Optometric education at Westville: past, present and future

This article presents historical information, current activities and future plans with regards to optometric education at the Department of Optometry, Westville campus of the University of Kwa-Zulu-Natal (UKZN) in Durban. The Department, established in 1979 under the political dispensation of apartheid was intended to cater to the needs of Indian students but now admits students of all races. Also, it has been developing in every aspect of optometric education, staffing and facilities. The undergraduate optometric curriculum at the Department has expanded tremendously over the years and there are now master and doctoral programmes. The number of full-time academic staff has increased from four in 1980 to eleven in 2009. The undergraduate student enrolment has increased from twelve in 1980 to one hundred and sixty in 2009. Research activities and publication output have increased over the years. Community engagement activities have been expanded to meet the needs of the community. Also, physical and training facilities have improved over the years to meet the increasing number of students. The content of this article will be of interest to alumni, current and future students and staff of the Department as well as other stakeholders in the optometric profession and education.(S Afr Optom 2010 69(1) 14-20

Night vision and glare vision thresholds and recovery time in myopic and hyperopic eyes

The purpose of this study was to compare night vision and glare vision thresholds and recovery times in myopic and hyperopic eyes. Using a Night Sight Meter, these three parameters were measured in 44 myopic and 44 hyperopic eyes of Black male subjects age-matched 20.8 years ± 1.67 and 21.6 years ± 1.05 old respectively and compared. Thresholds were measured first by assessing the eye’s ability to see under conditions of low illumination and in the presence of a glare source. Glare recovery time was determined by measuring the minimum time neededto adjust to low levels of light illumination after exposure to a glare stimulus. Descriptive, two-sample t-test and Pearson correlation statistics were used to analyze and compare the sets of data from the two groups. The mean refractive error in the myopic eyes was –2.15 D ± 1.41 (range = –0.50 D to –4.50 D) and 1.76 D ± 1.22 (range = 0.50 D to 4.00 D) in the hyperopic group. The mean night vision thresholds for the myopic eyes was 32 cd/m2 ± 4.69 (range = 23 cd/m2 to 42 cd/m2) and 28.97 cd/m2 ± 4.90 (range = 18 cd/m2 to 37 cd/m2) for hyperopic eyes. The difference between the mean night vision thresholds of the myopic and hyperopic eyes wasstatistically significant (p < 0.05). For glare vision threshold, the mean for myopic eyes was 64 cd/m2 ± 5.81 (range = 53 cd/m2 to 78 cd/m2), while the mean for hyperopic eyes was 44.84 cd/m2 ± 5.69 (range = 32 cd/m2 to 59 cd/m2). Also, the difference between the mean glare vision thresholds of the myopic and hyperopic eyes was statistically significant (p < 0.05). The recovery times ranged from 0.45 s to 3.10 s for the myopic eyes and 0.30 s to 2.25 s for the hyperopic eyes. The mean glare recovery time for the myopic eyes (mean = 1.41 s ± 0.77) was significantly longer (p < 0.05) than the times for hyperopic eyes (mean = 1.04 s ± 0.65). There was a significant positive correlation between recovery times and the magnitude of myopia (r = 0.93, p < 0.05) while the relationship between recovery times and the magnitude of hyperopia was significantly negatively correlated (r = –0.76,  p < 0.05). These findings suggest that myopic persons would have more difficulty seeing under conditions of low illumination and in the presence of glare than hyperopic eyes. This could probably be due to aberrations resulting from larger pupils in the myopic eyes. (S Afr Optom 2010 69(3) 132-139

Utilization of eye care services by elderly persons in the northern Ethekwini district of Kwa-Zulu-Natal province, South Africa

