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Lalit Dandona, Rakhi Dandona, Marmamula Srinivas, Pyda Giridhar, Kovai Vilas, Mudigonda N. Prasad, Rajesh K. John, Catherine A. McCarty, Gullapalli N. Rao; Blindness in the Indian State of Andhra Pradesh. Invest. Ophthalmol. Vis. Sci. 2001;42(5):908-916.
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purpose. To determine the current prevalence and causes of blindness in the
Indian state of Andhra Pradesh to assess if blindness has decreased
since the last survey of 1986–1989.
methods. A population-based epidemiology study, using a stratified, random,
cluster, systematic sampling strategy, was conducted in the state of
Andhra Pradesh in India. Participants of all ages
(n = 10,293), 87.3% of the 11,786 eligible, from
94 clusters in one urban and three rural areas representative of the
population of Andhra Pradesh, underwent interview and a detailed
dilated ocular evaluation by trained professionals. Blindness was
defined as presenting distance visual acuity < 6/60 or
central visual field < 20o in the better eye.
results. Two hundred seventy-five participants were blind, a prevalence of
1.84% (95% confidence interval, 1.49%–2.19%) when adjusted for the
age, sex, and urban–rural distribution of the population in 2000. The
causes of this blindness were easily treatable in 60.3% (cataract,
44%; refractive error, 16.3%). Preventable corneal disease, glaucoma,
complications of cataract surgery, and amblyopia caused another 19% of
the blindness. Blindness was more likely with increasing age and
decreasing socioeconomic status, and in female subjects and in rural
areas. Among the 76 million population of Andhra Pradesh, 714,400 are
estimated to have cataract-related blindness (615,600 cataract, 53,200
cataract surgery-related complications, 45,600 aphakia), and 228,000
refractive error-related blindness (159,600 myopia, 22,800 hyperopia,
45,600 refractive error-related amblyopia). If 95% of the cataract and
refractive error blindness in Andhra Pradesh had been treated
effectively, 3.4 and 7.4 million blind-person-years, respectively,
could have been prevented. If 90% of the blindness due to preventable
corneal disease and glaucoma had been prevented, another 2.7 million
blind-person-years could have been prevented.
conclusions. The prevalence of blindness in this Indian state has increased from
1.5% in the late 1980s to 1.84% currently, as against the target of
the National Program for Control of Blindness to reduce the prevalence
to 0.3% by 2000. The number of people with cataract-related blindness
has not reduced even with the eye care policy focus on cataract.
Reduction of blindness in India will require strategies that are more
effective than those that have been pursued so
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