Dandona R, Dandona L, Srinivas M, Giridhar P, Prasad M N, Vilas K, McCarty C A, Rao G N
International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India.
Br J Ophthalmol. 2002 Apr;86(4):373-7. doi: 10.1136/bjo.86.4.373.
To assess the prevalence and demographic associations of moderate visual impairment in the population of the southern Indian state of Andhra Pradesh.
From 94 clusters in one urban and three rural areas of Andhra Pradesh, 11 786 people of all ages were sampled using a stratified, random, cluster, systematic sampling strategy. The eligible people were invited for interview and detailed dilated eye examination by trained professionals. Moderate visual impairment was defined as presenting distance visual acuity less than 6/18 to 6/60 or equivalent visual field loss in the better eye.
Of those sampled, 10,293 (87.3%) people participated in the study. In addition to the previously reported 1.84% prevalence of blindness (presenting distance visual acuity less than 6/60 or central visual field less than 20 degrees in the better eye) in this sample, 1237 people had moderate visual impairment, an adjusted prevalence of 8.09% (95% CI 6.89 to 9.30%). The majority of this moderate visual impairment was caused by refractive error (45.8%) and cataract (39.9%). Increasing age, female sex, decreasing socioeconomic status, and rural area of residence had significantly higher odds of being associated with moderate visual impairment.
These data suggest that there is a significant burden of moderate visual impairment in this population in addition to blindness. Extrapolation of these data to the population of India suggests that there were 82 million people with moderate visual impairment in the year 2000, and this number is likely to be 139 million by the year 2020 if the current trend continues. This impending large burden of moderate visual impairment, the majority of which is due to the relatively easily treatable refractive error and cataract, would have to be taken into account while estimating the eye care needs in India, in addition to dealing with blindness. Specific strategies targeting the elderly population, people with low socioeconomic status, those living in the rural areas, and females would have to be implemented in the long term to reduce moderate visual impairment.
评估印度南部安得拉邦人群中中度视力损害的患病率及其人口统计学关联。
采用分层随机整群系统抽样策略，从安得拉邦一个城市和三个农村地区的94个群组中抽取了11786名各年龄段的人。符合条件的人被邀请接受训练有素的专业人员的访谈和详细的散瞳眼部检查。中度视力损害定义为较好眼的远视力低于6/18至6/60或等效视野缺损。
在抽样的人群中，10293人（87.3%）参与了研究。除了该样本中先前报告的1.84%的失明患病率（较好眼的远视力低于6/60或中心视野小于20度）外，有1237人患有中度视力损害，校正患病率为8.09%（95%可信区间6.89至9.30%）。这种中度视力损害的大多数是由屈光不正（45.8%）和白内障（39.9%）引起的。年龄增加、女性、社会经济地位下降以及居住在农村地区与中度视力损害相关的几率显著更高。
这些数据表明，除失明外，该人群中存在中度视力损害的重大负担。将这些数据外推至印度人口表明，2000年有8200万人患有中度视力损害，如果目前的趋势持续下去，到2020年这个数字可能会达到1.39亿。在估计印度的眼保健需求时，除了应对失明问题外，还必须考虑到即将出现的这种中度视力损害的巨大负担，其中大多数是由于相对易于治疗的屈光不正和白内障。从长远来看，必须实施针对老年人群、社会经济地位低的人群、农村地区居民以及女性的具体策略，以减少中度视力损害。
