Prevalence and Characteristics of Eye Problems Reported in an East African Refugee Camp: A Cross-Sectional Survey

Despite efforts to improve global access to basic ophthalmologic services, there remains a paucity of data regarding the prevalence of untreated ocular disease among forced migrants and refugees, particularly in east Africa. We aimed to estimate the prevalence of untreated and surgically amenable eye conditions among refugees in Nyarugusu Refugee Camp, Tanzania, and to identify factors associated with untreated eye problems. We conducted cluster-randomized sampling using the cross-sectional Surgeons OverSeas Assessment of Surgical Needs (SOSAS) survey tool to assess prevalence of surgical eye disease and access to health services among refugees in Nyarugusu from August-September 2021. Descriptive analysis and multivariable logistic regression were performed to explore associations between covariates and the presence of unresolved eye problem(s). Among 3574 refugees, 12% (n=430; mean age 36±20 yrs.) reported eye issues. Of these, 296 (69%) further characterized their problems, with 44% reporting acquired disability and 42% non-injury-related wounds. Of the 368 (86.4%) who described their issues as disabling, 78.8% endorsed a negative impact on ability to work and 27.7% required help with daily living. Most were currently (84.6%; 357/427) and chronically affected (>12 months; 88.3%; 378/428). Farming and housewife occupations were positively associated with unresolved eye problem(s). Among 312 (72.7%) who sought care, only 13 (4.2%) underwent surgery. Nearly half (136) of 279 surveyed individuals self-reported potential surgical needs, citing barriers to surgical care such as lack of available services, financial and time constraints, and limited knowledge about accessing treatment. In conclusion, nearly 1 in 8 refugees endorsed chronic and disabling eye problems, negatively impacting their work and daily life. Most who may benefit from surgery have not received care due to significant barriers and gaps in ophthalmologic services. Further investigation to better characterize specific ocular etiologies in under-resourced protracted refugee settings can inform resource allocation strategies to address unmet eye care needs.