Prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma in Bhaktapur district of Nepal: The Bhaktapur Glaucoma Study

<p>Abstract</p> <p>Background</p> <p>Cataract and glaucoma are the major causes of blindness in Nepal. Bhaktapur is one of the three districts of Kathmandu valley which represents a metropolitan city with a predominantly agrarian rural periphery. This study was undertaken to determine the prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma among subjects residing in this district of Nepal.</p> <p>Methods</p> <p>Subjects aged 40 years and above was selected using a cluster sampling methodology and a door to door enumeration was conducted for a population based cross sectional study. During the community field work, 11499 subjects underwent a structured interview regarding awareness (heard of) and knowledge (understanding of the disease) of cataract and glaucoma. At the base hospital 4003 out of 4800 (83.39%) subjects underwent a detailed ocular examination including log MAR visual acuity, refraction, applanation tonometry, cataract grading (LOCSΙΙ), retinal examination and SITA standard perimetry when indicated.</p> <p>Results</p> <p>The age-sex adjusted prevalence of blindness (best corrected <3/60) and low vision (best corrected <6/18 ≥3/60) was 0.43% (95%C.I. 0.25 - 0.68) and 3.97% (95% C.I. 3.40 - 4.60) respectively. Cataract (53.3%) was the principal cause of blindness. The leading causes of low vision were cataract (60.8%) followed by refractive error (12%). The cataract surgical coverage was 90.36% and was higher in the younger age group, females and illiterate subjects. Pseudophakia was seen in 94%. Awareness of cataract (6.7%) and glaucoma (2.4%) was very low. Among subjects who were aware, 70.4% had knowledge of cataract and 45.5% of glaucoma. Cataract was commonly known to be a 'pearl like dot' white opacity in the eye while glaucoma was known to cause blindness. Awareness remained unchanged in different age groups for cataract while for glaucoma there was an increase in awareness with age. Women were significantly less aware (odds ratio (OR): 0.63; 95%, confidence interval (CI): 0.54 - 0.74) for cataract and (OR: 0.64; 95% CI: 0.50 - 0.81) for glaucoma. Literacy was also correlated with awareness.</p> <p>Conclusion</p> <p>The low prevalence of visual impairment and the high cataract surgical coverage suggests that cataract intervention programs have been successful in Bhaktapur. Awareness and knowledge of cataract and glaucoma was very poor among this population. Eye care programs needs to be directed towards preventing visual impairment from refractive errors, screening for incurable chronic eye diseases and promoting health education in order to raise awareness on cataract and glaucoma among this population.</p

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Sagarmatha (2009)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Seti and Mahakali (2008)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Dhaulagiri (2010)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Rapti (2010)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Karnali (2008)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Mechi (2009)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Nepal, Bheri (2009)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Visual impairment among weaving communities in Prakasam district in South India.

PURPOSE: To assess the prevalence and causes of visual impairment in weaving communities in Prakasam district in South India state of Andhra Pradesh. METHODS: Using Rapid Assessment of Visual Impairment (RAVI) methodology, a population based cross-sectional study was conducted. A two-stage sampling strategy was used to select 3000 participants aged ≥40 years. Visual Acuity (VA) was assessed using a tumbling E chart and ocular examinations were performed by trained Para medical ophthalmic personnel. A questionnaire was used to collect personal and demographic information. Blindness and moderate Visual Impairment (VI) was defined as presenting VA <6/60 and <6/18 to 6/60 respectively. VI included blindness and moderate VI. RESULTS: 2848 of 3000 enumerated subjects (94.0%) participated. 39% were in 40-49 years age group and 11.8% were aged ≥70 years, 55% were women and nearly half of them had no formal education. 400 (14%; 95% CI: 12.8-15.3) subjects had VI, including blindness in 131 (4.6%; 95% CI: 3.8-5.4) and moderate VI in 269 (9.4%; 95% CI: 8.3-10.5) individuals. On applying multiple logistic regression, VI was significantly associated with older age and no formal education. Though the odds of having VI were higher in females, it was of borderline statistical significance (p = 0.06). Refractive error was the leading cause of all VI followed by cataract (56%). However, refractive errors were the leading cause of moderate VI (73.2%) and cataract was the leading cause of blindness (62.6%). 'Cannot afford the cost of services' was the leading barrier for utilization of eye care services (47%). CONCLUSIONS: There is a significant burden of VI in weaving communities in Andhra Pradesh, India most of which is avoidable. With this information as baseline, services need to be streamlined to address this burden