Abstract
Purpose: :
The SKES aims to provide the knowledge base for the design of a comprehensive eye screening program for older adults in the Eastern Caribbean. We report on the design and initial findings from this study.
Methods: :
A group of 373 residents of St Kitts (169 women, 204 men; mean age 56 yrs, range 50 - 87 yrs) were selected at random from eligible individuals (age 50+ yrs) registered with the Department of Social Security of St Kitts and Nevis (n=3240). Personal invitation letters were sent out by the Ministry of Health, and additional publicity was provided by radio and TV. The examinations were carried out during a two-week period in the Eye Centre of the Joseph N France hospital in Basseterre. Prior to a comprehensive eye examination including threshold perimetry (Humphrey Field Analyzer [HFA] SITA Standard program 24-2), confocal scanning laser tomography (Heidelberg Retina Tomograph II), stereo fundus photography (Nidek AFC-230/210), gonioscopy and dilated slit-lamp examination of anterior and posterior segments), participants were examined with screening tests such as non-contact tonometry (Keeler EasyEye), the Moorfields Motion Displacement Test, 24-2 (1%) suprathreshold Humphrey-Matrix Frequency Doubling perimetry, and a three-zone 76-point age-related suprathreshold test (HFA).
Results: :
Of 373 invitees, 172 attended (46%). Rates of attendance were similar for residents of rural parishes (87/190) and those living in Basseterre (85/183; p>0.1) and did not depend on age (p=0.87, Mann-Whitney) or gender (p=0.78, MW). In addition to the selected group, we examined 20 men and 24 women who sought to participate despite not having been selected. Nearly all participants (n=208, 96%) were able to complete the entire program of tests (average duration, 3.5 hours). Amongst the invited individuals, there were 18 cases of glaucoma (8 of which were previously unknown) and 15 cases of ocular hypertension (12 unknown). Other highly prevalent conditions included visually significant cataract, diabetic eye disease, and pterygium.
Conclusions: :
The initial findings of the SKES underscore the need for a comprehensive eye screening program in St Kitts and Nevis. The data gathered in this study will be analysed to derive the most efficient combination of structural and functional tests to be used in such a program, as well as inform on decision criteria with sufficiently high specificity for referral into secondary care.
Keywords: clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • visual fields • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)