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Christian Ezelum, Hessom Razavi, Selvaraj Sivasubramaniam, Clare E. Gilbert, Gudlavalleti V. S. Murthy, Gabriel Entekume, Tafida Abubakar, Nigeria National Blindness and Visual Impairment Study Group; Refractive Error in Nigerian Adults: Prevalence, Type, and Spectacle Coverage. Invest. Ophthalmol. Vis. Sci. 2011;52(8):5449-5456. doi: 10.1167/iovs.10-6770.
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To provide data on prevalence and types of refractive error and the spectacle-wearing rate among adults in Nigeria and the degree to which the need for distance correction could be met by off-the-shelf spectacles.
Multistage, stratified, cluster random sampling with probability proportional to size was used to identify a nationally representative sample of 15,027 persons aged ≥40 years. Distance vision was measured using a reduced logMAR tumbling-E chart. All participants underwent autorefraction, and those with presenting acuity of <6/12 in one or both eyes had their corrected acuity measured and underwent detailed clinical examination to determine the cause.
Included in the survey were 13,599 (89.9%) of the 15,122 persons aged ≥40 years who were enumerated. Uncorrected refractive error was responsible for 77.9% of mild visual impairment (<6/12–6/18), 57.1% of moderate visual impairment (<6/18–6/60), 11.3% of severe visual impairment (<6/60–3/60), and 1.4% of blindness (<3/60). The crude prevalence of myopia (≤0.5 D) and high myopia (≤5.0 D) were 16.2% and 2.1%, respectively. Spectacles could improve the vision of 1279 (9.4%) and 882 (6.5%) participants at the 6/12 and 6/18 level, respectively, but only 3.4% and 4.4% of these individuals wore spectacles to the examination site. Approximately 2,140,000 adults in Nigeria would benefit from spectacles that improved their vision from <6/12 to ≥6/12. More than a third of the need could be met by low-cost, off-the-shelf spectacles.
Uncorrected refractive errors are an important cause of visual impairment in Nigeria, and services must be dramatically improved to meet the need.
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