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Background: The purpose of this study was to quantify how much of the burden of visual impairment (VI) and unmet need in Talagang, identified by Rapid Assessment of Avoidable Blindness (RAAB) survey data, has been addressed by Community Eye Health (CEH) programme efforts. Methods: A RAAB survey was carried out in November 2018, with 2,824 participants in Talagang Tehsil, Punjab, Pakistan, aged 50 and over. Census data were used to extrapolate survey data to the population. Alongside this, a CEH programme was launched, consisting of community eye screening, and onward referral to rural health centres, secondary or tertiary ophthalmological services, as required. This health intervention aimed to address the eye care needs surfaced by the initial survey. From 2018 to 2022, 30,383 people aged 50 or over were screened; 14,054 needed referral to further steps of the treatment pathway and more detailed data collection. Programme data were compared to estimates of population unmet needs. Main outcome measures were prevalence of VI, and proportion of need met by CEH Programme, by cause and level of VI. Results: Among those aged 50 and over, 51.0% had VI in at least one eye. The leading causes were cataract (46.2%) and uncorrected refractive error (URE) (25.0%). In its first four years, the programme reached an estimated 18.3% of the unmet need from cataract, and 21.1% of URE, equally in both men and women. Conclusions: Robustly collected survey and programme data can improve eye health planning, monitoring and evaluation, address inequities, and quantify the resources required for improving eye health. This study quantifies the time required to reach eye health needs at the community level. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study was undertaken to ascertain the current magnitude and causes of blindness and visual impairment in persons aged 50 years and over and to assess the impact of a 10-year eye care program in Sokoto State, Nigeria. METHODS: A rapid assessment of avoidable blindness (RAAB) survey (in persons 50 years and over) was conducted in 2016. Participants were selected in Wurno health zone using a two-stage cluster randomized sampling with probability proportional to size. Operational definitions were based on RAAB and World Health Organization eye examination record definitions. Eye care program documents were reviewed and data from a baseline survey undertaken in 2005 were reanalyzed. RESULTS: A response of 89.1% (2405 of 2700 participants) was obtained in the 2016 survey. With available correction, the unadjusted prevalence of blindness was 7.7% (95% confidence interval [CI]: 6.4, 8.9). The odds of blindness were 1.8 times higher in females than males (95% CI: 1.3, 2.4;P< 0.001). Major causes of blindness were cataract (48.9%) corneal disease (20.1%), glaucoma (10.3%), and uncorrected refractive error/aphakia (8.7%). The age- and sex-adjusted prevalence of blindness has declined from 11.6% (95% CI: 7.4, 17.0) in 2005 to 6.8% (95% CI: 5.6, 8.0%) in 2016. CONCLUSION: The blindness prevalence is high, and the major causes are avoidable in the health zone. The findings suggest that investments in the program over the last 10 years might have led to almost a halving in the prevalence of blindness in th e population. However, the small sample size of persons 50+ years from Wurno zone in the 2005 survey necessitate caution when comparing the 2005 and the 2016 surveys. [ABSTRACT FROM AUTHOR]

India has done well in eye care delivery by recognizing visual impairment and blindness as a major medical challenge. Major contributions have come from ophthalmologists (mass cataract surgery in the early 1900s; major participation of non-government organizations), policy makers (National Program for Control of Blindness and Visual Impairment 1976; systematic development under the World Bank assisted India Cataract Project, 1995-2002), and the industry (manufacturing of affordable surgical instruments and medicines). Although the country could boast of higher cataract surgical coverage and near-total elimination of trachoma, there is increasing prevalence of diabetic retinopathy and undetected glaucoma. India is in the crossroad of adherence to old successful models of service delivery and adoption of new innovative methods of teaching and training, manpower development and skill-based training, relevant medical research and product development. In the absence of these new approaches, the initial gains in eye care could not be furthered in India. A new approach, that will combine the best of the "old" tradition of empathy and the "new" technology of analytics, is required to imagine the future of eye care in India. [ABSTRACT FROM AUTHOR]

