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Y. B. Liang, D. S. Friedman, T. Y. Wong, S. Y. Zhan, L. P. Sun, J. J. Wang, X. R. Duan, X. H. Yang, F. H. Wang, N. L. Wang; Prevalence and Causes of Low Vision and Blindness in a Rural Adult Chinese Population: The Handan Eye Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4449.
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The majority of Chinese people (64%) live in rural regions remote from cities. However, the prevalence of visual impairment in the rural Chinese population is largely unknown. We aimed to describe the prevalence and causes of low vision and blindness in a rural adult Chinese population.
A population-based study of 6,830 (90.4% of 7577 eligible) Chinese aged 30+ years was conducted between Oct. 2006 and Oct.2007 in a rural area of Yongnian County in Handan, north China. Participants underwent a comprehensive ocular examination, including standardized visual acuity (VA) tests using logMAR charts. Low vision was defined if VA <20/60 but ≥20/400 and blindness defined if VA <20/400. Primary causes of visual impairment were determined by study ophthalmologists according to World Health Organization (WHO) definitions. Prevalence was age- and gender-standardized to the 2000 China Census.
Population-weighted prevalence of bilateral blindness was 0.6% and bilateral low vision 4.7%, defined using presenting VA. Corresponding prevalence of bilateral blindness and low vision, defined using best corrected VA, was 0.5% and 0.9%, respectively. Blindness and low vision were strongly age-related (p for trend=0.0001). Cataract was the predominant cause of presenting bilateral blindness (36.6%), while under-corrected refractive error was the predominant cause of presenting low vision (35.7%). Myopic retinopathy (11.0%), glaucoma (6.4%) and corneal opacity (5.5%) were the major leading causes of blindness and low vision.
This study found a high prevalence of blindness and low vision in the rural Chinese population, substantially higher than has been observed in urban Chinese populations. The estimated number of adults with low vision and blindness in rural China is 3.77 million and 2.04 million, respectively. The predominant causes of low vision and blindness are preventative and treatable.
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