Apr 2019 DOI 10.14302/issn.2470-0436.jos-19-2693
E. Moroi SayokoCorresponding author
Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, Michigan, 48105 USA.
Given limited knowledge regarding validity of the Titmus vision screener, we sought to compare visual acuity measurements obtained from the Titmus with that from the Snellen chart and assess the validity properties of the Titmus as a screening instrument to detect vision impairment. Visual acuity was measured in 150 participants recruited from an academic ophthalmology practice, using the Snellen chart as well as the Titmus vision screener. Visual acuities from the Titmus and Snellen were compared and validity of the Titmus vision screener was assessed by computing sensitivity and specificity. Using Snellen visual acuity as the reference standard, the sensitivity of the Titmus vision screener to detect vision impairment, defined as visual acuity worse than 20/40, was 92% (95% CI (72.5, 98.6)) and the specificity was 64% (95% CI (57.9, 70.1)). Comparisons of the precise visual acuity level revealed poor agreement between the two methods (weighted Kappa: 0.15, 95% CI (0.08, 0.21)). Visual acuities obtained from the Titmus were, on average, two lines worse than Snellen visual acuities. ((logMAR Snellen – logMAR Titmus) = - 0.19 ± 0.29, 95% confidence interval (CI) (-0.23, -0.16)). Titmus vision screener is a sensitive tool to detect visual impairment. However high false positive results and poor agreement with Snellen limits its widespread use in clinical applications.
Jan 2019 DOI 10.14302/issn.2470-0436.jos-19-2602
Adaboh HayfordCorresponding author
Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Vision impairment and blindness remain a challenge in developing countries, especially in rural communities. Notwithstanding, VISION 2020 global initiative seeks to eliminate avoidable blindness by 2020. This community-based cross-sectional study aimed at determining the accessibility of ophthalmic services and barriers to its utilization in rural communities in the Upper Denkyira West District, Ghana. One-hundred and seventy participants from 5 randomly chosen rural communities in the district were included. Participants were interviewed using a structured questionnaire. Socio-demographic information, information regarding accessibility, utilization, and barriers to eye care services were obtained. Descriptive statistics were carried out using SPSS version 23. The Chi-squared test was employed to determine associations. P-values less than 0.05 at a confidence interval of 95% were considered significant. Only 21.8% of participants had had eye examination within the past 3 years, with over half of the examinations undertaken at screening grounds and health centres. Significant associations were found between ophthalmic services utilization and increasing age (p = 0.004), female gender (p = 0.027) and those who had a past history of eye problem(s) (p = 0.0010. The study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Public health education and eye care interventions should prioritize and target rural populations. Key Messages This study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Rural dwellers were thus compelled to resort to harmful eye care practices. Public health education and eye care interventions should prioritize and target rural populations