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J. A. McBride, E. Gable, H. Saeed; The Need for and Effectiveness of Small-Scale Developmental Programs in Eye Health: A Study of a Kenyan Village. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2504.
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To demonstrate the need for basic eye care in the developing world and the effectiveness of small-scale medical programs contributing to short-term and long-term eye health.
Eye exams were performed on 663 men, women and children of the rural Kenyan village Embul-bul by medical students from the Loyola University Global Health Fund. Eyes were screened for visual acuity (VA), intact extra-ocular muscles (EOM) and Vitamin A deficiency (Vit. A Def). VA was determined using Snellen Charts. EOM were examined through eye movement in the 6 cardinal directions. Vit. A deficiency was assessed based on the presence of Bitot spots in the conjunctiva and a history of problematic nighttime vision. Native speakers recorded patients’ eye complaints in their primary language. Patients with VA ≤ 20/30 were fitted with glasses when possible and corrected VA was recorded. A basic statistical analysis was performed on the collected data.
Of the 268 (106 male, 162 female) patient complaints, 73 (27.2%) were near blur, 63 (23.5%) were related with sun exposure, 61 (22.7%) to distance blur. EOM were intact in 636 (99.8%) patients. Screening revealed 107 cases (16.7%) of potential Vit A Def. 101 (94.4%) cases of Vit A Def were found in children. Overall, 101 (22.3%) of total children were identified with potential Vit A Def. A record of Vit A Def was recorded and information distributed to families and community leaders. Multi-vitamins were distributed initially and children are to receive future doses by community leaders. Of the 1259 eyes examined, the VA in 1079 (85.7%) were found to be ≤ 20/40 and 180 (14.3%) > 20/40. 134 (74.4%) of the eyes found to have VA > 20/40 were found in adults, leaving 47 (26.1%) of cases with VA > 20/40 in children. Of the 153 patients fitted with glasses, an average improvement of 2.55 Snellen lines in VA was found.
The results highlight the need for basic eye care in the developing world and demonstrate the effectiveness of community programs in meeting visual needs. The improvements in VA after the distribution of glasses demonstrate that recycled eyewear can dramatically improve vision. The analysis of the complaints shows needs for future visits; sunglasses and additional reading glasses can be specifically addressed.
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