Although most of the causes of visual impairment and blindness in the developing world are treatable, many people do not receive eye care attention. The appropriate use of eye care services is a key factor to reducing visual impairment and blindness in any community. However, eye care services are not always provided, accessible or utilized and do not always meet the needs of specific groups; one such group is older adults. The purpose of this study was to evaluate the use of eye care services in adults aged 60 years and older living in the eThekwini district of KwaZulu-Natal, South Africa. Information regarding the use of eye care services was collected from 1008 participants through a questionnaire interview using items derived from the World Health Organization multi-country World Health Survey administered by trained field workers. The participants included 77.3% females and 22.7% males. Their mean age was 68.9 ± 7.4 years (range = 60 to 103 years). Less than half (38.7%) of the participants thought that they should have their eyes tested every year. Although many (57.4%) knew where to go to get treatment for eye problems or to have their eyes tested, a significant proportion (42.5%) did not know. Almost a third (32.8%) felt that they need to get treatment for an eye problem or to have their eyes tested. Less than one third(25.2%) indicated that they last visited a health facility for an eye test 2-5 years ago. Above one third (38.3%) reported that they were told they could not see at distance, 22% reported that theywere told that they had reduced capacity to see at near, while 23.4% and 9.2% respectively were told they had had eye infections or cataracts. Of these, 59.7% stated that new glasses were recom-mended to them as treatment, 22.7% were recommended eye drops and 7.8% had cataract surgery recommended. Most (80.5%) reported that they received the recommended treatment while 19.5% reported that they did not. Of those who reported not receiving the treatment, 36.4% stated that it was due to inability to afford the treatment recommended while 29.1% stated that they were unable to get the treatment due to long waiting times.The majority of participants (86.9%) agreed that the treatment they received solved their eye problems. Knowledge about regular eye examinations and available eye care services was poor amongparticipants in this study. This suggests the need for awareness campaigns and early intervention programmes. Furthermore, cost of services had a significant influence on the affordability of eye care services among participants. (S Afr Optom 201

Perceptions and opinions of graduating South African optometry students on the proposed community service

Community service (CS) was introduced inSouth Africa in an attempt to address the shortageand maldistribution of health care professionalswithin the public sector. The Professional Board forOptometry and Dispensing Opticians (PBODO)has approved legislation for the introductionof CS for graduating optometry students. This study examined the perceptions and opinionsof graduating optometry students regarding the proposed CS. A mixed-method design(questionnaires and interviews) was used. Bothapproaches yielded similar results. The quantitativecomponent included 119 participants, aged between 20 and 35 years (mean age and standard deviation;22.8 ± 2.3 years). There were 43.2% Blacks, 28.5%Whites, 19.1% Indians and 9.2% Coloureds. The qualitative part included fourteen participantsfrom the Optometry Department of the University of KwaZulu-Natal. The major themes emergingfrom the questions concerning the participants’ perceived advantages and benefits of CS were (i) it would improve the eye care service delivery to disadvantaged communities; (ii) it would improve the technical and clinical skills of the graduating optometrists and (iii) it would enhance their confidence, personal and social skills. Some of the perceived drawbacks cited by the participants about such service included poor remuneration and concerns about personal safety, transport and accommodation. The findings of this study suggest that graduating optometry students acknowledge the importance of CS in improving access of many South Africans to quality eye care. In order to maximise the full benefits of CS, all stakeholders need to address the highlighted concerns of the participants. (S Afr Optom 2013 72(1) 11-18

An assessment of the level of diabetic patients’ knowledge of diabetes mellitus, its complications and management in Durban, South Africa

Epidemiological data shows that Diabetes Mellitus (DM) in South Africa is increasing with changes in lifestyles and ageing of the population. Early diagnosis and management of DM is an important factor for limiting visual and physical complications of the disease. The purpose of this study was to establish the level of knowledge about DM, its ocular complications and management protocol amongst diabetic patients. A questionnaire was provided to a total of 106 diabetic patients attending the Tongaat Community Clinic, the University of KwaZulu Natal Eye Clinic and the Diabetic Awareness day in Chatsworth. All patients were receiving treatment for DM. The questionnaire consisted of questions relating to the patients’ knowledge of the disease, its ocular complications and its management. The respondents were mostly females (65%), aged between 30 to 85 years (mean = 52.45 ± 3.75 years). The majority (96%) of respondents knew about the existence of two main types of DM and 77% reported having Type 2 DM, 18% reported having Type 1 DM, and only 5% did not know the type of DM that they had. Many respondents thought that hereditary factors (78%), and diet and lifestyle modifications (77%), were important risk factors in the development of DM. Glucose levelcontrol (84%) and duration (85%) were thought as important risk factors for its complications. Although many subjects (66.1%) were aware of the visual threat that DM posed, only 42%, 44% and 53% knew that DM could result in diabetic retinopathy, cataracts and glaucoma respectively. Less than half (48.3%) of the respondents had their last eye examination more than a year and a half ago. A significant proportion (60.8%) reported that the threat to vision was reason enough for them to have regular eye examinations. A large proportion (76%) of respondents reported that they had adequate knowledge of management of DM. Many (81%) of the respondents reported routinely controlling their DM through diet,  65% through exercise, 84% through sugar monitoring and 76% through regular medical examinations. The participants in this study had a significant knowledge of DM and its management. However, their knowledge of ocular effects was limited. These results highlight the need for educational programmes aimed at improving the knowledge of the effects of DM on the eyes including the need for regular eye examinations

