The high proportion of avoidable blindness, with half being attributable to cataract alone and uncorrected refractive errors being responsible for 57% of moderate visual impairment, means that appropriate and accessible refraction and surgical services need to be provided. If priority attention is not given, the number of blind and severely visually impaired adults in Nigeria will increase by >40% over the next decade.

There was a high prevalence of diabetes, DR and STDR. It was possible to assess diabetes and DR within RAAB but it increased the survey duration, cost and complexity.

Aims-A population based cross sectional survey was conducted to determine the magnitude of cataract blindness and the barriers to uptake of cataract services in a rural community of northern Nigeria. Methods-1461 people out of 1924 registered eligible people were examined. The study population was chosen by two stage cluster random sampling. In the first sampling stage 15 villages were randomly chosen while in the final stage 170 people who were 40 years and over were selected in each village. Each selected person had visual acuity recorded for both eyes. Those with vision of less than 3/60 in the better eye were assessed for cataract. People with cataract were asked why they had not sought medical attention. Results-A blindness prevalence of 8.2% (95% CI 5.8%-10.5%) was found among the sampled population. Cataract was responsible for 44.2% of the blindness. Thus, a cataract blindness prevalence of 3.6% was found. The cataract surgical coverage (people) was 4.0% and the couching coverage (people) was 18%. The main barrier to seeking cataract surgery was cost of the service (61%). Conclusion-Some regions of the world still have high burden of cataract blindness that needs attention. Such areas need an eVective free cataract outreach programme. (Br J Ophthalmol 2001;85:776-780) Cataract is responsible for about 16 million blind people worldwide. The burden of blindness is more in remote rural communities of developing countries.1 These countries are characterised by high backlog of unoperated cataract and increasing incidence of cataract due to population ageing. However, these countries have inadequate and ineYcient cataract surgical service. For these regions of the world, it becomes imperative to develop a cost eVective, sustainable service delivery system for cataract surgery. However, this is only possible with relevant data on the magnitude of the cataract blind in the areas and also information on factors that hinder the people from accessing such sight restoring services in the areas. This is important because various studies 2 had revealed that availability of eye care services in such communities may not necessarily translate into appropriate utilisation.There has evolved a rapid form of cataract blindness assessment in communities.3 This involves surveying the most vulnerable portion of the community-that is, the elderly, since cataract blindness (senile cataract) occurs mainly in old age.A study was planned to determine the number of cataract blind and the barriers to cataract surgery uptake among people 40 years and above in a rural community of northern Nigeria. The study was also to determine the cataract surgical and couching coverage and to assess the visual outcome of cataract surgery and couching in the area. Materials and methodsThe study was a population based cross sectional survey of people 40 years and above in a rural community of Katsina State, northern Nigeria and was conducted in the months of April and May 1999. SAMPLE SIZE DETERMINATIONThe SAMPLE XS computer program using t...

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Background: Despite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken to estimate the prevalence and determine the major causes of blindness and low vision. This paper presents the detailed methodology used during the survey.