The Nakuru Eye Disease Cohort Study

The study team lead by Dr Bastawrous in Nakuru

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


Establishing strategies for the prevention and control of eye diseases in Africa

This large cohort study of eye disease is the first in Sub-Saharan Africa and aims to assess the six-year incidence and progression of blindness and visual impairment as well as specific diseases including:

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

in a Kenyan population aged 50 and over as a follow up of our 2007 study on posterior segment eye disease in Nakuru, Kenya. Although data now exists on the prevalence of eye diseases from multiple surveys, no data on incidence (new cases) and progression (change over time) exists. The findings of this study will provide valuable information for the planning and targeting of eye services in the region.

The findings from this study will contribute to establishing diagnostic and prevention strategies, advocacy for provision of resources and identification of high-risk groups. Specifically, Africa is on the cusp of a diabetes epidemic and the impact of DR needs to be assessed. People from various African populations appear to be more vulnerable to glaucoma however, currently no incidence and progression data exists. The baseline data on ARMD suggests this disease presents differently in the Kenyan population, and it is important to assess how it progresses.

During the study, project leader Andrew Bastawrous and Stewart Jordan developed and tested Peek, a revolutionary new smartphone system for comprehensive eye examinations designed to be used in even the remotest of settings. Patients in the study underwent both a comprehensive ophthalmic assessment and examination by community health care workers using Peek. The results were compared with the measures taken as part of the Cohort study to ensure that Peek is not only effective but accurate.

Peek – Portable eye examination kit

Peek is being developed by ICEH/LSHTM in collaboration with the University of Strathclyde and the Glasgow Centre for Ophthalmic Research.  Peek is easy to use, affordable and portable. Peek aims to empower general health workers and eye care practitioners to diagnose eye diseases and provide a means for managing and monitoring the treatment of patients, anywhere in the world.

To find out more visit the ICEH Peek website.


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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