Prevalence, management strategies, and visual outcomes of amblyopia among paediatric patients at Kenyatta National Hospital, Kenya

Jebitok Betty; Sheilah  Nangena; Christine  Wanjala; Walter Yego

doi:10.51867/ajernet.7.4.45

Authors

Jebitok Betty Masinde Muliro University of Science and Technology, Kenya https://orcid.org/0009-0003-8233-4329
Sheila Nangena Masinde Muliro University of Science and Technology https://orcid.org/0000-0001-5889-5802
Christine Wanjala Masinde Muliro University of Science and Technology https://orcid.org/0000-0001-6200-5278
Walter Yego University of South Eastern Norway https://orcid.org/0000-0001-6786-7109

DOI:

https://doi.org/10.51867/ajernet.7.4.45

Keywords:

Amblyopia, Atropine, Eyeglasses, Eye Occlusion, Prevalence, Visual Acuity, Vision Screening

Abstract

Amblyopia is a major cause of preventable visual impairment among paediatric population. Global prevalence was estimated at 1.44% by Fu et al., 2020, with the burden projected to rise to 175 million in 2030. Management strategies include optical correction, patching, atropine, and dichoptic therapy. This study aimed to determine the prevalence, management strategies, and visual outcome of amblyopia among paediatric patients at Kenyatta National Hospital. A retrospective clinical case series study design was adopted. The study population included all paediatric patients aged neonate to 18 years who were diagnosed with amblyopia and seen at Kenyatta National Hospital between August 2023 and September 2025, as identified through record books. Data were analyzed using SPSS 26.0, descriptive statistics, Pearson’s chi-square test for associations between categorical variables, and regression modelling to identify predictors of clinically meaningful visual improvement. Prevalence is the proportion of the paediatric population with amblyopia within the study period. A total of 7,041 paediatric patients visited the facility within the study period; 106 were diagnosed with amblyopia and met the study criteria, giving a hospital-based prevalence of 1.51%. The cohort received combined management strategies; optical correction was the most commonly adopted strategy and was found to be statistically significant at p < 0.001 (71.7%); patching was applied (n=61, 57.5%); surgical intervention (n=38, 35.8%); and atropine penalization (n=4, 3.8%). Baseline index eye visual acuity was poorer than final visual acuity, indicating overall improvement. Shapiro-Wilk p<0.001 was used to analyze baseline VA, final VA, and VA improvement. The baseline mean visual acuity index (Log MAR) was 0.792, and the final mean was 0.554; 48 patients (45.3%) achieved clinically significant vision improvement of≥ 0.2 lines. Mean age at diagnosis was 7.55 years; older age at diagnosis and bilateral presentation remained associated with lower odds of ≥0.2-line improvement, and worse baseline VA remained strongly associated with higher odds of improvement. Pre-school visual screening and management of refractive errors are recommended for early diagnosis and management of amblyopia.

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Author Biographies

Sheila Nangena, Masinde Muliro University of Science and Technology

Sheilah Nangena is an educator, researcher and an assistant Lecturer at the department of Optometry and Vision Science at Masinde Muliro University of Sciecne and Technology.Her research focus is in public eye health, myopia, cornea , keratoconus.
Christine Wanjala, Masinde Muliro University of Science and Technology

Dr. Christine Wanjala is a senior lecturer in the Department of Medical Laboratory Science, with a keen interest in medical parasitology and vector biology

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