LOW-VISION IN EAST-AFRICAN BLIND SCHOOL STUDENTS - NEED FOR OPTICAL LOW-VISION SERVICES

Aims-There is increasing awareness of the needs of children with low v ision, particularly in developing countries where programmes of integr ated education are being developed. However, appropriate low vision se rvices are usually not available or affordable. The aims of this study were, firstly, to assess the need for spectacles and optical low visi on devices in students with low vision in schools for the blind in Ken ya and Uganda; secondly, to evaluate inexpensive locally produced low vision devices; and, finally, to evaluate simple methods of identifyin g those low vision students who could read N5 to N8 print after low vi sion assessment. Methods-A total of 230 students were examined (51 sch ool and 16 university students in Uganda and 163 students in Kenya, ag ed 5-22 years), 147 of whom had a visual acuity of less than 6/18 to p erception of Light in the better eye at presentation. After refraction seven of the 147 achieved 6/18 or better. Eighty two (58 . 6%) of the 140 students with low vision (corrected visual acuity in the better e ye of less than 6/18 to Light perception) had refractive errors of mor e than 2 dioptres in the better eye, and 38 (27 . 1%) had more than 2 dioptres of astigmatism. Results-Forty six per cent of students with l ow vision (n = 64) could read N5-N8 print unaided or with spectacles, as could a further 33% (n = 46) with low vision devices. Low vision de vices were indicated in a total of 50 students (35 . 7%). The locally manufactured devices could meet two thirds of the need. Conclusion-A c orrected distance acuity of 1/60 or better had a sensitivity of 99 . 1 % and a specificity of 56 . 7% in predicting the ability to discern N8 print or better. The ability to perform at least two of the three sim ple tests of functional vision had a sensitivity of 95 . 5% and a spec ificity of 63 . 3% in identifying the students able to discern N8 or b etter.