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F. Kyari, B. Dineen; The prevalence and causes of blindness and visual impairment and the barriers to the up–take of eye surgery in Borno State, Nigeria . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1065.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:A population–based cross–sectional survey was conducted to identify the prevalence of blindness and visual impairment among adults 30 years and older in Mobbar local government authority (LGA) of Borno State, Nigeria. Barriers to access and up–take of ophthalmic surgery were also assessed. Methods:A total of 1503 subjects (87.7% response rate) were interviewed and examined. The study sample was chosen by two–stage cluster random sampling with probability– proportional–to–size techniques. The first stage consisted of selection of 16 rural villages and 4 urban clusters, while the second sampling stage involved enumeration and examination of 90 adults aged 30 years and older per cluster. Each person underwent logMAR visual acuity (VA) testing and an eye exam, including lens opacity grading and cup:disc ratio assessment. Those with VA of less than 6/18 in one or both eyes were further examined in order to determine the cause of visual loss. Those with operable cataract, glaucoma or trichiasis were asked why they had not sought medical attention. Results:A blindness prevalence of 8.3% (95% CI 7.0 to 9.9%) was found among the sampled population. Cataract was responsible for 56.8% of the blindness, giving a cataract blindness prevalence of 4.72%, and prevalence of blinding bilateral cataract of 2.67%. Post–intervention complications (12.8%) and corneal opacity (10.4%) were the next leading causes of blindness. Trachoma and glaucoma accounted for 4% and 3.2% of blindness, respectively. Women, the aged and rural dwellers were more likely to be blind. The cataract surgical coverage (for persons) was 30% for operable cataracts VA < 6/60. Trichiasis surgical coverage (for persons) was 22% and glaucoma surgical coverage (for persons) was 37.5%. The main barrier to ophthalmic surgery was related to cost and affordability, though nearly one–quarter of respondents did not indicate any specific reason. Conclusions:A comprehensive eye care service to provide good quality high output cataract surgery would address about 75% of blindness in this underserved community.
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