Postoperative trachomatous trichiasis: a systematic review and meta-analysis study.

BACKGROUND: Trachomatous trichiasis is the potential stage of trachoma in which the eyelashes scratch the surface of the globe, ultimately causing corneal opacity, visual impairment and blindness. The aim of this systematic review and meta-analysis is to obtain the pooled prevalence and associated factors of postoperative trachomatous trichiasis (PTT) in World Health Organization (WHO) trachoma-endemic regions. METHODS: An inclusive literature search was undertaken using PubMed, Cochrane Library, Science Direct and Google Scholar databases from 30 May 2022 to 28 June 2022. I2 statistics and funnel plots were used to determine heterogeneity and publication bias among included studies. A random effects model was used to estimate pooled prevalence, incidence and odds ratios (ORs) with the respective 95% confidence intervals (CIs) using RevMan 5.4 software. RESULTS: Eighteen articles were included in this meta-analysis and systematic review. The pooled prevalence of PTT was 19% (range 18-21). PTT was lower among young adults compared with old adults (OR 0.63 [95% CI 0.44 to 0.92]), single-dose oral azithromycin as compared with tetracycline eye ointment users (OR 0.82 [95% CI 0.69 to 0.99]) and minor trichiasis before surgery as compared with major trichiasis (OR 0.63 [95% CI 0.47 to 0.85]). CONCLUSIONS: The incidence of PTT was higher than the WHO's recommendation. Prescribing single-dose oral azithromycin after surgery, periodic training for trichiasis surgeons, close follow-up and health education after surgery are crucial to minimize the recurrence.Study protocol registration on PROSPERO: CRD42022336003.

Knowledge and attitude towards strabismus among adult residents in Woreta town, North West Ethiopia: A community-based study.

BACKGROUND: Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies. METHODS: A community-based cross-sectional study was done in Woreta town from April-May 2020 with a sample size of 424. A systematic random sampling technique was employed to achieve the required sample size. A pre-tested self-administered questionnaire was used to collect the data. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance. RESULT: A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus. CONCLUSION AND RECOMMENDATION: The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its' possible treatments and the need to bring children to the eye care center for early diagnosis and treatment.

Symptomatic dry eye disease and associated factors among postgraduate students in Ethiopia.

BACKGROUND: Symptomatic dry eye disease is a growing public health challenge especially among those who are visual display unit (VDU) users and other long-time near activity workers. Globally, computer user adults experience a surge in the prevalence of dry eye. Data is insufficient on the prevalence of dry eye disease among postgraduate students in Ethiopia. Therefore, the present was aimed to assess the prevalence of dry eye and its associated factors among postgraduate students at the University of Gondar, Northwest Ethiopia. METHODS: A cross-sectional study was conducted on a total of 423 postgraduate students who were selected based on a simple random sampling technique. Data was collected through online symptom-based ocular surface disease index questionnaire. Binary logistic regression was used to test the association and p-value of <0.05 was considered to determine the significance of the association. RESULTS: From the total postgraduate students, 404 completed the study with a response rate of 95.5%. The prevalence of symptomatic dry eye disease was 50.5% (95% CI, 45.1%-54.9%). Average continuous visual display unit use for 2-4hours per day[AOR = 2.57 (95% CI, 1.27-5.21)] and for> 4hours per day[AOR = 3.77 (95% CI 1.87-7.59)], duration of visual display unit use for 3-5 years [AOR = 2.24 (95% CI, 1.17-4.31)], 6-8 years [AOR = 2.46 (95% CI,1.31-4.62)] and > 8 years [AOR = 3.25 (95% CI, 1.63-6.48)], average sleeping hour < 7 hours/day within last week [AOR = 2.17 (95% CI, 1.35-3.49)] and current known allergic conjunctivitis [AOR = 5.42 (95% CI, 2.43-12.10)] were significantly associated with symptomatic dry eye disease. CONCLUSION AND RECOMMENDATION: In this study, about half of postgraduate students faced symptomatic dry eye disease. Significant association was observed between symptomatic dry eye disease and average continuous hours of visual display unit use, duration of visual display unit use in years, shortage of sleep and current known allergic conjunctivitis. It is advisable for postgraduate students to limit screen exposure hour and establish regular breaking time along their exposure. It is also advisable to have optimum sleep as possible. It is also important to explore dry eye disease on a large sample incorporating clinical tests.

