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Title: PREVALENCE, CAUSES AND CLINICAL PRESENTATIONS OF CORNEAL BLINDNESS AND VISUAL IMPAIRMENT AMONG PATIENTS (2018)

Background: Corneal diseases are among the major causes of vision loss and blindness in the world, after cataract and glaucoma but their magnitude is not known in our setting. Some of those causes are either preventable or treatable and could therefore be targeted by clinicians, public health stakeholders in order to prevent visual impairment (VI) and blindness (BL) related to corneal diseases. Objectives: To determine the prevalence, causes and clinical presentations of corneal BL and VI among patients attending Ruharo Eye Centre (REC), Southwestern Uganda. Methods: This was a descriptive hospital-based cross sectional study, conducted at REC. The study population included all patients attending REC during the period of data collection and targeted all patients diagnosed with corneal BL/VI. We collected data on socio- demographic, medical history as well as clinical data related to corneal BL/VI on all consenting patients and then conducted a full eye examination. The prevalence of corneal BL/VI among patients presenting with corneal BL/VI at REC was expressed as a proportion of patients with corneal BL/VI out of all the patients enrolled in the study. Results were shown on tables and graphs. Results: A total number of 601 consecutive patients were recruited and corneal blindness was present in 72 patients in total, giving a prevalence of 11.9% whereas corneal VI was present in 56 patients thus a prevalence of 9.3%. The mean age of the participants was 42.2 (±23.4) years. The participants were mainly Banyankore (76.2%) from rural areas (75.3%) and they were farmers (54.4 %) with primary education level (34.4 %). The causes of corneal BL were ulcerative keratitis 59.7%, corneal trauma 20.8%, bullous keratopathy 11.1%, keratoconus 4.1%, corneal staphyloma 2.7% and auto immune disease 1.3% (1/72). The causes of corneal VI were ulcerative keratitis 46.4%, corneal trauma17.8%, bullous keratopathy 17.8% and keratoconus. Corneal ulcer 54.1%, corneal scar 20.8%, corneal edema 12.5%, corneal perforation 11.1%, corneal bullae 11.1 % and corneal thinning 4.1% were the clinical presentations of corneal BL. The clinical presentations of corneal VI were corneal ulceration 50.0 %, cornea scar 19.6 %, corneal edema 16.0%, corneal bullae 14.2 %, corneal thinning 5.3 % and corneal perforation 1.7 %. Conclusion: The prevalence of corneal BL/VI among patients seen at Ruharo Eye Centre is high. Corneal ulcers and corneal scars were the common clinical presentations. Treatable or avoidable causes such as ulcerative keratitis and trauma were the main causes of corneal BL/VI.

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