Productivity Loss and Predictive Factors Among Visually Impaired Adults in Tertiary Eye Care Centers, Addis Ababa, Ethiopia: A Dual-Center Cross-Sectional Study.

Introduction: Visual impairment has a profound impact on loss of economy and productivity, which can impair health-related quality of life. Objective: The purpose of this study was to determine productivity loss and its predictive factors among adults with visual impairment in Addis Ababa tertiary eye care centers, Ethiopia. Methods: An institution-based cross-sectional study was conducted between February and July 30, 2021. A total of 425 samples were retrieved using systematic random sampling. Data collection included socio-demographic information, employment status, job absenteeism, presenteeism and reduced work participation. Analysis was done by SPSS version 23, and binary logistic regression was employed for statistical analysis. P-values less than 0.05 were used to state significant associations between dependent and outcome variables. Results: A total of 416 study participants were involved in the study, with a response rate of 97.88%. The mean age was 48±14.3 years. The total productivity loss was $775,325.51, with a median of $358.02. Maximum productivity loss was contributed by reduced workforce participation, which was about $746,337.45, with a median of $1,432.10. Regarding predictor factors, gender, monthly income, degree and duration of visual impairment and support of family to get job were statistically associated with high productivity loss. Conclusion: In general, the current study revealed that there is a profound annual loss of productivity due to visual impairment. The predictor factors for higher productivity loss were gender, monthly income, degree of visual impairment, duration of visual impairment and presence of support from family to get job or achieve better performance on job activities. Rehabilitation for visually impaired adults is recommended to enhance their quality of life by increasing their workplace participation to the maximum potential.

Knowledge and practice towards glaucoma among glaucoma patients at University of Gondar Tertiary Eye Care and Training Center.

BACKGROUND: For better treatment outcome, exploring the knowledge of glaucoma and practices among glaucomatous patients is much more important. OBJECTIVE: The aimed of this study was to determine the knowledge and self-care practice and their associated factors towards glaucoma and its medications among glaucoma patients. METHODS: Cross section design study was conducted between May and July, 2017. The data was collected from glaucoma patients. Descriptive statistics was done to summarize socio demography data and associated factors with good knowledge and good practice were determined using binary logistic regression. Statistically significant variables were generated by considering p-value < 0.05. RESULTS: A total of 360 glaucoma patients were participated in this survey. The median age of the participant was 65 years. About 177 (49.25%) (95%CI: 43.9, 54.4) had good knowledge and a total of 197 or 54.7% (95%CI: 49.4, 59.7) had good practice about glaucoma and its medical treatments. The factors such as residence, marital status, educational status and stages of glaucoma of study participants were independently associated with having good knowledge. With respect to practice, educational status, duration of glaucoma, laterality and frequency of follow up were significantly associated with practice status of study participants. CONCLUSION: In this study among glaucoma patients in a tertiary hospital, only half of patients have good knowledge about the disease and good practice pattern. Those with urban residence, higher education status and advanced stage of glaucoma were more likely to have good knowledge.

Barriers to Cataract Surgery Utilization Among Cataract Patients Attending Surgical Outreach Sites in Ethiopia: A Dual Center Study.

BACKGROUND: Cataract is the leading cause of avoidable blindness globally and in Africa. Various barriers limit access of cataract blind individuals to cataract surgery. This study aimed to determine the barriers to cataract surgery utilization among cataract blind patients presenting to campaign sites in Ethiopia. METHODS: An institution-based cross-sectional design study was conducted to select 209 patients. The study was conducted from July to August 2020. A structured questionnaire was used to collect socio-demographic data and barriers for not having cataract surgery. Physical examination such as visual acuity, slit lamp bio microscopy and direct ophthalmoscopy was done for all participants. Epi Info 7 was used for data entry and Statistical Package for Social Science/SPSS version 23 was used for analysis after data were exported. Descriptive methods were employed for analysis. RESULTS: A total of 209 subjects were recruited in the study with a mean age of 64.2 (±14.6) years, with a range of 32-99 years. From the total study subjects, 53% were males and 40.2% were over 66 years old. Upon presentation to the campaign site, 33% of study subjects had visual acuity of operable eye under blindness category and half of the study subjects (50.2%) had mature cataract. The most reported barriers were waiting until cataract becomes mature (18.7%), fear of surgery complications (16.7%), far from eye health institution (16.4%) and lack of income/cost for surgery (11.5%). CONCLUSION: Recognizing the severity and the blindness burden of cataract in Ethiopia, creating public awareness, establishing eye health institutions, increasing the number of eye health professionals, increasing the quantity and the quality of cataract campaigns to alleviate these barriers are of paramount importance at the country level.

