REFRACTIVE ERRORS AMONG CHILDREN ATTENDING A TERTIARY EYE FACILITY IN IBADAN, NIGERIA: HIGHLIGHTING THE NEED FOR SCHOOL EYE HEALTH PROGRAMS


B.A. Olusanya1, M.O. Ugalahi1, O.T. Ogunleye2, and A.M. Baiyeroju1

  1. Dept. of Ophthalmology, College of Medicine, University of Ibadan/University College Hospital, Ibadan.
  2. Department of Ophthalmology, University College Hospital, Ibadan

Abstract

Background: It is estimated that 19 million children aged below 15 years are visually impaired globally. Twelve million of these are due to uncorrected refractive errors. The aim of this study was to describe the pattern of refractive errors seen in children attending the eye clinic of the University College Hospital, Ibadan,
Nigeria.

Methods: A descriptive retrospective study of children with refractive errors seen between January 2011 and December 2012 was conducted. Information on the age, sex, type of refractive error, degree of error (spherical equivalent), presenting complaint, previous spectacle use and return for follow-up visit were retrieved and analyzed using SPSS version 20.

Results: Three hundred and sixty-six children diagnosed with refractive errors accounted for 34.6% of all children seen. Of these, 267 (73%) records were successfully retrieved. The mean age was 10.58 (± 3.14) years, with 156 (58.5%) aged between 11 and 15 years. The male to female ratio was 1:2. The commonest refractive error was myopia, found in 124 (23.2%) of 534 eyes followed by simple myopic astigmatism and compound myopic astigmatism found in 117 (21.9%) and 111 (20.8%) eyes respectively. Majority, 229 (85.8%) had never worn spectacles previously and only 80(30%) children returned for a follow up visit.

Conclusion: Refractive errors constitute a common diagnosis among children seen in our tertiary eye facility. Late presentation and poor follow up among our patients are a cause for concern. Public enlightenment, health education and school eye programs are recommended to reverse this trend.

Keywords: Refractive error, Children, Early detection, Visual impairment, Nigeria.

Correspondence:

Dr. M.O. Ugalahi
Department of Ophthalmology,
College of Medicine,
University of Ibadan,
Ibadan
Email: oheobe26@yahoo.com

Introduction

Based on recent figures, it is estimated that 253 million people are visually impaired worldwide, with 36 million people blind while 217 million have low vision.1 Uncorrected refractive error (URE) is the leading cause of visual impairment (VI) globally (43%), followed by cataract (33%).2 URE is responsible for 18% of cases of blindness worldwide, second to cataract (39%). Nineteen million children are estimated to be visually impaired globally, and 12 million of these children have URE.2 In other words, URE is responsible for almost two thirds of cases of visual impairment in children across the world.

Refractive errors include myopia, hypermetropia and astigmatism. They cause defocussing of images formed on the retina of a relaxed eye resulting in poor vision and/or asthenopia (eye strain). Uncorrected refractive errors in children can result in amblyopia, limited or slow academic progress, poor social functioning and impaired quality of life.3-8

Refractive errors can be easily diagnosed, measured and corrected. In fact, spectacle correction of refractive errors is considered to be one of the most cost effective interventions in eye care.3 However, refractive errors often remain uncorrected due to various reasons such as lack of awareness, failure to recognize symptoms in children by parents and teachers, non-availability or inability to afford refractive services and negative attitude to the use of spectacle in children.7

In view of the significant burden of refractive errors in children, this study was conducted to determine the frequency and pattern of refractive errors among children attending the eye clinic at the University College Hospital, Ibadan, Nigeria.