Profile of Low Vision Patients in a Resource-Poor Underserved Setting of a Developing Country

Abstract

Objectives: To identify causes of low vision among the patients in the Eye clinic of University of Nigeria Teaching Hospital (UNTH). Methods: This was a cross-sectional study of all new consecutive low vision patients seen at the eye clinic of University of Nigeria Teaching Hospital-(UNTH) Ituku-Ozalla. All patients with low vision were evaluated by the researcher and the findings entered on a research protocol. Data were analyzed using descriptive statistics to generate frequency and percentage distributions and analytical statistics to test for significance of observed inter-group differences. In all comparisons, statistical significance was indicated by p < 0.05. Results: A total of 197 patients were seen comprising of 120 males and 77 females (M:F = 1.6:1) aged 39.3 ± 22.9 SD years. The main causes of low vision in the study population were glaucoma (36.0%), followed by oculocutaneous albinism (14.7%). The mean presenting distant VA was logMAR 1.1 (95% CI), while the mean near VA is logMar 1.0 (6/60, 20/200). After refraction, the mean distant VA was logMar 1.0, using unpaired t-test, the difference between the distant presenting and refracted VA were not statistically significant. 57.9% had distant VA after optical low vision assessment of logMar 0.9-logMar-0.2 while the mean distant VA was logMar 0.8 which was statistically significant. Near vision after optical assessment improved with a mean of logMar 0.8, which was statistically significant. Conclusion: Glaucoma was the commonest cause of low vision in this study. Optical low vision aids improved the visual functions of majority of the patients in this study.

A profile of patients presenting at a low vision clinic in a resource-limited setting

“…The high prevalence of amblyopia and corneal abnormalities could be a reflection of inadequate primary eye care services in this area. Gilbert and Ellwein 13 and Eze et al 9 reported similar findings in Africa, whilst Olusanya et al 8 and Khan 23 reported albinism, retinitis pigmentosa and hereditary macular diseases as common causes of low vision in Nigeria and India, respectively. Again, factors such as differences in study areas and settings may largely account for these observed discrepancies in the above-mentioned studies.…”

“…For example, a younger population of low-vision patients was reported by Ackuaku-Dogbe et al 10 in Ghana, in which the median age was 38 years. Other studies 8,9,21,22,23 from developing countries have reported high proportions of low-vision patients aged below 50 years and low proportion of low-vision patients aged 60 years and above. In contrast, studies 18,19,24 from developed countries reported high proportions of lowvision patients aged 60 years and above.…”

“…Profiles of low-vision patients have been studied extensively in different countries and reported in many publications. 6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25 These studies have used information from one or a few low vision clinics, from questionnaire reports or from blindness registration data to provide detailed information regarding the profiles of low-vision patients. Low-vision clinic-based studies provide reliable and usually detailed ophthalmic information about low-vision patients when compared with population surveys, blind school studies or blind register studies.…”

“…It is therefore important to make these devices available and affordable to those who need them. Eze et al 9 reported that 57.9% of the patients benefitted from low-vision aids at the UNTH. Leat et al 24 reported a much higher percentage (89.5%) who benefitted by attending the clinic, and 81% were using low-vision devices regularly in Ontario, Canada.…”

“…A recent study to identify causes of low vision in the patients of the eye clinic at the University of Nigeria Teaching Hospital (UNTH) showed that glaucoma (36%) and oculocutaneous albinism (14.7%) were the main causes of low vision. 9 A retrospective study of 604 patients managed at the low vision centre of the Korle Bu Teaching Hospital in Ghana showed that glaucoma was the leading cause of low vision in 135 (22.35%) patients, followed by non-glaucomatous optic atrophy in 62 (10.26%), retinitis pigmentosa in 54 (8.94%), maculopathy in 52 (8.61%) and ARMD in 48 (7.95%) patients. The study also showed that magnifiers and telescopes were the most commonly prescribed devices.…”