Prevalence of myopia and its socio-demographic distribution amongst secondary school going adolescents in Lurambi Sub-County, Kakamega, Kenya

Background: Globally the prevalence of myopia has increased alarmingly and is expected to affect an estimated 2.56 billion people in the world by the end of 2020. It is believed to be the leading cause of visual impairment in Kenya, contributing 59.5% of all causes of visual impairment. Still, agreement on the exact prevalence in Kenya and whether socio-demographic factors have an influence on myopia is unknown. This study was aimed at evaluating the prevalence of myopia and its socio-demographic distribution amongst randomly selected school-going adolescent. This study was conducted in Lurambi Sub-County in Kakamega, Kenya. Material and methods: The study adopted a school-based cross-sectional descriptive study design. Using a multi-stage sampling technique, 733 participants from a population of 7,400 secondary school students within Lurambi Sub-County were randomly selected. A standard optometric vision-assessment protocol was applied to those who met the inclusion criteria and cycloplegic refraction was conducted to elicit those who had myopia. Results: The prevalence of myopia was found to be 7.5% of which 29 (52.7%) were male while 26 (47.3%) were female and there was no association between gender and myopia (p = 0.572). Myopia was found to be more prevalent in urban 49 (87.3%) as compared to rural 7 (12.7%) areas and there was no association between place of residences and myopia (p = 0.381). Similarly, 15–18 years was the dominant age group 39 (70.9%) and there was no association between age and having myopia (p = 0.926). The study also found that there was no association (p = 0.207) between school class of the participants and having myopia, although most myopic cases were in the form four class 15 (27.3%). Conclusion: Myopia was found to be mostly prevalent in the urban setting and upper classes as compared to rural and lower classes. This may link myopia to other risk factors such as near work and outdoor activities, but more research needs to be done in these areas.

Impact of surface treatments on the sorption and solubility of a heat-cured denture base material

Removable dentures fabricated from polymethylmethacrylate material are the most common prostheses used to treat edentulism worldwide. This research aimed to compare the sorption and solubility characteristics of a mechanically polished heat-cured acrylic denture material and a light-cured varnished material against non-treated material, all of which were soaked in distilled water. A total of 45 specimens were prepared and tested according to the ISO Standard 20795-1: 2013 (E) to test for sorption and solubility. The data were analysed through one-way analysis of variance (ANOVA) and Tukey-Kramer multiple comparison test

Practitioners’ opinions on the presentation of ocular pathology and ametropia in patients wearing ready-made reading spectacles

This paper presents the findings of a study to determine optometrists’ opinions on the presentation of ocular pathology and ametropia in patients wearing ready-made reading spectacles. Ninety-seven optometrists completed a questionnaire pertaining to ametropia and ocular diseases among these patients. The questionnaire contained information regarding patient demographics, ocular pathology, ocular ametropia and the regulatory and public health aspects of ready-made readers.Ninety-five percent of respondents stated that they had seen patients with ready-made readers in their practice and 62% of these stated that they had found the presence of ocular pathology in these patients. The pathologies most commonly reported as seen by practitioners were dry eye (86% of practitioners), cataracts (80%) and diabetic retinopathy (54%). In addition, 39% of practitioners reported seeing patients with anisometropia. The majority of practitioners (71%) stated that they sold ready-made readers in their practice. Sixty-three percentof practitioners indicated that they would be prepared to offer a service whereby a reduced consultation fee and a pair of ready-made readers could be incorporated into an indigent “package”. An overwhelming 88% of the practitioners felt that the sale of ready-made readers should be more regulated and 74% of practitioners felt that the Professional Board for Optometry and Dispensing Opticians should be responsible for monitoring their sale. The research suggests that wearers of ready-made readers should be screened for ocular pathology, reduced visual acuity and amblyopia. Current regulations should be tightened and a public awareness education campaign should be initiated. The use of ready-made reading spectacles, in deference to an eye examination by an optometrist, appears to be largely as a result of the perceived costs of pri- vate practice combined with ignorance and apath

The monitored performance of the first new London dwelling certified to the Passive House standard

