Abstract:
Background: The red reflex test is an assessment for the clarity of ocular media which
is useful for early detection of preventable sight-threatening conditions like congenital
cataract, congenital glaucoma and corneal opacity. Early detection and timely referral
for ophthalmological review of patients with abnormal red reflex prevents visual
impairment, amblyopia and even save life of newborns affected by retinoblastoma.
Prevalence and causes of abnormal red reflex test remains unknown at Muhimbili
National Hospital.
Aim: Screening newborns to determine the prevalence and causes of abnormal red
reflex test at Muhimbili National Hospital.
Methodology: A hospital-based descriptive cross-sectional study was conducted at
Muhimbili National Hospital in maternal and neonatal wards. Systematic sampling of
1,153 newborns was done to recruit 315 study participants. Red reflex test was
performed using direct ophthalmoscope to detect causes of abnormal red reflex test. Collected data was captured on a structured questionnaire. Data was analyzed using
Statistical Package for Social Sciences version 23. Statistical tables and charts were
used to present the results.
Results: Abnormal red reflex test was observed in 101 (32.1%) and the most common
cause was vacuolated lens seen in 26 (25.7%) newborns followed by 23 (22.8%) retinal
hemorrhage and 21 (20.7%) persistent pupillary membrane. Other visually significant
causes were refractive errors in 18 (17.8%) newborns followed by 4 (4.0%) retinopathy
of prematurity and 3 (3.0%) congenital cataract.
Conclusion: The prevalence of abnormal red reflex test among newborns at Muhimbili
National Hospital is high. The commonest causes of abnormal red reflex test were
vacuolated lens followed by retinal hemorrhages and persistent pupillary membrane.
