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  • Population-based assessment of prevalence and causes of visual impairment in the state of Telangana, India: a cross-sectional study using the Rapid Assessment of Visual Impairment (RAVI) methodology

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Ophthalmology
Research
Population-based assessment of prevalence and causes of visual impairment in the state of Telangana, India: a cross-sectional study using the Rapid Assessment of Visual Impairment (RAVI) methodology
  1. Srinivas Marmamula1,2,3,4,
  2. Rohit C Khanna1,2,
  3. Eswararao Kunkunu1,2,
  4. Gullapalli N Rao1,2,3
  1. 1Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao—International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
  3. 3Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, Telangana, India
  4. 4Wellcome Trust/Department of Biotechnology India Alliance Research Fellow, L V Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Srinivas Marmamula; srioptom{at}lvpei.org

Abstract

Objective To assess the prevalence and causes of visual impairment (VI) among a rural population aged 40 years and older in the state of Telangana in India.

Design Population-based cross-sectional study.

Setting Districts of Adilabad and Mahbubnagar in south Indian state of Telangana, India.

Participants A sample of 6150 people was selected using cluster random sampling methodology. A team comprising a trained vision technician and a field worker visited the households and conducted the eye examination. Presenting, pinhole and aided visual acuity were assessed. Anterior segment was examined using a torchlight. Lens was examined using distant direct ophthalmoscopy in a semidark room. In all, 5881 (95.6%) participants were examined from 123 study clusters. Among those examined, 2723 (46.3%) were men, 4824 (82%) had no education, 2974 (50.6%) were from Adilabad district and 1694 (28.8%) of them were using spectacles at the time of eye examination.

Primary outcome measure VI was defined as presenting visual acuity <6/18 in the better eye and it included moderate VI (<6/18 to 6/60) and blindness (<6/60).

Results The age-adjusted and gender-adjusted prevalence of VI was 15.0% (95% CI 14.1% to 15.9%). On applying binary logistic regression analysis, VI was associated with older age groups. The odds of having VI were higher among women (OR 1.2; 95% CI 1.0 to 1.4). Having any education (OR 0.4; 95% CI 0.3 to 0.6) and current use of glasses (OR 0.19; 95% CI 0.1 to 0.2) were protective. VI was also higher in Mahbubnagar (OR 1.0 to 1.5) district. Cataract (54.7%) was the leading cause of VI followed by uncorrected refractive errors (38.6%).

Conclusions VI continues to remain a challenge in rural Telangana. As over 90% of the VI is avoidable, massive eye care programmes are required to address the burden of VI in Telangana.

  • PRIMARY CARE
  • EPIDEMIOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-012617

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    Footnotes

    • Contributors SM conceived the idea, designed and conducted the study, analysed the data and wrote the manuscript. EK assisted in data collection and supervised the field activities. RCK and GNR reviewed the earlier version of the manuscripts and provide the intellectual inputs.

    • Funding This work was supported by Hyderabad Eye Research Foundation, India and Christoffel Blindenmission (CBM), Germany.

    • Competing interests None declared.

    • Ethics approval The Institutional Review Board (IRB) of Hyderabad Eye Research Foundation, L V Prasad Eye Institute, Hyderabad, India, approved the study protocol.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.