Theses and Dissertations (Optometry)

Exploring the management modalities for a paediatric population presenting with binocular vision anomalies in public health care facilities in Limpopo Province, South Africa

2026-03-13T06:16:00Z

Exploring the management modalities for a paediatric population presenting with binocular vision anomalies in public health care facilities in Limpopo Province, South Africa Maribeng, Ennie Raesibe Background and aim: Misdiagnosing and mismanaging accommodative and vergence anomalies can result in patients experiencing a poor quality of life due to poor visual status, particularly in the paediatric population. As a result, periodic binocular vision assessment is critical in the lives of children, mainly during their early growth. The current study aims to determine the management modalities used by the optometrists in the public health sectors on paediatric population presenting with binocular vision anomalies in Limpopo Province, South Africa. A thorough understanding of paediatric binocular vision management modalities by public-sector optometrists may help inform health policy and practices. Methods: A cross-sectional descriptive and quantitative research method was adopted for the current study. Using purposive sampling, 98 optometrists practicing in theselected 43 public hospitals within the Limpopo Province were included as participants. Participants completed online self-administered questionnaires that included demographics, self-reported clinical competencies, management modalities and the availability of clinical resources. Descriptive (frequency counts, percentages) and inferential statistics (Pearson correlation) were used to analyse the data using SPSS version 29.0. Results: More than half (56.5%) of the participants reported to have competencies in diagnosing and managing binocular vision anomalies. The most common mode of management used was spectacles (69%), and was reported to be a successful mode of treatment by 80.8% of the participants. Drugs and contact lenses were the least preferred management methods used by 1.4% of the participants. The lack of both appropriate equipment and the requisite competencies were identified as the primary reason for non-management of binocular vision anomalies by 49.8% and 41.9% of the participants, respectively. In addition, 62.9% of the participants had not attended any continuous professional development (CPD) activity within the preceding six months. Most hospitals are equipped with ophthalmoscopes, trial frames, distance and near charts, but have limited number of equipment designed for diagnosing binocular vision anomalies.Conclusions: Half the participants demonstrated their ability to diagnose and manage paediatric binocular vision disorders. Most participants reported to lack the necessary training for binocular vision management. Periodic training for practicing optometrists in the public health sector on paediatric binocular vision anomalies is essential for ensuring quality optometric services. By attending relevant training, optometrists in public hospitals will learn the latest modalities to treat paediatrics binocular vision anomalies that will improve paediatrics quality of life. It is imperative that the government prioritise the provision of instruments for binocular vision assessment and management in all public health facilities to facilitate the efficient and effective diagnosis and management of paediatric binocular vision disorders. This practice of binocular vision will enhance the quality of optometric services both in the Limpopo Province and throughout South Africa. Thesis (M.Optom.) -- University of Limpopo, 2025

Cumulative radiation dose incurred by patients in intensive care unit at Mankweng Hospital

2025-02-01T01:00:23Z

Cumulative radiation dose incurred by patients in intensive care unit at Mankweng Hospital Mpfumali, Prince Ndanganeni BACKGROUND: Patients admitted in the Intensive Care Unit (ICU) are critically ill and may require multiple radiological imaging studies. These imaging studies may be repeated in a short space of time and patients are therefore at an increased risk of receiving high cumulative radiation dose in a single admission at a hospital. This study aimed at quantifying the amount of cumulative radiation dose incurred by patients admitted in ICU at Mankweng Hospital in a single admission. METHODOLOGY: A retrospective descriptive study design was conducted on hospital records of patients admitted to the Intensive Care Unit, in the period between 01 April 2019 and 31 March 2020. Data was collected using a data collection sheet and captured into Microsoft excel for analysis. The study applied descriptive statistics (mean, median, quantile ranges, and frequencies and percentages) to summarise the patients’ demographical information and profile. Analysis of variance was used to assess the difference between means by reason of admission. The Chi-square test was used to analyse the relationship between the reason for admission in ICU and the cumulative radiation dose incurred. Regression analysis was applied to determine the relationship between the length of ICU stay and the cumulative radiation dose incurred by patients in a single admission. Statistical Package for Social Sciences (SPSS) version 28 was used to analyse the data. RESULTS: During the study period, a total of 221 imaging studies were conducted, out of which 150 (68%) were plain X-rays and 71 (32%) were CT scans. The radiation dose received by the patients was 644mSv, with a mean of 4.9mSv. Plain X-rays were more frequent than CT scans, but contributed only 5% of the radiation dose, whereas CT scans accounted for 95% of it. The average length of stay in the ICU was 5 days, ranging from 1 to 17 days. Most patients (63.57%; n=82) stayed in the ICU for less than 5 days, while the remaining (35.66%; n=46) stayed for more than 5 days. The study also found a significant positive correlation between length of stay and X-ray (p-value <0.0001). The Chi-square test demonstrated that the cumulative radiation dose received by patients during a single admission was associated with the reasons for admission (p-value=0.03260<0.05). CONCUSION: ICU patients at Mankweng Hospital are experiencing higher radiation doses in a single admission, with CT scans being the biggest contributor of the radiation dose. Radiation dose increases with increase in length of ICU stay. Thesis (M. Med. (Diagnostic Radiology)) -- University of Limpopo, 2024

Contact lens fitting in North-West Province, South Africa : practitioner clinical competencies and contact lens related practices

