Quality in Primary Care Open Access

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Abstract

A study of ocular morbidity, utilization and impact on patients' satisfaction in an ophthalmic clinic at Primary Health Center in Al Ahsa district of Saudi Arabia

Ataur Rahman Khan

Purpose:Ocular morbidity is the spectrum of eye diseases regardless of resultant visual loss experienced by a population. In the light of very few information regarding ocular morbidity in Saudi Arabia, we conducted a study to find out the ocular problems experienced by patients attending a community eye clinic situated in its eastern province.

Methods:It was a cross sectional , descriptive study which in included all patients attending a community eye clinic of Al Ahsa district of Saudi Arabia during the three months period starting from August 2014. Visual acuity was assessed at distance with Snellen Illiterate E chart and at near with Low Vision Resource Centre (LVRC) near acuity chart. Anterior segment was examined with slit lamp biomicroscopy. Fundus was examined with + 90 diaoptor lenses with slit lamp bio microscopy with mydriatics. Intraocular pressure were measured by applanation tonometer.

Results: One thousand one hundred and ten patients were included in this study.The mean age was 35.47 yrs (range 0.5 to 88 years).Among the all received patients the leading cause of ocular morbidity was refractive error (27.7% , n=308) followed by conjunctivitis (26.1%, n=290),Lid disorder(10.9%,n=121), Cataract(4.3%,n=48), Glaucoma (2.3%, n=25),Trauma (3.8%, n=42),Diabetic Retinopathy(2.4%,n=27), Childhood misalignment of the eyes (1.2%, n=13),Disease of the Nasolacrimal duct (2.1%, n=23) and Congenital eye problem (0.2%, n=2). A total of 167 diabetic patients were screened for the detection of Diabetic Retinopathy and 27 patients (2.4%) were found to be suffering with diabetic retinopathy. The utilization of clinic in term of procedure performed in the clinic consisted of medical management (41.1%,n=456), routine fundus examination for the detection of diabetic retinopathy(14.1%,n=156),Minor surgical procedures(6.6%, n=73),Refraction (29.37%,n=326),Referral to tertiary eye center(6.7%,n=75) and vision test for driving license (2.1%,n=24). As far as the satisfaction of the patients attending the clinic is concerned , more than ninety percent of the subjects agreed that they were satisfied with the courtesy and interaction by the eye specialists ,their convenience of attending the community eye care clinic , benefits of saving time and money in attending the clinic , eye health education and their satisfaction with the eye specialist for follow up management .More than eighty percent patients were of the opinion that they receive most of the minor surgeries as treatment and were satisfied with the result of the surgeries.

Conclusion:A large number of people affected by different type of ocular morbidity attended the community clinic in this survey and optimally utilized the clinic and were mostly satisfied with the eye care services. Most of these people could potentially be managed in their own communities through primary care.