Prevalence of Amblyogenic Risk Factors among Preschool Children in Rural Ghana

Abstract

Purpose : Early childhood vision screening remains paramount in the detection of refractive amblyogenic risk factors. However, in resource-constrained environment the limited number of eye care cadres and disproportionate distribution of eye care services mostly lives the rural areas underserved. Photoscreening is a promising technology with increased specificity and sensitivity to identify these refractive anomalies, and with greater propensity to filling this human resource and service gap. Therefore, using plusoptix vision screener A12 we determined the prevalence of amblyopic risk factors among preschool children in rural communities in the Bosomtwi District of Ghana.

Methods : This was a community-based cross-sectional study. Photoscreening was performed for 169/202 children (response rate 83.7%) aged 2-5 years. Referral for comprehensive ophthalmic assessment by an experienced optometrist was dependent on a prespecified amblyopic risk factors criterion by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Vision screening was not performed on sleeping and uncooperative children.

Results : The mean age of children was 3.20 (± 0.98) years, with the majority (53.2%) being males. Mean spherical equivalent (S.E.) for the right and left eyes were 0.47 ± 0.42 and 0.68 ± 0.54 diopter respectively. Out of the 14 subjects referred (8.28%) the proportion of amblyogenic risk factors were as follows: 4.14% (7/169) anisocoria, 1.78% (3/169) myopia, 1.18% (2/169) anisometropia, 0.59% (1/169) hyperopia, 0.59% (1/169) gaze asymmetry and 0.0% astigmatism. Anisocoria was more prevalent in females 85.7% (6/7) compared to males 1 (14.3%).

Conclusions : The prevalence of amblyopia risk factors in this study was 8.28%. Anisocoria and myopia were commonly encountered, and female pediatrics were mostly found of unequal pupil size. This results showed undiagnosed amblyogenic risk cases which merits vision screening among children in these rural areas to enhance early detection and management.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.