This article has a correction

Please see: BMJ Open 2013;3

BMJ Open 3:e002576 doi:10.1136/bmjopen-2013-002576
  • Ophthalmology
    • Research

A cross-sectional study of visual impairment in elderly population in residential care in the South Indian state of Andhra Pradesh: a cross-sectional study

  1. Rohit C Khanna1
  1. 1Allen Foster Community Eye Health Research Centre, International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
  2. 2Bausch & Lomb School of Optometry, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
  3. 3Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4Community Health & Nutrition Office, Area Hospital, Kandukur, Andhra Pradesh, India
  5. 5School of Optometry & Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Srinivas Marmamula; srioptom{at}
  • Received 9 January 2013
  • Revised 15 February 2013
  • Accepted 22 February 2013
  • Published 15 March 2013


Objective To assess the prevalence and major causes of visual impairment (VI) in elderly residents of ‘home for the aged’ institutions in the Prakasam district in India.

Design Cross-sectional study.

Setting ‘Home for the aged’ institutions in the Prakasam district in the South Indian state of Andhra Pradesh.

Participants All 524 residents in the 26 ‘homes for aged’ institutions in the district were enumerated.

Primary and secondary outcome measures Prevalence and causes of VI; visual acuity (VA) was assessed using a Snellen chart at a distance of 6 m. Pinhole VA was assessed if presenting VA was <6/18. Torchlight examination and direct ophthalmoscopy were performed. VI was defined as presenting VA <6/18 in the better eye.

Results Of the 494 participants examined (response rate 94.3%), 78.1% were women, 72.1% had no formal schooling. The mean age of participants was 70 years (SD ±8.6 years). VI was present in 280/494 individuals (56.9%; 95% CI 52.3 to 61.3). Over 80% of the VI was due to avoidable causes including cataract (57.1%) and uncorrected refractive errors (26.4%). Among 134 individuals who had undergone bilateral cataract surgery, only 78 (58.2%) individuals had presenting VA ≥6/18 and 13/134 (9.7%) participants were blind.

Conclusions There is high prevalence of VI in the institutionalised elderly population in the Prakasam district in India. A significant proportion of this elderly population with VI can benefit from spectacles and cataract surgery. Strategies are required to provide high-quality services to this population.

this is an open-access article distributed under the terms of the creative commons attribution non-commercial license, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. see: and

blog comments powered by Disqus