|Year : 2015 | Volume
| Issue : 1 | Page : 15-18
Pattern of eye diseases at tertiary eye hospital in Sudan (Makah Eye Hospital, Khartoum)
Khalil A lakho1, Atif B Mohamed Ali2
1 Department of LVA, Makkah Eye Complex, Sudan Eye Center, Khartoum, Sudan
2 Faculty of Optometry, Al.Neelain University, Khartoum, Sudan
|Date of Web Publication||10-Nov-2015|
Atif B Mohamed Ali
Faculty of Optometry, Al Neelain University, Khartoum
Purpose: The aim of the study was to determine the frequency and pattern of eye diseases among patients attending the eye clinics of Makah Eye Hospital, Khartoum, Sudan. Methods: A retrospective study involved all the new cases presenting to the outpatient department of the hospital over a 22-month period from January 2012 to October 2013. Patients were examined by optometrists/ophthalmologists through routine examination using the Snellen's chart, refraction, tonometry, slit-lamp examination of the anterior segment, and fundus examination. Results: A total of 64,529 patients were seen during this period with a male to female ratio of 1:1.1. The most common eye diseases were cataract, allergic conjunctivitis, infective conjunctivitis, refractive disorders, and glaucoma. Conclusion: The pattern of eye diseases observed in Makah Eye Hospital was similar to other reports from developing world and such study will be helpful in planning, management, and prevention of blindness.
Keywords: Ocular morbidity, pattern, Sudan
|How to cite this article:|
lakho KA, Mohamed Ali AB. Pattern of eye diseases at tertiary eye hospital in Sudan (Makah Eye Hospital, Khartoum). Albasar Int J Ophthalmol 2015;3:15-8
|How to cite this URL:|
lakho KA, Mohamed Ali AB. Pattern of eye diseases at tertiary eye hospital in Sudan (Makah Eye Hospital, Khartoum). Albasar Int J Ophthalmol [serial online] 2015 [cited 2019 Apr 22];3:15-8. Available from: http://www.bijojournal.org/text.asp?2015/3/1/15/169304
| Introduction|| |
The pattern of eye diseases differs in developing and developed countries and often in communities. A study of the pattern of ocular diseases is very important because while some eye conditions are just causes of ocular morbidity others may lead to blindness. In Sudan and other African countries, studies carried out on the pattern of ocular diseases in children , have shown that refractive errors, allergic, and infective conjunctivitis are the most common causes of ocular morbidity.
However, the trend of ocular diseases varies worldwide and is also influenced by racial, geographic, socio-economic, and cultural factors. The common ocular diseases worldwide are cataract, glaucoma, conjunctivitis, corneal ulcers, uveitis, refractive errors, and pterygium. The most common eye diseases seen among patients attending ophthalmic outreach services in a rural area in Ethiopia were conjunctivitis, cataract, presbyopia, refractive errors, and blepharitis. From Benin City (Nigeria) reported refractive errors, conjunctivitis, cataract, and glaucoma to be the common eye diseases. The retinal disease had a low priority in the prevention of blindness programs in developing countries mainly because retinal diseases were considered an uncommon cause of blindness in the developing world. In spite of the effort and expense involved in acquiring costly equipment and developing skilled human resource for retinal subspecialty, failure in justifying the treatment results of retinal disease has also contributed to the development and strengthening of this assumption.
Sudan is a developing country located in central and east African region, in which ophthalmology is one of the important specialties in medical services. The number of ophthalmologists, optometrists, and eye care service is increasing rapidly to make eye health services accessible to the entire population. Al-Basar International Foundation established a charity eye hospital in 1995 in Khartoum; now, this hospital called Makah Eye Complex (MEC). The hospital includes a number of specialized ophthalmic clinics to contribute in the domestication of treatment. MEC is provided with variable surgical equipment, many types of surgeries are performed in the theater such as Phacoemulsification and small incision cataract surgeries, Glaucoma, Corneal Graft, Squint, Retina, Orbit, and deferent Oculoplastics surgeries.
