Population-based assessment of prevalence of spectacle use and effective spectacle coverage for distance vision in Andhra Pradesh, India – Akividu Visual Impairment Study

ABSTRACT

Clinical relevance

Effective spectacle coverage is a useful indicator to assess the coverage of refraction services in a given region. We found a low coverage in the Akividu region suggesting a need to develop effective refraction services.

Background

To assess the prevalence of spectacle use and effective spectacle coverage for distance vision among people aged 40 years and older in the Indian state of Andhra Pradesh.

Methods

A population-based cross-sectional survey was carried out in the Akividu region in West Godavari and Krishna districts. The study teams visited selected households and conducted eye examinations in the selected clusters. A structured questionnaire was used to collect information on spectacle use. ‘Met Need’ was defined as unaided VA worse than 6/12 but improved to 6/12 or better with their current spectacles. ‘Unmet Need’ was defined as unaided VA worse than 6/12 but improved to 6/12 with pinhole, among those not using spectacles. The ‘Under-met Need’ was defined as aided VA worse than 6/12 but improving with pinhole to 6/12 or better. Based on these definitions, Effective Refractive Error Coverage (e-REC) is calculated as: e-REC (%) s = ((met need)/(met need + under-met need + unmet need)) X100.

Results

Of 3,000 enumerated from 60 clusters, 2,587 (86.2%) participants were examined. The prevalence of current spectacle use was 43.1% (95% CI:41.2–45.0). The e-REC was 37.4%. It was also lower in men compared to women and among those without any education. Participants who had cataract surgery in either eye had similar e-REC compared to those who were not operated.

Conclusion

Though spectacle use was found to be high, there is a still large unmet need for refractive correction for distance. Effective service delivery models to provide refraction and spectacle dispensing services are needed to achieve universal eye health coverage in the region.

KEYWORDS:

• Uncorrected Refractive Errors
• Spectacle coverage
• Rapid Assessment of Visual Impairment
• Andhra Pradesh

Acknowledgements

The authors thank the volunteers for their participation in the study. The authors acknowledge the assistance of Kolakaluri Praveen Kumar, Seelam Siva Nagaraju (vision technicians) in data collection. Muni Rajya Lakshmi is acknowledged for support in data management. The authors also thank Dr. Sreedevi Yadavalli and Ms. Neha Hassija for their language inputs on earlier versions of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Hyderabad Eye Research Foundation [LEC08173].