The monitored performance of the first new London dwelling certified to the Passive House standard is presented. The first detailed analysis of the energy consumption of the heating, ventilation and domestic hot water systems are given. The annual space heating demand of the 2 bedroom, 101 m2 dwelling was 12.1 kWh/m2, achieving the 15 kWh/m2 Passive House target. The annual primary energy demand was 125kWh/m2, marginally above the 120 kWh/m2 target. The measured internal heat gains of 3.65 W/m2 are much greater than the 2.1 W/m2 suggested as standard for dwellings. The Passive House Planning Package, PHPP, is found to be a good predictor of space heating demand and the risk of summer time over heating. Winter space heating demand is sensitive to occupant blind use. With a total metered energy consumption of 65 kWh/m2, the Camden Passive House is one of the lowest energy, small family dwellings, monitored in the UK

Factors associated with uncorrected refractive errors in school-going adolescents in Kakamega County, Kenya

Background: Uncorrected refractive errors (URE) present an enormous burden on children in Kenya. The study investigated factors associated with URE in school-going adolescents in Kakamega County, Kenya. Material and methods: An observational, cross-sectional study with multistage sampling was conducted with randomly selected secondary school students in forms one to four. Comprehensive clinical examinations conducted by optometrists were used to determine participants’ URE types and dioptric strength. Structured pre-validated questionnaires were administered to participants to elicit information on their sociodemographic and socioeconomic statuses. Results: A total of 165 students, aged 17.45 ± 1.44 years, with URE classified into myopia, hyperopia, and astigmatism, participated in the study. There were more males (57%) than females in this study, and most participants had astigmatism (52%). The study found no-to-weak association between predefined factors and URE. While males had decreased odds [odds ratio (OR): 0.557, 95% confidence interval (CI): 0.211–1.470] for myopia than astigmatism, the converse was true for hyperopia (OR: 1.165, 95% CI: 0.385–3.524) compared with astigmatism. Even though participants from families with lower affluence and living in rural settings had up to 18 times increased odds (OR: 18.699, 95% CI: 0.840–416.442) for myopia than astigmatism and hyperopia, significant dioptric power was less likely to be present in those with myopia (OR: 0.529, 95% CI: 0.165–1.698) and hyperopia (OR: 0.011, 95% CI: 0.001–0.192). Conclusions: URE may not be significantly associated with school-going adolescents’ sociodemographic and socioeconomicstatuses. However, myopia and astigmatism are increasingly likely to be present among participants from families with lower affluence and living in rural settings

Awareness of the phototoxic effects of sunlight among South African university students

Due tothe depletion of the atmospheric ozone, there is currently a great concern for the phototoxic effects of sunlight on humans worldwide. The purpose of this study was to evaluate the awareness of the phototoxic effects of sunlight among a sample of South African university students.  A questionnaire on awareness of the adverse effects of excessive exposure to sunlight was completed by the participants and findings were analyzed. Ages of the participants (n=1832) ranged from 17 to 55 years (mean = 21.03 ± 3.44) and there were 43.7% males and 56.3% females.  Many, (73.9%) agreed that excessive exposure to the sun is harmful to health, but only 56.9% could adequately explain how it is harmful to health.  Many, (68.2%) agreed that fair-skinned individuals are more likely to be affected by the sun than dark-skinned ones.  Only 52% reported that childhood exposure to sunlight is more dangerous than adulthood exposure. A few (32.9%) agreed that short term intensive exposure was more dangerous than chronic regular moderate exposures.  Although 72.3% had heard about ultraviolet (UV) radiation, only 47.1% had heard of cataracts and fewer (25.7%) agreed that cataracts can be caused by UVR exposure.  A few (28.7%) had heard of macular degeneration, but only 17.6% agreed that it can be caused by UVR.  Although awareness was good in certain aspects, it was poor in others; suggesting the need for an awareness campaign among South Africans. It is recommended that the awareness campaign should include avoidance of excessive exposure and the use of appropriate protective devices. (S Afr Optom 2010 69(3) 146-151

