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Cypel MC, Berezovsky A, Fernandes AG, Watanabe SS, Kimie Higashi Mitsuhiro MR, Ferraz NN, Sacai PY, Furtado JM, Morales PH, Muñoz S, Cohen JM, Belfort R, Salomão SR. Regional Disparities in Prevalence and Causes of Visual Impairment and Blindness, Cataract Surgical Coverage and Ocular Findings in Adults 50 Years and Older in Brazil: A Comparative Analysis between Two Population-Based Cross-Sectional Surveys Performed Within a 10-Year Interval. Semin Ophthalmol 2023; 38:656-664. [PMID: 37154578 DOI: 10.1080/08820538.2023.2209164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To investigate disparities in the prevalence and causes of visual impairment and blindness, cataract surgical coverage, and ocular findings in older adults from two Brazilian geo-socio-demographic areas, São Paulo and Parintins cities. METHODS Data from two population-based studies including participants 50 years and older from the cities of São Paulo (São Paulo Eye Study - SPES, 2004) and Parintins (Brazilian Amazon Region Eye Survey - BARES, 2014) were aggregated. RESULTS A total of 5318 participants (3677 from SPES;1641 from BARES) were included. The prevalence of severe visual impairment (SVI) and blindness were, respectively, 0.74% (0.46-1.02) and 0.77% (0.48-1.05) in SPES and 1.72% (1.09-2.35) and 3.44% (2.55-4.33) in BARES. SVI and blindness were associated with BARES study [OR = 2.27 (1.30-3.95); p = .004 - SVI] [OR:4.07 (2.51-6.60); p < .001- blindness]; and older age [OR = 10.93 (4.20-28.45); p < .001 - SPES; OR = 17.96 (8.75-36.83); p < .001 - BARES] while higher education level was a protective factor [OR = 0.21 (0.05-0.95) - SPES; p = .042; OR = 0.21 (0.05-0.91); p = .037 - BARES]. Cataract was the main cause of bilateral severe visual impairment (25.93% in SPES and 64.29% in BARES) and bilateral blindness (21.43% in SPES and 35.71% in BARES). Cataract surgical coverage was significantly lower in BARES (36.32%) compared to SPES (57.75%). CONCLUSION The prevalence of SVI and blindness was three times higher in older adults from the Brazilian Amazon compared to those living in São Paulo city, despite a 10-year interval between the two studies. These disparities should be mitigated by initiatives to promote access to eye care services targeting underprivileged and remote Brazilian areas.
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Affiliation(s)
- Marcela Colussi Cypel
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Adriana Berezovsky
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Arthur Gustavo Fernandes
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Sung Song Watanabe
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Marcia Regina Kimie Higashi Mitsuhiro
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Nivea Nunes Ferraz
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Paula Yuri Sacai
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - João Marcello Furtado
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
- Departamento de Oftalmologia, Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil
| | - Paulo Henrique Morales
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Sergio Muñoz
- Department of Public Health-CIGES, Universidad de La Frontera, Temuco, Chile
| | - Jacob Moysés Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas (UFAM), Manaus, Brazil
| | - Rubens Belfort
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
- Instituto da Visão, Instituto Paulista de Estudos e Pesquisas em Oftalmologia (IPEPO), São Paulo, Brazil
| | - Solange Rios Salomão
- Núcleo de Epidemiologia Ocular, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
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Reis T, Lansingh V, Ramke J, Silva JC, Resnikoff S, Furtado JM. Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020. Am J Ophthalmol 2021; 225:1-10. [PMID: 33412124 DOI: 10.1016/j.ajo.2020.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region. DESIGN Population-based systematic review with longitudinal comparisons. METHODS The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men. RESULTS Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%. CONCLUSIONS Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.