The aim of this study is to determine the pattern of eye diseases at tertiary eye hospital and to compare the findings with previous studies in the same environment. It is hoped that this study will show the trend of ocular morbidities in our environment and help to provide basic data for planning and provision of adequate eye care services, appropriate treatment, and intervention for these diseases.
| Methods|| |
The case records of all consecutive patients seen at the outpatient department (OPD) of MEC between January 2012 and October 2013 were retrieved. The demographic data such as age and sex of the patients were noted. The patient data were collected from the OPD registers at the clinics and analyzed retrospectively. A total of 64,529 patients attended the OPD, which constituted the sample size of the study. The patients were first seen by optometrist for refraction and visual acuities before turn into the general OPD. Every patient was seen by consultant ophthalmologist who examines the anterior segment with the slit lamp, measures the ocular tension (IOP), and examines the posterior segment using a direct ophthalmoscope/or 90D lens with the pupils dilated. Treatment was offered following a diagnosis or a patient may be referred to subspecialty clinics. A computerized register found in IT department when opened the names of all patients seen with the hospital number, date, age, sex, and diagnosis were recorded.
| Results|| |
The majority of the patients were adults, in which age more than 20 years were 49,253 (76.32%) while children and young adults were 15,276 (23.68%). There were 30,464 males (47.21%) and 34,065 (52.79%) females giving a male to female ratio of 1:1.1 [Table 1]. Although there was a preponderance of males only in inner eye disorders [Table 2] and [Table 3], no significant differences noticed in pattern of eye diseases due to gender. The most common eye disorder [Table 4] encountered was cataract; this was followed by allergic and infective conjunctivitis. Refractive errors and presbyopia [Table 2] and [Table 5] present the third cause succeeding the former outer eye diseases. On the other hand, glaucoma present as a fourth cause of morbidity.
| Discussion|| |
This study reveals a slight female preponderance. This differs with the general observation in most of the studies that fewer females are seen in medical clinics than males in the developing countries. This may be due to the location of the hospital making it easily accessible to women who do not have to depend on their spouses or relations to bring them to the hospital as well as good awareness among community about importance of eye examination and prevention of blindness particularly in urban areas such as the capital Khartoum. Thus, the evidence in this study shows [Table 2] that 6501 (10.07%) subjects came to the hospital only for routine eye check (personal or occupational motivation) without apparent complaint or other pathological and clinical features. A similar study in Nigeria also reported a female preponderance. More adults had ocular problems in this study than children. Ajaiyeoba and Scott  reported a similar trend. A likely explanation for this is that children may not be able to adequately express their problems and, hence, may not present to the hospital until the features are prominent enough to be ocular morbidity. The dry, sunny, and dusty nature of the weather in Sudan may be responsible for the high occurrence of cataract and conjunctival diseases in this study. This agrees with other hospital-based studies as well as school eye health surveys that have also reported it as the most common eye diseases.,, Uncorrected refractive errors constitute important ocular health problems worldwide. It has impact on quality of life and has educational and socioeconomic consequences. In this present study, it was the third most common cause of ocular morbidity. This is in agreement with previous reports., Sudan studies  have also shown that a major cause of eye disorder in school children screened for refractive errors revealed that refractive errors were not detected before. Presbyopia was the most common refractive disorder in this study, and that is similar to observations by other authors. Africans have been reported to have a younger age of onset as well as more severe presbyopia. Glaucoma that was seen in 1837 of patients in this study has been reported to be the second most common cause of blindness or visual impairment worldwide. It is the leading cause of irreversible blindness in West Africa, and it has been estimated that 20% of people older than age 40 in West Africa may be at risk from the disease. Ocular trauma has recently been highlighted as an important cause of visual morbidity. The prevalence of trauma in this study was 2.79%; this is comparable to study of Olukorde and Oluymka, which shows trauma of less than 3%, but in contrast with other studies, which reported ocular trauma as the third , major cause of ocular morbidity in children. The retinal disease pattern noted in this study (4.93%) comparable to those noted at other clinical studies of the developing world; it was found ranging from 3.9% in South-Eastern Nigeria  to 12.5% in Ethiopia. Recently, vitreo-retinal disorders constituted a significant reason for presentation to eye clinics and tertiary eye department. Diabetic retinopathy was the most common cause for attendance in the retina clinic. This is similar to the results from Nigeria  and Malaysia  and diabetic retinopathy accounted for 9.7% and 9.6% retinal diseases, respectively.
| Conclusion|| |
The pattern of diseases observed in this study is similar to the findings from other parts of the developing world in spite of variability of methods for calculating causes. This type of study is helpful to have idea about the epidemiology of any diseases. This helps in planning and management of a hospital. Early detection of diseases such as cataract and glaucoma in this population will reduce the burden of blindness in Sudan. Programs should be put in place following the guidelines and strategies of Vision 2020 to help in reducing the burden of visual impairment and blindness from these disorders.
