Ophthalmology

Social determinants of blindness in Sudan- 2019 Mohanad Kamaleldin Mahmoud Ibrahim Al-Basar International Journal of Ophthalmology 2020 7(1):1-3 Background: The term blindness is used for complete or nearly complete vision loss. The number of people estimated to be visually impaired worldwide is 285 million; 39 million are blind and 246 have low vision. About 90% of the world visually impaired lives in low-income settings. The overall objective of this study was to identify the social determinants of blindness in Sudan, aiming for prevention and control. Methodology: This was an outreached service cross-sectional study conducted among 858 participants selected using multistage cluster sampling and drawn proportionate to size among four cities in Sudan using probability sampling technique. The data were collected using closed-ended administered questionnaires, and data were analyzed using the Statistical Package for the Social Sciences version 21. The analysis included uni-variate for all determinants and bi-variate cross-tabulation using Chi-square test to reveal associations between variables of interest. The study was estimated at 95% confidence level. Results: The overall socioeconomic profile of the study group was low. The mean monthly income of the blind participants was only 1991 sustainable development goal. The majority of the blind participants were unemployed, where they represented >70% and there was a significant association between occupation and blindness (P = 0.000). More than half of the blind participants (58%) were living in rural areas, and the study revealed a significant association between blindness and living are (P = 0.000). Conclusion: The socioeconomic status in terms of income, occupation, and living area and is significantly associated with blindness. A majority of the blind participants are living in rural areas, unemployed, and earn low monthly income.

Tear film assessment in sudanese diabetic patients attending Jabir Abu Eliz Diabetic Center, Khartoum, Sudan Saeeda Mohammed Osman, Mahgoub Saleem Al-Basar International Journal of Ophthalmology 2020 7(1):4-10 Background: Several local and systemic conditions predispose the eye to the development of dry eye disorders due to tear film dysfunction, which is presented in variable degrees of eye irritations and inflammation. Diabetes mellitus (DM) is among the most common risk factors of dry eye disease (DED). It is more common in older females than males. Tear film assessment can be tested with some simple tests such as Schirmer's test (ST), fluorescein strip (FS) (breakup time [BUT]) test, and lissamine green strip (LGS) test. Objective: The aim of this study is to assess the tear film dysfunction in diabetic patients with ST, FS papers, and LGS papers and compare their diagnostic values. Materials and Methods: In a cross-sectional hospital-based study, consecutive 126 diabetic patients were examined at Jabir Abu Eliz Diabetic Center in Khartoum for their tear film dysfunction. All selected patients had simultaneously undergone ST, FS (BUT) test, and LGS test in the same order and equal definite intervals in all patients over a 2-month period (September 1, 2013–November 1, 2013). Clinical and personal information was obtained by direct patients and chart review before complete ophthalmic examinations. Results: The mean age of the study group was 53 ± 12.1 years (30–78 years). Fifty-seven patients (45.2%) were female and 69 (54.8%) were male. In the age group, 11 (8.7%) patients were of type I DM, whereas 115 (91.3%) of type II DM. Forty-four (34.9%) patients had good DM control and 82 (65.1%) had poor DM control. The ST results of the current study demonstrated the presence of 142 patients (56.3%) in the “normal Schirmer's grade,” 49 patients (19.4%) in “mild-to-moderate Schirmer's grade,” and 61 patients (24.2%) in “severe Schirmer's grade.” In the BUT “FS” test, 165 patients (65.5%) gave normal results, whereas 87 patients (34.5%) showed severe tear dysfunction results, with a highly significant difference with P = 0.001. Whereas, in the LGS test, 201 patients (79.8%) were of “normal grade” results and 51 patients (20.2%) were “mild-to-moderate” grade. Conclusion: DED is an important feature of poorly controlled DM, which can be easily detected by performing a variety of simple quick tests such as the ST, fluorescein tear BUT test, and LGS test. There is notable variation among these three tears; therefore, a combination of any two tests is necessary. There is a strong correlation between qualities of the DM control, duration of DM, and severity of DED.

