Abstract
Background: Visual Impairment (VI) is caused by various conditions such as uncorrected refractive error (URE), cataracts, glaucoma, age-related macular degeneration (ARMD), diabetic retinopathy (DR), trauma, HIV/AIDS, and hypertension (HTN). The World Health Organisation (WHO) defines VI as visual acuity (VA) worse than 6/18 to no light perception (NLP) in the better eye. Most cases of VI can be prevented or treated when identified earlier. However, utilisation of eye healthcare services particularly in poor communities remains a major challenge due to various reasons. Inadequate healthcare services pose challenges.
Aim: To determine the prevalence of VI amongst patients aged 35 years and older visiting the Phelophepa Train Eye Clinic in the Eastern Cape province (South Africa).
Methods: A quantitative cross-sectional study was conducted using a systematic random sampling method to select a sample of 563 participants aged ≥35 years. This retrospective study was conducted using data obtained from patients attending the Phelophepa mobile healthcare eye clinic in the Eastern Cape province of South Africa from 30 January to 31 March 2023. Data on demographic characteristics, visual status, ocular and systemic conditions were collected from the patient’s record cards. The collected data were analysed using the Statistical Package for Social Sciences (SPSS) software version 29. Analyses included bivariate analyses, linear regression analysis, and Pearson correlation coefficient used to determine the associations between variables and the presence of VI. Adjusted Odds Ratios (AOR), Confidence Intervals (CI), and Chi-Squared test statistics were determined to identify the significance of findings, prevalence and factors associated with VI.
Results: The mean age of participants was 59.17±12.95 years (range = 35 to 93 years). The combined prevalence of VI and blindness was 57.6% [95% CI: 53.0% - 61.0%], with 51% experiencing VI and 6.6% being blind. The median age was 59 years old. Most participants were female and resided in rural areas, with low socioeconomic status being a significant risk factor for VI (p= 0.00). Increased age, low socioeconomic status, poor VA, presence of URE, and ocular disease were associated with high VI and blindness (p= 0.00). The primary causes of VI were URE (38%), cataracts (20%), glaucoma (2.3%), DR (1.6%), and corneal opacities (0.5%). HTN was the most prevalent chronic disease (28.4%), followed by comorbidities of HTN and diabetes mellitus (DM) (17.94%), HIV/AIDS (7.82%), and DM (5.20%) (p= 0.00).
Conclusion: VI is a growing health concern that affects mobility, social participation, and quality of life. Age, poor living conditions, female gender, and low socioeconomic status were
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associated with VI. Early screening, accessible eye care, and correcting refractive errors are needed. Improving cataract surgery rates is crucial in underdeveloped regions.
Keywords: Blindness, Cataract, Glaucoma, Hypertension, Refractive error, Visual Impairment