Ocular anterior segment pathologies as a cause of visual impairment in diabetes mellitus in Port Harcourt

Abstract

Background: Diabetes mellitus has considerable impact on the eye, accounting for one of the commonest causes of blindness in the world. The world is currently experiencing a global epidemic of diabetes mellitus and most of the cases are in the developing countries of Asia and Africa. Current predictions estimate over 60% increase in the number affected from the current 285 million to an estimated 439 million in 2030.
Aim: To determine the impact of anterior segment pathologies of diabetes mellitus on vision in Port Harcourt.
Materials and Method: A hospital-based cross-sectional study of diabetic patients attending the Endocrinology clinic of University of Port Harcourt Teaching Hospital was carried out on consecutive adult diabetic patients, 19 years and older. Their bio data and relevant medical and ocular history were recorded. Their visual acuity, complete ocular examination and evaluation including objective and subjective refractions were done with appropriate techniques. 
Result: Of the 225 patients examined, refractive error found in 154 (68.4%) patients was the commonest anterior segment manifestation. Hypermetropia (n=128, 56.9%) was found to be commoner than myopia (n=26, 11.5%). Cataract was the second commonest anterior segment disorder (n=45, 20%). Other anterior segment disorders included ocular hypertension (n=21, 9.3%), iris new vessels (n=2, 0.9%) and primary open angle glaucoma (n=43, 19.1%). Thirteen (5.8%) patients were bilaterally blind while 26 (11.5%) had bilateral visual impairment. Cataract (n=16) was the leading cause of both bilateral and unilateral blindness. Refractive error (n=8) was the leading cause of bilateral visual impairment.
Conclusion: This study showed that anterior segment complications were important causes of ocular morbidities among diabetic patients seen in University of Port Harcourt Teaching Hospital, Nigeria. The prevalence of blindness of 10.2% and visual impairment of 20.4% recorded among these patients were significant and to reduce this burden, there is need for the primary caregivers and ophthalmologists to collaborate on the patients’ management

Key words: Anterior Segment, Visual Impairment, Diabetes Mellitus