Systemic Ocular and Refractive Conditions in a Clinical Population in the DominicanHaitian Border Town of Pedernales

Hector Santiago


Purpose: Uncorrected refractive error and ocular disease are the main causes of visual impairment worldwide. There are few studies of the causes of visual impairment in underserved areas of the Caribbean region. This is the first study of the prevalence of refractive error, systemic and ocular diseases in a clinical population in a town at the border between the Dominican Republic and Haiti.

Methods: The sample included 473 patients (ages 3 to 95. Mean = 46.8 ± 20.1 years) from Pedernales (Dominican Republic) who responded to an open invitation to a free eye care town clinic in March 2015. They were examined by optometrists and supervised student clinicians from the Inter American University of Puerto Rico School of Optometry using a uniform protocol for each patient. Every patient was consented, had a case history and tested for blood pressure, visual acuities, cover test, objective and subjective refraction, external and internal ocular health

Results: 41.2% of all patients never had an ocular examination. Hypertension (36.44%), diabetes (3.93%), cataracts (8.75%), pterygium (5.84%) and glaucoma (2.39%) were the most commonly reported systemic and ocular diseases. Our testing revealed that 82.4% of the patients were hypertensive (44.9% Stage 1 and 37.5% Stage 2 hypertension). The most common ocular abnormalities found were pinguecula (25.6%), pterygia (21.1%) and cataracts (25.6%). 48.2% of the patients were visually impaired (presenting distance visual acuity less than 20/40) out of which 6.5% were blind. Visual impairment was reduced to 15.8% after refractive correction. The mean spherical equivalent of the refractive error was 0.06 ± 2.54 D, Range -14.5 D to +5.00 D. The spherical equivalent of the refractive error was statistically different between age groups (F (7,400) = 4.65, p <0.01). Post-hoc testing revealed that the mean spherical equivalent for the 11-20-year-old group was significantly more myopic than most other age groups.

Conclusion: The prevalence of hypertension, ocular diseases and presenting visual impairment in this clinical population of Pedernales is the highest reported for any Caribbean group of patients. The main cause of visual impairment was uncorrected refractive error. Improved access to optometric care, ultraviolet protection, and patient clinical education can significantly improve the ocular health of this population.


Year: 2018

Program Number: 185236

Resource Type: Scientific Program

Author Affiliation: Inter American University of Puerto Rico

Co-Authors: n/a

Co-Author Affiliation: n/a

Room: Exhibit Hall 3