Prevalence and correction of near vision impairment at Kaski, Nepal

Feb 21, 2012Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH

How common near vision problems are and how they are fixed in Kaski, Nepal

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Abstract

The age- and gender-standardized prevalence of uncorrected near visual impairment in rural Nepal is 66.1%.

A total of 2,156 individuals aged 35 and over were examined, representing 91.3% of those enumerated.
Near vision could not be corrected to better than 20/40 in 6.4% of the population despite distance and near vision correction.
Uncorrected near visual impairment is associated with older age (odds ratio of 1.13) and lower educational level (odds ratio of 1.11).
Female gender is less associated with uncorrected near visual impairment (odds ratio of 0.72).
Over 90% of individuals with near visual impairment do not possess spectacles.

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INTRODUCTION: Presbyopia is an important cause of avoidable visual disability.

OBJECTIVE: To estimate the prevalence of near vision impairment and spectacle coverage among middle and older-aged adults in rural Nepal.

MATERIALS AND METHODS: The surveys was carried out among the people of age 35 and over in randomly-selected cluster samples in rural settings of Kaski district of western Nepal, Near visual acuity, with and without presenting near correction, was measured at 40 cm using a LogMAR near vision tumbling E chart under ambient indoor lighting. Subjects with uncorrected binocular distance vision of 20/40 or worse were refracted and those with near vision of 20/40 or worse tested with plus sphere to obtain the best-corrected binocular near visual acuity.

RESULTS: A total of 2,360 persons aged 35 years and over were enumerated and 2,156 (91.3%) were examined. The age- and gender-standardized prevalence of uncorrected near visual impairment (vision of 20/40 or worse) in study population was found to be 66.1 %. Near vision could not be corrected (>20/40) even after distance and near vision correction in 6.4 % . Using the multiple logistic regression models, uncorrected visual impairment was associated with an older age (odds ratio [OR] = 1.13, P less than 0.001) and a lower educational level (OR = 1.11, P = 0.01) was less associated with female gender (OR = 0.72, P = 0.038). Over 90 % of people with near visual impairment did not have spectacles.

CONCLUSION: The prevalence of presbyopia appears to be higher with an earlier onset and over 90 % of people in need of near correction do not have spectacles in this setting.

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