Jialiang Zhao1, Xiao Xu2, Leon B Ellwein3, Huaijin Guan4, Mingguang He5, Ping Liu6, Jianhua Lv7, Xunlun Sheng8, Peizeng Yang9, Jinglin Yi10, Ning Cai11, Mei Yang4, Miaomiao Chen11, LiangLiang Deng10, Xiaohu Ding5, Liping Du9, Fengrong Li12, Xian Liu10, Hong Lu4, Changliang Shao7, Junwei Wang6, Wenjuan Zhuang8, Lei An2. 1. Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China. Electronic address: zhjialiang@163.com. 2. Rehabilitation Administration Department, National Institute of Hospital Administration, Beijing, China. 3. National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA. 4. The Affiliated Hospital of Nantong University, Nantong, China. 5. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. 6. Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin, China. 7. Hebei Eye Hospital, Xingtai, China. 8. Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan, China. 9. Chongqing Medical University, Chongqing, China. 10. Affiliated Eye Hospital of Nanchang Univerity, Nanchang, China. 11. The First Affiliated Hospital of Kunming Medical University, Kunming, China. 12. Beijing Hospital of Traditional Chinese Medicine, Beijing, China.
Abstract
PURPOSE: To investigate the primary causes of visual impairment and blindness in rural China. DESIGN: Population-based, cross-sectional study. METHODS: Geographic cluster sampling was used in randomly selecting residents from a rural county/district within 9 provinces in the East Coast, Inland Middle, and West regions of mainland China. Persons aged 50 years or older were enumerated through household visits and invited to examination sites for visual acuity testing and ocular examination. Causes of vision impairment and blindness in 2014 were compared with data from an earlier 2006 survey. RESULTS: Mild visual impairment (20.4% prevalence) was caused by uncorrected refractive error in two thirds of cases and by cataract in nearly another one fourth; moderate-to-severe visual impairment (10.3% prevalence) was caused by cataract in over onec half of cases and by uncorrected refractive error in another one fifth; blindness (1.66% prevalence) was caused by cataract in approximately one half of cases and in another one fourth by retinal disease. Primary causes of visual impairment and blindness in cataract-operated eyes were uncorrected refractive error, posterior capsule opacity, and retinal disease. From 2006 to 2014, the proportion of visual impairment caused by uncorrected refractive error increased, but rates for unoperated cataract were reduced. CONCLUSIONS: Uncorrected refractive error and unoperated cataract are the 2 primary causes of mild, moderate, and severe visual impairment in rural China, with unoperated cataract and retinal diseases primary causes for blindness. An effective public health strategy to increase service delivery for these causes would lead to substantial reduction in vision impairment and blindness.
PURPOSE: To investigate the primary causes of visual impairment and blindness in rural China. DESIGN: Population-based, cross-sectional study. METHODS: Geographic cluster sampling was used in randomly selecting residents from a rural county/district within 9 provinces in the East Coast, Inland Middle, and West regions of mainland China. Persons aged 50 years or older were enumerated through household visits and invited to examination sites for visual acuity testing and ocular examination. Causes of vision impairment and blindness in 2014 were compared with data from an earlier 2006 survey. RESULTS: Mild visual impairment (20.4% prevalence) was caused by uncorrected refractive error in two thirds of cases and by cataract in nearly another one fourth; moderate-to-severe visual impairment (10.3% prevalence) was caused by cataract in over onec half of cases and by uncorrected refractive error in another one fifth; blindness (1.66% prevalence) was caused by cataract in approximately one half of cases and in another one fourth by retinal disease. Primary causes of visual impairment and blindness in cataract-operated eyes were uncorrected refractive error, posterior capsule opacity, and retinal disease. From 2006 to 2014, the proportion of visual impairment caused by uncorrected refractive error increased, but rates for unoperated cataract were reduced. CONCLUSIONS: Uncorrected refractive error and unoperated cataract are the 2 primary causes of mild, moderate, and severe visual impairment in rural China, with unoperated cataract and retinal diseases primary causes for blindness. An effective public health strategy to increase service delivery for these causes would lead to substantial reduction in vision impairment and blindness.