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Tarek Bin Yameen, myrna lichter; Unmet Eye Care Needs Among a Syrian Adult Refugee Population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5234.
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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.
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.
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%).
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.
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