A population-based eye survey of older adults in a rural district of Rajasthan I. Central vision impairment, blindness, and cataract surgery

Purpose: To assess the prevalence of central vision blindness and cataract surgery in older adults in rural northwest India. Design: Population-based, cross-sectional study. Participants: A total of 4284 examined persons 50 years of age or older. Methods: A random selection of village-based clusters was used to identify a population sample in the predominantly rural Bharatpur district of Rajast han. Eligible subjects in the 25 selected clusters were enumerated through a door-to-door household survey and invited to village sites for visual acu ity testing and eye examination early in 1999. The principal cause of reduc ed central vision was identified for eyes that had visual acuity worse than 6/18. Independent replicate testing for quality assurance monitoring took place in participants with reduced vision and in a sample of those with nor mal vision in five of the study clusters. Main Outcome Measures: Presenting and best-corrected visual acuity and lens status. Results: A total of 4728 eligible persons in 2821 households were enumerate d, and 4284 (90.6%) were examined. The prevalence of presenting and best-co rrected visual acuity worse than 6/60 in both eyes was 11.9% (95% confidenc e interval: 10.0%-13.9%) and 6.1% (95% CI: 4.7%-7.4%), respectively. Presen ting blindness was associated with increasing age, female gender, lack of s chooling, and rural residence. Cataract was the principal cause of blindnes s in one or both eyes in 67.5% of blind persons, with uncorrected aphakia a nd other refractive error affecting 18.4% in at least one eye. The prevalen ce of cataract surgery was 12.8% (95% CI, 11.6%-14.0%), with an estimated 6 5.7% of the cataract blind operated on; low surgical coverage was associate d with lack of schooling. Conclusions: Blindness, particularly blindness because of cataract, continu es to be a significant problem among the elderly living in remote areas of rural northwest India. increased attention should be given to reaching wome n and the illiterate. (C) 2001 by the American Academy of Ophthalmology.