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Refractive errors, visual impairment, and the use of low-vision devices in albinism in Malawi

  • Pediatrics
  • Published:
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Abstract

Background

This study focuses on the refractive implications of albinism in Malawi, which is mostly associated with the burden of visual impairment. The main goal was to describe the refractive errors and to analyze whether patients with albinism in Malawi, Sub-Saharan Africa, benefit from refraction.

Methods

Age, sex, refractive data, uncorrected and best-corrected visual acuity (UCVA, BCVA), colour vision, contrast sensitivity, and the prescription of sunglasses and low vision devices were collected for a group of 120 albino individuals with oculocutaneous albinism (OCA). Refractive errors were evaluated objectively and subjectively by retinoscopy, and followed by cycloplegic refraction to reconfirm the results. Best-corrected visual acuity (BCVA) was also assessed binocularly.

Results

One hundred and twenty albino subjects were examined, ranging in age from 4 to 25 years (median 12 years), 71 (59 %) boys and 49 (41 %) girls. All exhibited horizontal pendular nystagmus. Mean visual acuity improved from 0.98 (0.33) logMAR to 0.77 (0.15) logMAR after refraction (p < 0.001). The best improvement of VA was achieved in patients with mild to moderate myopia. Patients with albinism who were hyperopic more than +1.5 D hardly improved from refraction. With the rule (WTR) astigmatism was more present (37.5 %) than against the rule (ATR) astigmatism (3.8 %). Patients with astigmatism less than 1.5 D improved in 15/32 of cases (47 %) by 2 lines or more. Patients with astigmatism equal to or more than 1.5 D in any axis improved in 26/54 of cases (48 %) by 2 lines or more.

Conclusions

Refraction improves visual acuity of children with oculocutaneous albinism in a Sub-Saharan African population in Malawi. The mean improvement was 2 logMAR units.

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Acknowledgments

We thank Sight Savers (SS) for supporting refractive and low-vision care for patients with albinism in Malawi. We thank Else Kröner–Fresenius Stiftung for supporting the College of Medicine, Blantyre, Malawi. We thank Professor. Dr. Peter König, Mechanical and Automotive Engineering, Trier University of Applied Sciences, for the statistical support.

Conflict of interest

All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Authorship according to ICMJE guidelines

M Schulze Schwering, N Kumar, K Kalua, and P Kayange: designed study

M Schulze Schwering, N Kumar, and K Kalua: collected data

M Schulze Schwering, N Kumar, D. Bohrmann, M Spitzer, and P Kayange: did study analysis

M Schulze Schwering, M Spitzer, and P Kayange: edited manuscript for submission.

M Schulze Schwering, N Kumar, D Bohrmann, G Msukwa, K Kalua, M Spitzer, and P Kayange: Reviewed manuscript before submission

M Schulze Schwering, N Kumar, G Msukwa, M Spitzer, K Kalua, and P Kayange: agreed to manuscript being published.

Competing interests

None.

Author information

Authors and Affiliations

  1. c/o College of Medicine, University of Malawi, P Bag 360, Blantyre 3, Blantyre, Malawi

    M. Schulze Schwering, K. Kalua, P. Kayange & M. S. Spitzer

  2. University Eye Hospital Tübingen, Schleichstr. 12–16, 72076, Tübingen, Germany

    M. Schulze Schwering & M. S. Spitzer

  3. Lions Sight First Eye Hospital, Post dot net, Blantyre 3, PO Box E 180, Blantyre, Malawi

    N. Kumar, G. Msukwa & K. Kalua

  4. Mechanical and Automotive Engineering, Trier University of Applied Sciences, Trier, Germany

    D. Bohrmann

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  1. M. Schulze Schwering
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  2. N. Kumar
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  3. D. Bohrmann
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  4. G. Msukwa
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  5. K. Kalua
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  6. P. Kayange
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  7. M. S. Spitzer
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Correspondence to M. Schulze Schwering.

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Schulze Schwering, M., Kumar, N., Bohrmann, D. et al. Refractive errors, visual impairment, and the use of low-vision devices in albinism in Malawi. Graefes Arch Clin Exp Ophthalmol 253, 655–661 (2015). https://doi.org/10.1007/s00417-015-2943-0

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  • DOI: https://doi.org/10.1007/s00417-015-2943-0

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