The impact of visual impairment on health-related quality of life in rural Africa.

Purpose: To assess the impact of visual impairment (VI) on utility values in Sub-Saharan Africa and compare findings with other studies from low- and high-income countries.

Methods: Patients with normal vision and various levels of VI were recruited from a secondary eye clinic in rural Kenya and interviewed using time trade-off (TTO). VI was classified using the World Health Organization definition of (normal vision, visual acuity ≥20/60, VI 20/80-20/200, severe VI 20/240-20/400, and blindness <20/400).

Cataract surgery in patients taking alpha-1 antagonists: know the risks, avoid the complications.

Background: The growing use of alpha-1 receptor antagonists in the treatment of benign prostatic hyperplasia (BPH) has created a new problem in ophthalmic surgery, the so-called intraoperative floppy iris syndrome (IFIS). This consists of a billowing iris, insufficient pupillary dilation with progressive intraoperative miosis, and protrusion of iris tissue through the tunnel and side port incision that are made for access to the anterior chamber during surgery. IFIS presents particular difficulties in cataract surgery which is carried out through the pupil with manipulations in the immediate vicinity of the iris.

Validity of first post-operative day automated refraction following dense cataract extraction.

Background: The aim of this study was to assess the refractive stability and validity of automated refraction obtained at day one after surgery for dense cataracts in a developing country setting, where patient follow-up is often erratic.

Methods: In a prospective study in rural Kenya, we compared automated refraction and visual acuity (VA) after manual small incision cataract surgery (SICS) and phacoemulsification cataract surgery (Phaco) at day one with autorefraction and subjective refraction obtained at a later visit.

Results: Ninety eyes of 83 patients fulfilled the ultimate inclusion criteria (21 SICS eyes and 69 Phaco eyes).

The importance of biometry to cataract outcomes in a surgical unit in Africa.

Purpose: To determine how much difference biometry makes to refractive outcomes in a population in Sub-Saharan Africa compared to using standard-power intraocular lenses (IOLs).

Methods: In a secondary eye-clinic in Kenya, IOL-powers in half diopters (D) were implanted according to biometry prediction in patients undergoing routine cataract surgery with small-incision techniques. A model was generated to predict refractive outcomes if standard-IOLs had been used.

Understanding why patients with cataract refuse free surgery: the influence of rumours in Kenya.

Objectives: To understand the reasons that hinder people from uptake of sponsored cataract surgery.

Methods: A mixed methods (qualitative and quantitative) approach was used. During routine screening activities at Kwale District, Kenya, local residents with visually impairing cataract were clinically assessed and offered free surgery.

Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya.

Purpose: To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery.

Methods: Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL.