Abstract
Purpose :
There is a lack of data on vision problems in an adult refugee population in North America. We performed a cross-sectional, descriptive study to assess the prevalence of visual impairment and unmet eye care needs of adult Syrian refugees in Toronto.
Methods :
Five single-day clinics were organized. Enrolment was offered to Syrian refugees registered with resettlement agencies, not for profit organizations, and/or private sponsorship groups. Through a structured interview, socio-demographics, medical history, subjective visual acuity, and access to eye care information was collected. Comprehensive visual screening, slit-lamp, dilated direct funduscopy, and refractions were performed. Visual acuity data was compared to Canadian prevalence data. χ2 tests was used for statistical analysis.
Results :
248 patients were examined. The median age was 36 years (interquartile range (IQR)= 30-35) and 53% were females. Most patients lived outside Syria as refugees for 1 to 5 years (69.4%) and earn less than $1000 monthly (49.6%).
The prevalence of reported uncorrected vision problems was 22.2% for distance vision, 6.5% for near vision, and 5.6% for distance and near vision, including loss of vision. When compared to the general Canadian population, Syrian adult refugees were 19 times more likely to report uncorrected vision problems (34.4% v. 1.8%, p < 0.01). A majority had not visited an eye specialist in the past year (95.2%) and 60.5% were dissatisfied with their vision.
The presenting visual acuity in the better-seeing eye was 20/50 or worse in 19.4% (95% CI, 14.6%-24.8%). By using pin-hole correction, this improved to 12.5% (95% CI, 8.7%-17.3%). Compared to the Canadian population (0.95%), Syrian adult refugees were 13 times more likely to have 20/50 vision or worse (p < 0.01).
The most common finding was refractive error in 46.0% (95% CI, 39.6%-52.4%) followed by non-refractive error in 15.3% (95% CI, 11.1%-20.4%). The most frequent non-refractive errors were cataracts (4.0%), glaucoma (2.8%), traumatic injuries (2.4%), dry age related macular degeneration (2.0%), diabetic retinopathy (2.0%), and retinitis pigmentosa (1.6%).
Conclusions :
This is the first study to assess ocular health in a refugee population in Canada. Syrian adult refugees have a high prevalence of visual impairment, even when living within a system of universal healthcare. Vision-screening programs and accessible eye clinics may address this need.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.