High cataract surgical rate and universal eye-care delivery model for elimination of cataract blindness in Theni District, India

Session Details

Session Title: Orbis Treatment and Prevention of Blindness in the Developing World

Session Date/Time: Monday 16/09/2019 | 12:15-12:51

Paper Time: 12:33

Venue: West 7

First Author: : A.Vardhan S INDIA

Co Author(s): :    L. Pooludaiyar   V. Kumar   S. Kumar   K. Raja   T. Ravilla                 

Abstract Details

Purpose:

High cataract surgical rate (CSR) in a district is thought to be effective in achieving elimination of blindness due to cataract. Theni district in India has had a high CSR of >8000 in the recent years. Aravind Eye hospital, which is the the major eye care provider here has been doing various innovative eye care delivery services towards universal coverage. It will be worthwhile to know the present status of blindness due to cataract in this district and identify potential risk factors for it. This will let us know how close are we in attaining the goals of vision 2020

Setting:

Population based cross sectional study done among residents 40 years and above in 34 randomly selected cluster locations in Theni district, Tamil Nadu State, India.

Methods:

10,144 subject’s ≥ 40 years were consented and enumerated in their households. They were then referred for a full eye examination conducted by the medical team within the cluster. The medical team did Visual acuity testing, comprehensive eye examination, and interview to understand previous eye care service usage and eye glass usage by the subjects. After the examination the doctor assigned Visual Impairment(VI) status and cause for VI to the subject. The crude and age gender adjusted prevalence of VI, blindness were calculated. Multivariate logistic regression analysis was done to know the association of various risk factors with VI.

Results:

Of the 10,144 subjects enumerated, 7127 subjects (70.3%) had completed the eye examination. Females had a better response rate than men (78.5% vs 61.4%). Examination showed that overall 89.9 % of males and 85.9% females had normal vision. In the remaining subjects who had subnormal vision; cataract was responsible for 55.3 % of blindness and 77.6% of visual impairment. Age and gender adjusted prevalence of blindness due to cataract is 0.26%, Moderate VI 0.8%, Severe VI 0.34%. Factors such as increasing age, living alone without spouse, being illiterate, lower socioeconomic status were showing significant association with VI due to cataract.

Conclusions:

In this epidemiological study we find that the visual impairment and blindness rates in Theni district are very low compared to other studies reported from India. This shows some evidence on the impact of having a higher cataract surgical rate and universal eye care service delivery model in Theni district. The risk factors found will help the eye care providers in developing specific targeted strategies to combat the problem. Similar eye care delivery systems and studies can be replicated elsewhere in the developing world to attain the stated goals of vision 2020.

Financial Disclosure:

None