[Extent of visual impairment in a population attending an ophthalmology center in Africa. Findings in 828 cases at the Tropical Ophthalmology Institute of Africa in Bamako, Mali].

The purpose of this prospective observational study was to evaluate the extent of visual impairment in a socially and professionally active population attending the Tropical Ophthalmology Institute of Africa (IOTA). Thanks to high recruitment rate at the IOTA, which is the third reference eye centre, a total of 828 patients ranging from 18 and 50 years of age and consulting for the first time were included between February 1 and May 4, 2003. Each patient underwent a thorough ocular examination. Data were recorded using a dedicated study form. Most patients (40%) consulted for reduced visual acuity. Diagnosis determined organic disease in 75.6% of cases (626 patients) and ametropia (including presbyopia) in 18.5% (153 patients). In the remaining 6% of cases (49 patients), ophthalmic examination was normal. Bilateral blindness was observed in 5.8% of cases (48 patients). The main cause of bilateral blindness was cataract (19.2%). The third most common cause (14.6%) was ocular manifestations of HIV infection, confirming that the epidemiology of blindness is changing and that HIV/AIDS should be taken into account. Unilateral blindness accounted for 11.5% of cases (95 patients). The main causes of unilateral blindness were trauma (50.5%), infection (26%) and degenerative disease (18%). Low vision accounted for 8.5% of cases (70 patients). The main cause of low vision was ametropia. This is one of the few hospital-based studies on causes of blindness in West Africa. The major finding is the high prevalence of blinding ocular complications of HIV infection. Another important finding is the high incidence of low vision that is often disregarded in West Africa.