Prevalence and factors associated with corneal related blindness among patients attending Mbale Regional Hospital Eye Clinic

Abstract

Background: Corneal related blindness (CRB) is blindness in an eye as a result of corneal disease. Its distribution and predisposing factors vary from one region of the world to another and Uganda is among heavily burdened countries yet deficient of recent data. Unlike other forms of blindness such as cataract, CRB is difficult to reverse. Surgical management is standard care, but is expensive and requires expertise and facilities hardly available in a low income country like Uganda. Even then, not all corneal conditions are amenable to surgery. Thus prior knowledge of area specific CRB disease burden and predisposing factors is important for adoption of appropriate prevention efforts. The purpose of this study therefore was to determine the prevalence and factors associated with corneal related blindness among patients attending Mbale regional hospital eye clinic. Methods: This was a dual design study namely a baseline cross-sectional study and a case control study. Case notes of all new patients who attended Mbale hospital eye clinic during the period January 2010 to December 2012 were retrieved and assessed. Interest was on patients with blindness associated with corneal disease and those who had presented with chalazion. Simple random sampling was employed to obtain a sample of 257 participants for the baseline cross-sectional study. Systematic sampling procedure was employed to select 203 cases and 203 Results The prevalence of corneal related blindness was 2.72% (95% CI 0.7 - 4.6%). Factors found to be independently associated with CRB were age in years (OR 1.7, 95% CI 1.12 - 2.7 I ); unemployment (OR 1.9, 95% CI 1.20 -3.08) and traditional ocular medicine (OR 16.9, 95% CI 2.22 - 129.70). Conclusions The prevalence of CRB in this study was low compared to similar studies done elsewhere in Sub-Saharan Africa. Participants who were unemployed were twice at risk of CRB compared to the employed while participants of age a 27 years were 1.7 times more likely to have CRB compared to the lower age group. In addition, the use of traditional eye medicine (TEM) was 17 times more likely to lead to CRB compared to non use. A comprehensive study of nature and types of TEM associated with corneal blindness need to be undertaken as part of a greater effort to determine real causes of corneal ulceration and ultimate blindness in communities.