Elsevier

Ophthalmology

Volume 109, Issue 10, October 2002, Pages 1871-1878
Ophthalmology

Planning low vision services in India: A population-based perspective

https://doi.org/10.1016/S0161-6420(02)01183-1Get rights and content

Abstract

Objective

To assess the prevalence and causes of low vision in a population in southern India for planning low vision services.

Design

Population-based, cross-sectional study.

Participants

A total of 10,293 persons of all ages from 94 clusters representative of the population of the Indian state of Andhra Pradesh.

Methods

The participants underwent a detailed eye examination, including measurement of visual acuity with logarithm of the minimum angle of resolution charts, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and stereoscopic dilated fundus evaluation. Automated threshold visual fields and slit-lamp and fundus photography were done when indicated using predefined criteria.

Main outcome measures

Low vision was defined as permanent visual impairment that was not correctable with refractive error correction or surgical intervention. The participants with best-corrected distance visual acuity <6/18 to perception of light or central visual field <10° because of an untreatable cause in both eyes were considered as having low vision.

Results

Low vision was present in 144 participants, an age, gender, and urban-rural distribution adjusted prevalence of 1.05% (95% confidence interval, 0.82%–1.28%). The most frequent causes of low vision included retinal diseases (35.2%), amblyopia (25.7%), optic atrophy (14.3%), glaucoma (11.4%), and corneal diseases (8.6%). Multivariate analysis showed that the prevalence of low vision was significantly higher with increasing age, and there was a trend for higher prevalence with decreasing socioeconomic status. Extrapolating these data to the estimated 1014 million population of India in the year 2000, 10.6 (95% confidence interval, 8.4–12.8) million people would have low vision.

Conclusions

These data imply that there is a significant burden of low vision in this population, suggesting the need for low vision services.

Section snippets

Study design

Various aspects of the study design of the Andhra Pradesh Eye Disease Study (APEDS) have been described previously.3, 4, 5, 6, 7, 8 A brief description of the sampling procedure follows. A multistage sampling procedure was used to select 24 urban clusters and 70 rural clusters from one urban and three rural areas from different parts of the southern Indian state of Andhra Pradesh, with the aim of having a study sample representative of the urban-rural and socioeconomic distribution of the

Results

Of the 11,786 eligible subjects, 10,293 (87.3%) participated in the study from the four areas of APEDS. Of these, 7775 (75.3%) were from the three rural areas, 5439 (52.8%) were females, and 122 (1.2%) were examined at home.

Discussion

The APEDS was a cross-sectional population-based study representative of the population of Andhra Pradesh in which the participants underwent a detailed eye examination. This allows us to comment on low vision for the population at large.

Acknowledgements

The authors acknowledge the guidance of Dr. Catherine A. McCarty and Prof. Hugh R. Taylor in the study design.

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  • Cited by (0)

    Support for the Andhra Pradesh Eye Disease Study was provided by the Hyderabad Eye Research Foundation, Hyderabad, India, and Christoffel-Blindenmission, Bensheim, Germany. Dr. Rakhi Dandona was supported in part by the R. B. McComas and Hugh Noel Puckle scholarships from the University of Melbourne, Melbourne, Australia.

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