Prevalence and causes of visual impairment among hearing impaired students in Lagos, Nigeria.

ABSTRACT

OBJECTIVES: To determine the prevalence and causes of visual impairment in hearing-impaired students in Lagos, Nigeria and to assess their level of ophthalmic care utilization. METHODS: Descriptive cross sectional study carried out in a primary school for hearing impaired students in Lagos, Nigeria. Socio-demographic characteristics, medical and ocular history were obtained. Ocular examination comprised of distance and near visual acuity assessment; cover tests; anterior segment examination and direct fundoscopy. Visually impaired students had cycloplegic refraction, dilated fundoscopy and subjective refraction. In-depth interviews were carried out for parents of students requiring referral for further eye care. RESULTS: One hundred and nine students participated in the study. The prevalence of visual impairment was 19%. The causes of visual impairment were refractive error (11%), amblyopia (6%), cataract (1%) and macular scarring (1%). A lower mean age (p = 0.020) and ocular misalignment (p = 0.037) were associated with visual impairment on multivariate analysis. The spectacle correction coverage was 11% and only 8% of the students had prior ophthalmic care utilization. Ignorance of ocular morbidity and perceived inaccessibility of eye care were cited by parents/guardians as reasons for poor utilization of eye-care services. CONCLUSION: A high prevalence of visual impairment was found among the hearing impaired students; uncorrected refractive error and refractive amblyopia were the most prevalent causes. The level of prior ophthalmic service utilization was found to be low. It was recommended that ophthalmic services especially refractive services should be made available in schools for the hearing impaired.