Ocular findings among children in Samburu handicap and rehabilitation programme

Abstract

Background: Samburu handicap education and rehabilitation programme (SHERP) is a community based organisation which caters for children with various handicaps from all over Samburu district. Its main aim is to provide a home for these children, rehabilitate them and integrate them back into normal schools. Aims/Objectives: To determine the prevalerice and pattern of eye diseases, and their association with other handicaps in children under SHERP. Methodology: A cross sectional community based study in which '172 children registered under SHERP were examined. Results: 272 children out of a total of 341 were examined. Majority of the children were male (59.2%). The youngest child was aged 4 years while the oldest was 15 years. The mean age was 11 years with 34% of the children being in the 13-15 year age bracket. Amongst the children, 27% had ocular anomalies, 21% had mental retardation, 18% were deaf and 21.3% had various limb anomalies including paralytic disorders. Refractive errors were the commonest ocular anomaly (40.8%) while corneal scars and cataracts were seen in 17% and 5.2% of children respectively. 30% of mentally retarded children had ocular anomalies with refractive errors and optic nerve atrophy having a prevalence of 7.8% and 6.2% respectively. Both findings were statistically significant. Cataracts and corneal scars were each seen in 6.2%.Both were not statistically significant.35% of deaf children had ocular anomalies, most being refractive errors (26%) and cataracts (7.3%). These results were both were statistically significant. The only finding in children with paralytic diseases was refractive errors (29.7%). This was not statistically significant. 70% of the children had normal visual acuity (6/6-6/18), while 21% had visual impairment. Only 0.73% had severe visual impairment and 5.9% were blind. The major causes of visual impairment were refractive errors (52.6%) and corneal scars (21 %). The major causes of severe visual impairment! blindness were corneal opacities (44.4%) and optic nerve disease (33.3%). Conclusions There was a high prevalence of ocular anomalies (27%) in children under SHERP. Refractive errors were the commonest eye condition causing visual impairment while the commonest cause of severe visual impairment and blindness was corneal scars. Recommendations Screening for ophthalmic problems in deaf and mentally retarded children should be done as soon as the conditions are diagnosed to enable early intervention. There is need for proper record keeping in SHERP. This should include complete demographic .. details, medical and family social history of the children. Low cost, durable spectacles should be supplied to these children. Studies should be done in both schools for the deaf and mentally retarded involving larger sample sizes to shed more light on ocular disorders in these children.