Abstract
BackgroundUniversal access to Primary Eye Care (PEC) is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI). PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE) and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa.MethodsA national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12) was assessed using Portable Eye Examination Kit (PEEK); URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions) were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression.Results4618 participants were examined and interviewed out of 5361 enumerated (86% response rate). The adjusted population prevalence of VI was 3.7% (95%CI = 3.0–4.5%), URE was 2.2% (95%CI = 1.7–2.8%) and overall need for PEC was 34.0% (95%CI = 31.8–36.4%). Women and older people were more likely to need PEC and require a referral.ConclusionsNearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women.
Highlights
Vision loss is a leading cause of disability worldwide
A third of the population in Rwanda has the potential to benefit from Primary Eye Care (PEC), with greater need identified in older people and women
Population need for primary eye care in Rwanda: A national survey population who could benefit from primary eye care
Summary
Vision loss is a leading cause of disability worldwide. An estimated 624 million people live with visual impairment (VI), including 19 million children. [1] Visual impairment infers a considerable economic burden to the individual, family and society through the costs of lost productivity and care.[2]. The most common cause of VI is uncorrected refractive error (URE), where the eye fails to focus light rays clearly onto the retina.[4] The resulting blurred vision can be corrected with glasses. An age related decline in near vision due to loss of lens elasticity (presbyopia) is common, and correctable with glasses. Universal access to Primary Eye Care (PEC) is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI). PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE) and create a referral pathway for specialist eye care, offering a potential solution to a lack of eye health specialists in low-income countries. There is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa
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