A COMMUNITY-BASED PREVALENCE OF PRESBYOPIA AND SPECTACLE COVERAGE IN SOUTHWEST NIGERIA.

ABSTRACT

BACKGROUND: The use of population-based method to assess the prevalence of presbyopia and spectacle use is few even though it is more reliable compared to the commoner hospital based studies. This study was carried out to determine the need for spectacle services in our coverage area. AIM: To determine the prevalence of presbyopia among adults of 30 years old and above in Sagamu local government area of Ogun state, South-West, Nigeria. DESIGN: The study was a population based descriptive and cross-sectional design. SETTING: The study was carried out using a multistage cluster random sampling with probability proportional to size of regular adult residents of Sagamu Local Government area, Sagamu, Ogun state, Nigeria. MATERIALS AND METHODS: Examination of respondents included administration of semi-structured interviewer assisted questionnaire and distance visual acuity measurement with or without pinhole at 6 meters using the Snellen's charts. Automated refraction with subjective refraction was carried out in all participants with presenting visual acuity (PVA) worse than 6/9 but with an improvement with pinhole. Near assessment was done at 40cm with the distance correction in place if required. Ocular examination was also carried out in all participants that had refraction including pupillary dilatation when indicated. RESULTS: The prevalence of presbyopia was 80.9%. There was an increasing prevalence with age (p<0.001) with a 100% prevalence in the ≥80 years age group. The mean add requirement was +2.24DS. The met presbyopic need was 22.9% and the unmet need 58%. The presbyopic spectacle coverage was 28.4% which was positively associated with younger age (p=0.034), attaining at least secondary school education (p<0.001), and living in an urban area (p<0.001). CONCLUSION: The prevalence of presbyopia is high in this community and found in persons younger than 40 years and the spectacle coverage for the population is low with a high unmet spectacle need. There is a need to provide near vision spectacles to a large proportion of residents in the community.