Description
ABSTRACT
Visual impairment is one of a major public health problem among elderly people. The number of people with age-related eye diseases is assumed to be on the rise with increasing life expectancy. Cataract is still the major cause of visual impairment and blindness globally, but other age-related eye diseases, that is, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), and degenerative myopia, are becoming the most important causes in developed countries.
In this cross sectional study, with a simple random sampling, 446 patients older than 5o years who were referred to Obe community. Participants first complete a questionnaire with 25 questions toward demographic and past medical history and then were examined by ophthalmologist. These examinations includes direct and indirect ophthalmoscopy, slit lamp examination, measurement of uncorrected visual acuity and visual acuity with current glasses, lensometery of the previous glasses, refraction with and without the use of cycloplegic and determining the best corrected visual acuity. All slit lamp examinations were performed by the same ophthalmologist. Data were analyzed with SPSS16 with use of Chi – Square test with Pvalue <0.05.
In this study 446 patients were examined that 54.7% were male. Mean age of study population was 62+-9.3 years old. 96.4% of participants had refractory disorder. Prevalence of myopia, hyperopia and astigmatism were 33.6%, 45.9% and 16.8% respectively. Of patients 17.4% had diabetes. Of participants 28.9% had temporal headache, 37% red eye, 41.2% flashing, 27.3% and 28% had dryness and discharge of eye respectively. 31.1% of participants had eyelid problem, 4.7% Color Vision Deficiency (CVD) and 3.8% had family history of CVD. Of total 4.5% had glaucoma, 3.3% macular degeneration and 21.7% had hypertension. 0.6% of population had macular degeneration, 0.4% of population had glaucoma Of 892 eyes (446 individuals), 36.2% had visual acuity less than 7/10, 1.7% light perception (LP) and 0.22% no light perception (NLP) and 2.7% finger count.
TABLE OF CONTENTS
COVER PAGE
TITLE PAGE
APPROVAL PAGE
DEDICATION
ACKNOWELDGEMENT
ABSTRACT
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
- PROBLEM STATEMENT
- AIM OF THE STUDY
- SIGNIFICANCE OF THE STUDY
- PURPOSE OF THE STUDY
- RESEARCH HYPOTHESIS
- DEFINTION OF TERMS
- METHODOLOGY
- PROJECT ORGANISATION
CHAPTER TWO
LITERATURE REVIEW
2.1 CONCEPTUAL REVIEW
2.2 THEORETICAL REVIEW
CHAPTER THREE
3.0 MATERIALS AND METHODS
3.1 STUDY AREA
3.2 SAMPLE COLLECTION
3.3 ANALYSIS OF SAMPLES
3.4 DATA MANAGEMENT AND STATISTICAL ANALYSIS
CHAPTER FOUR
4.1 RESULTS AND DISCUSSION
CHAPTER FIVE
5.0 CONCLUSION AND REFERENCES
- CONCLUSION
REFERENCES
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Visual impairment is a major public health problem among elderly. Over 285 million people in the world are visually impaired, of whom 39 million are blind and 246 million have moderate to severe visual impairment (WHO, 2010). It is predicted that without extra interventions, these numbers will rise to 75 million blind and 200 million visually impaired by the year 2020 (WHO, 2011). WHO (World Health Organization) also estimated that about 80% of blindness around the world is avoidable and 90% of the world’s blind live in a developing country (WHO, 2010). Among persons who are blind worldwide 58% are age 60+ and 32% are ages 45-59. The main causes of blindness are cataract (47.8%), glaucoma (12.3%) and age related macular degeneration (8.7%). Other causes include corneal opacity (5.1%), diabetic retinopathy (4.8%), childhood blindness (3.9%), trachoma (3.6%), and onchocerciasis (0.8%) (WHO, 2010). The prevalence of visual impairment increased rapidly with age among all racial and ethnic groups, particularly among people older than 75 years (National Institutes of Health, 2008). Cases of macular degeneration are expected to double by 2050, from 9.1 million to 17.8 million for aged 50 years or older (Rein et al., 2009). Cases of diabetic retinopathy among people older than 65 or older are expected to quadruple by 2050 from 2.5 million to 9.9 million (Saaddine et al., 2008). With increasing of chronic disease in developed and developing country, prevalence of visual loss is increased. In all developing countries the death and disability from chronic disease now exceeds that from communicable disease comprising 49% compaired with about 40% for communicable disease and 11% for injuries (Lopez et al., 2006). Many studies showed that visual loss is associated with higher prevalence of chronic health conditions (Crews et al., 2006), death (Lee et al., 2002), falls and injuries (Ivers et al., 2000), depression and social isolation (Jones et al., 2009; Horowitz et al., 2003; Rein et al., 2006). Nigerian old peoples such as other developing countries have fronted with many of chronic disease and injuries that could be affected on visual power and finally quality of life. A few studies are conducted on visual impairment on old peoples in Nigeria. Therefore we designed this study with the aim of determining the prevalence of visual impairment in old peoples in Obe community.
