Population eye health in Kenya

The study team lead by Dr Bastawrous in Nakuru

Establishing strategies for the prevention and control of eye diseases in Africa – The Nakuru Eye Disease Cohort Study

This large cohort study of eye disease was the first in Sub-Saharan Africa. A Kenyan population aged 50 and over were followed from our earlier 2007 study on posterior segment eye disease in Nakuru, Kenya. The study assessed the six-year incidence and progression of blindness and vision impairment as well as specific diseases including:

  • Cataract
  • Refractive Error
  • Diabetic retinopathy (DR)
  • Age related macular degeneration (ARMD)
  • Glaucoma

Although data exists on the prevalence of eye diseases from multiple surveys, prior to this study, no data on incidence (new cases) and progression (change over time) was available. The findings of this study provided valuable information for the planning and targeting of eye services in the region, which has now contributed to the establishment of diagnostic and prevention strategies, advocacy for provision of resources and identification of high-risk groups, as well as feeding into the national strategy for eye care.

The following key incidence studies (all open access) have been published with several more available:

Peek Vision

During the study, project leader Andrew Bastawrous and team tested Peek, a revolutionary smartphone assessment and data capture system designed to be used in even the remotest of settings. Patients in the Nakuru Eye Disease Cohort Study underwent both a comprehensive ophthalmic assessment and examination by community health care workers using prototypes of Peek.

Since Peek’s initial development led by ICEH/LSHTM in collaboration with multiple partners, Peek has spun out into a social enterprise.  Peek Vision Ltd develops technology to help eye health providers in low- and middle-income countries improve their services and serve the most difficult to reach populations. Today the Peek system includes smartphone-based vision screening (with the integrated Peek Acuity vision check application), real-time data reporting, eye health service analytics, programme design, and RAAB eye health surveys.  These systems provide data and insights enabling health services to optimise their programmes and deploy limited resources effectively.

To find out more visit the Peek Vision website.


For support of the Nakuru Eye Disease Cohort Study, we would like to thank:


  • Bastawrous A, Rono H, Livingstone IAT, Weiss HA, Jordan S, Kuper H, and Burton M. The Development and Validation of a Smartphone Visual Acuity Test (Peek Acuity) for Clinical Practice and Community-Based Fieldwork. JAMA Ophthalmology, 2015. Article
  • Bastawrous A, Mathenge W, Peto T, Weiss HA, Rono H, Foster A, Burton M, Kuper H. The Nakuru eye disease cohort study: methodology & rationale. BMC Ophthalmol. 2014 May 1;14(1):60. Article
  • Mathenge W, Bastawrous A, Peto T, Leung I, Yorston D, Foster A, Kuper H. Prevalence and correlates of diabetic Retinopathy in a population-based survey of older people in Nakuru, Kenya. Ophthalmic Epidemiol. 2014 Apr 23. Abstract
  • Bastawrous A, Burgess PI, Mahdi AM, Kyari F, Burton MJ, Kuper H. Posterior segment eye disease in sub-Saharan Africa: review of recent population-based studies. Trop Med Int Health. 2014 Jan 31. Abstract
  • Mathenge W, Bastawrous A, Peto T, Leung I, Foster A, Kuper H. Prevalence of Age-Related Macular Degeneration in Nakuru, Kenya: A Cross-Sectional Population-Based Study. PLoS Med. 2013;10(2):e1001393. Epub 2013 Feb 19. Article
  • Ploubidis GB, Mathenge W, De Stavola B, Grundy E, Foster A, Kuper H. Socioeconomic position and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya. Int J Public Health. 2013 Feb;58(1):133-41. Epub 2012 Jul 20. Abstract
  • Mathenge W, Bastawrous A, Foster A, Kuper H. The Nakuru posterior segment eye disease study : Methods and prevalence of blindness and visual impairment in Nakuru, Kenya. Ophthalmology. 2012 Oct;119(10):2033-9. Abstract
  • Sallo FB, Leung I, Mathenge W, Kyari F, Kuper H, Gilbert CE, Bird AC, Peto T; MacTel Study Group. The prevalence of type 2 idiopathic macular telangiectasia in two African populations. Ophthalmic Epidemiol. 2012 Aug;19(4):185-9. Epub 2012 Feb 24. Abstract

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Image credit: The current study team in Nakuru, Kenya. Peek/LSHTM

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