Kemmanu Vasudha, Naresh Piyush V, Bunce Catey, Hudedagaddi Keerthi P, Abhishek D, Chandrakala G R, Bowman Richard, Malik Aeesha N J
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT London.
Shri Sharada Devi Eye Hospital and Research Centre, Pavagada, Tumkur, Karnataka, India.
Indian J Ophthalmol. 2025 May 1;73(5):695-701. doi: 10.4103/IJO.IJO_1040_24. Epub 2025 Apr 24.
Primary eye healthcare in India has potential for improvement; enhancing it can play a role in universal health coverage, integrated people-centered eye care, and reducing the burden on overloaded secondary/tertiary facilities.
To assess the unmet need for primary eye care services in Pavagada taluk, Karnataka, India, by estimating ocular morbidity, blindness, and visual impairment among children <18 years, attending primary health centers for any health-related issue, and to examine their association with social factors.
Health facility-based cross-sectional study in primary health centers in Pavagada.
Trained ophthalmic technicians used E charts, red reflex testing, and external examination to screen. Patients with vision <6/9, abnormal red reflex, or external examination were referred to the base hospital.
The data was analyzed using STATA17.
Of 965 patients screened (mean [SD] age 6.87 [4.97] years), 125 were referred to the base hospital; seventy-two (57.5%) reported. The unmet need was 54% (39/72). Only 9/39 (23%) had major ocular morbidity necessitating secondary/tertiary care. Ocular morbidity was 8.60%, with uncorrected refractive errors predominant (6.84%). Visual impairment rates were lower among children of mothers with 8-12 years of education (13.64%), housewives (7%), upper-middle-class (0%), compared to those with no formal education (25%), non-agricultural laborers (29%), middle (22%), lower-middle class (17%), respectively.
Pavagada taluk has a significant unmet need for primary eye care services. Addressing this requires improving infrastructure, manpower, and training at existing health centers to provide primary eye care services and alleviate the burden on secondary/tertiary care facilities.
印度的初级眼科保健有改善的潜力；加强初级眼科保健可在全民健康覆盖、以患者为中心的综合眼科保健以及减轻不堪重负的二级/三级医疗机构负担方面发挥作用。
通过评估印度卡纳塔克邦帕瓦加达乡18岁以下因任何健康相关问题前往初级卫生中心就诊儿童的眼部发病率、失明和视力损害情况，评估该地区对初级眼科保健服务未满足的需求，并研究其与社会因素的关联。
在帕瓦加达的初级卫生中心开展基于医疗机构的横断面研究。
经过培训的眼科技术人员使用E视力表、红光反射检查和外部检查进行筛查。视力<6/9、红光反射异常或外部检查异常的患者被转诊至基地医院。
使用STATA17对数据进行分析。
在965名接受筛查的患者中（平均[标准差]年龄6.87[4.97]岁），125人被转诊至基地医院；72人（57.5%）前来就诊。未满足的需求为54%（39/72）。39人中只有9人（23%）患有需要二级/三级护理的严重眼部疾病。眼部发病率为8.60%，以未矫正屈光不正为主（6.84%）。与未受过正规教育的母亲的孩子（25%）、非农业劳动者的孩子（29%）、中等阶层的孩子（22%）、中低阶层的孩子（17%）相比，母亲受过8 - 12年教育的孩子（13.64%）、家庭主妇的孩子（7%）、中上层阶级的孩子（0%）的视力损害率较低。
帕瓦加达乡对初级眼科保健服务存在显著未满足的需求。解决这一问题需要改善现有卫生中心的基础设施、人力和培训，以提供初级眼科保健服务，减轻二级/三级护理设施的负担。