Public awareness and perception towards COVID-19 in sub-saharan African countries during the lockdown

Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors’ networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient β=-0.83 95% CI: -1.19, -0.48) and Southern Africa (β=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [β=-6.57, 95% CI: -7.53, -5.62], East [β=-6.24: 95% CI: -8.34,-4.15], Central [β=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [β=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19

Factors affecting willingness to comply with public health measures during the pandemic among sub-Sahara Africans

Background: The unprecedented outbreak of coronavirus disease (COVID-19) drastically spread worldwide, resulting in extraordinary measures put in place in various countries including Sub Saharan Africa (SSA) countries. Objective: To assess the factors associated with compliance with the public health measures imposed by various SSA countries. Method: Cross sectional study using self-administered surveys distributed on social media platforms between April 18th and May 16th, 2020, corresponding with the mandatory lockdown period in most SSA countries. Multivariate analysis examined the associated factors. Results: The prevalence of hand hygiene, quarantine, self isolation practices, wearing of face mask and attending large gatherings during COVID-19 were 94%, 39%, 31%, 64% and 14%, respectively. In multivariate models, older age 49+ years: adjusted OR 2.13, 95%CI 1.22,3.71), females (OR 1.41,95%CI 1.03,1.93), Central African countries (OR 3.73,95%CI 2.02,6.87) were associated with wearing face mask. Living alone (aOR 1.52,95%CI 1.04,2.24) during the lockdown was associated with avoiding large gatherings including religious events. Female respondents (aOR 1.61, 95%CI 1.30, 2.00), married (aOR 1.71,95%CI 1.33,2.21) and unemployed (aOR 1.62,95%CI 1.25,2.09) SSAs were more likely to practice self-quarantine measures. Conclusion: The low prevalence of mitigation practices suggest the need for targeted education campaign programs to sensitise the population

COVID-19 in Sub-Saharan African countries : association between compliance and public opinion

Background: The outbreak of coronavirus disease (COVID-19) has created a global public health crisis and non-compliance with public health measures to contain the infection poses a challenge to Sub-Saharan African governments. This study investigated the associations between compliance and public opinion on COVID-19 public health containment measures across selected SSA countries. Method: Anonymous online cross-sectional survey was administered to 1779 adults (18 years and older) during the mandatory lockdown period in most African countries (April 18 - May 16, 2020). Respondents were recruited via Facebook, WhatsApp, and authors' networks. Data on participants’ socio-demographics, their opinions regarding the precautionary measures against COVID-19, and their compliance with preventive measures were collected. Multiple logistic regression analysis was used to examine the association between compliance and public opinions about COVID-19. Results: Respondents who did not think that public health authorities in their countries were doing enough to control the C0VID-19 outbreak were more likely to attend crowded places (aOR 1.75, 95% CI 1.30-2.35). Those who thought COVID-19 would not remain in their countries (aOR 0.48, 95% CI 0.24 - 0.96) and those who thought self-isolation is not needed during the pandemic (aOR 0.29, 95% CI 0.13 - 0.65) were less likely to encourage others to comply with the strategies put in place to prevent the spread of the disease. Participants who thought the COVID-19 outbreak was dangerous and those wearing medical masks were found to wash their hands with soap under running water. Conclusion: The study showed that public opinion influenced the compliance of individuals to public health measures for containment and mitigation of COVID-19. There is a need to improve compliance by the public

Differences in perceived risk of contracting SARS-CoV-2 during and after the lockdown in Sub-Saharan African countries

This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18–28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively