ANNALS OF IBADAN POSTGRADUATE MEDICINE
O.I. Majekodunmi, B.A. Olusanya and T.S. Oluleye
Department of Ophthalmology, University College Hospital, Oyo State, Nigeria
Background: Vision screening and detection of ophthalmic disorders in hearingimpaired individuals is important to optimise their visual function and therefore, their quality of life.
Objective: To determine the utilisation of eye care services among students attending schools for the hearing impaired in Oyo State, Nigeria.
Methods: This was a descriptive cross-sectional study conducted among hearing impaired students aged 11 years and above. Using systematic random sampling, participants were selected from four schools. An interviewer administered semistructured questionnaire was used to collect socio-demographic data and information on history of eye symptoms and utilisation of eye care services. Data analysis was performed using the IBM SPSS software version 22 and test of association done using chi-square test with level of statistical significance set at p-value <0.05.
Results: A total of 335 students were recruited into the study. Mean age was 17 ± 2.9 years (range 11 - 39 years). Only 147 (43.9%) respondents had utilised eye care services in the past. Some of the reasons given for non-utilisation include financial constraints and lack of an escort to the hospital.
Conclusion: This study has demonstrated that the rate of utilisation of eye care services among the studied population is suboptimal. Therefore, it is essential for government, eye care providers and other stakeholders to design and implement policies and eye care programmes that would improve the uptake of eye care services among hearing-impaired individuals. This will reduce the compounding effect of visual impairment in such individuals.
Keywords: Hearing impaired, Visual impairment, Children, Students, Eye-care utilisation.
Dr. O.I. Majekodunmi
Department of Ophthalmology,
University College Hospital,
The burden of disabling hearing impairment is thought to be greatest in the Asia Pacific, South Asia and subSaharan Africa1 .Of the 466 million people thought to have disabling hearing impairment in 2019, approximately 34 million were children2 . It is estimated that by 2050, one in every 10 people will have disabling hearing loss2 . Olusanya et al.3 in 2000 reported a prevalence of 13.9% among school entrants in South-West Nigeria. This finding was also similar to a study done by Lasisi et al.4 among children in a tertiary hospital in Ibadan which also reported a prevalence of 14%. Both studies revealed that respondents with hearing impairment had educationally significant hearing loss at presentation. Deafness and hearing impairment do have profound effects on individuals, especially when commencing pre-lingually; and result in delayed development of speech, language and cognitive skills in children.
Being hearing impaired does not only affect a child’s academic performance, but can also influence his or her overall development and ability to succeed 5,6. At any age, disabling hearing impairment has a profound impact on interpersonal communication, psychosocial well-being, quality of life and economic independence and is also a high risk factor for visual problems7,8 .
The high rate of ocular pathology in deaf individuals is related to the fact that the retina and cochlear have the same embryonic origin during the sixth and seventh weeks of intrauterine development9 . Some of the hereditary diseases causing both hearing and visual impairment include Usher’s syndrome; which is a recognisable hereditary cause of profound deafness in children10 and congenital rubella syndrome11 . However, preventable diseases like measles and meningitis are also known causes of both deafness and visual impairment in West Africa12 probably due to the poor state of health facilities and inadequate health personnel.
Unfortunately, the combination of hearing and visual impairment worsens the overall burden of the sensory impairment. Usually, when one sense organ is impaired, the other sense organs are recruited to compensate for the disability. Thus, hearing-impaired individuals generally compensate by making greater use of their vision than their normal hearing peers. Therefore, even a mild refractive error may reduce the visual cues available to the deaf-mute person.13,14
The utilization of eye care services among deaf and hearing impaired persons is imperative to the promotion of their ocular health as well as the early detection and treatment of ocular diseases in them. Previous studies on the utilisation of care services among the hearing-impaired have reported varying rates. Onakpoya et al.15 found a utilisation rate of 29.5%, while Omolase et al.16 reported a higher utilisation rate of 72.5%; although the later study observed that students who had previously utilised eye care were prompted by ocular complaints.
Information on the factors associated with utilisation and reasons for non-utilisation of eye care services by hearing-impaired persons would aid the development of polices for adequate planning and provision of comprehensive healthcare services for them. Therefore, the aim of this study was to determine the utilisation of eye care services and its associated factors among students attending schools for the hearing impaired in Oyo state Nigeria.