Child Abuse and the Eye in an African Population.

PURPOSE: There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determine the causes and circumstances surrounding these occurrences and their effects on the eye and vision in a pediatric population. METHODS: A 3-year study of consecutive cases of ocular features that presented to an eye clinic following a history suggestive of child abuse along with any associated eye injury was carried out. Socio-demographic characteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eye examination was also done. RESULTS: Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the mean age was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The most common ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocular pressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normal vision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairment in 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most common injurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstances predisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications were cataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%). CONCLUSIONS: Injuries commonly resulted from canes and sticks used during beatings, as well as from child labor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negative psychosocial and economic impacts on the child, family and country as a whole.

Awareness, perceptions and knowledge of strabismus among patients visiting a tertiary eye clinic in Southwest Nigeria.

The purpose of this study was to assess the perceptions, knowledge of the causes, implications and treatment of strabismus in a black population. This was a descriptive cross-sectional study utilizing a total sampling technique. Face-to-face interviews were performed using a structured questionnaire. Socio-demographic characteristics, awareness, perceived causes, effect and treatment of squint were investigated. Data was analysed using descriptive and inferential (bivariate and binary regression) analysis. A total of 405 respondents (49.6 % male, 50.4 % female) were interviewed. Ages ranged from 11 ± 90 years (mean 41.26 ± 19.00). Modal age group was 17-44 (56 %). Levels of education showed that 22.0 % had no education, while primary, secondary and tertiary levels were 12.6, 31.6 and 33.8 %, respectively. Approximately 75 % of patients were aware of strabismus. Perceived causes were unknown to 53 % while 18.0 and 12 % mentioned eye disease and congenital-related, respectively. There was no knowledge of treatment in 54 % of patients, while 21 and 25 % knew about medical and surgical treatment, respectively. The effects on social and family life were stigmatization/social misfit (23 %), psychosocial/self pity/depression/inferiority complex (88 %), burden (economic/time) (7 %), and poor cosmesis (5 %). Females were significantly more aware than males (p = 0.043, OR 0.6, CI 0.399-0.986). Age (p = 0.187) and level of education (p = 0.321) had no significant relationship with the levels of awareness. Respondents who had no education were 1.25 times less likely to be aware of squint than those who had education (OR 0.8, CI 0.693-1.642). The awareness of the cause, effects and treatment of strabismus is poor in this population. Females were more aware than males.