Thulasiraj R D, Nirmalan Praveen K, Ramakrishnan R, Krishnadas R, Manimekalai T K, Baburajan N P, Katz Joanne, Tielsch James M, Robin Alan L
Aravind Eye Care System and Lions-Aravind Institute for Community Ophthalmology, Madurai, Tamil Nadu, India.
Ophthalmology. 2003 Aug;110(8):1491-8. doi: 10.1016/S0161-6420(03)00565-7.
To determine the prevalence of blindness and vision impairment in a rural population of southern India.
A population-based cross-sectional study.
A total of 17200 subjects aged 6 years or older, including 5150 subjects aged 40 years or older from 50 clusters representative of three southern districts of Tamil Nadu in southern India.
All participants had preliminary screenings consisting of vision using a LogMAR illiterate E chart and anterior segment hand light examinations at the village level. Subjects aged 40 years or older were offered comprehensive eye examinations at the base hospital, including visual acuity using LogMAR illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated Humphrey central 24-2 full threshold perimetry; subjects younger than 40 years of age who had any signs or symptoms of ocular disease were also offered comparable examinations at the base hospital.
Visual impairment was defined as best-corrected visual acuity <6/18, and blindness was defined using both Indian (<6/60) and World Health Organization (<3/60) definitions.
Comprehensive examinations at the base hospital were performed on 5150 (96.5%) of 5337 persons 40 years of age or older. Among those 40 years of age and older, presenting visual acuity at the <3/60 level was present in 4.3% (95% confidence interval [CI]: 3.8, 4.9) and 11.4% (95% CI: 10.6, 12.3) at the <6/60 level. After best correction, the corresponding figures were 1.0% (95% CI: 0.79, 1.2) and 2.1% (95% CI: 1.7, 2.5). Over 70% of subjects improved their vision by at least one line, and nearly a third by three lines after refraction. Age-related cataract was the most common potentially reversible blinding disorder (72.0%) among eyes presenting with blindness.
Blindness and vision impairment remain major public health problems in India that need to be addressed. Cataracts and refractive errors remain the major reversible causes for the burden of vision impairment in this rural population.
确定印度南部农村人口中失明和视力损害的患病率。
一项基于人群的横断面研究。
共有17200名6岁及以上的受试者，其中包括来自印度南部泰米尔纳德邦三个南部地区50个群组的5150名40岁及以上的受试者。
所有参与者在村级进行初步筛查，包括使用LogMAR文盲E视力表检查视力和前段手持灯光检查。40岁及以上的受试者在基层医院接受全面的眼科检查，包括使用LogMAR文盲E视力表检查视力和验光、裂隙灯生物显微镜检查、前房角镜检查、压平眼压测量、散瞳眼底检查以及自动 Humphrey 中央24-2全阈值视野检查；40岁以下有任何眼部疾病体征或症状的受试者也在基层医院接受类似检查。
视力损害定义为最佳矫正视力<6/18，失明采用印度（<6/60）和世界卫生组织（<3/60）的定义。
在5337名40岁及以上的受试者中，有5150名（96.5%）在基层医院接受了全面检查。在40岁及以上的人群中，初诊视力<3/60的比例为4.3%（95%置信区间[CI]：3.8，4.9），<6/60的比例为11.4%（95%CI：10.6，12.3）。最佳矫正后，相应数字分别为1.0%（95%CI：0.79，1.2）和2.1%（95%CI：1.7，2.5）。超过70%的受试者视力至少提高了一行，近三分之一的受试者验光后视力提高了三行。年龄相关性白内障是失明眼中最常见的潜在可逆性致盲疾病（72.0%）。
失明和视力损害在印度仍然是需要解决的主要公共卫生问题。白内障和屈光不正仍然是该农村人口视力损害负担的主要可逆原因。