1.2 PROBLEM STATEMENT
According to World Health Organization (WHO), the number of people with age-related eye diseases is assumed to be on the rise with increasing life expectancy. Cataract is still the major cause of visual impairment and blindness globally, but other age-related eye diseases, that is, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), and degenerative myopia, are becoming the most important causes in developed countries. The most recent data published by World Health Organization (WHO) showed that the total number of persons with visual impairment worldwide in 2010 was estimated to be 285 million, including 39 million blind people, of whom around 80 per cent are above age of 50, with most of the causes being preventable. This study was carried out to assess the prevalence of age-related eye diseases such as cataract, AMD, glaucoma and ocular hypertension (OHT), DR, degenerative myopia, and cataract surgery in a sample population of Polish older adults.
1.3 AIM OF THE STUDY
Aim of this study was determining the prevalence of visual impairment in old peoples in Obe community, in Ikpo-Okha Local Government Edo State.
1.4 SIGNIFICANCE OF THE STUDY
Because current healthcare costs have been rising, due to the ageing of the population, our study was also strongly motivated by the need to collect accurate prevalence data for the planning of specific prevention strategies for ophthalmic care in Obe community, in Ikpo-Okha Local Government Edo State
1.5 PURPOSE OF THE STUDY
The purpose of this work is to determine the prevalence of age-related eye diseases among older adults in Obe community.
1.6 RESEARCH HYPOTHESIS
H0: Aged people are prone to eye related disease than young people
H1 : Aged people are not prone to eye related disease than young people
1.7 DEFINITIONS OF TERMS
PREVALENCE is defined as the proportion of a population, or sub-population, that has a particular disease at a particular point in time.
VISUAL IMPAIRMENT was defined as BCVA less than 0.5 decimal (<20/40) in either eye. Low vision was defined as BCVA less than 0.1 decimal (<20/40) but better than 0.1 decimal (>20/200) in better seeing eye and blindness was defined as BCVA equal to or less than 0.1 decimal (≤20/200) in both eyes (United States criteria) according Crews J. E,(2006).
AGE-RELATED MACULAR DEGENERATION (AMD) was defined according to the international classification and grading system for age-related maculopathy and age-related macular degeneration developed by the International ARM Epidemiological Study Group. In brief, early AMD was defined as a degenerative disorder characterized by the presence of the following abnormalities in the macular area: drusen, hyperpigmentation, and/or hypopigmentation of the retinal pigment epithelium (RPE). Late AMD was defined as the presence of geographic atrophy of the RPE (in the absence of neovascular AMD) or neovascular AMD defined as RPE and associated neurosensory detachment, retinal (periretinal) hemorrhages, and/or retinal (periretinal) fibrous scarring in the absence of other retinal (vascular) disorders [Gwiazda, 2009].
Glaucoma was diagnosed based on characteristic morphological changes of the optic nerve head and retinal nerve fibre layer (RNFL) not related to other ocular diseases or congenital anomalies, associated with glaucomatous visual filed loss [Hashemi, 2009]. When results of optic nerve head examinations and visual field were unavailable because of media opacity, glaucoma was diagnosed based on previous evidence of glaucoma treatment. The diagnosis of ocular hypertension (OHT) was based on elevated intraocular pressure with the remainder of the examination being normal.
Diabetic retinopathy (DR) was defined according to Early Treatment Diabetic Retinopathy Study Research Group [16]. In brief, DR was categorized into various stages of nonproliferative DR (NPDR) and proliferative DR upon presence of retinal hemorrhages and/or microaneurysms, venous beading, soft and hard exudates, new vessels, fibrous proliferations, and macular edema [Jacobs J, 2005]. The diagnosis of diabetes mellitus was based on the use of diabetic medication.
1.8 RESEARCH METHODOLOGY
In the course of carrying this study, numerous sources were used which most of them are by visiting libraries, consulting journal and news papers and online research which Google was the major source that was used.
1.9 STRUCTURE OF THE STUDY
The work is organized as follows: chapter one discuses the introductory part of the work, chapter two presents the literature review of the related works, chapter three describes laws and institutional framework for the protection of right of domestic servants, chapter four discusses protection of the rights of domestic servants, chapter five is on summary of findings, conclusion and recommendation.
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