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Vision Screening in Infants Attending Immunization Clinics in a Developing Country
Chinwe Cynthia Jac-Okereke1, Chukwunonso Azubuike Jac-Okereke2, Ifeoma Regina Ezegwui1
1University of Nigeria Teaching Hospital, Enugu, Nigeria.
Insights
Infant vision screening at immunization clinics identified a 15.5% prevalence of ocular abnormalities, including conjunctivitis and strabismus. Early detection and referral are crucial for preventing irreversible vision loss in infants.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Infant vision screening is vital for early detection of eye conditions.
- Untreated ocular anomalies in infancy can lead to permanent vision impairment.
- Prompt intervention is critical to prevent irreversible vision loss.
Purpose of the Study:
- To determine the prevalence of ocular anomalies in Nigerian infants.
- To assess the utility of immunization clinics for infant vision screening.
- To facilitate timely referral and treatment of identified eye conditions.
Main Methods:
- Cross-sectional, descriptive study involving 142 infants across 6 immunization clinics.
- Screening included ocular history, vision assessment, external examination, and red reflex testing.
- Infants with abnormalities or risk factors were referred for comprehensive eye exams.
Main Results:
- A 15.5% prevalence of ocular abnormalities was found in screened infants.
- Common conditions included neonatal conjunctivitis (38%), strabismus (14%), and nasolacrimal duct obstruction (14%).
- Prematurity was a significant risk factor identified in referred infants.
Conclusions:
- Immunization clinics are effective sites for infant vision screening in developing countries.
- Conjunctivitis, strabismus, and nasolacrimal duct obstruction are prevalent infant eye disorders.
- Screening can identify infants at risk for conditions like retinopathy of prematurity.
Abstract:
Background: Vision screening in infants is an important part of the medical care of children as some eye abnormalities, if not treated in the first few months or years of life, can lead to irreversible vision loss. Objective: The objective of this cross-sectional, descriptive study was to identify ocular anomalies among infants attending immunization clinics in Nigeria and refer promptly and appropriately. Methodology: Infants were screened across 6 immunization clinics. Screening activities included relevant ocular history, vision assessment, external ocular examination, ocular motility, Hirschberg's test, pupil examination, and the red reflex test. Infants with abnormal findings were referred for comprehensive eye examination. Result: Of the 142 infants who underwent vision screening, 29 were referred. These referrals were either as a result of ocular abnormalities (n = 22) or presence of risk factors from history (n = 7). The prevalence of ocular abnormalities was 15.5% and neonatal conjunctivitis (38%), was the commonest ocular abnormality found. Others were bacterial conjunctivitis (14%), nasolacrimal duct obstruction (14%), strabismus (14%), capillary hemangiomas (10%), iris nevi (5%), and vernal keratoconjunctivitis (5%). Of the 7 infants referred based on history alone, 6 (85.7%) had a history of prematurity. Conclusion: Conjunctivitis, strabismus, congenital nasolacrimal duct obstruction, and capillary hemangioma are some of the prevalent disorders seen in infants at immunization clinics in Nigeria. Babies at risk of retinopathy of prematurity (preterm birth and oxygen therapy) can be identified. Immunization clinics can serve as good points of vision screening for infants in developing countries to facilitate prompt referral and treatment.
