Changing trends in the prevalence of blindness and visual impairment in a rural district of India: Systematic observations over a decade

Khanna, Rohit C; Marmamula, Srinivas; Giridhar, Pyda; Chakrabarti, Subhabrata; Rao, Gullapalli N

doi:10.4103/0301-4738.100560

Cited by 27 publications

(17 citation statements)

References 24 publications

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“…18 24 25 When compared with results from a previous population-based study conducted in the same state, the prevalence of VI and blindness were about 2.5 times higher than those found in the present study 26. Only limited inferences can be made from comparison of these studies as the age groups and the study settings are different.…”

Section: Discussioncontrasting

confidence: 71%

A cross-sectional study of visual impairment in elderly population in residential care in the South Indian state of Andhra Pradesh: a cross-sectional study

et al. 2013

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ObjectiveTo assess the prevalence and major causes of visual impairment (VI) in elderly residents of ‘home for the aged’ institutions in the Prakasam district in India.DesignCross-sectional study.Setting‘Home for the aged’ institutions in the Prakasam district in the South Indian state of Andhra Pradesh.ParticipantsAll 524 residents in the 26 ‘homes for aged’ institutions in the district were enumerated.Primary and secondary outcome measuresPrevalence and causes of VI; visual acuity (VA) was assessed using a Snellen chart at a distance of 6 m. Pinhole VA was assessed if presenting VA was <6/18. Torchlight examination and direct ophthalmoscopy were performed. VI was defined as presenting VA <6/18 in the better eye.ResultsOf the 494 participants examined (response rate 94.3%), 78.1% were women, 72.1% had no formal schooling. The mean age of participants was 70 years (SD ±8.6 years). VI was present in 280/494 individuals (56.9%; 95% CI 52.3 to 61.3). Over 80% of the VI was due to avoidable causes including cataract (57.1%) and uncorrected refractive errors (26.4%). Among 134 individuals who had undergone bilateral cataract surgery, only 78 (58.2%) individuals had presenting VA ≥6/18 and 13/134 (9.7%) participants were blind.ConclusionsThere is high prevalence of VI in the institutionalised elderly population in the Prakasam district in India. A significant proportion of this elderly population with VI can benefit from spectacles and cataract surgery. Strategies are required to provide high-quality services to this population.

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Section: Discussioncontrasting

confidence: 71%

A cross-sectional study of visual impairment in elderly population in residential care in the South Indian state of Andhra Pradesh: a cross-sectional study

et al. 2013

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“…In fact, population-based studies that were conducted over a decade ago in several parts of India revealed poor outcomes after cataract surgery 18 19. However, technological advances and increase in availability of cataract surgical services support by NPCB are resulting in better outcomes as evidenced by recent publications 20 21. However, efforts are needed to pass this information on to the communities using effective information, education and communication tools so that these barriers are addressed.…”

Section: Discussionmentioning

confidence: 99%

A population-based cross-sectional study of barriers to uptake of eye care services in South India: the Rapid Assessment of Visual Impairment (RAVI) project

et al. 2014

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ObjectiveTo assess the barriers to uptake of eye care services among those with avoidable impairment in the population aged ≥40 years in the South Indian state of Andhra Pradesh.DesignCross-sectional study.SettingCommunity setting.ParticipantsOf 7800 participants recruited from one urban and two rural locations using a two-stage cluster random sampling methodology, 7378 (95%) were examined. Eye examinations were conducted using a rapid assessment protocol. Visual impairment (VI) was defined as presenting visual acuity <6/18 in the better eye. For the purpose of this study, VI caused due to cataract or uncorrected refractive error was considered avoidable VI. A validated questionnaire was used to collect information on barriers for uptake of services among those who had avoidable VI.Primary outcomeBarriers to uptake of services among those with avoidable VI.ResultsThe prevalence of avoidable VI was 11.8% (95% CI 11.0% to 12.5%; n=868). Among these, 71.1% (n=617) individuals reported ‘person-related’ barriers whereas 28.9% (n=251) individuals reported ‘service-related’ barriers to uptake of services. Among the ‘person-related’ barriers, the leading barrier was ‘lack of perceived need’ (61.1%; n=377) for reasons such as old age, good vision in the other eye. This was followed by ‘no one to accompany’ (20.3%; n=125). Of the 251 individuals who had ‘service-related’ barriers, lack of affordability was the major barrier (76.1%; n=191) followed by lack of accessibility (12.7%; n=32). Over 11% (n=28) of the individuals were advised to wait for cataract surgery.ConclusionsPerson-related barriers are more common than service-related barriers in Andhra Pradesh. As the barriers trend more towards ‘person-related’ phenomenon such as person's attitude and ‘felt need’ to improve vision, newer and much intensive awareness campaigns are needed to bring about an attitudinal/behavioural change among individuals to improve the uptake of services.

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“…[23] Only a repeat of this survey after 5–7 years could show the impact of the service delivery model in this region, through there is an evidence for this from other locations in the state. [23], [27] The Warangal district where no intervention is planned may act as a control for future comparisons.…”

Section: Discussionmentioning

confidence: 99%

Visual Impairment in the South Indian State of Andhra Pradesh: Andhra Pradesh - Rapid Assessment of Visual Impairment (AP-RAVI) Project

et al. 2013

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PurposeTo assess the prevalence and causes of visual impairment in urban and rural population aged ≥40 years in the South India state of Andhra Pradesh.MethodsA population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and an urban locations. Visual Acuity (VA) was assessed using a tumbling E chart and eye examinations were performed by trained vision technicians. A questionnaire was used to collect personal and demographic information and previous consultation to eye care providers. Blindness and moderate Visual Impairment (VI) was defined as presenting VA <6/60 and <6/18 to 6/60 in the better eye respectively. VI included blindness and moderate VI.ResultsOf the 7800 subjects enumerated, 7378 (94.6%) were examined. Among those examined, 46.4% were male and 61.8% of them had no education. The mean age of those examined (51.7 years; standard deviation 10.9 years) was similar to those not examined (52.8 years; standard deviation 9.9 years) (p = 0.048). Age and gender adjusted prevalence of VI was 14.3% (95% CI: 13.5–15.0). Refractive errors were the leading cause of VI accounting for 47.6% of all VI followed by cataract (43.7%). Together, they contributed to over 91.3% of the total VI. With multiple logistic regression, the odds of having VI increased significantly with increasing age. Those respondents who had no education were twice (95% CI: 1.7–2.5) more likely to have VI compared to those who were educated. VI was associated with rural residence (OR: 1.3; 95% CI: 1.1–1.6). The association between VI and gender was not statistically significant.ConclusionsThe visual impairment remains a public health challenge in Andhra Pradesh, most of which can be addressed with relatively straight forward interventions like cataract surgery and spectacles. The eye care services need to be streamlined to address this challenge.

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Changing trends in the prevalence of blindness and visual impairment in a rural district of India: Systematic observations over a decade

Cited by 27 publications

References 24 publications

A cross-sectional study of visual impairment in elderly population in residential care in the South Indian state of Andhra Pradesh: a cross-sectional study

A cross-sectional study of visual impairment in elderly population in residential care in the South Indian state of Andhra Pradesh: a cross-sectional study

A population-based cross-sectional study of barriers to uptake of eye care services in South India: the Rapid Assessment of Visual Impairment (RAVI) project

Visual Impairment in the South Indian State of Andhra Pradesh: Andhra Pradesh - Rapid Assessment of Visual Impairment (AP-RAVI) Project

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