Pseudoexfoliation Syndrome and Associated Factors Among Adults at Gondar University Comprehensive Specialized Hospital Tertiary Eye Care and Training Center: A Cross-Sectional Study.

BACKGROUND: Pseudoexfoliation syndrome is an age-related disorder characterized by the deposition of a distinct fibrillar extracellular material in various tissues and organs of the body. Glaucoma and cataract are the consistently reported clinical consequences of Pseudoexfoliation syndrome on the eye. This study aimed to estimate the proportion of pseudo-exfoliation syndrome and associated factors in Gondar university comprehensive specialized hospital tertiary eye care and training center. METHODS AND MATERIALS: Institution-based cross-sectional study was conducted from January to March 2019 at Gondar university comprehensive specialized hospital tertiary eye care and training center among 295 patients. Consecutive 295 participants aged above 40 years were involved in the study. A structured questionnaire and ocular examination were used to collect the data. Data were entered into EPI-INFO 3.5.1 and exported to SPSS version 20 for analysis. Factors associated with pseudoexfoliation syndrome were ascertained by chi-square and independent t-test. Statistical significance was considered when p-value <0.05. RESULTS: A total of 295 adults participated in the study with a response rate of 92.8%. The median (±IQR) age of study respondents was 64(±9) years and 67.8% were males. The proportion pseudoexfoliation syndrome was 34.6% [95% CI: 29.2-40.7%]. The mean IOP and mean age were significantly higher among patients with pseudoexfoliation syndrome. Age, sex, high IOP, glaucoma, outdoor work, and rural residence were significantly associated with the proportion of pseudoexfoliation syndrome. CONCLUSION: The proportion of pseudoexfoliation syndrome among participants aged ≥40 years was high. Age, sex, high IOP, glaucoma, outdoor work, and rural residence were factors having a significant association with the proportion of pseudoexfoliation syndrome.

Are Nonprescription Sunglasses in Ethiopian Market Protective for Ultraviolet Radiation?

BACKGROUND: Nonprescription sunglasses are available in bulk from authorized and unauthorized vendors. Sunglasses should follow the minimum requirements to sufficiently protect the eyes. In this study, we found that a significant proportion of nonprescription sunglasses available at authorized and unauthorized sources were not protective of ultraviolet radiation. PURPOSE: Protection from harmful ultraviolet radiation with sunglasses minimizes or avoids ocular complications. In developing countries like Ethiopia, sunglasses are imported without regulation. Sunglasses are distributed to the market without regulatory tests for potential causes of ocular complications. The purpose of this study was to determine commercially available nonprescription sunglasses' ultraviolet radiation protection level. METHODS: A total of 74 pairs of nonprescription sunglasses were collected from different parts of the country and tested for ultraviolet radiation protection using ultraviolet detector (anti-radiation UV sun detector, China) instrument. Brand, lens color and average of three readings of ultraviolet radiation protection were recorded. The International Commission on Non-Ionizing Radiation Protection standard followed. Data were entered and analyzed by using SPSS version 20. Descriptive and analytical statistics were performed. RESULTS: Of the total 74 different pairs of nonprescription sunglasses, 47.3% (35) were obtained from authorized sources and 86.5% (p=0.23) were brand tagged. Only 73.0% (p=0.81) of nonprescription sunglasses were in accordance with the standards and protective to ultraviolet radiation, while the remaining 27.0% (p=0.59) were failed to block the harmful ultraviolet radiation. Upon one sample t-test, the mean ultraviolet radiation protection level of commercially available sunglasses was 392.77 (t-value= -7681.54, p<0.001). CONCLUSION: Significant proportions of nonprescription sunglasses available from vendors were not protective of ultraviolet radiation and performed below the expected international standards. Reassurance is mandatory before dispensed to users irrespective of source.

Prevalence of pterygium and its associated factors among adults aged 18 years and above in Gambella town, Southwest Ethiopia, May 2019.

