A survey of blindness and cataract surgery in Doumen County, China

doi:10.1016/S0161-6420(99)90459-1

Ophthalmology

Volume 106, Issue 8, 1 August 1999, Pages 1602-1608

Presented in part at the Global China Ophthalmology Congress, Beijing, China, August 1998

https://doi.org/10.1016/S0161-6420(99)90459-1 Get rights and content

Abstract

Purpose

To assess blindness prevalence and that caused specifically by cataract in rural southern China.

Design

Population-based, cross-sectional study.

Participants

A total of 5342 persons older than 50 years of age.

Methods

Visual acuity and eye examinations were performed in the summer of 1997 in a random sample of villages in Doumen County. Differences in blindness prevalence associated with age, gender, and education were explored using logistic regression. The survey was preceded by a pilot study in which operational methods were refined and quality assurance measures were performed.

Main outcome measures

Distance visual acuity and lens status.

Results

Bilateral blindness (presenting visual acuity < 0.10) was found in 4.37% (95% confidence interval, 3.67%–5.06%). Blindness was associated with increasing age (P < 0.001) and with the lack of education (P < 0.01). Cataract was the principal cause of blindness in at least one eye in 61.5% of blind people, with refractive error responsible for another 10%. An estimated 40% of the cataract blind were operated on; surgical coverage was lowest among the elderly, women, and those without schooling, although not at statistically significant levels.

Conclusions

Despite the increased attention given to eye care in Doumen County, blindness remains a major public health problem. Cataract surgery is reaching fewer than half of those who could benefit from it.

Section snippets

Methods

The study population was selected by a random sampling of the rural population of Doumen County. The sampling design used village-based clusters of approximately equal size (1000 people). Villages larger than 1500 in population were subdivided into more than 1 cluster, and where geographically practical, villages smaller than 750 were combined. In this fashion, 182 cluster sampling units were created.

Sample size requirements were based on estimating cataract blindness (<0.05 in both eyes) in

Results

Within the 34 randomly selected clusters, 6444 persons 50 years of age and older were enumerated from the village registers. In the smallest cluster, 86 such people were listed, 280 in the largest cluster. The median cluster had 171 people, with quartiles of 150 and 234 persons. Compared with the 1990 census of rural Doumen County as a whole, this register-based enumerated population was under-represented in the 50- to 59-year age group; the difference was statistically significant for men

Discussion

The sampling plan ensured that each individual living within rural Doumen County had an equal chance of being selected for inclusion in the survey. Because a predetermined number of clusters were randomly selected, cluster size had no influence on the chance of an individual being selected. (Each individual had a 34 in 182 chance of being included.) The cluster sampling design, although logistically efficient, had little negative effect on the precision of prevalence estimates. Standard errors

Acknowledgements

The authors thank Mangxuan Hu, MD, Zhongliang Chen, MD, and Jialiang Zhao, MD, for their assistance with project implementation and data analysis; the Doumen County government and the Bureau of Public Health for their cooperation in this survey; and Dominique Negrel, MD, G. P. Pokharel, MD, and Astrid Fletcher, PhD, who, along with one of the authors (LBE), served as an external technical advisory committee.

References (10)

M. He et al.
Visual acuity and quality of life in patients with cataract in Doumen County, China
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J. Zhao et al.
Prevalence of blindness and cataract surgery in Shunyi County, China
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J. Zhao et al.
Visual acuity and quality of life outcomes in patients with cataract in Shunyi County, China
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W. Mao et al.
Survey and treatment of the blind in Xinhui, Guangdong, China
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(1992)
J.J. Xu et al.
An epidemiological survey and treatment of blindness in Kaipin County of Guangdong Province
Chung Hua Yen Ko Tsa Chih
(1992)

There are more references available in the full text version of this article.

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^☆: Supported by a grant from Lions Club International Foundation and by the World Health Organization under National Institutes of Health Contract N01-EY-2103.

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A survey of blindness and cataract surgery in Doumen County, China☆

Abstract

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Section snippets

Methods

Results

Discussion

Acknowledgements

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