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Visual impairment and unmet eye care needs among a Syrian adult refugee population in a Canadian city

Published:October 23, 2019DOI:https://doi.org/10.1016/j.jcjo.2019.07.023

      Abstract

      Objective

      To assess the prevalence of visual impairment and unmet eye care needs of the Syrian adult refugee population in Canada.

      Design

      Cross-sectional descriptive study.

      Participants

      Enrolment was offered to all Syrian refugees 18 years or older, with 248 patients enrolled.

      Methods

      Five clinics were organized from July 2016 to November 2017 in Toronto, Ontario. A vision screening and dilated retinal examination was performed on all participants. Prevalence of visual impairment and nonrefractive pathologies as well as information on sociodemographics and subjective visual acuity were obtained.

      Results

      The mean age of participants was 36 years (interquartile range, 30–35) and 53% were females. The prevalence of reported uncorrected vision problems was 22.2% for distance vision, 6.5% for near vision, and 5.6% for both distance and near vision, including loss of vision. Compared with the Canadian population, Syrian adult refugees were 19.04 times more likely to report uncorrected vision problems (34.4% vs 1.8%, p < 0.01). The presenting visual acuity in the better-seeing eye was 20/50 or worse in 19.4%. Pinhole improved this to 12.5% (95% confidence interval [CI], 8.7%–17.3%). Compared with the Canadian population (0.95%), Syrian adult refugees were 13 times more likely to have 20/50 vision or worse (p < 0.01). The most common finding was refractive error in 46.0% (95% CI, 39.6%–52.4%) followed by nonrefractive error in 30.2% (95% CI, 24.9%–36.2%).

      Conclusions

      This is the first study to assess ocular health in a refugee population in Canada. Syrian adult refugees have a high prevalence of visual impairment, even when living within a system of universal health care.

      Résumé

      Objectif

      Établir la prévalence des troubles de la vision et le fardeau des soins visuels à combler chez des réfugiés d'origine syrienne d’âge adulte au Canada.

      Nature

      Étude descriptive transversale.

      Participants

      L'admission à l’étude, offerte à l'ensemble des réfugiés syriens d'au moins 18 ans, a permis de recruter 248 patients.

      Méthodes

      Cinq journées d'examen ont été organisées entre juillet 2016 et novembre 2017 à Toronto, en Ontario. Tous les participants ont subi un dépistage des troubles de la vision et un examen dilaté de la rétine. On a mesuré la prévalence des troubles de la vision et des affections d'origine non réfractive, obtenu les données sociodémographiques et noté l'acuité visuelle subjective de tous les participants.

      Résultats

      L’âge moyen des participants se chiffrait à 36 ans (intervalle interquartile : 30–35 ans), et 53% étaient des femmes. La prévalence de troubles de la vision non corrigés était de 22,2% pour la vision de loin, de 6,5% pour la vision de près et de 5,6% pour les deux types de vision combinés, y compris la perte de vision. Comparativement à la population canadienne, les réfugiés syriens adultes étaient 19,04 fois plus susceptibles de présenter des troubles de la vision non corrigés (34,4% vs 1,8%; p < 0,01). Au moment de l'examen, l'acuité visuelle du meilleur œil était de 20/50 ou pire dans 19,4% des cas. Le trou sténopéïque a permis de porter ce score à 12,5% (intervalle de confiance [IC] à 95% : 8,7%–17,3%). Toujours par rapport à la population canadienne (0,95%), les réfugiés syriens adultes étaient 13 fois plus susceptibles d'avoir une acuité visuelle de 20/50 ou pire (p < 0,01). L'observation la plus fréquente, relevée chez 46,0% des sujets (IC à 95% : 39,6%–52,4%), était une erreur de réfraction, suivie d'une erreur non réfractive chez 30,2% des participants (IC à 95% : 24,9%–36,2%).

      Conclusions

      Il s'agit de la première étude portant sur l’évaluation de la santé oculaire au sein d'une population de réfugiés au Canada. Les réfugiés d'origine syrienne d’âge adulte ont une prévalence élevée de troubles de la vision, malgré le fait qu'ils bénéficient dorénavant d'un système de soins de santé universel.
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