Research Article
Prevalence and Characteristics of Eye Problems Reported in an East African Refugee Camp: A Cross-Sectional Survey
Dorothy Wang*
,
Ashwin Reddy,
Shruti Anant,
Mohamed Yunus Rafiq,
Omar Juma,
Hilary Ngude,
Frank Manyama,
Alexander Blum,
Joseph Sakran,
Kent Stevens,
Ruth Tessema,
Zachary Obinna Enumah
Issue:
Volume 10, Issue 1, March 2025
Pages:
1-15
Received:
27 January 2025
Accepted:
17 February 2025
Published:
6 March 2025
DOI:
10.11648/j.ijovs.20251001.11
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Abstract: Despite efforts to improve global access to basic ophthalmologic services, there remains a paucity of data regarding the prevalence of untreated ocular disease among forced migrants and refugees, particularly in east Africa. We aimed to estimate the prevalence of untreated and surgically amenable eye conditions among refugees in Nyarugusu Refugee Camp, Tanzania, and to identify factors associated with untreated eye problems. We conducted cluster-randomized sampling using the cross-sectional Surgeons OverSeas Assessment of Surgical Needs (SOSAS) survey tool to assess prevalence of surgical eye disease and access to health services among refugees in Nyarugusu from August-September 2021. Descriptive analysis and multivariable logistic regression were performed to explore associations between covariates and the presence of unresolved eye problem(s). Among 3574 refugees, 12% (n=430; mean age 36±20 yrs.) reported eye issues. Of these, 296 (69%) further characterized their problems, with 44% reporting acquired disability and 42% non-injury-related wounds. Of the 368 (86.4%) who described their issues as disabling, 78.8% endorsed a negative impact on ability to work and 27.7% required help with daily living. Most were currently (84.6%; 357/427) and chronically affected (>12 months; 88.3%; 378/428). Farming and housewife occupations were positively associated with unresolved eye problem(s). Among 312 (72.7%) who sought care, only 13 (4.2%) underwent surgery. Nearly half (136) of 279 surveyed individuals self-reported potential surgical needs, citing barriers to surgical care such as lack of available services, financial and time constraints, and limited knowledge about accessing treatment. In conclusion, nearly 1 in 8 refugees endorsed chronic and disabling eye problems, negatively impacting their work and daily life. Most who may benefit from surgery have not received care due to significant barriers and gaps in ophthalmologic services. Further investigation to better characterize specific ocular etiologies in under-resourced protracted refugee settings can inform resource allocation strategies to address unmet eye care needs.
Abstract: Despite efforts to improve global access to basic ophthalmologic services, there remains a paucity of data regarding the prevalence of untreated ocular disease among forced migrants and refugees, particularly in east Africa. We aimed to estimate the prevalence of untreated and surgically amenable eye conditions among refugees in Nyarugusu Refugee C...
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Case Report
Multimodal Imaging in a Case of Behcets Uveitis with Anterior Ischcmic Optic Neuropathy: A Microvascular Perspective
Issue:
Volume 10, Issue 1, March 2025
Pages:
16-22
Received:
16 February 2025
Accepted:
26 February 2025
Published:
7 March 2025
DOI:
10.11648/j.ijovs.20251001.12
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Abstract: A 68-year-old fair-skinned Indian woman presented to our hospital with a primary complaint of vision loss in her right eye, accompanied by increased light sensitivity, pain, and redness that had persisted for one month. Additionally, she reported progressive visual impairment in her left eye over the past two years, along with oral and genital lesions, and multiple joint pains, for which she had been receiving ongoing treatment. She had previously been diagnosed with Behçet's uveitis, with systemic involvement, according to the criteria outlined by an international study group on Behçet's disease. On examination, the right eye showed pan-uveitis with a large optic disc cup and significant disc pallor. The left eye had corneal decompensation and was phthisical. Fundus fluorescein angiography (FFA) detected minimal disc leakage and peripheral vascular leaks. Optical coherence tomography angiography (OCT-A) revealed increased retinal nerve fibre layer loss, large cup, and severe peri-papillary capillary dropout. Macular OCT-A showed significant capillary loss, widened inter-capillary distances, and an enlarged foveal avascular zone. Laboratory tests revealed a strongly positive antinuclear antibody (ANA) with a speckled homogenous pattern. The erythrocyte sedimentation rate (ESR) was elevated at 52 mm/hr, and C-reactive protein (CRP) was 6.12 mg/dl. The differential leukocyte count showed elevated segmented neutrophils, while other blood parameters were normal. Serology for tuberculosis (TB), HLA-B27, p-ANCA, c-ANCA, and anti-CCP was negative. Based on her clinical presentation, histopathology, and investigations, she was diagnosed with Behçet's eye disease with multi-system involvement, including gastrointestinal and joint disease, and confirmed to have right-eye ischemic optic neuropathy. She was treated with topical steroids and intravenous methylprednisolone, resulting in significant visual improvement. After eight weeks, her vision improved to 6/36, with better contrast and color vision. Mycophenolate mofetil, oral steroids, and tacrolimus were restarted. Due to poor response to oral medications, intravenous adalimumab was considered but discontinued due to side effects. At three months, her right-eye vision stabilized at 6/24, with normal color perception, improved contrast sensitivity, and stable lab results.
Abstract: A 68-year-old fair-skinned Indian woman presented to our hospital with a primary complaint of vision loss in her right eye, accompanied by increased light sensitivity, pain, and redness that had persisted for one month. Additionally, she reported progressive visual impairment in her left eye over the past two years, along with oral and genital lesi...
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