Ocular morbidity, visual impairment and its association with social factors in children attending primary healthcare services for any health-related problem in Pavagada, India – A health facility-based cross-sectional study

Background:

Primary eye healthcare in India has potential for improvement; enhancing it can play a role in universal health coverage, integrated people-centered eye care, and reducing the burden on overloaded secondary/tertiary facilities.

Purpose:

To assess the unmet need for primary eye care services in Pavagada taluk, Karnataka, India, by estimating ocular morbidity, blindness, and visual impairment among children <18 years, attending primary health centers for any health-related issue, and to examine their association with social factors.

Setting and Design:

Health facility-based cross-sectional study in primary health centers in Pavagada.

Methods:

Trained ophthalmic technicians used E charts, red reflex testing, and external examination to screen. Patients with vision <6/9, abnormal red reflex, or external examination were referred to the base hospital.

Statistical Methods:

The data was analyzed using STATA17.

Results:

Of 965 patients screened (mean [SD] age 6.87 [4.97] years), 125 were referred to the base hospital; seventy-two (57.5%) reported. The unmet need was 54% (39/72). Only 9/39 (23%) had major ocular morbidity necessitating secondary/tertiary care. Ocular morbidity was 8.60%, with uncorrected refractive errors predominant (6.84%). Visual impairment rates were lower among children of mothers with 8–12 years of education (13.64%), housewives (7%), upper-middle-class (0%), compared to those with no formal education (25%), non-agricultural laborers (29%), middle (22%), lower-middle class (17%), respectively.

Conclusion:

Pavagada taluk has a significant unmet need for primary eye care services. Addressing this requires improving infrastructure, manpower, and training at existing health centers to provide primary eye care services and alleviate the burden on secondary/tertiary care facilities.