Abstract
Purpose :
Vision impairment (VI) is public health challenge affecting over two billion people worldwide. VI at this scale is best addressed by a strategy of ‘Universal Eye Health’, where everyone has access to good quality, affordable eye care. Delivering eye care at such a large scale requires careful planning and regular monitoring to ensure success. Understanding the temporal trends in the prevalence of VI is vital for such an approach towards achieving universal eye health. We report on the temporal trends in the prevalence VI in the Nirmal district in the South Indian state of Telangana where a universal eye health service delivery model of primary and secondary eye care is in operation for over 25 years.
Methods :
Methods: Two population-based cross-sectional studies using rapid assessment methodology were conducted in the years 2014 and 2022 in the Nirmal district of Telangana state. Identical study methods were used. Individuals aged ≥40 years were included. Trained eye care teams and community eye health workers visited households in randomly selected clusters and conducted eye examinations. VI is defined as presenting visual acuity (PVA) worse than 20/40 in the better eye. It included three categories: Mild VI (MiVI - PVA worse than 20/40 to 20/60), Moderate Severe VI (MSVI – PVA worse than 20/60 to 20/400), and blindness (PVA worse than 20/400). Age and gender-adjusted prevalence are presented.
Results :
In total, 2,974 and 2,375 participants were examined in the 2014 and 2022 studies respectively. The mean age (±standard deviation) of the participants was higher in the 2022 study compared to the 2014 study (55.0 ±11.0 years versus 51.7 ±9.9 years; p<0.05). Similarly, more women were examined in the 2022 study (45.6% versus 42.5%; p=0.03). Overall, a 19.3% decline in the prevalence of VI was noted compared to the 2014 baseline study (20.2% to 16.3%; p<0.01). In terms of categories of VI, MiVI declined by 21.9% (6.4% to 5.0%; p=0.03), MSVI declined by 15.1% (11.9% to 10.1%; p=0.04) and blindness declined by 36.8% (1.9% to 1.6%).
Conclusions :
The prevalence of VI in the Nirmal district reduced by nearly 20% in a span of seven years. Improved availability, enhanced access and uptake of services are the possible reasons for this decline.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.