Prevalence of Posterior Segment Disease in Subjects Screened for Cataract- A Retrospective Study

Abstract

Introduction: Glaucoma, retinal vein occlusion and diabetic retinopathy are the common posterior segment diseases affecting the eye and need to be specifically looked for in the community by Intra Ocular Pressure (IOP) measurement and a dilated fundus examination. Cataract screening alone in eye camps might not be adequate to prevent and treat these causes of blindness. Aim: To establish the need for routine screening of posterior segment diseases at primary and secondary eye care level by estimating the prevalence of this diseases in patients presenting with cataract in order to prevent avoidable blindness. Materials and Methods: This was a retrospective observational study conducted at Tertiary Care Hospital comprising of 1109 subjects who were screened for cataract and underwent cataract surgery, at screening camps from semi urban and rural localities in and around Hyderabad city between October 2018-March 2019. All subjects underwent detailed ophthalmic evaluation including visual acuity assessment, applanation tonometry, slit lamp examination and dilated fundus examination. Prevalence of blindness and moderate to severe visual impairment caused by posterior segment disease among these patients was analysed. Percentage distribution of the data was calculated mathematically. Results: Of the 1109 subjects, posterior segment diseases causing blindness was seen in 0.63%, severe visual impairment in 0.99% and moderate visual impairment in 3.78%. Glaucomatous optic neuropathy was the most common posterior segment disease followed by retinal vein occlusion and diabetic retinopathy in that order. Diabetes Mellitus (DM) and Hypertension (HTN) were associated with increased risk of glaucoma. Conclusion: Routine screening for posterior segment disease is recommended with the use of portable fundus cameras in the elderly population along with IOP measurement using hand held portable tonometer in screening camps in order to reduce the burden of avoidable blindness. Monitoring of life style diseases like HTN and DM at the time of cataract screening is needed for primary prevention of most of these diseases of the eye.