Utilisation of eye care services in rural south India: the Aravind Comprehensive Eye Survey

• Published in: British journal of ophthalmology 2004-10, Vol.88 (10), p.1237-1241
• Main Authors: Nirmalan, P K, Katz, J, Robin, A L, Krishnadas, R, Ramakrishnan, R, Thulasiraj, R D, Tielsch, J
• Format: Article
• Language: English
• Subjects: ACES; Adult; Age Distribution; Age Factors; age related maculopathy; Aged; Aravind Comprehensive Eye Survey; ARM; Biological and medical sciences; Blindness; Camps; Cataracts; clinically significant macular oedema; Cross-Sectional Studies; CSMO; Defects; Diabetic retinopathy; Educational Status; Eye diseases; Eye Diseases - diagnosis; Eye Diseases - epidemiology; Female; Glaucoma; Hospitals; Humans; India; India - epidemiology; Male; Medical sciences; Middle Aged; non-proliferative diabetic retinopathy; NPDR; older adults; Ophthalmology; PACG; Patient Acceptance of Health Care - statistics & numerical data; PDR; Physicians; POAG; Population; posterior subcapsular cataract; PPDR; pre-proliferative diabetic retinopathy; primary angle closure glaucoma; primary open angle glaucoma; proliferative diabetic retinopathy; PSC; retinal pigment epithelium; RPE; Rural areas; Rural Health - statistics & numerical data; rural population; Urban areas; utilisation of eye care; Vision disorders; Vision Disorders - diagnosis; Vision Disorders - epidemiology; Visual impairment; World View
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2004.042606

Aim: To determine utilisation of eye care services in a rural population of southern India aged 40 years or older. Methods: 5150 subjects aged 40 years and older selected through a random cluster sampling technique from three districts in southern India underwent detailed ocular examinations for vision impairment, blindness, and ocular morbidity. Information regarding previous use of eye care services was collected from this population through a questionnaire administered by trained social workers before ocular examinations. Results: 3476 (72.7%) of 5150 subjects examined required eye care examinations. 1827 (35.5%) people gave a history of previous eye examinations, primarily from a general hospital (n = 1073, 58.7%). Increasing age and education were associated with increased utilisation of eye care services. Among the 3323 people who had never sought eye care, 912 (27.4%) had felt the need to have an eye examination but did not do so. Only one third of individuals with vision impairment, cataracts, refractive errors, and glaucoma had previously utilised services. Conclusions: A large proportion of people in a rural population of southern India who require eye care are currently not utilising existing eye care services. Improved strategies to improve uptake of services is required to reduce the huge burden of vision impairment in India.