July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Presenting characteristics: The spectrum and prevalence of self-reported pain in ocular emergencies in a tertiary center of Southeast Africa
Author Affiliations & Notes
  • Friederike Charlotte Kortuem
    Eye Clinic, University Tübingen, Tübingen, Germany
  • Constanze Ilse Kortuem
    Eye Clinic, University Tübingen, Tübingen, Germany
  • Esther Misango
    Eye Clinic, Lions Sight First, Blantyre, Malawi
  • Petros Kayange
    Eye Clinic, Lions Sight First, Blantyre, Malawi
  • Justus Benrath
    Pain Department Mannheim, University Heidelberg, Mannheim, Germany
  • Focke Ziemssen
    Eye Clinic, University Tübingen, Tübingen, Germany
  • Footnotes
    Commercial Relationships   Friederike Kortuem, None; Constanze Kortuem, None; Esther Misango, None; Petros Kayange, None; Justus Benrath, None; Focke Ziemssen, Alimera (C), Allergan (C), Allergan (R), Bayer Healthcare (C), Biogen (R), Boehringer-Ingelheim (C), Clearside (R), Genetech/Roche (C), Genetech/Roche (R), MSD (C), Novartis (C), Novartis (R), NovoNordisk (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2517. doi:
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      Friederike Charlotte Kortuem, Constanze Ilse Kortuem, Esther Misango, Petros Kayange, Justus Benrath, Focke Ziemssen; Presenting characteristics: The spectrum and prevalence of self-reported pain in ocular emergencies in a tertiary center of Southeast Africa. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2517.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : The cultural background as well as the frequency and patterns of different eye diseases have an influence on how patients present themselves in emergency consultation hours: The subjective perception of pain, the low density of eye specialists in some African countries could play a role as much as the body image and health literacy. Therefore, a pilot study was initiated to assess the significance of pain (indicating for the diagnosis) in patients that presented as emergency cases and follow-ups at the emergency clinic in Blantrye, Malawi.

Methods : Within a non-interventional prospective pilot study, consecutive patients were interviewed using a standardized questionnaire. In addition, factors potentially influencing the presentation of pain as well as where the pain was located were documented. Because the English questionnaire was not understood by many, the help of interpreters was needed to communicate with the local population. The data were analyzed with descriptive statistics (SPSS version 25 for Windows, SPSS Inc, Chicago, IL).

Results : 140 consecutive patients were included showing a mean age of 37.0 (±16.2). About half of the respondents were women (55% females).
Pain was reported as a leading symptom by a third of males (32.3%), but only 18.2% of female patients. The vast majority of respondents (>60%) rated the actual visual function as ‘good’ to ‘very good’. There was no significant correlation between the overall self-expressed health state, visual acuity measured and the pain felt. Pain was obviously not a path-breaking symptom of vision impairment or concern. With regard to the localization of possible pain, the inner corner of the eye (12.5%, in the conjunctival region), the eyelid (7.9%) or the eye surface (6.4%, cornea) was mentioned with decreasing frequency.

Conclusions : Although pain in Malawian emergency patients was found to be a common presenting complaint, few conclusions could be drawn with regard to a possible loss of vision or the causative eye disease. Pain did not correlate with concern for visual loss. The data from this pilot study must be interpreted with greater caution because the language of established questionnaires proved to be an important barrier. Particularly with regard to the diagnostic selectivity of the history, different languages and regional accents should be taken into account.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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