Is Self-Test Vision Corridor a useful Screening Tool in Nigeria?

Presented by Anne Ebri

Co-Authors:VingFai ChanPirindha GovenderJyotikumarie JaggernathKovin Naidoo

4 STVCs are set up in many countries:Gambia, Nigeria - 20 STVCs by a project

3 Enables people detect their reduced vision

2 Widely used, convenient, simple to use

1Snellen chart painted or mounted on a wall for self - vision screening in underserved communities in West Africa.

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STEPS TO PROCESSSelf -Test Vision Corridor (STVC)

Purpose

• To explore the users’ perceptions on how to improve usage.

• To determine the reasons for not going for further management if they failed the screening.

Methods

• Descriptive study using mixed methods. • In-depth interviews were conducted using a

question guide. – Demography– Factors to improve the usage of STVC– Perception of users towards STVC– Reasons for not going for follow-up management

• Trained personnel observed users perform self Vision testing.

Self-Test Vision Corridor

Methods

• Quantitative data were tabulated in percentages.

• Qualitative data were analysed thematically.

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12% unemployed

INFO CIRCLESResults- Demography

150 respondentsMedian age of 37.5 years old

(IQR 22-57 years)

43.3% were females.

64% at least primary education

Results: Right VA Test

ItemAMAC Bwari Kuje Total

Performed correctly,

N (%)

Performed correctly,

N (%)

Performed correctly,

N (%)

Performed correctly,

N (%)

Right eye

1 Subject standing at the marked spot. 49 (98) 48 (96) 50 (100) 147 (98)2 Subject has not moved from the spot throughout the procedures 49 (98) 50 (100) 50 (100) 149 (99.3)3 Subject covered his/her left eye 48 (96) 50 (100) 49 (98) 147 (98)4 Subject covered his/her left eye adequately without peeping 42 (84) 49 (98) 50 (100) 141 (94)5 Subject read from the top of the chart to the bottom of the chart 39 (78) 43 (86) 48 (96) 130 (86.7)

Left eye1 Subject standing at the marked spot. 49 (98) 50 (100) 50 (100) 149 (99.3)2 Subject has not moved from the spot throughout the procedures 46 (92) 50 (100) 49 (98) 143 (95.3)3 Subject covered his/her left eye 46 (92) 50 (100) 49 (98) 145 (96.7)4 Subject covered his/her left eye adequately without peeping 43 (86) 50 (100) 50 (100) 143 (95.3)5 Subject read from the top of the chart to the bottom of the chart 46 (92) 38 (76) 47 (94) 131 (87.3)

98.7%

Close proximity to an eye facility are.

Factors to improve usage

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CHART 1

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CHART 199%

Located at easily noticeable sites and

at no cost are.

57%

Considered privacy as very important

What do people think of STVC?

What will improve the usage of the STVC?

Clear

Easily understood

Sufficient and effective

Creating more awareness about the existence of the SVTC and eyecarePutting more STVCs, to be mounted in strategic and public areasFree assistance for people found to have an eye defect

What prompted them to use the SVTC?

They were curious to know their vision statusBecause the testing is easy, accessible and free of chargeThey felt that it is important to do the testingSome were told to test their vision because they know they have a vision problem

QUALITATIVE RESULTS

PHASE PROCESS

2 were hoping that the outreach would be visiting their community

8

Because they have no money (n=4)7

Wait for hospital management to provide free service(n=4)

6

10 respondents who did not go for follow up treatment:5

1 was diagnosed of glaucoma and 2 needed glasses.

4

2 of them went to the general hospital while 1 went to an eye center

3

3 went for follow up eye management:

2

13 of 16 people who failed their vision testing while using STVC were contacted

1

Phase 2- Follow up

Discussion

• STVCs are accessible, easy to use and free of cost.

• Respondents will recommend STVCs to others for its clear instructions, comparative accessibility and flexibility

• 3 participants who failed the test and followed up, one was diagnosed of glaucoma & 2 others received recommendation to wear spectacles

• 10 others did not follow up for reasons of lack of money, anticipated high cost of treatment and perceived unaffordability.

Discussion

• STVC cannot replace a proper eye examination at an eye care facility by trained eye care personnel.

• They can sensitize users who failed the test to seek proper attention at a nearby facility

• Self -Test Vision Corridors can be more effective if combined with regular health education.

References 1. Abdull MM, Sivasubramaniam S, Murthy GV, et al. Causes of blindness and visual

impairment in Nigeria: the Nigeria National Blindness and Visual Impairment Survey. Invest Ophthalmol Vis Sci 2009;50:4114e20.

2. Ezelum C, Razavi H, Sivasubramaniam S, et al. Refractive error in Nigerian adults: prevalence, type, and spectacle coverage. Invest Ophthalmol Vis Sci 2011;52:5449e56.

3. Federal Capital Territory Administration Official website 2011. Retrieved from http://www.fct.gov.ng/index7732.html?option=com_content&view=article&id=45&Itemid=87. Accessed 26 Aug 2013 Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol 2012;96:614–18.

4. Holden BA, Fricke TR, Ho SM, et al. Global vision impairment due to uncorrected presbyopia. Arch Ophthalmol 2008;126:1731e9.

5. Qureshi MB. Training to meet the needs for refractive error. Comm. Eye Health Journ. 2007; 20:6

6. Vision 2020 World Health Organization report. 1996. Retrieved from http://www.who.int/blindness/Vision2020_report.pdf. Accessed on 19 Aug 2012