Ophthalmologic Abnormalities in Hearing Impaired Children Attending a School for Deaf Students in Kinshasa, Democratic Republic of the Congo
Sarah A. Nkumbi, Jean-Claude MwanzaIntroduction:
There is a dearth of data on the characteristics of ophthalmologic abnormalities including visual impairment (i.e., blindness and low vision) in children who are deaf or hard of hearing, particularly in sub-Saharan Africa. The purpose of this study was to determine the profile of ophthalmologic abnormalities among hearing-impaired students attending a school for people who are deaf in an urban setting of the Democratic Republic of the Congo.
Methods:
This study was a descriptive cross-sectional study of 101 students with profound sensorineural hearing loss. Students underwent complete ophthalmologic examination that included visual acuity measurement, refraction, color vision, binocular vision assessment, and anterior and posterior segment evaluation.
Results:
The mean age was 16.8 ± 5.3 years. Only 3 (3.0%) students had received prior ophthalmologic examinations. Although 37 (36.6%) students had at least one ocular complaint, 87.5% of those without complaints had an abnormal ophthalmologic examination. Hemeralopia (25.7%) and blurred vision (20.8%) were the most common complaints. Overall, 93 (92.1%) students had one or more abnormalities. Refractive errors (81.2%) were the most frequent abnormalities. Other common abnormalities included macular dystrophies (18.8%), salt and pepper retinopathy (17.8%), retinal vessel tortuosity (8.9%), chorioretinal scars (6%), iris bombe (5.9%), iris atrophy (5.0%), and Shafer's sign (5.0%). Hyperopia and astigmatism accounted for 47.9% and 31.7% of all abnormalities, respectively. Visual impairment was present in 7.0% of the students and due to preventable causes including refractive amblyopia, unoperated congenital cataract, postcataract extraction aphakia, and congenital rubella retinopathy.
Conclusion:
Children who have hearing impairments have a high prevalence of undiagnosed ophthalmic abnormalities including visual impairments due to treatable causes.
Implications for Practitioners:
Practitioners should be aware of the high frequency of ophthalmologic abnormalities in children who are deaf and promptly refer them for ophthalmologic assessment. Ophthalmologists should play a key role in early screening and treatment of these ophthalmic abnormalities to optimize visual function.