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

Abstract

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.