Abstract
BackgroundReliable data are a pre-requisite for planning eye care services. Though conventional cross sectional studies provide reliable information, they are resource intensive. A novel rapid assessment method was used to investigate the prevalence and causes of visual impairment and presbyopia in subjects aged 40 years and older. This paper describes the detailed methodology and study procedures of Rapid Assessment of Visual Impairment (RAVI) project.MethodsA population-based cross-sectional study was conducted using cluster random sampling in the coastal region of Prakasam district of Andhra Pradesh in India, predominantly inhabited by fishing communities. Unaided, aided and pinhole visual acuity (VA) was assessed using a Snellen chart at a distance of 6 meters. The VA was re-assessed using a pinhole, if VA was < 6/12 in either eye. Near vision was assessed using N notation chart binocularly. Visual impairment was defined as presenting VA < 6/18 in the better eye. Presbyopia is defined as binocular near vision worse than N8 in subjects with binocular distance VA of 6/18 or better.ResultsThe data collection was completed in <12 weeks using two teams each consisting of one paramedical ophthalmic personnel and two community eye health workers. The prevalence of visual impairment was 30% (95% CI, 27.6-32.2). This included 111 (7.1%; 95% CI, 5.8-8.4) individuals with blindness. Cataract was the leading cause of visual impairment followed by uncorrected refractive errors. The prevalence of blindness according to WHO definition (presenting VA < 3/60 in the better eye) was 2.7% (95% CI, 1.9-3.5).ConclusionThere is a high prevalence of visual impairment in marine fishing communities in Prakasam district in India. The data from this rapid assessment survey can now be used as a baseline to start eye care services in this region. The rapid assessment methodology (RAVI) reported in this paper is robust, quick and has the potential to be replicated in other areas.
Highlights
Reliable data are a pre-requisite for planning eye care services
Of the 1700 subjects enumerated from 34 clusters, 1560 (91.8%) were available for examination
The current study revealed that the prevalence of blindness and moderate visual impairment was 7%, and 23.0% respectively compared to blindness prevalence of 8% and visual impairment of 16.5% in Rapid Assessment of Avoidable Blindness (RAAB) survey in India [19]
Summary
Reliable data are a pre-requisite for planning eye care services. Though conventional cross sectional studies provide reliable information, they are resource intensive. A novel rapid assessment method was used to investigate the prevalence and causes of visual impairment and presbyopia in subjects aged 40 years and older. This paper describes the detailed methodology and study procedures of Rapid Assessment of Visual Impairment (RAVI) project. Cataract and uncorrected refractive errors constitute the leading causes of visual impairment in most parts of the developing world, including India [1]. Rapid Assessment of Cataract Surgical Services (RACSS) is one of the earliest of rapid assessment methods used in eye care [12]. The Rapid Assessment of Avoidable Blindness (RAAB) is a recent rapid assessment method that is more comprehensive and includes all the causes of visual impairment [7,13]
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