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BMC Ophthalmology

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Open Access 01-12-2020 | Refractive Errors | Research article

The prevalence and causes of visual impairment among children in Kenya – the Kenya eye study

Authors: Shadrack Muma, Stephen Obonyo

Published in: BMC Ophthalmology | Issue 1/2020

Abstract

Background

Visual impairment is the partial or complete loss of vision in which the presenting visual acuity lie between 6/18-no perceptions of light. In Kenya, little attention has been directed towards children vision and causes of visual impairment. Therefore, this study was designed to investigate the prevalence and causes of visual impairment in the children population of Kenya.

Methods

This cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years). Visual acuity was taken using Snellens chart at 6 m. Anterior and posterior segment was assessed using slit lamp and indirect ophthalmoscope. The World Health Organization definition formed the baseline for calculating the mean prevalence of visual impairment.

Results

Visual acuity measurements were available for 3240 (95.3%) participants. The mean prevalence of visual impairment based on pin-hole value was 1.7 ± 0.3% using World Health Organization definition. The prevalence of visual impairment based on presenting visual acuity value was 2.4 ± 0.7% using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole increased significantly with increasing age (odds ratio 1.230, P = .021) and uncorrected refractive error (odds ratio 0.834, P = .032) according to World Health Organization definition. Cases of uncorrected refractive error remained the major cause for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were nystagmus (14%), amblyopia (24%) and uncorrected refractive error (62%).

Conclusion

The prevalence of visual impairment in Kenya is associated with age. Uncorrected refractive error remains the major causes of visual impairment.

Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(9):e888–97.CrossRef

Whitfield R, Schwab L, Ross-Degnan D, Steinkuller P, Swartwood J. Blindness and eye disease in Kenya: ocular status survey results from the Kenya rural blindness prevention project. Br J Ophthalmol. 1990;74(6):333–40. https://doi.org/10.1136/bjo.74.6.333.CrossRefPubMedPubMedCentral

Bastawrous A, Mathenge W, Wing K, et al. Six-year incidence of blindness and visual impairment in Kenya: the Nakuru eye disease cohort study. Invest Ophthalmol Vis Sci. 2016;57:5974–83. https://doi.org/10.1167/iovs.16-19835.CrossRefPubMedPubMedCentral

Chiang PP, Keeffe JE, Le Mesurier RT, Taylor HR. Global burden of disease and visual impairment. Lancet. 2006;368:365.CrossRef

McCarty MF. Mortality from Western cancers rose dramatically among African-Americans during the 20th century: are dietary animal products to blame? Med Hypotheses. 2001;57:169–74.CrossRef

Khanna RC, Murthy GV, Giridhar P, et al. Cataract, visual impairment and long-term mortality in a rural cohort in India: the Andhra Pradesh eye disease study. PLoS One. 2013;8:e78002.CrossRef

Fricke TR, Tahhan N, Resnikoff S, Papas E, Burnett A, Suit MH, Naduvilath T, Naidoo K. Global prevalence of presbyopia and vision impairment from uncorrected presbyopia: systematic review, meta-analysis, and Modelling, ophthalmology; 2018.CrossRef

Klein R, Klein BE, Linton KL, De Mets DL. The beaver dam eye study: visual acuity. Ophthalmology. 1991;98:1310–5.CrossRef

Mitchell P, Smith W, Attebo K, Healey PR. Prevalence of openangle glaucoma in Australia. Blue Mountains Eye Study. Ophthalmol. 1996;103:1661–9.CrossRef

10.

Sasaki H, Jonasson F, Kojima M, et al. The Reykjavik eye study– prevalence of lens opacification with reference to identical Japanese studies. Ophthalmologica. 2000;214:412–20.CrossRef

11.

Azen SP, Varma R, Preston-Martin S, et al. Binocular visual acuity summation and inhibition in an ocular epidemiological study: the Los Angeles Latino eye study. Invest Ophthalmol Vis Sci. 2002;43:1742–8.PubMed

12.

Saw SM, Foster PJ, Gazzard G, Friedman D, Hee J, Seah S. Undercorrected refractive error in Singaporean Chinese adults: the Tanjong Pagar survey. Ophthalmology. 2004;111:2168–74. https://doi.org/10.1016/j.ophtha.2004.05.032.CrossRefPubMed

13.

Ndegwa LK, Karimurio J, Okelo RO, Adala HS. Prevalence of visual impairment and blindness in a Nairobi urban population. East Afr Med J. 2006;83(4):69–72.CrossRef

14.

Huang S, Zheng Y, Foster PJ, Huang W, He M. Prevalence and causes of visual impairment in Chinese adults in urban southern China. Arch Ophthalmol. 2009;127:1362–7. https://doi.org/10.1001/archophthalmol.2009.138.CrossRefPubMed

15.

Clare G. New issues in childhood blindness. Comm Eye Health J. 2001;14(40):53–6.

16.

Attebo K, Mitchell P, Smith W. Visual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study. Ophthalmology. 1996;103:357–64. https://doi.org/10.1016/S0161-6420(96)30684-2.CrossRefPubMed

17.

Wang X, Lamoureux E, Zheng Y, Ang M, Wong TY, Luo N. Health burden associated with visual impair- ment in Singapore: the Singapore epidemiology of eye disease study. Ophthalmology. 2014;121:1837–42. https://doi.org/10.1016/j.ophtha.2014.03.017.CrossRefPubMed

18.

Zhao J, Xu X, Ellwein LB, et al. Causes of visual impairment and blindness in the 2006 and 2014 Nine-Province surveys in rural China. Am J Ophthalmol. 2019;197:80–7. https://doi.org/10.1016/j.ajo.2018.09.011.CrossRefPubMed

19.

Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs–an extension of the modi- fied Airlie House classification. ETDRS report number 10. Ophthalmology. 1991;98:786–806. https://doi.org/10.1016/S0161-6420(13)38012-9.CrossRef

20.

Xu L, Wang Y, Li Y, et al. Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology. 2006;113:1134. e1–11. https://doi.org/10.1016/j.ophtha.2006.01.035.CrossRefPubMed

21.

Leung GM, Ni MY, Wong PT, et al. Cohort profile: FAMILY cohort. Int J Epidemiol. 2017;46:e1. https://doi.org/10.1093/ije/dyu257.CrossRefPubMed

Title: The prevalence and causes of visual impairment among children in Kenya – the Kenya eye study
Authors: Shadrack Muma
Stephen Obonyo
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Refractive Errors
Nystagmus
Published in: BMC Ophthalmology / Issue 1/2020
Electronic ISSN: 1471-2415
DOI: https://doi.org/10.1186/s12886-020-01665-w

At a glance: The STEP trials

Springer Medicine

The prevalence and causes of visual impairment among children in Kenya – the Kenya eye study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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