(SD). The commonest causes of eye disorders were refractive errors 8.0% (n=26), allergic conjunctivitis 7.3 % (n=24), glaucoma suspects 3.7% (n=12) and colour deficiency 1.5%(n=5).CONCLUSION :The major causes of childhood eye disorders were uncorrected refractive errors and allergic conjunctivitis. The predominance of uncorrected refractive error is similar to what is obtainable in other parts of the world especially in the urban areas

Visual Impairment among Commercial Motorcyclists

Background: Normal vision is a universal requirement for safe riding of motorcycles. This study aims to determine the prevalence of visual impairment among commercial motorcyclists in Benin City; Nigeria. Method: This is a prospective cross sectional study carried out in Oredo Local Government Area (LGA) of Benin City. Each motorcycle park was taken as a cluster; and all motorcyclists in that park had structured questionnaires administered to them. One hundred and forty three commercial male motorcyclists in eleven motorcycle parks in Oredo LGA were subsequently examined with Snellen's chart or illiterate E chart as applicable. The main outcome measures eligibility for driver's licence on account of vision test as required by the Federal Road Safety Corps of Nigeria. Results: Ninety eight point six percent (98.6) of those examined had acceptable driving vision requirement according to Federal Road Safety Corps. One point four percent (1.4) had subnormal visual acuity; while 5.3had refractive errors. Ocular pathologies were found in 11.5of the eyes examined. Conclusion: Most commercial motorcyclists may pass the Federal Road Safety Corps. However Colour vision and visual field testing may give a more reliable result

Manifestations oculaires liees a la carence en vitamine A en zone rurale du Burkina Faso

Le deficit en vitamine A est responsable de cecite crepusculaire ou hemeralopie; de xerophtalmie et peut aboutir a la cecite. Au Burkina Faso; les etudes realisees dans differentes regions ont montre la gravite de la situation mais la methodologie utilisee ne permet pas d'extrapoler des resulats obtenus a l'ensemble du pays. La notion d'hemeralopie a ete dans un premier temps recherchee chez 466 enfants ages de 6 a 14 ans et a ete notee chez 14 d'entre eux soit une prevalence de 3 p. 100 dans cette tranche d'age. Dans un second temps; au sein d'un echantillon de 281 sujets de tous ages issus de 30 familles du village selectionnees de facon aleatoire; la prevalence de l'hemeralopie etait de 3;9 p; 100 (6 p. 100 chez les enfants ages de 2 a 5 ans). L'examen clinique a montre qu'une xerophtalmie etait presente chez 7 p. 100 des sujets examines. La frequence de celle-ci a diminue de moitie apres la saison des mangues pour devenir nulle apres administration d'une capsule de 200000 UI de vitamine A. Sur 8 cas de cecite recenses; 5 etaient d'origine onchocerquienne et 2 etaient lies a la carence en vitamine A. Ces donnees soulignent la place importante de cette carence dans la survenue de manifestations oculaires severes au Burkina Faso et la necessite d'une prevention

Simple Vision Screening in Lower Primary School Children in Port Harcourt City

Background: Vision disorders are significant causes of morbidity worldwide and in children; can lead to life long visual impairment or blindness. Thus; the impact on a child's education and life if not detected and ameliorated on time; can constitute a huge socio-economic burden to the child; family and community. Aim: To determine the prevalence of reduced vision in lower primary school children in Port Harcourt city. Methods: A multi-staged sampling technique was used to select 1;234 lower primary school pupils from 12 schools in Port Harcourt for visual screening. Visual acuity (VA) measurements using Snelling's charts; and a basic eye examination using a pen torch was carried out in all the pupils. Vision was regarded as reduced if VA is 6/18; in which case a pinhole was presented to the affected eye and VA repeated; to check for presence of refractive error. Results: A total of 1;234 school children were screened; 73 pupils had reduced vision in one or both eyes giving a prevalence of 5.9. Refractive errors accounted for 72.6of cases of reduced vision. Gross external eye abnormalities accounted for 9.6of cases of reduced vision; with corneal opacity and nystagmus being the most commonly seen. Conclusion: Reduced vision is an important cause of visual disability in primary school pupils in Port Harcourt city; mostly due to correctable refractive errors. There is therefore a need for routine vision screening of all pupils; especially on commencement of school for early detection and treatment; to prevent life long visual disability