Tuesday, 16 August 2016

Pattern of Ocular Morbidities Among First Year Students in a Public University in Ghana

                                                          www.mathewsopenaccess.com



Vision is the most important human sense for every student, especially for students in tertiary institutions where academic performance involves a lot of reading and research. It is generally claimed that visual input accounts for 75% of information acquisition. As such, the existence of any ocular condition that causes poor vision or inhibits the comfortable use of the eyes could have negative impact on the student’s academic performance. It is therefore important that students admitted into universities to pursue various programs have optimal comfortable vision. Ocular morbidity refers to a condition in a study subject, recognized or suspected, ocular or vision abnormality, which require treatment or surveillance. Studies have shown that ocular morbidities are a major public health problem in developing countries like Ghana, where about 90% of the world’s visually impaired people live. Visual problems have been known to lead to 4-8% slower performance on occupational tasks. 

Students suffer varieties of symptoms of these visual problems, which are frequently associated with near work (reading and writing) whereby eye accommodative and vergence processes are more intense. These asthenopia symptoms such as burning such as burning sensations, eye strain, tearing and photophobia can be severe enough to limit personal activities and further result in the development of age related eye disease. A study by Rafindhadi et al revealed that most subjects who suffered ocular morbidity were students, and the least were farmers. A common ocular condition affecting students is refractive error. For example, higher education has been found to correlate with long hours of near work (reading and writing), and this environmental factor has been found to contribute to the development of myopia. 

Thus, if myopic students admitted into the university are uncorrected, the exposure to long hours of near work may progress the refractive error (as shown by a 5-year longitudinal study in one university and cause more vision problems. Other studies have also reported on ocular problems affecting students such as refractive error allergic conjunctivitis, which has been found to be a leading cause of absenteeism from school and computer vision syndrome. With the advent of technology, students are glued to computer screens for the majority of their academic work and entertainment. This excessive use of computer comes with it visual and ergonomic problems. Headache, burning sensation in eyes and dry/tires/sore eyes were the most common visual related problems associated with usage of computers in one study. The discomfort associated with computer usage has not yet been proven to result in permanent ocular damage, but may cause a reduction in work accuracy and this can reduce productivity by as much as 40%. Cataract, refractive errors, glaucoma, diabetes and injuries have been shown to be causes of blindness in middle age but more importantly in age group 20 to 40 years, and this happens to be the age group for most undergraduates. Unfortunately, information on the distribution of ocular conditions among students in tertiary education is very limited, particularly for developing countries. However, the few studies on selected ocular conditions among university students have recorded significant problems. It is important that these and other non-blinding morbidities are detected at the earliest to reduce the possible complications. The good news is, many ocular problems that are amenable to interventional measures are detected through vision screening of selected populations. 

The purpose of this study was to outline the pattern of ocular conditions among students who have been admitted into first year programs in the Kwame NkThe research was designed as a cross-sectional, randomized study of all first year KNUST students for the 2014/2015 academic year residing in the halls of residence. Simple random sampling was used to randomly select three out of the six halls of residence and then three floors in each of the sampled halls for the study. On each sampled floor, systematic random sampling was used to select the rooms, starting from the first room, for the study. Each student in a sampled room who satisfied the inclusion criteria was eligible to partake in the study. The total number of students sampled was determined to be 167, using Epi Info version 7.1.4.0, an expected prevalence of 19.6% and a confidence level of 90%.An informed consent was obtained from each student sampled. For each student who consented to the study, a detailed clinical history was taken. The clinical history covered presenting complains, past ocular history and general medical history as well as family ocular history and family medical history. 

After the clinical history, visual acuity was recorded, with and without prescription if any, using a 6-metre Snellen chart. For visual acuities less than 6/9, the pinhole test was performed from the same distance. If the visual acuity improved with pinhole, non-cycloplegic refraction was performed. External examination was performed with a pentorch, followed by anterior and posterior segment examination as well as fundus examination using a direct ophthalmoscope. All findings obtained were recorded on examination forms designed for this study and diagnoses made accordingly. Subjects who required further examination and management were referred to the University Hospital Eye Clinic for further examination and care. For purposes of this study, refractive error was defined as uncorrected visual acuity of less than 6/9 which improved with pinhole. Refractive error of -0.50DS or more was diagnosed as myopia, +1.50DS or more as hyperopia and 0.75DC or more as astigmatism.Completed examination forms were cross-checked in the field for completeness of data. Data was analyzed using STATA for Windows, version 16.0. Frequency and distribution tables were constructed, as well as graphs drawn using Microsoft Excel (Microsoft Office Professional Plus 2010) as descriptive statistics. Continuous variables were expressed as mean ± standard deviation (M ± SD). Chi-square test was employed to find significant differences between comparable categorical groups. Statistical significance was set at p values less than 0.05 (p < 0.05).

No comments:

Post a Comment