Visual Impairment Among Children with Epilepsy at a Tertiary Hospital in Nigeria.

Visual Impairment among African children with epilepsy

Abstract

Background

Visual impairment (VI) may be one of the least reported neurologic comorbidities among children with epilepsy. But its impact on the child’s development and quality of life makes it of public health importance. This study describes the prevalence of VI, clinical and schooling factors associated with VI among children with epilepsy (CWE) being managed at the Jos University Teaching Hospital (JUTH).

Methods: A cross-sectional comparative study of CWE and their age, sex matched controls. Eligible children diagnosed with epilepsy and being managed at the JUTH were consecutively recruited after obtaining signed informed consent from their caregivers. Their sociodemographic data, clinical and schooling histories were obtained from the caregivers. Vision was assessed using the American Academy of Paediatrics guideline for visual systems assessment in infants, children and young adults by paediatricians and categorized using the International Center for Disease control version 11 (ICD11) guidelines. Result of the findings were compared with that of age and sex matched controls recruited from neighbouring schools and the community.

Results

A total of 200 children were recruited for the study; 100 CWE and 100 controls aged between 1-18 years with a male to female ratio of 1.2:1. The prevalence of VI among CWE (5.0%) was significantly higher than the prevalence (2.0%) among the controls (p < 0.001). Vision loss in both groups was in the moderate VI category. No association was found between patients’ clinical parameter and VI. Similarly, although the CWE had significantly poorer schooling history compared to the control group (p < 0.001), no statistically significant relationship was found between VI and schooling history (p = 0.363) or school performance (p = 0.130) of CWE. 

Conclusion

VI is more common among CWE at the JUTH compared to the controls but no significant association was found between VI and clinical parameters, schooling history or school performance of CWE. An interdisciplinary approach involving caregivers, teachers, paediatricians and ophthalmologist is required to enhance early detection and management of VI associated with childhood epilepsy.     

Key words:Visual impairment, epilepsy, school