Background One barrier to patient adherence with chronic topical glaucoma treatment is an inadequate amount of medication available between prescription refills. We examined the self-reported prevalence of early exhaustion of glaucoma eye drops prior to a scheduled refill, and associated risk factors. Methods This cross-sectional survey was performed at a University-based clinical practice. Glaucoma patients at the University of Washington who were experienced with eye drop application and were on a steady regimen of self-administered glaucoma drops in both eyes took a survey at the time of clinic examination. The main outcome measure was self-reported early eye drop bottle exhaustion. Results 236 patients were eligible and chose to participate. In general, patients included were relatively healthy (mean 2.3 comorbid medical conditions). Sixty patients (25.4%) reported any problem with early exhaustion of eye drop bottles, and this was associated with visual acuity ≤ 20/70 in the better eye (P = .049). Twelve patients (5.1%) reported that they "often" (5-7 times per year), "usually" (8-11 times per year) or "always" ran out of eye drops prior to a scheduled refill. Patients affected by this higher level (≥5 times yearly) of eye drop bottle exhaustion were more likely to have poor visual acuity in their worse eye ≤ 20/70 (P = .015) and had significantly lower worse-eye logMAR (P = .043). Conclusions Self-reported early glaucoma bottle exhaustion regularly affected 5% of patients in our population and 25% reported early exhaustion at least once; the main risk factor was poor vision in at least one eye. These results may not be generalizable to a broad patient population, or to those inexperienced with eye drop self-administration. However, this pilot study compels further evaluation and consideration of early eye drop bottle exhaustion in glaucoma patients. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether regular eye examinations are associated with a greater or lesser rate of loss of ability to read newsprint, onset of blindness or low vision, or onset of limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs). Design: A sample of 14,215 Medicare beneficiaries observed between 1994 and 1999 linked to the 1994 and 1999 National Long-Term Care Surveys (NLTCS). Effects of annual examinations were assessed using instrumental variables. Setting: The Medicare-linked NLTCS is representative of U.S. elderly persons from 1994 to 1999. Participants: Longitudinal observational study of persons aged 65 and older. Measurements: Change in self-reported and provider-reported vision and change in functional limitations associated with vision related to the number of years with eye examinations and other factors. Results: Persons with more-regular eye examinations between 1994 and 1998 were less likely to have experienced a decline in vision or in functional status between 1994 and 1999. On average, an additional year with an eye examination was associated with a decrease in the probability of becoming unable to read newsprint of 0.12 ( P=.03), a lower probability of onset of low vision or blindness of 0.009 ( P=.06), and a decrease in the probability that the number of functional limitations increased of 0.13 ( P=.002) for IADLs and 0.05 ( P=.003) for ADLs. Conclusion: Elderly persons who have regular eye examinations experience less decline in vision and functional status. [ABSTRACT FROM AUTHOR]

Abstract: Importance: National data on eye health‐care service utilization will inform Australia's eye health policy. Background: To investigate the utilization of eye health‐care services by Australians. Design: Cross‐sectional survey. Participants: Indigenous Australians aged 40 years and older and non‐Indigenous Australians aged 50 years and older. Methods: One thousand seven hundred thirty‐eight Indigenous Australians and 3098 non‐Indigenous Australians were recruited from 30 randomly selected sites, stratified by remoteness. Sociodemographic, ocular history and eye health‐care service utilization data were collected, and an eye examination was conducted. Main outcome measures: Recentness of eye examinations, types of providers used and associated risk factors. Results: Approximately 67.0% of Indigenous Australians and 82.5% of non‐Indigenous Australians underwent an eye examination within the previous 2 years. Indigenous status (P < 0.001), male gender (P < 0.001), Outer Regional (P < 0.001) and Very Remote (P < 0.001) residence were associated with less recent examinations. Participants with >self‐reported eye disease or diabetes were most likely to have been examined within the past year (P < 0.001). For Indigenous Australians, older age was associated with recent eye testing (P = 0.001). Those with retinal disease and cataract were more likely to see an ophthalmologist (P < 0.001), and those with refractive error were more likely to see an optometrist (P < 0.001). In Regional Australia, non‐Indigenouspeople were more likely to see optometrists (P < 0.001), and Indigenous Australians were more likely to utilize other, non‐specialistservices (P < 0.001). Conclusions and relevance: Eye examination frequency has improved in Indigenous and non‐Indigenous Australians compared with previous population‐based research. Further improvements are required in risk groups including Indigenous Australians and those living in Regional and Remote areas. [ABSTRACT FROM AUTHOR]