Pokharel G P, Regmi G, Shrestha S K, Negrel A D, Ellwein L B
Foundation Eye Care Himalaya, Kathmandu, Nepal.
Br J Ophthalmol. 1998 Jun;82(6):600-5. doi: 10.1136/bjo.82.6.600.
A national eye care programme was launched in Nepal in the early 1980s. The impact of this programme on blindness and cataract surgery prevalence was evaluated in two geographic zones.
People aged 45 years and older were sampled using a stratified cluster design. Within randomly selected clusters, door to door enumeration was followed by visual acuity measurement and eye examinations at conveniently located sites. The full survey was preceded by a pilot study where operational methods were refined and quality assurance measures carried out.
Of the 5112 enumerated individuals 90% were examined. Blindness, defined as presenting visual acuity less than 6/60 in both eyes, was found in 5.3% (95% CI 3.6, 6.8) of individuals examined, with cataract being the principal cause in at least one eye in 78% of cases. Considering both cataract operated and unoperated cataract blind cases, surgical coverage was approximately 42%.
The findings suggest that blindness prevalence may have decreased slightly from that estimated in a 1981 national survey, both overall and cataract related. Similarly, cataract surgical coverage may have increased somewhat. None of these changes, however, are at statistically significant levels. Accordingly, the blindness problem remains challengingly high.
20世纪80年代初，尼泊尔启动了一项全国性眼保健计划。在两个地理区域评估了该计划对失明率和白内障手术患病率的影响。
采用分层整群设计对45岁及以上人群进行抽样。在随机选择的群组中，先挨家挨户进行普查，然后在便利地点进行视力测量和眼部检查。在全面调查之前先进行了一项试点研究，对操作方法进行了完善并实施了质量保证措施。
在5112名接受普查的个体中，90%接受了检查。在接受检查的个体中，双眼视力低于6/60被定义为失明，失明率为5.3%（95%可信区间3.6, 6.8），在78%的病例中，白内障是至少一只眼睛失明的主要原因。考虑到已接受白内障手术和未接受手术的白内障致盲病例，手术覆盖率约为42%。
研究结果表明，总体失明率以及与白内障相关的失明率可能比1981年全国调查估计的略有下降。同样，白内障手术覆盖率可能有所提高。然而，这些变化均未达到统计学显著水平。因此，失明问题仍然严峻。
