Prevalence and Pattern of Manifest Strabismus in Paediatric Patients at CCBRT, Dar es Salaam, Tanzania

Abstract

Background: Awareness on the magnitude of strabismus burden is crucial in preventing development of amblyopia, restore binocularity, aid in development of stereopsis and improve treatments outcomes.
Objective: To determine the prevalence, and pattern of strabismus presentation in paediatric patients at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT).
Design: Retrospective descriptive hospital based study.
Subjects: Children aged 16 years and below presenting with strabismus at CCBRT between January 1, 2014 and June 30, 2014.
Methods: All strabismus coded files of patients below 16 years were identified from medical records. The data collected included patients’ demographic data; age at onset of strabismus; visual acuity; characteristics of the deviation; refractive status; binocular functions and amblyopia assessment; and relevant ocular and systemic findings.
Results: The prevalence of strabismus was 5.9%. Males were 49.1% and females 50.9%. Family history was present in 3.3% of the patients. Most of the patients (61.8%) were below five years; average 4.6 years. A third of the patients (32.5%) presented within one year of onset of strabismus; average duration 25.7 months. Systemic and ocular co morbidities were present in 17.9% and 46.2% of the patients respectively. About half (47.9%), had normal vision. Esotropia was the commonest deviation ( 63.3%); exotropia, 24% and hypertopia 2.8% . In 76.9% the strabismus was unilateral and alternating in 22.6%. Most of the deviations (42.9%) were between 30-50 prism dioptres. Hyperopia was in 51.7%; myopia in 14.4% and astigmatism 11.6% of the eyes. Amblyopia was noted in 25.9% of the patients. Binocular single vision assessment was done in 14.1%; 62.5% had a negative result.

Conclusion: The prevalence of strabismus in this study was high at 5.9%. Esotropia was the commonest deviation.