2025-01-22T01:00:08Z

Contact lens fitting in North-West Province, South Africa : practitioner clinical competencies and contact lens related practices Maluleka, Keitumetse Joan Background: Contact lens remain one of the critical options for vision correction. In a rapidly evolving global landscape of ocular healthcare, the application of new information in contact lens clinical practice appears paramount to sustaining proficiency and patient satisfaction by optometrists. Superior clinical proficiency and availability of relevant equipment enhance success in contact lens fitting and contact lens wear. Purpose: The study aimed to determine practitioner clinical competencies and contact lens-related practices of optometrists, to inform the need to address challenges encountered for optimal fitting of patients essential for improved eye health planning and curriculum advancement for contact lenses. Methods: A descriptive cross-sectional quantitative design was used in the study which entailed a questionnaire to establish the clinical competencies of practitioners and contact lens-related practices in the North-West Province. The analyses included descriptive analysis of data, using statistical package for Social Science (SPSS) version 28.0 software, in consultation with the statistician. For the association of variables, categorical variables were compared for association and a chi-square test was performed with the significance level set at p=0.05 or less. Results: A total of 121 questionnaires were completed by optometrists working in the North-West Province. The majority of the participants were Black African (96%) and 53.8% with 6 years or more of working experience. There was a significant difference (p=0.011) in the number of years spent in practice and fitting of contact lenses. One hundred and one (83.5%) participants indicated that they fitted contact lens in the practices, with the majority fitting soft lens (73.9%) and few scleral lens (6.7%). There was no significant difference in whether participants fitted contact lens by gender (p=0.333), and by race (p=0.310). Many indicated having a keratometer (86.8%), followed by a slit lamp biomicroscope with very few corneal topographers (5%). There was a significant difference (p=0.039) in contact lens fitting between participants having slit lamp biomicroscopy and those without contact lens fitting. A mean score of 4.74±0.56 was calculated for the self-reported competencies of contact lens fitting suggesting an excellent rating. Eighty-nine (72.2%) indicated that they referred vi keratoconus patients followed by myopia (70.7%). Participants reported keratoconus as the most common corneal ectasia (84%) followed by pellucid marginal degeneration (32%) among patients presenting in different settings. Lens use and personal hygiene (46.3%) followed by the importance of aftercare (12.4%) were highlighted as the most important factors that formed part of contact lens patient education. Conclusion: To guarantee the effective utilisation of contact lens wear and fitting, optometrists require sufficient clinical knowledge and skills in screening and examination of different ocular conditions. There is a need for the rein-enforcement of relevant continued clinical training and working resources for contact lens-related practices to improve service provision Thesis (M. Optom.) -- University of Limpopo, 2023

A comparative study of a subjective heterophoria testing with a phoropter and trial frame among health science students at University of Limpopo, South Africa

2022-04-09T01:00:15Z

A comparative study of a subjective heterophoria testing with a phoropter and trial frame among health science students at University of Limpopo, South Africa Tsotetsi, Annah Lerato Background: There are several clinical techniques for the subjective measurement of heterophoria. In South Africa, von Graefe is one of the most commonly used techniques to quantify heterophoria using the phoropter. However, most rural community clinics have trial frames rather than phoropters to perform heterophoria measurements and other clinical tests. Heterophoria or phoria is the misalignment of an eye that occurs when binocular sensory fusion is blocked. The distance heterophoria is determined by the tonic vergence resting state and negative accommodative vergence. In distance vision, normal heterophoria is zero. The tonic vergence resting state is the vergence angle dictated by tonic vergence innervation alone. However, during a near heterophoria test, the vergence angle observed involves multiple innervational factors. Blocking binocular fusion eliminates disparity vergence innervation. Because of the dual interaction, the loss of disparity vergence innervation initiates simultaneous changes of accommodation innervation. Purpose: The purpose of the study was to investigate the agreement of von Graefe heterophoria measurement using the phoropter and a trial frame. Setting: The study was conducted at an Optometry Clinic, University of Limpopo, South Africa. Methods: Distance and near horizontal and vertical heterophoria measurements were performed on 88 visually-normal university students using the phoropter and a trial frame. The 95% limits of agreement were compared using the exact Bland-Altman statistical test. To measure the horizontal heterophoria, 12 prism base-in was placed before the right eye and 6 prism base-up before the left eye. The prism in front of the right eye was reduced until the participant reported that the two images were vertically aligned. The vertical heterophoria was measured by reducing the prism in front of the left eye until the participant reported that the two images were horizontally aligned. Zero deviation was recorded as ortho or orthophoria. Results: For distance horizontal heterophoria, the Von Graefe values were 0.39±2.0 and 0.38±1.8Δ with the phoropter and trial frame, respectively. The mean near v horizontal heterophoria were 3.69±3.3 and 4.13±3.27Δ with the phoropter and trial frame. There were no significant differences between the mean heterophorias measured using the phoropter and the trial frame, p ˃ 0.05. For the vertical heterophorias at distance and near vision, the means were close to orthophoria. The mean differences and limits of agreement showed good agreement of Von Graefe test using the phoropter and trial frame. Conclusion: Measurement of Von Graefe testing with the phoropter and trial frame showed a high level of agreement for both distance and near vision performed through the phoropter and a trial frame. For clinical and research purposes, the phoropter and trial frame can be used interchangeably for measuring heterophoria. Keywords: heterophoria, phoropter, trial frame, von Graefe, prism Thesis (M. A. (Optom.)) -- University of Limpopo, 2021