Sapkota Yuddha D, Sunuwar Mohan, Naito Takeshi, Akura Junsuke, Adhikari Him K
Nepal Netra Jyoti Sangh, Tripureshwor, Kathmandu, Nepal.
Ophthalmic Epidemiol. 2010 Mar;17(2):82-9. doi: 10.3109/09286581003624947.
The Gaur Eye Hospital, which provides eye care services to the people in Rautahat and adjacent districts, completed 9 years of operation in 2006. Over 14,000 cataract surgeries were performed during this period. This study aimed to ascertain the impact of the hospital services by estimating the prevalence of blindness, visual impairment and cataract surgical coverage among the older adult population of the Rautahat district.
People aged 50 years and older were enrolled in this study that used a stratified cluster design. Subjects in 32 randomly selected clusters were identified through door-to-door visits, presenting and corrected visual acuities measurement, and clinical examination by ophthalmologists were conducted at a centrally located site.
Of the 5,533 identified subjects, 85.3% were examined. Blindness was defined as presenting with visual acuity < 6/60 in both eyes. Blindness was found in 17.4% (95% Confidence Interval: 15.1 to 19.7); however, 55.6% of individuals examined had vision < 6/18 in one or both eyes. Cataracts were the principal cause of blindness in 82.1%, and were associated with elder age, illiteracy and female gender. Surgical coverage was found to be 37.3%.
The findings suggest that despite 9 years of hospital and community eye care services the prevalence of blindness in this area is still challengingly high and the cataract surgical coverage unacceptably low. Community outreach awareness programs and accessibility for the Nepali cataract blind to the hospital need to be upgraded.
高乌尔眼科医院为劳塔哈特区及周边地区的民众提供眼科护理服务,于2006年完成了9年的运营。在此期间共进行了超过14000例白内障手术。本研究旨在通过估算劳塔哈特区老年人群中的失明、视力损害患病率以及白内障手术覆盖率,来确定该医院服务的影响。
本研究采用分层整群设计,纳入50岁及以上的人群。通过挨家挨户走访确定32个随机选择群组中的受试者,并在一个中心地点进行视力测量(包括裸眼视力和矫正视力)以及眼科医生的临床检查。
在5533名确定的受试者中,85.3%接受了检查。失明定义为双眼裸眼视力<6/60。失明率为17.4%(95%置信区间:15.1%至19.7%);然而,接受检查的个体中有55.6%的人单眼或双眼视力<6/18。白内障是82.1%失明病例的主要原因,且与老年、文盲和女性性别有关。手术覆盖率为37.3%。
研究结果表明,尽管有9年的医院和社区眼科护理服务,但该地区的失明患病率仍然高得惊人,白内障手术覆盖率低得令人无法接受。需要加强社区外展宣传项目,并提高尼泊尔白内障盲人到该医院就诊的可及性。