The Prevalence And Pattern Of Visual Impairment And Blindness Among Primary School Pupils In Kitale Municipality, Kenya

Visual impairment is defined as a corrected visual acuity of less than 6/18 to 3/60 in the better eye. Blindness on the other hand is defined as corrected visual acuity in the better eye of less than 3/60 or a constricted visual field of less than 10 degrees from the point of central fixation. Visual loss in childhood has implications in all aspects of the child’s development. It posses educational, occupational and social challenges, with affected children being at risk of behavioral, psychological and emotional difficulties, impaired self-esteem and poorer social integration. There is an estimated 1.5 million blind children worldwide, with an additional 5 million who are visually impaired. Among the blind and visually impaired children, 90% live in the developing countries. There are variations in the causes of blindness and visual impairment across countries and the pattern changes with time. The purpose of this study was to investigate the prevalence and pattern of visual impairment and blindness among primary school pupils in Kitale Municipality. This was a cross sectional school-based study conducted in twenty four randomly selected schools. The selected pupils were screened for visual acuity and those affected underwent a detailed ophthalmic examination. Data was collected using an examination protocol for the first part of the study. Semi-structured questionnaires were used to establish some factors associated with visual impairment and blindness among parents, pupils and teachers. Data was then analyzed using chi square and multiple logistic regression (SPSS Version 13.0). The prevalence of visual impairment was 4.77% while that of blindness was 0.13%. Girls contributed 35.14% of cases of visual impairment while boys contributed 64.86%. The age group most affected was 11-15 years (59.46%).  There were higher chances of developing VI with increasing age. Public schools contributed 81.08% of cases of visual impairment while for private schools, it was

18.92%. Two zones (Grassland and Bidii) with peri-urban characteristics contributed

75.68% of VI cases while two purely urban zones (Milimani and Bondeni) contributed 24.31%. The only case of blindness was due to retinal disease in a standard one female pupil aged 8 years, in a public school within Bondeni zone. The leading cause of visual impairment was refractive error (81.08%). Other causes included albinism, corneal disease, disease of whole globe and strabismus. Majority of the pupils cited allergy as the leading cause of visual impairment and blindness (50.00%), early treatment as a leading means of prevention (70.83%) and 92.11% informed their parents or teachers whenever they had eye ailments. Majority of the teachers cited poor hygiene as the leading cause of VI and blindness (44.17%) and good nutrition as the leading means of prevention. There is need to enforce the school health policy on visual assessment before school admission and carry out annual school eye screening in order to enhance early detection and management of eye problems. There is need to provide subsidized spectacles since a large number of pupils with visual impairment had refractive error as the cause of impairment