Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India

Abstract

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort ( P < 0.001 ). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 ( P < 0.001). Females ( P < 0.001) and older individuals ( P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years. Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Determinantes sociales de la ceguera y deficiencia visual y estrategias de prevención: análisis y experiencia desde el ámbito de la salud visual

“…Un ejemplo de la creación parcial de este sistema fue en el distrito de Pune, en Maharasthra, donde, después de un seguimiento de cuatro años de un mismo centro de visión de los que habían sido construidos cercanos a la comunidad, se pudo observar que la prevalencia de ceguera y deficiencia visual se redujeron significativamente. No obstante, es importante señalar que este mismo estudio percibe al inicio de este una brecha de acceso entre hombres y mujeres que no desaparece en esos cuatro años (Gogate et al, 2022).…”

Primary eye care – Key to universal eye health

“…This article in this issue by Gogate et al . [ 5 ] is probably the first publication to document the impact of VC services on blindness and vision impairment. The authors have leveraged their service delivery model that integrated door-to-door visual acuity assessment, documentation, case finding, and referral to the VC that was being established.…”