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

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.

Knowledge, attitude and practice of eye care professionals in Kenya on atropine prescription for myopia progression in children aged 4–12 years

“…Establishing clear guidelines for eye care professionals to utilize in the management of myopia progression should be prioritized. With the burden of myopia [12], this study highlights the importance of establishing a pediatric refraction guideline for utilization by eye care professionals in Kenya. The motivation for this initiative is to ensure that facilities offering refractive error services to children equip and stock the refraction points with corrective devices and consumables like atropine for utilization by eye care professionals.…”

“…Although spectacles are suitable for addressing myopia, evidence exists for the prescription of atropine 0.01%, 0.025%, and 0.05% in children for slowing down myopia progression [10,11]. With a projection of approximately 49.8% of the global population suffering from myopia by 2050 with 9.8% cases of high myopia [12], eye care professionals' attitude towards implementing evidence-based approaches is desirable to slow myopia progression and improve quality of life. To facilitate this, a pediatric refractive error management guideline is desirable to act as a baseline for all eye care professionals engaged in refractive error management.…”

Visual impairments amongst preschool and school attendees: A scoping review of vision school screening in Nigeria and Kenya

“…The Ophthalmic Division in Kenya has improved the healthcare awareness on ocular disorders like URE. 28 This improves early detection and management and provides patients with spectacles to regain their sight at an early age. To optimise learning, there is a need to prioritise regular vision school screening as part of primary eye care in Nigeria.…”

Understanding Vision Impairment: A Comprehensive Study of Uncorrected Refractive Errors among Primary School Teachers and Pupils in Nongowa Chiefdom, Kenema District, Sierra Leone

“…90% live in developing countries, with 39 million being blind and 246 million having low vision (Fricke et al, 2012a;Parikshift & Clare, 2007b). Vision impairment is defined by the WHO as visual acuity (VA) of worse than 6/18 (Fricke et al, 2012) but other widely acceptable definitions of vision impairment include VA 6/12 or worse (Muma et al, 2007) and VA worse than 6/12. In developed countries, the major cause of vision impairment is age-related macular degeneration; while in developing countries it is uncorrected refractive errors (URE) (43%) (Parikshift & Clare, 2007).…”

“…Global causes of vision impairment are uncorrected refractive errors (myopia, hyperopia or astigmatism representing 43% of all vision impairment); un-operated cataract representing 33% and glaucoma representing 2% (Bourne et al, 2010). A global estimate shows that annually, the world economy loses $269 billion in productivity due to uncorrected refractive Error (URE) (Fricke et al, 2012) and 640 million people are visually impaired due to refractive error (Muma et al, 2007). However, there are regional and ethnic variations in the contribution of each type of refractive error to vision impairment.…”