Ocular health status of rural dwellers in south-western Nigeria.

OBJECTIVE: To determine the prevalence and causes of ocular morbidity, visual impairment and blindness, and suggest strategies for blindness prevention in a rural population.
DESIGN: A population-based cross-sectional study.
SETTING: Imesi-Ile, in Obokun local government area of Osun State, Nigeria.
METHODS: All participants had preliminary interview and screening consisting of vision assessment using an illiterate E-chart and anterior segment hand light examination at their houses. Those who had signs and symptoms of ocular disease were offered comprehensive eye examination at the base hospital, including visual acuity using illiterate E-chart and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry and dilated fundus examination as necessary.
RESULTS: Of the 2201 patients examined, 298 (13.5%) had signs and symptoms of ocular disease. This consisted of 153 male (51.3%) and 145 (48.7%) female patients. Their ages ranged between 8 and 92 years, with a peak age range of 41-70 years (45.6%). Most of them had never seen an eye care specialist for appropriate ophthalmic care. The common eye problems encountered were cataract (48.0%), glaucoma (21.1%), allergic conjunctivitis (16.4%), refractive errors (12.4%), age-related macular degeneration (0.7%) and corneal opacities (0.7%). Thirty-two eyes of 27 persons (1.2%) (22 monocular and 5 binocular) were blind by the World Health Organisation definition. Cataract was the leading cause of blindness (44.4%), followed by glaucoma (33.3%), macular degeneration (7.4%), corneal opacity (7.4%), optic atrophy (3.7%) and phthisis bulbi (3.7%).
CONCLUSION: A significant proportion (13.5%) of people in this community had ocular diseases which require treatment. The role of primary eye care health workers in a rural community as Imesi-Ile cannot be overemphasised.