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Affiliation(s)
- Tulio Reis
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Van Lansingh
- HelpMeSee, New York City, New York, USA; Instituto Mexicano de Oftalmología, Queretaro, Mexico
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Juan Carlos Silva
- Eye Care Program, Pan-American Health Organization, Bogotá, Colombia
| | - Serge Resnikoff
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Goyal A, Richards C, Patel V, Syeda S, Guest JM, Freedman RL, Hall LM, Kim C, Sirajeldin A, Rodriguez T, Arsenault SM, Boss JD, Hughes B, Juzych MS. The Vision Detroit Project: Visual Burden, Barriers, and Access to Eye Care in an Urban Setting. Ophthalmic Epidemiol 2021; 29:13-24. [PMID: 33576279 DOI: 10.1080/09286586.2021.1884264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: Vision loss and blindness are among the top ten disabilities in the United States, yet access and utilization of eye care remains low. Vision Detroit aimed to address eye-care disparities via community-based screenings. By investigating burden of eye disease and barriers to eye-care utilization in an underserved urban community, we may direct efforts to improve access.Methods: Twenty-three screenings were conducted from March 2015-November 2017. Patient information gathered at screenings were demographics, medical and social history, eye exam/referral history, insurance status, primary care physician (PCP) status, and patient-perceived eye-care barriers.Results: Three-hundred-eighty patients were screened, 42% African American and 51% Hispanic. Average age was 53 ± 16.4 years, 70% reported vision problems, 50% reported over two years of vision problems, and average habitual visual acuity in best-seeing eye was 20/37. Eye-care underutilization was reported in 61% of type-2 diabetics. Older age and PCP recommendations/referrals were associated with increased utilization in all patients. Insurance was the most common barrier (53%); of the 55% insured, 31% reported financial barriers. Employed patients were more likely than unemployed to report a time barrier (odds ratio = 1.76, 95% confidence interval 1.03-3.01). Those with high school or less education reported "unaware of need", "unsure where to go", "transportation", and "insurance" as barriers more often.Conclusions: Visual burden was pervasive, yet access was suboptimal. Financial, logistical, and awareness barriers were common. PCP referral and older age were associated with increased utilization. Those less educated reported more barriers, highlighting the need to address fiscal concerns and eye-health education.
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Affiliation(s)
- Anju Goyal
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Collin Richards
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Vaama Patel
- Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sarah Syeda
- Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - John-Michael Guest
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ryan L Freedman
- Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Leo M Hall
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Chaesik Kim
- Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Abdala Sirajeldin
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Tannia Rodriguez
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Samantha M Arsenault
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Joseph D Boss
- Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Bret Hughes
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mark S Juzych
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Ophthalmology, Visual, and Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
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Amritanand A, Jasper S, Paul P, Kuriakose T. Facilitating factors in overcoming barriers to cataract surgical services among the bilaterally cataract blind in Southern India: A cross-sectional study. Indian J Ophthalmol 2018; 66:963-968. [PMID: 29941740 PMCID: PMC6032741 DOI: 10.4103/ijo.ijo_216_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To effectively address cataract blindness, increasing sight-restoring surgeries among the bilaterally blind are essential. To improve uptake of surgical services among this group, evidence regarding the problems of access is vital. Barriers in accessing eye care services have previously been reported but not specific to bilaterally cataract blind patients. Further, there is a gap in knowledge regarding factors facilitating access to eye care. Our aims were to (1) report proportion of bilaterally cataract blind patients undergoing surgery and sight restoration rate (SRR) and (2) analyze barriers and factors enabling access to eye care services among bilaterally cataract blind patients. Methods Retrospective analysis of interview and clinical data of bilaterally cataract blind patients undergoing surgery through outreach services at the base hospital, from June 2015 to May 2016, was performed. Demographic data, vision, postoperative visual outcomes, barriers, and facilitating factors in accessing cataract surgical services were obtained. Results Bilateral cataract blindness was present in 196/3178 (6.2%, 95% confidence interval 5.4-7.06) patients. SRR was 6.5%. Fear of surgery (24.2%) and lack of family support/escort (22.9%) were the most common barriers. Neighbors and acquaintances (28.6%), general health workers (20.2%), and persons who had undergone cataract surgery (19.6%) were the most common facilitating factors. Conclusion Proportion of bilaterally cataract blind people undergoing surgery and consequently SRR were low. The most common barriers were at the individual level while facilitating factors at the community level were instrumental in promoting uptake of services. Interventions involving community-based support for the blind may be useful in overcoming barriers to eye care.
