Rapid assessment of avoidable blindness in the northern eThekwini district of KwaZulu-Natal Province, South Africa | Zendy

Pirindhavellie Govender-Poonsamy | Zendy; Prasidh Ramson | Zendy; Linda Visser | Zendy; Kovin Naidoo | Zendy

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Rapid assessment of avoidable blindness in the northern eThekwini district of KwaZulu-Natal Province, South Africa

Author(s) -

Pirindhavellie Govender-Poonsamy,

Prasidh Ramson,

Linda Visser,

Kovin Naidoo

Publication year - 2015

Publication title -

african vision and eye health

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.186

H-Index - 5

eISSN - 2413-3183

pISSN - 2410-1516

DOI - 10.4102/aveh.v74i1.15

Subject(s) - medicine , visual impairment , visual acuity , cataracts , refractive error , blindness , cataract surgery , childhood blindness , optometry , fundus (uterus) , eye examination , ophthalmology , retinopathy of prematurity , pregnancy , genetics , psychiatry , biology , gestational age

Aim: To determine the prevalence and causes of visual impairment, cataract surgical coverage and barriers to cataract surgery amongst people in the northern eThekwini district of KwaZuluNatal Province, South Africa.

Method: Thirty-three clusters of 50 subjects ≥ 50 years old were randomly selected. Consenting subjects underwent enumeration to establish a demographic profile and thereafter a clinical examination. Visual acuity (VA) was measured with a Tumbling ‘E’ chart; participants having a VA < 6/18 were retested with a pinhole. If no improvement in VA occurred, subjects underwent clinical examination, including a dilated fundus exam where necessary, to determine the cause of visual impairment.

Results: Of the 1650 subjects selected, 1542 (93.5%) were examined. The overall prevalence of blindness was 1.9%. The age- and gender-adjusted prevalence of blindness was 2.1%, severe visual impairment (SVI) 1.2%, and moderate visual impairment (MVI) 3.9%. Untreated cataract was the major cause of blindness (55.2%) and SVI (53.3%), and uncorrected refractive error was the major cause of MVI (49.1%). The cataract surgical coverage rate was 70% at visual acuity < 3/60 level; 51% at visual acuity < 6/60 level; and 38% at visual acuity < 6/18 level. Poor awareness of cataract surgical intervention was the main reason that participants with untreated cataracts had not used existing cataract services.

Conclusion: The prevalence of blindness in the study region was lower (by 1.98%) than World Health Organization estimates of 9% for the Africa-E sub-region (within which South Africa falls). There is no permanent cataract service in this region; the lower cataract surgical coverage rates indicate that a permanent eye care centre could significantly alleviate avoidable blindness, particularly that caused by cataract.

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