‘Prevalence and causes of abnormal red reflex test in newborns at Muhimbili National Hospital`

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.