Abstract
Purpose::
To determine the prevalence and causes of visual impairment in the Meiktila District of central, rural Myanmar.
Methods::
Randomized, stratified, cluster sampling of the inhabitants 40 years of age and over from villages in the Meiktila District of central Myanmar was performed; 2481 eligible participants were identified and 2076 participated in the study. Participants received an ophthalmic examination, including presenting and pinhole Snellen visual acuity with an illiterate E chart, slit lamp examination of the anterior segment and dilated stereoscopic fundus examination. The principal cause of visual impairment was recorded. Visual impairment and blindness were defined by both presenting (habitual) and pinhole visual acuity according to World Health Organization criteria: better eye < 20/60 and < 20/400 respectively.
Results::
Visual acuity was recorded in 2073 participants (83.6%) The prevalence estimate of presenting visual impairment was 40.4% (95% CI 36.1-44.7), and of presenting blindness was 8.1% (95% CI 6.5-9.9). After pinhole correction the corresponding prevalences were 26.8% (95% CI 23.5-30.1) and 5.3% (95% CI 4.0-6.6). Cataract, uncorrected refractive error and primary angle-closure glaucoma were the commonest causes of visual impairment. In multivariate regression analyses, increasing age was a strong predictor of blindness (P < 0.001).
Conclusions::
Visual impairment and blindness remain major public health problems in rural Myanmar. The prevalence of habitual blindness in this region is amongst the highest ever reported in a population-based study. Specific programmes directed towards the cataract burden need to be implemented.
Keywords: visual acuity • cataract