Abstract
Abstract: :
Purpose: To determine the prevalence of refractive errors and investigate factors associated with refractive error in adults 30 years of age and older in Bangladesh. Methods: A nationally representative sample of 12, 782 adults 30 years of age and older was selected based on multi-stage, cluster random sampling with probability-proportional-to-size procedures. The examination protocol consisted of an interview that included measures of literacy, education, occupation, and refractive correction. Visual acuity testing (logMAR), automated refraction, and optic disc examination was performed on all subjects. Subjects with <6/12 (0.3 logMAR) acuity in either eye were additionally graded for cataract and underwent a dilated fundal examination. Subjects for whom no refractive error was recorded (312 subjects (2.7%) or that had undergone cataract surgery (123 subjects (1.1%) were excluded from the analysis. Results: 11624 subjects were examined (90.9% response rate, mean age 44 +/- 12.6 (SD) years). 5489 (49.1%) were men and 5700 (50.9%) women. Mean spherical equivalent was –0.19D (+/-1.50D). 6412 subjects (57.3%) were emmetropic, 2469 (22.1%) were myopic (<-0.5D), and 2308 (20.6%) hypermetropic (>+0.5D). 206 subjects (1.8%) were highly myopic (<-5D). Myopia was more common in men, and hyperopia in women. Myopia increased with age. A subanalysis of subjects without cataract, showed increasing hyperopia with age, and an association between myopia and higher education and employment. Astigmatism (>0.5D) was present in 3625 subjects (32.4%), more common among women, illiterate subjects and unschooled subjects. Against-the-rule astigmatism (ATR) was more common (58.7%) than oblique astigmatism (29.3%), which was more common than with-the-rule astigmatism (WTR) (12.1%). ATR and oblique astigmatism increased with age unlike WTR. Of 830 (7.5%) subjects, women were more commonly anisometropic (>1.0D). Anisometropia increased with age. Conclusions: Refractive error data is described for a country and region which has previously lacked population-based data. Prevalence and factors associated with refractive error are presented, with a detailed comparison with other population-based surveys regionally and internationally.
Keywords: refraction • myopia • clinical (human) or epidemiologic studies: pre