Ocular Biometry and Their Correlations with Ocular and Anthropometric Measurements Among Ethiopian Adults.

PURPOSE: To determine the average values of ocular biometry dimensions and investigate their inter-correlations and their association with anthropometric measurements among Ethiopian adults with healthy eyes. METHODS: A cross-sectional study was undertaken from June 2018 to July 2019. A total of 400 eyes of 200 subjects were included in the study. Univariable and multivariable linear regression were used to determine the association of demographic variables (age and sex) and anthropometric parameters (height, weight and BMI) with ocular biometric indices. RESULTS: The mean age was 40.31±11.39 with a range from 18 to 69 years. The mean (SD) of horizontal corneal diameter, average corneal refractive power, anterior chamber depth (ACD), lens thickness (LT) and axial length (AL) were 11.45 (0.89) mm, 43.94 (9.78) diopter, 2.91 (0.43) mm, 4.29 (0.55) mm and 22.96 (0.82) mm, respectively. Age had a negative correlation with ACD (r= -0.196, p= <0.001) and positive correlation with lens thickness (r= 0.324, p<0.001). Height had a positive correlation with ACD (r=0.114, p=0.023) and LT (r= 0.206, p=<0.001) while negative correlation with LT (r=-0.129, p=0.01). In the multivariate linear regression, age (-0.009 (-0.013, -0.05), p-value <0.001) and sex (0.104 (0.01, 0.198), p-value=0.03) had a significant association with ACD and only gender (0.478 (0.302, 0.654), p-value <0.001) had a statistically significant association with lens thickness. CONCLUSION: This study determined the normative values for ocular biometric parameters among Ethiopian adults for the first time. Age, gender and height were associated with biometric indices. AL was significantly positively correlated with ACD and negatively correlated with LT. There was a negative correlation between LT and both AL and ACD.

Vision-Related Quality of Life among Adult Patients with Visual Impairment at University of Gondar, Northwest Ethiopia.

PURPOSE: The purpose of this study was to assess vision-related quality of life and associated factors among adult patients with visual impairment at the University of Gondar Tertiary Eye Care and Training Center, Northwest Ethiopia. METHODS: The institution-based cross-sectional study was conducted from April 24 to May 12, 2017, at the University of Gondar Tertiary Eye Care and Training Center among 484 patients with visual impairment. Pretested, structured National Eye Institute Visual Function Questionnaire-25 was used to collect data by interviewing. Data were entered using EPI-INFO version 3.5.1 and analyzed with SPSS version 20. Binary logistic regression was used to determine factors associated with vision-related quality of life. Variables with p value <0.05 in multivariable logistic regression were considered as statistically significant. RESULT: A total of 484 study subjects participated with a response rate of 98.9%. The median age of the participants was 60 years with the interquartile range of 25 years. The proportion of poor vision-related quality of life was 238 (49.2%) (95% CI: 44.2%-53.3%). Age >75 years (AOR = 1.87 (95% CI: 1.02-3.40)), rural residency (AOR = 1.71 (95% CI: 1.13-2.60)), severe visual impairment/blindness (AOR = 2.76 (95% CI: 1.80-4.23)), and history of visual impairment longer than 3 years (AOR = 2.85 (95% CI: 1.61-5.04)) had statistically significant association with poor vision-related quality of life. CONCLUSION: Almost half of the patients with visual impairment had poor vision-related quality of life. Severe visual impairment/blindness, long duration of visual impairment, older age, and rural residency had a statistically significant association with poor vision-related quality of life.

Adherence to topical glaucoma medications and associated factors in Gondar University Hospital Tertiary Eye Care Center, northwest Ethiopia.

