Abstract
Objective: To determine the prevalence, causes and risk factors to visual impairment among patients with
diabetes at Mbarara Regional Referral Hospital (MRRH) as a baseline pilot for developing diabetic retinopathy
treatment services.
Design: This was a descriptive cross sectional hospital based study conducted for a period of six months.
Methods: In a cross-sectional study done at Mbarara Regional Referral Hospital, 318 patients with diabetes aged
18 years and above were enrolled. Their visual acuity was determined. Those that had visual acuity of below
6/18 underwent a detailed ocular exam including refraction and a dilated fundoscopy to determine the cause
of visual impairment.
Results: The prevalence of visual impairment was 28.6% without correction, and 17% with correction. Cataract
was the commonest cause of visual impairment (34.5%) followed by refractive error (20.8%), glaucoma (16.8%)
and diabetic retinopathy (12.5%). Age was the only significant risk factor to visual impairment in this population.
Conclusion: The proportion of visual impairment was high and cataract was the commonest cause of visual
impairment in this population.
References
Federation ID. International Diabetes Federation, IDF
World Atlas Fifth Edition, ‘The Global Burden’,. IDF;
[cited 2012 12th Dec]; Fifth:[Available from:
http://www.idf.org/diabetesatlas/5e/the-global-burden.
Resnikoff S, Pascolini D, Etya’ale D, Kocur I,
Pararajasegaram R, et al. Global data on visual
impairment in the year 2002. Bull World Health Org.
; 82(11):844-851.
Nandutu G. Factors affecting adherence to nutrition
therapy by type 11 diabetics attending Mulago Hospital
diabetic clinic, [Dissertation] Kampala, Uganda. 2008.
Sjolie AK. Ocular complications in insulin treated
diabetes-mellitus-an epidemiological-study. Acta
Ophthalmologica. 1985; 63:1-77.
Sjølie AK, Stephenson J, Aldington S, Kohner E,
Janka H, et al. Retinopathy and vision loss in insulindependent
diabetes in Europe: the EURODIAB
IDDM complications study. Ophthalmology. 1997;
(2):252-260.
Brechner RJ, Cowie CC, Howie LJ, Herman WH,
Will JC, Harris MI. Ophthalmic examination among
adults with diagnosed diabetes mellitus. JAMA. 1993;
(14):1714-1718.
Herse P. A review of manifestations of diabetes mellitus
in the anterior eye and cornea. Amer J Optometry
Physiological Optics. 1988; 65(3):224-230.
Klein BE, Klein R, Wang Q, Moss SE. Older-onset
diabetes and lens opacities. The Beaver Dam Eye
Study. Ophthal Epidemiol. 1995; 2(1):49-55.
Kahloun R, Jelliti B, Zaouali S, Attia S, Ben Yahia S,
Resnikoff S, et al. Prevalence and causes of visual
impairment in diabetic patients in Tunisia, North Africa.
Eye (Lond). 2014; 28(8):986-991. Epub 2014/06/14.
Glover SJ, Burgess PI, Cohen DB, Harding SP, Hofland
HW, et al. Prevalence of diabetic retinopathy, cataract
and visual impairment in patients with diabetes in sub-
Saharan Africa. Br J Ophthal. 2012; 96(2):156-161.
Mabaso R, Oduntan O. Prevalence and causes of visual
impairment and blindness among adults with diabetes
mellitus aged 40 years and older receiving treatment
at government health facilities in the Mopani District,
South Africa. Afr Vision Eye Health. 2014; 73(1):8-15.
Nabatanzi C. Pattern of ocular manifestations among
diabetics at Mulago Eye Clinic [dissertation]. Kampala:
Makerere University; 1999.
Rotimi C, Daniel H, Zhou J, Obisesan A, Chen G,
Chen Y, et al. Prevalence and determinants of diabetic
retinopathy and cataracts in West African type 2 diabetes
patients. Ethnicity Dis. 2003;13 (2; SUPP/2):S2-110.
Zhang X, Cheng Y. Diabetes mellitus and visual
impairment: National health and nutrition examination
survey 1999-2004. J Ophthalmol. 2008; 126(10):1421-1427.
Al-Bdour MD, Al-Till MI, Samra KMA. Risk factors
for diabetic retinopathy among Jordanian diabetics.
East Afr J Ophthalmol. 2008;15(2):77.