Uncorrected refractive errors, presbyopia and spectacle coverage: results from a rapid assessment of refractive error survey

Abstract

Purpose: To investigate the prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in subjects aged 15-50 years using rapid assessment methodology in the Mahabubnagar district of Andhra Pradesh, India. Methods: A population-based cross sectional study was conducted using cluster random sampling to enumerate 3,300 subjects from 55 clusters. Unaided, aided and pinhole visual acuity was assessed using a LogMAR chart at a distance of 4 meters. Near vision was assessed using N notation chart. Uncorrected refractive error was defined as presenting visual acuity worse than 6/12 but improving to at least 6/12 or better on using a pinhole. Presbyopia is defined as binocular near vision worse than N8 in subjects aged more than 35 years with binocular distance visual acuity of 6/12 or better. Results: Of the 3,300 subjects enumerated from 55 clusters, 3,203 (97%) subjects were available for examination. Of these, 1,496 (46.7%) were females and 930 (29%) were ≥ 40 years. Age and gender adjusted prevalence of uncorrected refractive errors causing visual impairment in the better eye was 2.7% (95% CI, 2.1-3.2%). Presbyopia was present in 690 (63.7%, 95% CI, 60.8-66.6%) subjects aged over 35 years. Spectacle coverage for refractive error was 29% and for presbyopia it was 19%. Conclusions: There is a large unmet need for refractive correction in this area in India. Rapid assessment methods are an effective means of assessing the need for services and the impact of models of care.