PURPOSE:: The purpose of the study was to determine proportion of adherence to topical glaucoma medications and associated factors among glaucoma patients in Gondar University Hospital Tertiary Eye Care and Training Center, northwest Ethiopia. METHODS:: This cross-sectional design study was conducted on 360 participants from April-May 2017. Structured questionnaire was completed and adherence was assessed by patients' self-report survey. The data were analyzed by SPSS version 20. Multivariate logistic regression was used to identify the determinant factors. The significance was considered at p value less than 0.05. RESULT:: More than half, 221 (61.4%) (95% confidence interval: 56.1-66.7), of the study participants were found to adhere well to glaucoma medications. Male sex (adjusted odds ratio = 1.86 (95% confidence interval: 1.13-3.06)), urban residence (adjusted odds ratio = 2.33 (95% confidence interval: 1.46-3.72)), normal visual acuity (adjusted odds ratio = 2.23 (95% confidence interval: 1.13-4.42)), low visual acuity (adjusted odds ratio = 1.74 (95% confidence interval: 1.05-2.88)), and self-sponsor for medications (adjusted odds ratio = 0.21 (95% confidence interval: 0.12-0.38)) were significantly associated with good adherence. CONCLUSION:: The level of medication adherence to topical glaucoma medications is not good enough as compared to other studies done in Ethiopia. Male sex, urban residence, normal, and low visual acuity were positive predictors, whereas self-sponsored for medications was negative predictors for good adherence to glaucoma medications.

Prevalence and associated factors of low vision and blindness among patients attending St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

BACKGROUND: Low vision and blindness are major public health problems. A vast burden of worlds visually impaired live in low-income settings especially in sub Saharan Africa. In such settings the blindness is associated with considerable disability and excess mortality, resulting in huge economic and social consequence. The main purpose of this study was to determine the prevalence and associated factors of low vision and blindness among patients at St. Paul's hospital millenium medical college. METHODS: Institution based cross sectional design study was carried out from January to April, 2017 with sample size of 904. Systematic random sampling was used to recruit the study subjects. Retrospective medical chart review was done; data was entered into and analyzed by SPSS 23. Descriptive statistics such as frequency cross tabulation and chi-square test was carried out to translate data into information. P-value less than 0.05 was considered as statistically significant. RESULTS: A total of 881 subjects with a response rate of 97.4% selected. The mean age of the study subjects was 44.53(SD: ± 21.85) with a range of 1-100 years. The prevalence of low vision and blindness was 91 (10.3% (95% CI: 8.2, 12.3)), and 64 (7.3 95%CI: 5.7, 9.0)) respectively. Age (p-value < 0.001), cataract (p-value = 0.002), glaucoma (p-value = 0.002) and age related macular degeneration (p-value < 0.001) were significantly associated with low vision and blindness. CONCLUSION: Low vision and blindness found in this study was high. Age, cataract, glaucoma and age related macular degeneration were significantly associated with low vision and blindness. This amount of magnitude will be reduced if prevention, early diagnosis and management will be targeted towards avoidable causes of visual impairment.

Prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia.

PURPOSE: The aim of this study was to assess the prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. METHODS: A cross sectional design study was carried out in 390 participants in Gondar city from April 15 to May 7, 2016. Basic ophthalmic examination was performed using portable slit lamb, 3.5x magnifying loop with torch light and a pretested and structured questionnaire was completed. The raw data has been entered into EPI INFO 3.5.1 and analyzed by SPPSS version 20. Descriptive statistics was summarized descriptive data. Logistic regression was used to summarize the predictors of pterygium. The variables with p-value less than 0.05 were considered as significant risks of pterygium. RESULT: The prevalence of pterygium among study participants was 151(38.7% (95%CI; 33.8-43.8)). Among those who have pterygium, 149(98.7%) were developed pterygium on the nasal side and 15(9.9%) on temporal side of the either eye and 13(8.6%) have both. Age between 41-60(AOR = 2.20(95%CI: 1.22, 3.39)), age between 61-86(AOR = 7.97(95%CI: 2.74, 23.17)), male sex (AOR = 2.20(95%CI: 1.28, 3.82)), outdoor working area(AOR = 3.75(95%CI: 2.18, 6.46)), the use of traditional eye medication (AOR = 2.55 (95%CI: 1.04, 5.90)) and family history of pterygium (AOR = 6.68(95% CI: 2.53, 17.60)) were positively associated with pterygium whereas use of sunglass/hat (AOR = 0.40(95%CI:0.20, 0.78)) was negatively associated. CONCLUSION: There is a high prevalence of pterygium in Gondar city northwest Ethiopia. Old age, male sex, outdoor working area, utilization of traditional eye medication and family history of pterygium were statistically significant predictors of pterygium. The use of sunglass/hat was protective against pterygium.