INTRODUCTION: A pterygium is a wing-shaped fibro-vascular growth of conjunctiva on the superficial cornea/conjunctiva. It is an elastotic degeneration of conjunctival stroma mainly due to Ultraviolet light exposure. The prevalence of pterygium varies in different environmental conditions. Its magnitude varies widely from 1.1% to 53% globally and in Ethiopia, it reaches from 8.8% to 38.7%. OBJECTIVE: To determine the prevalence of pterygium and its associated factors among adults aged 18 years and above in Gambella town, Southwest Ethiopia, 2019. METHODS AND MATERIALS: A community based cross-sectional study was conducted from April 15 to May 3, 2019, in Gambella town. A total of 402 study participants were selected using a systematic random sampling technique. A pre-tested semi-structured questionnaire, torch, and magnifying loops were used to collect data. The data was entered into epidemiological information 7.1 and exported to statistical package for social science version 20 for analysis. The binary and multivariate logistic regression analysis model was fitted to identify factors associated with pterygium. Odds ratio with respected 95% CI was used to identify the direction and strength of association. RESULTS: A total of 400 participants were examined with a response rate of 99.50%. The mean age of the study participants was 39.9±9.8years. The prevalence of pterygium among adults aged 18 years and above in Gambella town was 127(31.80%), (95% CI: 27.3, 36.3). male sex (AOR = 2.10 (95% CI: 1.26, 3.45), sunlight exposure (AOR = 6.86 (95% CI: 4.00, 11.79) and outdoor works (AOR = 2.10 (95% CI: 1.21, 3.60) were positively associated with pterygium whereas wearing sunglass/hat was a protective factor. CONCLUSION: The prevalence of pterygium was high among adults living in Gambella town. Wearing sunglass/hat and reducing exposure time to the sun was important to reduce the development of pterygium in adults.

Proportion of Ophthalmic Self-Medication and Associated Factors among Adult Ophthalmic Patients Attending Borumeda Hospital, Dessie, Northeast Ethiopia.

PURPOSE: The aim of this study was to determine the proportion of ophthalmic self-medication and associated factors among adult ophthalmic patients attending Borumeda Hospital, Northeast Ethiopia, 2019. METHODS: An institution-based cross-sectional study design was conducted on 402 participants at Borumeda Hospital from April 29 to May 24, 2019. Systematic random sampling technique was used to get study participants. Data were collected with a face-to-face interview by using a semistructured questionnaire. Data were entered into Epi Info 7 and analyzed by SPSS 20. Descriptive statistics and binary logistic regression analysis were employed. P values of less than 0.05 were considered statistically significant. RESULTS: The proportion of ophthalmic self-medication was 28.6% (95% CI; 24.6-33.3). Age-group 29-42 years (AOR: 2.19, 95% CI: 1.06-4.52), absence of health insurance (AOR: 4.29; 2.35-7.84), more than 10 kilometer traveling distance to get eye services (AOR: 3.11; 1.58-6.12), previous experience of ocular illness (AOR: 2.62, 95% CI: 1.53-4.48), family or friend experience of ocular illness (AOR: 2.65, 95%CI: 1.43-4.92), availability of ophthalmic medicine bottle/tube at home (AOR: 4.59, 95% CI: 2.36-8.92), and poor knowledge about hazards of self-medication (AOR: 6.22; 3.26-11.85) were significantly associated with ophthalmic self-medication. Conclusion and Recommendations. The proportion of ophthalmic self-medication was high, which needs stakeholders' attention. The policymakers and regulatory body better to scale-up health insurance coverage, nearby accessible eye care services, improve knowledge of patients regarding the effect of ophthalmic self-medication, and proper disposal of leftover eye medication from the house. It is better to take regulatory actions on those who dispense ophthalmic medications without prescription.

Unmet need for presbyopia correction and its associated factors among school teachers in Hawassa city, South Ethiopia.

