Patterns and Causes of Adult Blindness in a Tertiary Ophthalmic Center in Somalia: The Burden of Trauma-Related Visual Loss

Abstract

Purpose To describe the patterns and causes of adult blindness in patients attending a tertiary ophthalmic center in Somalia, to examine age- and gender-related associations with major causes of blindness, and to assess the contribution of trauma-related visual loss. Methods A retrospective cross-sectional study was conducted using medical records of all eligible patients aged 16 years and older evaluated at a tertiary ophthalmic center in Mogadishu, Somalia, between January and December 2025. Demographic characteristics, blindness laterality, and clinical causes were extracted from electronic medical records jointly by the two investigators and recorded in a Microsoft Excel spreadsheet. Descriptive analyses and multivariable logistic regression were performed to evaluate the distribution of blindness and age- and gender-related associations with major causes of blindness. Results Of 10,000 patient records screened, 9740 met the eligibility criteria and were included in the analysis. Among these, blindness was identified in 1236 patients (12.7%), of whom 77.9% had unilateral blindness and 22.1% had bilateral blindness. Cataract was the leading cause of blindness overall, followed by trauma-related ocular disease, glaucoma, and corneal opacity. Trauma-related conditions predominated among younger adults, whereas cataract and glaucoma were more common in older age groups. Corneal opacity related to microbial keratitis or undetermined corneal scarring remained among the leading causes of unilateral blindness across age groups. Conclusions Adult blindness in this hospital-based population reflected distinct age-related patterns, with trauma-related visual loss predominating among younger adults and age-related ocular diseases among older individuals. Corneal opacity remained an important cause of unilateral blindness across age groups. These findings have important implications for ophthalmic care in resource-limited settings.