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Open Access Highly Accessed Study protocol

The Nigerian national blindness and visual impairment survey: Rationale, objectives and detailed methodology

Brendan Dineen1, Clare E Gilbert1, Mansur Rabiu2, Fatima Kyari2, Abdull M Mahdi3, Tafida Abubakar4, Christian C Ezelum5, Entekume Gabriel6, Elizabeth Elhassan7, Adenike Abiose8, Hannah Faal9, Jonathan Y Jiya10, Chinenyem P Ozemela10, Pak Sang Lee11 and Murthy VS Gudlavalleti1*

Author Affiliations

1 International Centre for Eye Health, London School for Hygiene and Tropical Medicine, UK

2 National Eye Centre Kaduna, Nigeria

3 Specialist Hospital, Bauchi, Nigeria

4 Ministry of Health, Dutse, Jigawa State Nigeria

5 Ministry of Health Awka, Anambra State, Nigeria

6 Vision Health Services, Ikeja, Lagos State, Nigeria

7 Sight Savers, Country Office, Kaduna, Nigeria

8 International Agency for Prevention of Blindness, Africa region, Ibadan, Nigeria

9 Sight Savers West Africa Regional Office, Accra, Ghana

10 National Programme for the Prevention Blindness, Federal Ministry of Health, Abuja, Nigeria

11 Institute of Ophthalmology, UCL, London

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BMC Ophthalmology 2008, 8:17  doi:10.1186/1471-2415-8-17

Published: 22 September 2008

Abstract

Background

Despite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken to estimate the prevalence and determine the major causes of blindness and low vision. This paper presents the detailed methodology used during the survey.

Methods

A nationally representative sample of persons aged 40 years and above was selected. Children aged 10–15 years and individuals aged <10 or 16–39 years with visual impairment were also included if they lived in households with an eligible adult. All participants had their height, weight, and blood pressure measured followed by assessment of presenting visual acuity, refractokeratomery, A-scan ultrasonography, visual fields and best corrected visual acuity. Anterior and posterior segments of each eye were examined with a torch and direct ophthalmoscope. Participants with visual acuity of < = 6/12 in one or both eyes underwent detailed examination including applanation tonometry, dilated slit lamp biomicroscopy, lens grading and fundus photography. All those who had undergone cataract surgery were refracted and best corrected vision recorded. Causes of visual impairment by eye and for the individual were determined using a clinical algorithm recommended by the World Health Organization. In addition, 1 in 7 adults also underwent a complete work up as described for those with vision < = 6/12 for constructing a normative data base for Nigerians.

Discussion

The field work for the study was completed in 30 months over the period 2005–2007 and covered 305 clusters across the entire country. Concurrently persons 40+ years were examined to form a normative data base. Analysis of the data is currently underway.

Conclusion

The methodology used was robust and adequate to provide estimates on the prevalence and causes of blindness in Nigeria. The survey would also provide information on barriers to accessing services, quality of life of visually impaired individuals and also provide normative data for Nigerian eyes.