BACKGROUND: Presbyopia is a decline in the amplitude of accommodation with the onset in the age range 40-45 years affecting near visual task performance. As the age of presbyopia onset coincides with productive age, it results in great productivity loss especially in those with high near visual demand like teachers. A maximum near vision potential is essential for teachers in ensuring the quality of education, as most of the students' evaluations and scripts are assessed manually in Ethiopia. The prevalence of unmet need for presbyopia correction among school teachers ranges from 38.5-70.4% worldwide. Though presbyopia is a common ocular condition, there is limited evidence regarding the unmet need for presbyopia correction in Ethiopia as well as in Hawassa city. Therefore, this study aimed to determine the magnitude of unmet need for presbyopia correction and its associated factors among school teachers in Hawassa city, South Ethiopia. METHODS: A school-based cross-sectional study was conducted among teachers older than 35 years. A simple random sampling technique was used to select participants using name lists as a sampling frame from 69 schools. The participants selected underwent for distance and near visual acuity test. Those with distance visual acuity of 6/12 or worse were refracted before near visual acuity test. Information on the spectacle use and associated factors was obtained using the interviewer-administered questionnaire. Data analysis was done using Statistical Package for Social Sciences software version 20. Binary logistic regression analysis was performed to assess association between independent variables and the unmet need for presbyopia correction. RESULTS: A total of 459 study participants were included in the study with a response rate of 95.21%.The unmet need for presbyopia correction was 51.26% (95%CI: 46.7-55.6%). Female gender (AOR = 2.50; 95%CI: 1.51-4.15), age 36-45 (AOR = 4.12; 95%CI: 1.46-11.76), unaware of presbyopia (AOR = 2.36; 95%CI: 1.2-4.66) and self-rating of current vision as good (AOR = 3.5; 95%CI: 1.61-7.6) were factors significantly associated with the unmet need for presbyopia. CONCLUSIONS: The burden of unmet need for presbyopia correction is a moderate priority according to the World Health Organization for presbyopia correction services criteria. A school-based presbyopia awareness creation program is important to reduce this huge burden.

Knowledge, attitude and associated factors among primary school teachers regarding refractive error in school children in Gondar city, Northwest Ethiopia.

INTRODUCTION: Refractive error is an important cause of correctable visual impairment in the worldwide with a global distribution of 1.75% to 20.7% among schoolchildren. Teacher's knowledge about refractive error play an important role in encouraging students to seek treatment that helps in reducing the burden of visual impairment. OBJECTIVE: To determine knowledge, attitude and associated factors among primary school teachers regarding refractive error in school children in Gondar city. METHODS: Institution based cross-sectional study was conducted on 565 primary school teachers in Gondar city using pretested and structured self-administered questionnaire. For processing and analysis, SPSS version 20 was used and variables which had a P value of <0.05 in the multivariable analysis were considered as statistically significant. RESULT: A total of 565 study subjects were participated in this study with a mean age of 42.05 ± 12.01 years. Of these study participants 55.9% (95% CI: 51.9, 59.8) had good knowledge and 57.2% (95% CI: 52.9, 61.4) had favorable attitude towards refractive error. History of spectacle use [AOR = 2.13 (95% CI: 1.32, 3.43)], history of eye examination [AOR = 1.67 (95% CI: 1.19, 2.34)], training on eye health [AOR = 1.94 (95% CI; 1.09, 3.43)] and 11-20 years of experience [AOR = 2.53 (95% CI: 1.18, 5.43)] were positively associated with knowledge. Whereas being male [AOR = 2.03 (95% CI: 1.37, 3.01)], older age [AOR = 3.05 (95% CI: 1.07, 8.72)], 31-40 years of experience [AOR = 0.23 (95% CI: 0.07, 0.72)], private school type [AOR = 1.76 (95% CI: 1.06, 2.93)] and 5th -8th teaching category [AOR = 1.54 (95% CI: 1.05, 2.24)] were associated with attitude. CONCLUSION: Knowledge and attitude of study subjects were low which needs training of teachers about the refractive error.

Willingness to donate eyes and its associated factors among adults in Gondar town, North West Ethiopia.

BACKGROUND: In Ethiopia, there is a substantial mismatch between need and supply of corneal transplant. Although corneal transplantation service is affected by various factors, willingness to donate eyes is an essential indicator of its availability, accessibility, and acceptability. Therefore, this study aimed to determine the magnitude of willingness to donate eyes and its associated factors, which help to develop appropriate strategies that can address this undersupply and unmet need. METHODS: A community-based cross-sectional survey was conducted on 774 adults who were selected using multistage random sampling in Gondar town, North West, Ethiopia. The data were collected through interviews. RESULTS: In this survey, 774 adults with a median age of 30 ± 14.33 years participated. The proportion of willing to donate eyes was 37.6% [95% CI: 34.3%-41.3%]. It was positively associated with the religious belief of Christianity [AOR = 1.73, 95% CI: 1.08-2.75], having awareness about eye donation [AOR = 1.38, 95% CI: 1.01-1.92], educational level of high school [AOR = 2.90, 95% CI: 1.72-4.90], and College/University [AOR = 2.23, 95% CI: 1.28-3.87]. CONCLUSION: The magnitude of willingness to donate eyes was moderate and positively associated with the higher educational level and awareness. It is, therefore, strategic to plan awareness creation programs to mobilize the community.