Ocular Manifestations Among Patients with Pre-eclampsia and Eclampsia at Muhimbili National Hospital; Magnitude and Presentations.

Abstract

Background: To determine the prevalence and presentation of ocular manifestations among patients who presented with pre-eclampsia and eclampsia at a tertiary hospital.

Methods: A cross-sectional descriptive study was conducted at Muhimbili National Hospital (MNH). All patients with pre-eclampsia and eclampsia who met the inclusion criteria during the study period were included. A total of 113 patients were recruited. Data collection was done for six months which involved; case note review and ocular examination. Findings were recorded in structured questionnaires. Computer software SPSS version 20 was used for descriptive analysis of the gathered data. The results were summarized in frequency tables, bar and pie charts. inferential statistics were performed and a p<0.05 was considered significant.

Results: The patients age range was 18-49 years with a mean age of 29.26 years. Forty five (39.8%) patients had pre-eclampsia while 68 (60.2%) had eclampsia. The overall prevalence of visual disturbances was 51 (45.1%). Poor vision occured in 39 (35.4%) patients followed by photopsia 15.9% and diplopia 2.7%. Fundus findings were; papilledema 28.3%, retinal edema 19.5%, cotton-wool spots 18.6%, arteriolar narrowing 17.7%, flame-shaped haemorrhages 8% and macular edema 5.3%. On admision 39 (35.4%) patients had impaired vision with a corrected visual-acuity of <6/18. At discharge only 13.3% had impaired vision. The mean visual recovery time was 8.5±1.2 days.

Conclusion: The prevalence of visual disturbances among patients with pre-eclampsia and eclampsia at MNH was significantly high. Majority presented with blurred vision and it was temporary in 86.7% of patients. Recommendation: Measures to create awareness among health personnel regarding sudden visual loss among pregnant women as an alarming sign of pre-eclampsia are recommended. Obstetricians need to assess vision and fundus examination in these patients and refer them for ophthalmic care accordingly.