Prevalence and associated factors of myopia among high school students in Gondar town, northwest Ethiopia, 2016.

INTRODUCTION: Myopia is an important cause of correctable visual impairment and preventable blindness worldwide. Prevalence rates are approximately 20%-35% among the older teenage population globally. It has a medical burden of pathologic complications such as maculopathy and glaucomatous optic neuropathy. High school students experience high-performance and study pressures in the preparation for the final national examination. As a result they are exposed to excessive near work and indoor activities. They are also ignored for regular screening. OBJECTIVE: To determine the prevalence and associated factors of myopia among high school students in Gondar town, Ethiopia. METHODS: An institution-based cross-sectional study was conducted on 498 high school students with systematic random sampling method from April 18 to April 29, 2016, in three full-cycle high schools (9th-12th grades). A standardized structured questionnaire, Snellen acuity chart, pinhole, retinoscope, trial case lenses, pen torch, and direct ophthalmoscope were used to collect data. RESULTS: A total of 495 study participants were included, and they had a mean age of 17.48±1.59 years. The prevalence of myopia was 11.9% (95% confidence interval [CI]: 10.2, 17.9). Family history of myopia (adjusted odds ratio [AOR]=8.08 [95% CI: 4.30, 15.16]), school being private (AOR=2.88 [95% CI: 1.02, 8.11]), longer time spent for near work (AOR=2.89 [95% CI: 1.12, 7.43]), longer time spent partaking in indoor activities (AOR=4.32 [95% CI: 1.69, 10.99]), shorter near working distance (AOR=3.06 [95% CI: 1.33, 7.06]), lack of outdoor sport activities (AOR=2.27 [95% CI: 1.05, 4.90]), use of visual display units (AOR=2.81 [95% CI: 1.30, 6.10]), and abnormal ocular findings (AOR=6.69 [CI: 3.43, 13.03]) were found to be independently associated with myopia. CONCLUSION: The prevalence of myopia was 11.9%. Family history for myopia, school being private, longer time spent partaking in indoor activities, shorter working distance, lack of outdoor sport activities, use of visual display units, and presence of abnormal ocular findings were positively associated with myopia.

Prevalence and associated factors of computer vision syndrome among bank workers in Gondar City, northwest Ethiopia, 2015.

INTRODUCTION: Use of computers is generally encouraged; this is to keep up with the fast-moving world of technology, research and science. Extensive use of computers will result in computer vision syndrome (CVS), and the prevalence is increased dramatically. The main objective of the study was to assess the prevalence and associated factors of CVS among bank workers in Gondar city, northwest Ethiopia. METHODS: A cross-sectional institution-based study was conducted among computer-using bank workers in Gondar city from April to June, 2015. Data were collected through structured questionnaires and observations with checklists, entered with Epi Info™ 7 and analyzed by Statistical Package for the Social Sciences (SPSS) version 20. Descriptive statistics and logistic regression were carried out to compute the different rates, proportion and relevant associations. RESULTS: Among the total 304 computer-using bank workers, the prevalence of CVS was 73% (95% confidence interval [CI]=68.04, 78.02). Blurred vision (42.4%), headache (23.0%) and redness (23.0%) were the most experienced symptoms. Inappropriate sitting position was 2.3 times (adjusted odds ratio [AOR]=2.33; 95% CI=1.27, 4.28) more likely to be associated with CVS when compared with appropriate sitting position. Those working on the computer for more than 20 minutes without break were nearly 2 times (AOR=1.93; 95% CI=1.11, 3.35) more likely to have suffered from CVS when compared with those taking break within 20 minutes, and those wearing eye glasses were 3 times (AOR=3.19; 95% CI=1.07, 9.51) more likely to suffer from CVS when compared with those not wearing glasses. CONCLUSION: About three-fourths of computer-using bank workers suffered from CVS with the most experienced symptoms being blurred vision, headache and redness of eyes. In appropriate sitting position, working on the computer without a break for more than 20 minutes and wearing eye glasses were independently associated with CVS.