Screening of retinitis pigmentosa among Sudanese students of Al-Neelain University Eye Hospital, Khartoum, Sudan Reem Elrasheed Gadkariem, Mahgoub Saleem, Saeeda Mohammed Osman Al-Basar International Journal of Ophthalmology 2020 7(1):11-15 Background: Retinitis pigmentosa (RP) is a genetic retinal disorder that leads to progressive visual impairment. Early symptoms are night blindness, followed by the loss of peripheral vision and constricted visual fields. The symptoms and signs worsen as time goes. Objectives: The objective of this study was to determine the incidence of RP among Sudanese students of Al-Neelain University College of Optometry and Visual Science from March to May 2017. Materials and Methods: In a cross-sectional observational hospital-based study, which was conducted at Al-Neelain University Eye Hospital, Gabrah, Khartoum, Sudan, in 3-month period, from March to May 2017, by a consecutive sampling technique, 193 Sudanese students from Al-Neelain University College of Optometry and Visual Science were examined for the presence of RP. Data were statistically analyzed using SPSS. Results: Females were 154 (79.8%) and males were 39 (20.2%). Their mean age was 21.76 years ± 2.5 years (range: 16–25 years). One hundred and forty-five (75.1%) students were between 21 and 25 years and 48 (24.9%) students were between 16 and 20 years. The majority (99.5%) reported negative symptoms of night blindness, and few (0.5%) reported definite positive symptoms of night blindness. Only 2 (1.0%) students out of the whole study group disclosed family history of RP. Sixty-one (31.6%) participants revealed consanguinity; 2 (1%) of them were of first-degree and one (0.5%) of second-degree consanguinity. One hundred and forty-three (74.1%) participants were emmetropic while fifty (25.9%) with minor degrees of ammetropia (±0.5–0.75 diopter). Overall, 188 (97.4%) scored 6/6 best-corrected visual acuity. None of the partinsepants students reviled any degree of color defect. Intraocular pressure in all students was within normal limits. No single student revealed fundus appearance of RP in all 193 candidates and even in those with symptoms of night blindness or family history of RP. Conclusion: No single RP case with typical fundus appearance and visual functional loss was reported in 193 male and female Sudanese students of Al-Neelain University College of Optometry and Visual Science.

Rubella virus in association with congenital cataract at makkah eye complex Muhennad H Halees, Mahgoub Saleem, Arwa Abdalla Al-Basar International Journal of Ophthalmology 2020 7(1):16-20 Background: Rubella is a viral disease that causes many systemic and ocular postnatal anomalies known as congenital rubella syndrome (CRS). The most common ocular disorder is congenital cataract. Purpose: The purpose of this study was to determine the prevalence of CRS and its association with congenital cataract and systemic comorbidities. Materials and Methods: In this cross-sectional, hospital-based study, full ophthalmic and systemic examination was carried out on 45 infants (n = 45), aged below 1 year, with congenital cataract, attending the Pediatric Ophthalmology Clinic at Makkah Eye Complex, Khartoum, Sudan, in the period between February 2015 and June 2016. The 45 children were booked for phacoemulsification plus intraocular lens implantation. The children's biodata and maternal and neonatal history were obtained from the mothers and plotted in case investigation forms. Venous blood sample and lens aspirate were studied for rubella IgM, IgG, and polymerase chain reaction beside rubella virus detection in the National Laboratory of Measles and Rubella. Results: Blood and lens aspirate was collected from the study infants, which revealed that 38 infants (84%) were negative for rubella, whereas only seven infants (16%) showed positive result. The majority of the rubella-positive patients (n = 5, 71%) had bilateral cataract and only two infants had unilateral cataracts. Only one rubella-positive case (14.3%) had microphthalmia in one eye. Unfortunately, screening for pigmentary retinopathy was not done postoperatively. Four (57%) out of the seven rubella-positive cases reported systemic CRS. Microcephaly, patent ductus arteriosus, ventricular septal defect, and pulmonary hypertension were reported in one case (14.3%) each. Three mothers (43%) from the rubella-positive group had a history of febrile illness during pregnancy. Conclusion: Congenital cataract and systemic comorbidities are common in infants with congenital rubella.

Diabetic retinopathy-related knowledge level among the omani population Gopi Suresh Vankudre, Galal Ismail, Noof Salim Hamdan Al Maamari Al-Basar International Journal of Ophthalmology 2020 7(1):21-26 Background: An annual report published by the Ministry of Oman stated the diabetes mellitus (DM) prevalence of 15.7% among the patients attending a nutritional clinic. This estimate is higher than the prevalence rate of 12.3% that was reported in the national survey done in 2008. The Omani population having sight-threatening diabetic retinopathy (DR) ranges from 14.5% to 42.2%. Many factors can lead to the burden of DR, such as nonawareness or nonserious approach toward eye care. Materials and Methods: This cross-sectional questionnaire-based study included 232 participants through a convenient sampling technique. It used a semi-structured interview method to secure the participant responses for evaluating their DR-related knowledge. Statistical Analysis Used: The significance of the association for knowledge among the different study variables was analyzed by applying the Chi-square test and Fisher exact test. One-way analysis of variance was used to compare the knowledge level between participants with different sociodemographic backgrounds. Results: 91.4% of the study population with nonmedical background are aware of ocular complication of diabetes. Condition-linked knowledge adequacy was associated with gender (P < 0.013), personal (P < 0.00) or family history (P < 0.017) of diabetes, and area of residence (P < 0.012). Only 0.61% of the general population had excellent knowledge about DR, whereas 58.28% of the study participants had a poor, and 22.09% had very poor knowledge about the condition. Conclusions: Majority of the study participants are aware of ocular complications due to DM. However, variations were observed for the condition-related knowledge level, its prevention, diagnostic treatment, and managerial options in case of visual impairment.

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