FACTORS CONTRIBUTING TO LATE PRESENTATION OF PATIENTS WITH STRABISMUS TO THE KOMFO ANOKYE TEACHING HOSPITAL, GHANA

Abstract

Introduction Strabismus is an ophthalmic condition that refers to the misalignment of the eyes. It is a common eye problem in both children and adults resulting in reduced visual acuity, abnormal binocular vision and low self-esteem. Anecdotally, most patients with strabismus present late to the Eye Clinic at the Komfo Anokye Teaching Hospital (KATH). Factors contributing to this late presentation have not been studied. This study sought to determine the factors contributing to late presentation of patients with strabismus at KATH. Methods This was a hospital-based cross-sectional study of factors contributing to late presentation of patients with strabismus at KATH. Patients with strabismus who met the inclusion criteria were examined after informed consent and assent. Socio-demographic characteristics of the patients such as age, sex, place of residence, education, etc., were recorded using a structured questionnaire. Clinical findings (age at onset of strabismus, age at presentation, deviating eye, type of deviation, etc.) were documented on the questionnaire. Data collected was analysed using SPSS Version 20 and presented using descriptive and inferential statistics. Chi-square test, odds ratios and 95 % confidence intervals were computed. P-values less than 0.05 were considered statistically significant. Results A total of 330 (males-180, 54.5 % and females-150 (45.5 %) patients were recruited into this study. The mean age at onset and presentation of strabismus were 4.0±1.2 years and 10.1±9.4 years. Age of patient, education of patient, having no relative with strabismus, monthly income level of family and having no knowledge about strabismus were associated with late presentation of patients with strabismus (p-values = 0.002, 0.001, 0.025, 0.001 and 0.001 vi respectively). There was no association between type of strabismus, type of deviation, presenting visual acuity, angle of deviation and late presentation of patients with strabismus (p-values = 0.423, 0.196, 0.446 and 0.624). Children were 0.1 times less likely to present late compared to adults [OR = 0.1; CI = (0.01-0.8); p-value = 0.032]. Participants with lower education were 1.6 times more likely to present late with strabismus compared to those having higher education [OR = 1.6; CI = (1.1-2.3); p-value = 0.006]. Beneficiaries of National Health Insurance Scheme (NHIS) were 0.4 times less likely to present late compared with non-beneficiaries of NHIS [OR= 0.4; CI = (0.2 -0.9); p-value = 0.037]. Patients with no knowledge about strabismus were 2.9 times more likely to present late compared with those who have knowledge about strabismus [OR= 2.9; CI = (1.5 -5.8); p-value = 0.002]. Patients who have no relatives with strabismus 2 times more likely to present late compared with those having relatives with strabismus [OR= 2.0; CI = (1.0 -4.3); p-value = 0.042]. Conclusions Age, education of patient, having no relative with strabismus, monthly income level of family and having no knowledge about strabismus were associated with late presentation of strabismus. Being an adult, having a lower level of education, not having NHIS and knowledge about strabismus, not having relatives with strabismus could predict late presentation of patients with strabismus.