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Affiliation(s)
- Anika Amritanand
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Smitha Jasper
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Padma Paul
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thomas Kuriakose
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
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de Almeida Ferreira G, Schaal LF, Ferro MD, Rodrigues ACL, Khandekar R, Schellini SA. Outcomes of and barriers to cataract surgery in Sao Paulo State, Brazil. BMC Ophthalmol 2017; 17:259. [PMID: 29273018 PMCID: PMC5741937 DOI: 10.1186/s12886-017-0637-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/28/2017] [Indexed: 12/04/2022] Open
Abstract
Background Cataract is the leading cause of blindness in developing countries and identification of the barriers to accessing treatment is essential for developing appropriate public healthcare interventions. To evaluate the barriers to cataract surgery after diagnosis and assess the postoperative outcomes in Sao Paolo State, Brazil. Methods This prospective study evaluated cataract patients from 13 counties in São Paulo State in 2014. Cataract was diagnosed in the community by a mobile ophthalmic unit and patients were referred to a hospital for management. Gender, age, distance to the hospital and local municipal health structure were evaluated as possible barriers. Data were analyzed for postoperative outcomes and the impact on blindness and visual impairment. Results Six hundred patients were diagnosed with cataract with a mean age of 68.8±10.3 years and 374 (62.3%) were females. Two hundred and fifty-four (42.3%) patients presented to the referral hospital. One hundred forty-four (56.7%) underwent surgery, 56 (22.0%) decided not to undergo surgery, 40 (15.7%) required only YAG-Laser and 14 (5.5%) required a spectacle prescription only. Visual acuity increased statistically significantly from 1.07±0.73 logMAR at presentation to 0.25±0.41 logMAR at the final visit after intraocular lens implantation (p=0.000). There was a statistically significantly decrease from 17 (11.8%) blind patients and 55 (38.2%) visually impaired patients at presentation to 2 (1.4%) and 5 (3.5%) patients respectively after treatment (p=0.000). Conclusion Less than half of the individuals with cataract presented to the hospital for surgery. Among the patients who underwent treatment, there was an overall decrease in the number of blind individuals and visually impaired individuals. The barriers to cataract surgery were older age, greater distance to the hospital, municipalities with fewer inhabitants and less ophthalmic services.
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Affiliation(s)
- Gabriel de Almeida Ferreira
- Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Campus de Botucatu Botucatu, Sao Paulo, Brazil
| | - Luisa Fioravanti Schaal
- Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Campus de Botucatu Botucatu, Sao Paulo, Brazil
| | - Marcela Dadamos Ferro
- Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Campus de Botucatu Botucatu, Sao Paulo, Brazil
| | | | - Rajiv Khandekar
- Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Campus de Botucatu Botucatu, Sao Paulo, Brazil
| | - Silvana Artioli Schellini
- Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Campus de Botucatu Botucatu, Sao Paulo, Brazil.
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Marmamula S, Giridhar P, Khanna RC. Utilization of eye care services among those with unilateral visual impairment in rural South India: Andhra Pradesh Eye Disease Study (APEDS). Int J Ophthalmol 2017; 10:473-479. [PMID: 28393042 DOI: 10.18240/ijo.2017.03.23] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/13/2016] [Indexed: 02/04/2023] Open
Abstract
AIM To report on the utilization of eye care services and its associated factors among those with unilateral visual impairment (VI) in a rural South Indian population. METHODS A population based cross-sectional study was conducted in three districts (Adilabad, Mahbubnagar and West Godavari) in the state of Andhra Pradesh, India. A detailed interview and a comprehensive eye examination were conducted. Those with unilateral VI were asked questions about noticing any change in vision and on utilization of eye care services. The most important reason reported by the participant for not utilizing the services was used for the analysis. Multiple logistic regression models were used to examine the association between noticing a change in vision and socio-demographic variables such as age, gender, education and area of residence, severity and causes of VI. RESULTS Among the 4456 participants aged ≥16y who were administered the questionnaire, 53.2% were women, and 54.7% had no education. Of the 489 (11%; 95% CI: 10.1-11.9) people with unilateral VI, 399 (81.6%) participants reported noticing a change in their vision over the last five years but only 136 (34.1%) participants had sought eye care consultation. Those who had any education (OR: 1.9; 95% CI: 1.1-3.2), had blindness (OR: 2.7; 95% CI: 1.4-5.2), and cataract (OR: 2.1; 95% CI: 1.0-4.3) as a cause of unilateral VI were more like to seek eye care consultations. The most commonly reported reasons for not seeking eye care services were "do not have money for eye checkup" in 30.7% of the participants followed by "do not have a serious problem" (30.0%). CONCLUSION A large proportion of rural population though noticed a change in their vision did not seek eye care due to financial and person-related reasons. Eye care service providers need to address these barriers to enhance the uptake of eye care services among those with unilateral VI.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao, International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500034, India; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, India; Wellcome Trust/DBT India Alliance Fellow, L V Prasad Eye Institute, Hyderabad 500034, India; School of Optometry & Vision Science, University of New South Wales, Sydney NSW 2052, Australia; Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Pyda Giridhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao, International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao, International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500034, India; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, India; School of Optometry & Vision Science, University of New South Wales, Sydney NSW 2052, Australia
