Demographic, socio-economic and clinical characteristics: implications for time to presentation at a Nigerian tertiary ophthalmic outpatient population

• At UNTH, Enugu, the majority of new adult ophthalmic outpatients present late.
• Old age, female gender and sub-normal presenting visual acuity were the main causes.
• Individual-level deprivation and distance barrier were less important causes.

ObjectiveTo investigate the associations between time to presentation, and sociodemographic and clinical characteristics of new adult ophthalmic outpatients at the University of Nigeria Teaching Hospital (UNTH), Enugu, between March and August 2010.Study designHospital-based case–control study.MethodsConsecutive new ophthalmic outpatients at UNTH were categorized into controls (early presenters, i.e. <3 months after onset of current eye disease) and cases (late presenters, i.e. >3 months after onset of current eye disease). Relevant data were obtained from the participants' case notes and interviews. Descriptive statistics yielded frequency distributions; bivariate and multivariate comparisons were used to test the significance of associations. P < 0.05 was considered to indicate significance.ResultsEight hundred and twenty-four subjects [454 males and 370 females, mean age 39.2 (standard deviation 1.2) years, range 19–82 years] participated in this study. There were 370 early presenters and 454 late presenters. Multivariate analysis found that late presentation was significantly associated with age >50 years [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.28–2.22; P < 0.01], female gender (OR 1.63, 95% CI 1.52–2.11; P < 0.01), residence >20 km from UNTH (OR 0.65, 95% CI 0.38–0.89; P = 0.0212), individual-level deprivation (OR 0.69, 95% CI 0.55–0.92; P = 0.0324) and subnormal visual acuity at presentation (OR 1.32, 95% CI 1.05–1.76; P = 0.0353).ConclusionsAt UNTH, most new adult ophthalmic outpatients present >3 months after onset of their current eye disease. Measures to overcome age-, gender- and distance-related causes of late presentation, grassroots economic empowerment of the feeder population and public education about eye health are required.