Prevalence and risk factors for visual impairment among elderly patients attending the eye clinic at Mulago National Referral Hospital, Uganda: a cross-sectional study

Abstract

Background: The elderly have an increased risk of developing visual impairment (VI). Due to the increase in life expectancy of individuals in Sub-Saharan Africa, the population of the elderly is projected to increase. It is thus postulated that the prevalence of VI will increase which is currently unknown in Uganda. Objective: To determine the prevalence and risk factors for VI among the elderly at Mulago National Referral Hospital eye clinic in Uganda. Methods: This was a cross-sectional study carried out in 2020 with consecutive enrolment of patients aged 60 years and above. Obtaining history was followed by systemic and ocular examination. Statistical analysis was performed to determine the prevalence and factors associated with VI.Results: Of 346 elderly participants examined, 174 (50.3%) were males and median age was 67 (IQR 63-74). Prevalence of VI was 32.1%. Cataract was the leading cause of blindness 54.1%, followed by refractive error (21.6%), glaucoma (11.7%), and corneal opacities (5.4%). Age (adjusted Prevalence Ratio (aPR): 1.05, 95% CI (1.02, 1.06)), history of diabetes mellitus (aPR: 1.46, 95%CI (1.04, 2.05)), history of hypertension (aPR: 1.46, 95%CI (1.10, 1.93)), having completed primary level of education (aPR: 0.74, 95%CI (0.55, 0.98)) and secondary level of education (aPR: 0.47, 95%CI (0.30,0.73)), presence of a cataract at examination (aPR: 2.28, 95%CI (1.66, 3.13)) were statistically significantly associated with VI. Conclusion: In Mulago hospital, the prevalence of VI among the elderly is high with majority of the causes being correctable. We recommend that efforts towards early case identification of causes of VI among the elderly should be a priority. Keywords: Visual impairment; elderly patients; eye clinic; Mulago National Referral Hospital; Uganda.