Abstract
Aim: To assess the prevalence of severe visual impairment (SVI) and reasons for not accessing eye care services in a field practice area of a tertiary care hospital.
 Study design: Cross-sectional observational study.
 Materials and methods: Through a cross-sectional study using simple random sampling, a total of 1510, individuals above 18 years of age, from six rural and maternity welfare centers (RMCW) within a distance of 20 km from a tertiary hospital were approached. All participants underwent basic assessment of visual acuity, anterior segment evaluation using torch light, and answered a structured questionnaire on eye care.
 Results: Of 1510 subjects, 267 had SVI (defined as visual acuity < 6/60 either in one or both eyes) with a prevalence of 17.7%. SVI was higher among men and those above 60 years of age (52.8%). Significant association was found between barriers to accessing eye care facilities and lack of knowledge to access health care (p = 0.004), lack of financial support (95% CI, p = 0.006), and social reasons (95% CI, p = 0.028). Prevalence of SVI among diabetics was 32.7% as compared to non-diabetics (OR: 2.630; 95% confidence interval: 1.864–3.712), and among hypertensives was 34.61% as compared to non-hypertensives (OR: 2.836; 95% confidence interval: 1.977–4.068).
 Conclusion: In spite of being close to a tertiary care center, a prevalence of SVI in 17.7% of this population indicates a lack of knowledge regarding the importance of self-health care in subjects. This emphasizes the need to increase the awareness among the general public to access the ophthalmic health care facilities in order to improve the ocular health of the patients.
Highlights
According to a 2010 World Health Organization report on visual impairment (VI) in India, approximately 62.6 million people are visually impaired, 8.01 million are blind, and 54.5 million have low vision.[1]
The reasons for not accessing eye care services are good vision in the other eye, a feeling that there is no need for surgery, a belief that in older age VI is known to happen, fear of surgery, expenses, and lack of caretakers to accompany to the hospital
We aim to provide a snapshot on the prevalence of VI and the reasons for not utilizing eye care services in the areas of six rural and maternity welfare centers (RMCW) attached to a tertiary care center by conducting a house-tohouse survey
Summary
According to a 2010 World Health Organization report on visual impairment (VI) in India, approximately 62.6 million people are visually impaired, 8.01 million are blind, and 54.5 million have low vision.[1] A meta-analysis by Flaxman et al.,[2] as well as other studies,[3] have shown that, as the population increases and ages, common causes of VI are cataract and refractive errors, which are seen more in rural areas. In India, more than 80% patients with cataract blindness who were advised surgery did not take the advice over a 2-year follow-up period because of economic or social constraints.[4,5]. In studies on the impact of successful cataract surgery on quality of life conducted in India, Shamanna et al.[6] and Finger et al.[7] found that overall quality of life improved for patients after cataract surgery. Despite the advantage of free health and eye care services, the majority of Indians living in rural areas are less likely to use eye care services and are more likely to suffer disability-adjusted life years and heavier economic loss.[6,8,9,10] The reasons for not accessing eye care services are good vision in the other eye, a feeling that there is no need for surgery, a belief that in older age VI is known to happen, fear of surgery, expenses, and lack of caretakers to accompany to the hospital
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