Near vision impairment and effective refractive error coverage for near vision in Andhra Pradesh, India – The Akividu Visual Impairment Study (AVIS)

ABSTRACT

Clinical relevance

Near Vision Impairment (NVI) is common in developing countries. A substantial proportion of NVI can be addressed by providing spectacles. Innovative eye care programmes are needed to address NVI. Population-based epidemiological studies can provide vital data to plan such eye care service delivery models.

Background

To report the prevalence of NVI and effective Refractive Error Coverage (eREC) for near vision in West Godavari and Krishna districts in Andhra Pradesh, south India.

Methods

A population-based cross-sectional study was carried out using a Rapid Assessment of Visual Impairment methodology. Presenting and pinhole distance visual acuity were assessed followed by near vision assessment using a N notation chart at a fixed distance of 40 cm. If the presenting near vision was worse than N8, the best corrected near visual acuity was recorded with age appropriate near vision correction. NVI was defined as presenting near vision worse than N8 among those without distance vision impairment (6/18 or better in the better eye). Effective Refractive Error Coverage for near was calculated as the proportion of individuals with an adequate correction to the total participants, including those with inadequate, adequate, and no correction for near vision.

Results

Data of 2,228 participants aged ≥40 years were analysed. The mean age of these participants was 54.0 ± 10.4 years; 53.8% were women; 44.5% had no formal education. The prevalence of NVI was 27.1% (95% CI: 25.2–29.0%). NVI significantly associated with 70 and above age group (adjusted OR: 1.97; 95% CI: 1.45-3.70). Participants with formal education had lower odds for NVI (adjusted OR: 0.75; 95 % CI: 0.68-0.83). The eREC for near vision was 48.0%.

Conclusion

NVI affects over a quarter of people aged ≥40 years in the West Godavari and Krishna districts of Andhra Pradesh. However, eREC is under 50% and there is scope for improving this by establishing eye care services to achieve universal eye health for all.

KEYWORDS:

• Effective spectacle coverage
• near vision coverage
• near vision impairment
• universal eye health

Acknowledgements

The authors thank the volunteers for their participation in the study. The authors acknowledge the assistance of Rajesh Challa, Kolakaluri Praveen Kumar, and Seelam Siva Nagaraju (vision technicians) and Satya Brahmanandam Modepalli in data collection. Muni Rajya Lakshmi and Ratnakar Yellapragada are acknowledged for support in data management. The authors also thank Abhinav Sekar and 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 study was funded by the Hyderabad Eye Research Foundation (HERF), (LEC08173), India.