The Prevalence of Blindness and Cataract Surgery in Rautahat District, Nepal

Abstract

Purpose: 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.

Methods: 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.

Results: 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%.

Conclusion: 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.

KEYWORDS::

• Prevalence
• Blindness
• Visual outcome
• Cataract surgery
• Rautahat
• Nepal

ACKNOWLEDGMENTS

We sincerely acknowledge 24 hours Television, Japan and Association for Ophthalmic Cooperation to Asia (AOCA), Japan for their financial support for the study and for bearing the surgery cost of all cataracts selected during the survey. We are grateful to study ophthalmologist Dr. Kamal Bahadur Khadka and Dr. S.C. Das for their untiring field work during the data collection. We also acknowledge the hard work of ophthalmic technicians Ms. Bina Basnet, Ms. Asmita Karki and Mr. Shambhu Kuswaha for their consistence hard work during the study period. We appreciate the support of Mr. Takayuki Kiryu, Resident Representative of AOCA, Japan for his inspiration and moral support for the study.

Declaration of Interest: The authors have no financial or other conflicts of interest concerning this study.