Okpala Nonso Ejikeme, Umeh Rich Enujioke, Onwasigwe Ernest Nnemeka
Department of Ophthalmology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria. ; Guinness Eye Center Onitsha, Anambra, Nigeria.
Department of Ophthalmology, University of Nigeria, Enugu Campus, Enugu, Nigeria. ; Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Ophthalmol Eye Dis. 2015 Jun 21;7:13-9. doi: 10.4137/OED.S18659. eCollection 2015.
A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL) eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%), than males, 584 (47.2%), constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93%) children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34%) followed by eyebrow scar (2.10%). Canthal scar was the next (0.32%). Two girls had monocular blindness from eye trauma (0.16%). One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39%) followed by the school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms of treatment, 58.16% of the children with an eye injury had no form of treatment for it. The children from this study with monocular blindness did not receive adequate medical treatment. Treatment of an eye injury, according to this study, was sought from chemists (19.39%), at hospital/health centers (16.33%), at home (3.06%), and from traditional healers (3.06%). The persons who treated an eye injury, as observed from this study, were doctors (14.29%), nurses (4.08%), chemists (17.35%), and traditional healers and fathers (3.06% each). The frequency of noninjury-related diagnosis made in this study was refractive error, 4.85%; allergic conjunctivitis, 1.94%; oculocutaneous albinism, 0.24%; prepapillary vascular loops, 0.40%; and then ptosis, exotropia, stye, corneal opacity, and retinitis pigmentosa, 0.08% each. The annual incidence of an eye injury according to this study was 3.48%. The majority of the causes of an eye injury, as per this study, were preventable. Appropriate promotion of preventive eye care among children may go a long way in reducing the burden of blindness from eye injuries.
在尼日利亚埃努古州两个不相邻的地方政府辖区开展了一项关于小学生眼外伤患病率的横断面调查。其中一个地方政府辖区为城市地区，另一个为农村地区。对城市地区两所随机抽取的小学和农村地区三所随机抽取的学校中15岁以下的儿童进行了访谈，并使用斯内伦视力表、手电筒、头戴放大镜和直接检眼镜进行了检查。使用半结构化问卷和世界卫生组织预防失明规划（WHO/PBL）眼科检查表记录检查结果。为每位班级教师进行了视力测量培训。共研究分析了1236名15岁以下儿童。样本人群中女性略多于男性，女性652名（52.8%），男性584名（47.2%），男女比例为1.1:1。共有98名（7.93%）儿童有眼部或其附属器受伤的证据。眼睑瘢痕最为常见（5.34%），其次是眉部瘢痕（2.10%）。眦部瘢痕位列其后（0.32%）。两名女孩因眼外伤导致单眼失明（0.16%）。其中一名有角膜白斑，另一名晶状体脱位。本研究中所有单眼失明儿童均来自城市地区。家庭是眼外伤最常见的环境（69.39%），其次是学校（20.41%）。农场位列第三（7.14%），尤其是在农村地区的男孩中。教会和道路/街道占其余比例。关于致伤人员，儿童的玩伴最为常见（55.10%），其次是儿童自身（27.55%）。父母和监护人位列其后（9.18%）。这些是与体罚相关的损伤。根据本研究，体罚相关的眼外伤在农村地区似乎很常见，且主要影响男孩。其他导致眼外伤的人为中介因素包括路人（2.04%）、道路交通事故（2.04%）、兄弟姐妹（2.04%）以及其他（1.02%）。导致眼外伤的主要因素为棍棒/木材，共29例（29.60%）；石头，21例（21.43%）；金属片，19例（19.39%）；跌倒，10例（10.20%）；打架/拳击，9例（9.918%）；塑料，2例（2.04%）；指甲，2例（2.04%）；农具/水果，2例（2.04%）；道路交通事故、玻璃和头部撞击，各1例（1.02%）。农具/水果以及指甲似乎是尼日利亚埃努古农村地区导致眼外伤相当常见的主要因素。在患病率方面，城市和农村地区之间无显著差异。本研究结果显示小学生眼外伤患病率较高。在治疗方面，58.16%的眼外伤儿童未接受任何形式的治疗。本研究中患有单眼失明的儿童未得到充分的医疗治疗。根据本研究，眼外伤的治疗寻求于药剂师（19.39%）、医院/卫生中心（16.33%）、家中（3.06%）以及传统治疗师（3.06%）。从本研究观察到，治疗眼外伤的人员为医生（14.29%）、护士（4.08%）、药剂师（17.35%）以及传统治疗师和父亲（各3.06%）。本研究中非损伤相关诊断的频率为屈光不正，4.85%；过敏性结膜炎，1.94%；眼皮肤白化病，0.24%；视乳头前血管袢，0.40%；然后上睑下垂、外斜视、睑腺炎、角膜混浊和视网膜色素变性，各0.08%。根据本研究，眼外伤的年发病率为3.48%。根据本研究，大多数眼外伤原因是可预防的。在儿童中适当推广预防性眼保健对于减轻眼外伤导致的失明负担可能大有帮助。
