Pattern of ocular findings in persons with Albinism in Kenya

Abstract

Aim: The aim of this study was to establish the ocular findings in persons with albinisra in Kenya. Method This was a school based cross-sectional study conducted in schools for the blind and integrated education programmes in Eastern and Central province. All the pupils with albinism present during the study period were examined, giving a total of one hundred and one pupils. Assessment of visual acuity and stereo acuity for each pupil was carried out. Amsler grid was used to test macula function. Orthoptic assessment was done followed by anterior segment examination using a torch, +20 dioptre loupe and a portable slit lamp. Posterior segment examination was performed using a direct and indirect ophthalmoscope. Objective refraction was performed on all the pupils. All pupils with conditions requiring management were given appropriate treatment and referrals. Results A total of 101 pupils were examined, 49 males and 52 females. Common ocular complaints were photophobia(91 %) and reduced vision(78%). Majority of the pupils (83%) were wearing photochromic spectacles, prescribed to them by an ophthalmologist. Most of the pupils had moderate visual impairment (86%). Nystagmus (98%) and strabismus (91%) were common ocular findings. Stereopsis was absent in most pupils (93%). Amsler grid assessment was normal in most cases (7901o).Common refractive errors were hypermetropic astigmatism(46%) and myopic astigmatism(28%).The commonest anterior segment finding was iris trans-illumination defects(87%). The commonest posterior segment findings were foveal hypoplasia( 1 00%), hypopigmentation of the retina(97 .5%) and optic nerve hypoplasia(97%). Conclusion Most of the pupils examined had moderate (86.5%) and to a lesser extent severe visual impairment (5%). Common ocular symptoms were photophobia and reduced vision. Common ocular findings were iris transillumination defects, foveal hypoplasia, retinal hypopigmentation and optic nerve hypoplasia. A strong relationship was found between reduced vision and foveal hypoplasia, nystagmus, optic disc hypoplasia, refractive error and strabismus. However, these findings were also present in the pupils without visual impairment. Therefore, itt was difficult to single out one main cause of reduced vision in these pupils. The commonest refractive errors found were hypermetropic astigmatism and myopic astigmatism. Majority of the pupils were wearing photochromic spectacles, prescribed to them by an ophthalmologist.