Biomarkers as a predictor for diabetic retinopathy risk and management: A review

Background: The systemic and ocular manifestations of diabetes are an increasing burden on both private and public healthcare systems. The ability to accurately predict patient susceptibility and prognostic implications of the disease is essential to its optimal management and planning. Aim: The purpose of this paper was to review alternative biomarkers to those currently in use regarding the diagnosis and prognosis of diabetes and the ocular effects of the disease. Current biomarkers include Fasting Plasma Glucose (FPG), Oral Glucose Tolerance Test (OGTT) and Glycolated Haemoglobin (HbA1c). Methods: The research strategy comprised of a comprehensive literature review of articles from Mendeley, Cochrane and Elsevier with additional input from experts in the field serving as co-authors. Results: The review found that there are alternative biomarkers to those currently utilised. These include adiponectin, apolipoprotein B, C-reactive protein and ferritin. Fructosamine, while useful where whole blood is available, is unreliable as a diagnostic biomarker resulting in a 10% variation coefficient. Post-prandial glucose (PPG) measurement most closely predicted HbA1c. Conclusion: With prediction of risk for diabetes in individuals, a value combination, expressed as either a numerical score or a percentage, consisting of adiponectin, apolipoprotein B, C-reactive protein and ferritin, almost doubled the relative risk of contracting the disease. Eye care practitioners need to question diabetic patients about their FPG and HbA1c levels and encourage them to have the relevant tests regularly, including PPG. The importance of biomarkers should be emphasised and used as an educational tool to facilitate better diabetes management and treatment adherence

Emerging technologies in artificial ocular devices: A systematic review

Background: Recent developments in vision restoration include visual prostheses designed to electrically stimulate artificial vision in those who have lost their sight. Major efforts in this area include multi-electrode arrays surgically implanted at various placement areas throughout the visual pathway. Visual prosthetic devices are named according to these placement areas (cortical, optic nerve, sub-retinal and epiretinal). These devices attempt to restore sight for retinal degenerative diseases such as Retinitis Pigmentosa (RP) and Age-related Macular Degeneration (AMD). Aim: To summarise the emerging technologies in the development of artificial ocular devices. Methods: The search methodology comprised seven databases for articles published between January 2000 and March 2017. Outcome data were analysed descriptively with results summarised in a Microsoft Excel database. Both quantitative and qualitative methodologies were used, and the main findings are discussed in a narrative format. Results: Eighty-nine full-text articles were included in this systematic review. Conclusion: The primary goal of these artificial devices is to provide functional vision in order to perform normal daily activities. Even though recent clinical trials in certain countries have shown advances in the development of various vision-restoring devices, they do not produce the same experience for the majority of patients and are unable to completely restore normal vision. The most common type of device according to its placement is the epiretinal device which is also the most successful device as determined in the majority of clinical trials

Building consensus for the development of child eye care services in South Darfur State of Sudan using the Delphi technique

Background: Global estimates suggest there are almost 19 million visually impaired children worldwide, most of whom reside in poor countries, with the major cause being treatable. Aim: To determine the barriers to accessing childhood eye care services and to develop an eye care plan for children in South Darfur State, Sudan. Setting: The study took place in South Darfur State, Sudan. Methods: The classical Delphi technique was used to build consensus on a list of statements, which were generated based on the themes established by the experts, as well as on an extensive literature review. Results: Response rates ranged from 90% in the first round (n = 18), 100% in the second round (n = 18) to 89% in the third and final round (n = 16). The total number of statements recommended by the Delphi panellists for development of the paediatric eye care plan, was 60 based on a consensus level of 80% agreement or more. The expert’s consensus on the following key elements for promotion and improvement of child eye care: The main barriers to accessing child eye care were high poverty rate, unavailability of child eye services and a lack of community awareness. The challenges facing visually impaired children were an absence of paediatric ophthalmologists, low vision and orthoptic services. Conclusion: The main barriers to accessing child eye care services were financial, clinical access and lack of knowledge. There should be greater collaboration between the Ministries of Health, Education and non-governmental organisations (NGOs), to work together in addressing these barriers