Ocular findings among children in Samburu handicap and rehabilitation programme
Abstract
Background:
Samburu handicap education and rehabilitation programme (SHERP) is a community
based organisation which caters for children with various handicaps from all over
Samburu district. Its main aim is to provide a home for these children, rehabilitate
them and integrate them back into normal schools.
Aims/Objectives:
To determine the prevalerice and pattern of eye diseases, and their association with
other handicaps in children under SHERP.
Methodology:
A cross sectional community based study in which '172 children registered under
SHERP were examined.
Results:
272 children out of a total of 341 were examined. Majority of the children were male
(59.2%). The youngest child was aged 4 years while the oldest was 15 years. The
mean age was 11 years with 34% of the children being in the 13-15 year age bracket.
Amongst the children, 27% had ocular anomalies, 21% had mental retardation, 18%
were deaf and 21.3% had various limb anomalies including paralytic disorders.
Refractive errors were the commonest ocular anomaly (40.8%) while corneal scars
and cataracts were seen in 17% and 5.2% of children respectively. 30% of mentally
retarded children had ocular anomalies with refractive errors and optic nerve atrophy
having a prevalence of 7.8% and 6.2% respectively. Both findings were statistically
significant. Cataracts and corneal scars were each seen in 6.2%.Both were not
statistically significant.35% of deaf children had ocular anomalies, most being
refractive errors (26%) and cataracts (7.3%). These results were both were statistically
significant. The only finding in children with paralytic diseases was refractive errors
(29.7%). This was not statistically significant. 70% of the children had normal visual
acuity (6/6-6/18), while 21% had visual impairment.
Only 0.73% had severe visual impairment and 5.9% were blind. The major causes of
visual impairment were refractive errors (52.6%) and corneal scars (21 %). The major
causes of severe visual impairment! blindness were corneal opacities (44.4%) and
optic nerve disease (33.3%).
Conclusions
There was a high prevalence of ocular anomalies (27%) in children under SHERP.
Refractive errors were the commonest eye condition causing visual impairment while
the commonest cause of severe visual impairment and blindness was corneal scars.
Recommendations
Screening for ophthalmic problems in deaf and mentally retarded children should be
done as soon as the conditions are diagnosed to enable early intervention. There is
need for proper record keeping in SHERP. This should include complete demographic .. details, medical and family social history of the children. Low cost, durable spectacles
should be supplied to these children. Studies should be done in both schools for the
deaf and mentally retarded involving larger sample sizes to shed more light on ocular
disorders in these children.
Citation
Degree of Masters of Medicine (OphthalmologyPublisher
University of Nairobi School of Medicine
Description
A dissertation submitted in part fulfillment for the
Degree of Masters of Medicine (Ophthalmology)
University of Nairobi