We would like to express our gratitude to El Amin Mukhtar for preparing the data from IT to this study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Pi LH, Lin Chen L, Liu Q, Ning Ke N, Fang J, Zhang S, et al
. Prevalence of eye diseases and causes of visual impairment in school-aged children in western China. J Epidemiol 2012;22:37-44.
Adio AO, Alikor A, Awoyesuku E. Survey of pediatric ophthalmic diagnoses in a teaching hospital in Nigeria. Niger J Med 2011;20:105-8.
Rushood AA, Azmat S, Shariq M, Khamis A, Lakho KA, Jadoon MZ, et al.
Ocular disorders among schoolchildren in Khartoum State, Sudan. East Mediterr Health J 2013;19:282-8.
Catherine UU. Pattern of ocular morbidity in Nigeria. Asian Pac J Trop Dis 2013;3:164-166.
Edema OT, Okojie OH. Pattern of eye diseases in Benin City, Nigeria. Afr J Med Pract 1997;4:86-90.
Yorston D. Retinal diseases and VISION 2020. Community Eye Health 2003;16:19-20.
Kawuma M. Eye diseases and blindness in Adjumani refugee settlement camps, Uganda. East Afr Med J 2000;77:580-2.
Olukorde OA, Oluymka JS. Pattern of eye diseases in air force hospital in Nigeria. Pak J Ophthalmol 2012;28:144-8.
Ajaiyeoba AI, Scott SC. Risk factors associated with eye diseases in Ibadan, Nigeria. Afr J Biomed Res 2002;5:1-3.
Murad MA, Alam MS, Miah AKMA, Akter MS, Kabir MH. Pattern of eye diseases in a tertiary hospital in a suburban area: A retrospective study. Orion Med J 2007;28:492-4.
Sarita T, Sachin D. A pattern of ocular morbidity in patients attending anophthalmic clinic in a rural part of western Nepal. J Nobel Med Coll 2012;2:27-30.
Dandona L, Dandona R, Naduvilath TJ, McCarty CA, Srinivas M, Mandal P, et al.
Burden of moderate visual impairment in an urban population in southern India. Ophthalmology 1999;106:497-504.
Balarabe AH, Adamu S, Musa R. Presbyopia among health workers in a tertiary hospital in north western Nigeria. Sub-Saharan Afr J Med 2015;2:10-3.
Adeoye AO, Omotoye OJ. Eye disease in Wesley Guild Hospital, Ilesa, Nigeria. Afr J Med Med Sci 2007;36:377-80.
Amadi AN, Nwankwo BO, Ibe AI, Chukwuocha UM, Nwoga KS, Oguejiofor NC, et al
. Common ocular problems in Aba metropolis of Abia State, Eastern Nigeria. Pak J Soc Sci 2009;6:32-5.
Patel I, West SK. Presbyopia: Prevalence, impact, and interventions. Community Eye Health 2007;20:40-1.
Asaminew T, Gelaw Y, Alemseged F. A 2-year review of ocular trauma in Jimma University specialized hospital. Ethiop J Health 2009;19:67-73.
Bodunde OT, Onabolu OO. Childhood eye diseases in Sagamu. Niger J Ophthalmol. 2004;12:6-9.
Ezegwui IR, Onwasigwe EN. Pattern of eye disease in children at Abakaliki, Nigeria. Int J Ophthalmol 2005;5:1128.
Eze BI, Uche JN, Shiweobi JO. The burden and spectrum of vitreo-retinal diseases among ophthalmic outpatients in a resource-deficient tertiary eye care setting in South-Eastern Nigeria. Middle East Afr J Ophthalmol 2010;17:46-55.
Teshome T, Melaku S, Bayu S. Pattern of retinal diseases at a teaching eye department, Addis Ababa, Ethiopia. Ethiop Med J 2004;42:185-93.
Onakpoya OH, Olateju SO, Ajayi IA. Retinal diseases in a tertiary hospital: The need for establishment of a vitreo-retinal care unit. J Natl Med Assoc 2008;100:1286-9.
Reddy S, Tajunisah I, Low K, Karmila A. Prevalence of eye diseases and visual impairment in urban population-A study from university of Malaya Medical Centre. Malays Fam Physician 2008;3:25-8.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]