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Lin H, Lin D, Long E, Jiang H, Qu B, Tang J, Lin Y, Chen J, Wu X, Lin Z, Li X, Liu Z, Zhang B, Chen H, Tan X, Luo L, Liu Y, Chen W. Patient participation in free cataract surgery: a cross-sectional study of the low-income elderly in urban China. BMJ Open 2016; 6:e011061. [PMID: 27084286 PMCID: PMC4838725 DOI: 10.1136/bmjopen-2016-011061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To explore the characteristics of the low-income elderly who underwent free cataract surgery and to determine the degree of patient satisfaction with the free cataract surgery programme in urban China. METHODS A free cataract surgery management workflow was designed as a poverty relief project in Guangzhou. In this study, participants who underwent free cataract surgery between January and August 2014 received a telephone interview based on a structured questionnaire. Data were collected on patient demographics, resources, health conditions, reasons for undergoing the free surgery and overall evaluation of the free cataract surgery programme. RESULTS Among the 833 participants, the mean surgical age was 76.85±7.46 years (95% CI 76.34 to 77.36), and the male to female ratio was 385:448. The majority (94.31%, 746/791) of patients resided in the main urban districts. Patients underwent surgery 61.08±60.15 months (95% CI 56.17 to 66.00) after becoming aware of the cataract, although 66.83% of them reported that their daily lives were influenced by cataracts. Only 21.5% of the respondents underwent physical examinations that included regular eye screening, and only 6.30% were highly educated patients. Financial problems were the primary reason cited by patients for participating in the free surgery programme. Those patients with a monthly family income of 1000-2999¥ (US$161-482) per capita constituted the largest patient population. The free clinics in the parks and the free cataract surgery were highly rated (9.46 and 9.11 of 10 points) by the beneficiaries. CONCLUSIONS The telephone survey revealed a high level of patient satisfaction regarding the free cataract surgery programme. Most of the patients who participated in the programme resided in major urban districts and had poor health awareness and a low level of education. The information provided by this study is crucial for improving and expanding the management of free cataract surgery programmes. TRIAL REGISTRATION NUMBER NCT02633865; Post-results.
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Affiliation(s)
- Haotian Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Duoru Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Erping Long
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Haofeng Jiang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Qu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jinzhu Tang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yingfen Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jingjing Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaohang Wu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhuoling Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaoyan Li
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhenzhen Liu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Zhang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Hui Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xuhua Tan
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Lixia Luo
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yizhi Liu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Weirong Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
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He M, Mathenge W, Lewallen S, Courtright P. Global Efforts to Generate Evidence for Vision 2020. Ophthalmic Epidemiol 2016. [PMID: 26218105 DOI: 10.3109/09286586.2015.1058958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mingguang He
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia
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Langeslag-Smith MA, Vandal AC, Briane V, Thompson B, Anstice NS. Preschool children's vision screening in New Zealand: a retrospective evaluation of referral accuracy. BMJ Open 2015; 5:e009207. [PMID: 26614622 PMCID: PMC4663450 DOI: 10.1136/bmjopen-2015-009207] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To assess the accuracy of preschool vision screening in a large, ethnically diverse, urban population in South Auckland, New Zealand. DESIGN Retrospective longitudinal study. METHODS B4 School Check vision screening records (n=5572) were compared with hospital eye department data for children referred from screening due to impaired acuity in one or both eyes who attended a referral appointment (n=556). False positive screens were identified by comparing screening data from the eyes that failed screening with hospital data. Estimation of false negative screening rates relied on data from eyes that passed screening. Data were analysed using logistic regression modelling accounting for the high correlation between results for the two eyes of each child. PRIMARY OUTCOME MEASURE Positive predictive value of the preschool vision screening programme. RESULTS Screening produced high numbers of false positive referrals, resulting in poor positive predictive value (PPV=31%, 95% CI 26% to 38%). High estimated negative predictive value (NPV=92%, 95% CI 88% to 95%) suggested most children with a vision disorder were identified at screening. Relaxing the referral criteria for acuity from worse than 6/9 to worse than 6/12 improved PPV without adversely affecting NPV. CONCLUSIONS The B4 School Check generated numerous false positive referrals and consequently had a low PPV. There is scope for reducing costs by altering the visual acuity criterion for referral.
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Affiliation(s)
| | - Alain C Vandal
- Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Vincent Briane
- Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand
| | - Benjamin Thompson
- Department of Optometry and Vision Science, The University of Waterloo, Waterloo, Ontario, Canada School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Nicola S Anstice
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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