Epidemiology and visual outcomes of ocular injuries in a low resource country.

BACKGROUND: Ocular injury is a major cause of ocular morbidity and unilateral visual impairment and represents a considerable public health concern especially in low resource societies. OBJECTIVE: To evaluate the epidemiology and visual outcomes of ocular injuries in southern Ghana. METHODS: A retrospective hospital-based case series was conducted. Information on new cases of ocular injuries were retrieved and parameters including time between injury occurrence and reporting to the clinic, presenting visual acuity (VA), and the best corrected final VA were investigated and visual outcomes were assessed Results: Most (50.2%) of the patients reported to the hospital after a day of sustaining an ocular injury; workplace injuries, older patients and farm-related injuries were most likely to report after a day of sustaining an injury. A significant proportion (40.4%) of patients reported with good presenting vision (6/6-6/18) which increased to 56.7% after treatment; 45.3% of patients reported with visual impairment (<6/18) and reduced to 42.4% after treatment. Farming (AOR = 4.5, p = 0.02), reporting after a day of sustaining injury (AOR = 78, p< 0.001), workplace injuries (AOR = 3.1, p = 0.007) and roadside injuries (AOR = 3.1, p = 0.02) were associated with poor visual outcomes. Initial VA 6/18 or better was the highest predictor of good visual outcome. CONCLUSION: There is a shift in the pattern of ocular injury occurrence from work-related to home- related.

The practise of paediatric optometry in a low-resource environment.

BACKGROUND: The role of optometrists in paediatric visual assessment must compliment the role of other eye-care practitioners at all levels of care. This study was undertaken to determine if optometrists in Ghana screen, diagnose and manage paediatric ocular conditions (for example, strabismus, amblyopia), and further assessed if optometrists in Ghana have the requisite paediatric instrumentation in their practices. METHODS: This was a cross-sectional descriptive survey involving optometrists in both public and private eye-care sectors in Ghana. A paediatric visual assessment questionnaire was sent to all registered optometrists in Ghana. The contents of the questionnaire evaluated areas of vision assessment, refraction, and previous diagnosis and management, which were matched with practice characteristics such as location, type of practice and type of employment. Chi-squared statistic was used to test associations between variables. RESULTS: Responses were obtained from 140 optometrists out of the 326 registered optometrists, representing a response rate of 46 per cent. Overall, less than half of respondents (64 which represents 46 per cent) assessed themselves as practising full-scope paediatric eye care. These self-assessment views were more common among optometrists at the regional level (111: 79.3 per cent), followed by the district (20: 14.3 per cent) and sub-district levels (nine: 6.4 per cent) (χ2 = 4.774, p < 0.05), but was not influenced by type of employment, type of practice and level of training (p > 0.05). In addition, the study revealed that many respondents were more likely to assess pre-schoolers' visual acuity (VA) (121: 96.0 per cent), do refraction (109: 88.6 per cent) and perform binocular vision (BV) assessment (93: 76.9 per cent) compared to the toddlers' VA (72: 55.4 per cent), refraction (57: 46 per cent) and BV assessment (68: 56.2 per cent). CONCLUSION: Full-scope paediatric eye care services among optometrists in Ghana is limited.