A population-based eye survey of older adults in a rural district of Rajasthan: I. Central vision impairment, blindness, and cataract surgery


Murthy, GV; Gupta, S; Ellwein, LB; Munoz, SR; Bachani, D; Dada, VK; (2001) A population-based eye survey of older adults in a rural district of Rajasthan: I. Central vision impairment, blindness, and cataract surgery. Ophthalmology, 108 (4). pp. 679-85. ISSN 0161-6420 DOI: https://doi.org/10.1016/S0161-6420(00)00579-0

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Abstract

PURPOSE: To assess the prevalence of central vision blindness and cataract surgery in older adults in rural northwest India. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 4284 examined persons 50 years of age or older. METHODS: A random selection of village-based clusters was used to identify a population sample in the predominantly rural Bharatpur district of Rajasthan. Eligible subjects in the 25 selected clusters were enumerated through a door-to-door household survey and invited to village sites for visual acuity testing and eye examination early in 1999. The principal cause of reduced central vision was identified for eyes that had visual acuity worse than 6/18. Independent replicate testing for quality assurance monitoring took place in participants with reduced vision and in a sample of those with normal vision in five of the study clusters. MAIN OUTCOME MEASURES: Presenting and best-corrected visual acuity and lens status. RESULTS: A total of 4728 eligible persons in 2821 households were enumerated, and 4284 (90.6%) were examined. The prevalence of presenting and best-corrected visual acuity worse than 6/60 in both eyes was 11.9% (95% confidence interval: 10.0%-13.9%) and 6.1% (95% CI: 4.7%-7.4%), respectively. Presenting blindness was associated with increasing age, female gender, lack of schooling, and rural residence. Cataract was the principal cause of blindness in one or both eyes in 67.5% of blind persons, with uncorrected aphakia and other refractive error affecting 18.4% in at least one eye. The prevalence of cataract surgery was 12.8% (95% CI: 11.6%-14.0%), with an estimated 65.7% of the cataract blind operated on; low surgical coverage was associated with lack of schooling. CONCLUSIONS: Blindness, particularly blindness because of cataract, continues to be a significant problem among the elderly living in remote areas of rural northwest India. Increased attention should be given to reaching women and the illiterate.

Item Type: Article
Keywords: Age Factors, Aged, Aged, 80 and over, Blindness, Cataract, Cataract Extraction, Cross-Sectional Studies, Educational Status, Female, Health Surveys, Humans, India, Male, Middle Aged, Prevalence, Risk Factors, Rural Population, Vision Disorders, Visual Acuity, Age Factors, Aged, Aged, 80 and over, Blindness, diagnosis, epidemiology, etiology, Cataract, diagnosis, epidemiology, etiology, Cataract Extraction, statistics & numerical data, Cross-Sectional Studies, Educational Status, Female, Health Surveys, Humans, India, epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Rural Population, statistics & numerical data, Vision Disorders, diagnosis, epidemiology, etiology, Visual Acuity
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 11297483
Web of Science ID: 167749400026
URI: http://researchonline.lshtm.ac.uk/id/eprint/8785

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