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Background. For so long, corneal diseases have been known as one of the leading causes to blindness in the global. This blindness might be due to failure to accept the corneal transplantation. Therefore, this study aimed to determine the prevalence and the root challenges for corneal transplantation acceptance at the University of Gondar tertiary eye care and training center, Ethiopia. Methods. An institution-based cross-sectional study was conducted among patients who had an indication for corneal transplantation at the University of Gondar tertiary eye care and training center since January 1, 2017, up to October 30, 2018. A structured questionnaire was used to collect the data and entered into Epi-Info 7 software and analyzed using SPSS version 20. Simple logistic regression was used to identify the associated factors of corneal transplantation acceptance. Associations between outcome and exposure variables were expressed by the adjusted odds ratio with a 95% confidence interval and p value <0.05. Result. A total of 116 patients with a mean age of 51 (±21) years participated in the study. The overall acceptance level of corneal transplantation was only 38.8% (95% CI: 29.93, 47.66). Patients with poor knowledge [AOR = 2.41; 95% CI: 1.90, 6.48] and an unfavorable attitude [AOR = 6.33; 95% CI: 2.42, 16.54] were significantly associated with the acceptance of corneal transplantation. Conclusion. The study revealed that the corneal transplantation acceptance level was very low. Hence, the government and other concerned stakeholders should give due emphasis to the awareness creation and behavior change communication strategies to increase the acceptance level of corneal transplantation. [ABSTRACT FROM AUTHOR]

To test a model of integrated pediatric eye care delivery and examine the prevalence and factors associated with childhood ocular morbidity in a peri-urban setting in Bangladesh. Cross-sectional, population-based study. The study was conducted in three phases among children aged ≤15 years. Trained community health workers (CHWs) conducted awareness intervention and identified children with ocular problems. These children were then referred to the base hospital for examination and treatment by ophthalmologists. A pediatric ophthalmologist further examined the children with complicated eye diseases and ensured treatment at a tertiary public eye hospital. Awareness, referral patterns, and health-seeking behavior were also examined. All data were analyzed statistically using Statistical Package for Social Sciences. CHWs screened 33,549 eligible children and identified 1887 cases with ocular morbidity. The prevalence of ocular morbidity and childhood blindness were 5.63% (95% confidence interval [CI] = 5.27–6.16) and 0.060% (95% CI = 0.03–0.11), respectively. The most commonly observed ocular morbidities were refractive error (3.24%; 95% CI = 3.11–3.45), allergic eye conditions (1.2%; 95% = CI 0.74–1.27), and nasolacrimal duct obstruction (0.52%; 95% CI = 0.25–0.74). Blindness was more frequently seen in children aged <5 years than in those aged 5–15 years (χ2 = 7.25; P = 0.007). The causes of blindness were corneal opacity, congenital eye anomaly, cataract, retinopathy of prematurity, and retinoblastoma. The prevalence of ocular morbidity was higher among older children, boys, children with low parental education and income, and children from households dwelling in slums. This study demonstrated that in a setting where screening and treatment for vision problems remain low, ocular morbidity among children could be easily identified through well-designed community-based screening programs involving appropriately trained CHWs. Community mobilization, awareness, and early detection of childhood eye diseases, with effective referral mechanisms for accessing appropriate care, are crucially important to improve service delivery. • Trained community health workers conducted awareness interventions, identified and referred children with ocular problems. • Refractive error was the most common ocular morbidity. • Ocular morbidity was associated with older children and slum dwellers. • Gender inequalities existed in care seeking; fewer girls sought care from the referral hospital. • Community mobilization, early detection and effective referral are important for improving eye care service delivery. [ABSTRACT FROM AUTHOR]

Background: China used to be among the countries with a high prevalence of trachoma. At the launch of The Global Elimination of Trachoma (GET) 2020 campaign by the World Health Organization (WHO) in 1996, China was placed on the list of countries endemic for trachoma based on historical data. However, empirical observation and routinely collected eye care data were suggesting that trachoma was no longer a public health problem. To determine whether the GET 2020 goals had been met in P. R. China, we conducted a targeted assessment with national scope. Methodology/principal finding: Province assessment teams, trained in WHO Trachoma Rapid Assessment (TRA) methodology and in WHO simplified trachoma grading system, carried out assessments in 16 provinces (among them, 2 provinces conducted pilot assessment). Based on the published literature, including national and international reports, suspected trachoma-endemic areas within each province were identified. Within these areas, trachomatous inflammation- follicular (TF) assessments were carried out in at least 50 grade-one children in primary schools serving villages with the lowest socio-economic development. Trachomatous trichiasis (TT) and corneal opacity (CO) assessments were conducted among persons aged 15 and over in villages within the catchment area of the selected schools. Of 8,259 children examined in 128 primary schools in 97 suspected trachoma endemic areas, only 16 cases of conjunctivitis were graded as TF. 38 cases with TT were found among the 339,013 examined residents in villages surrounding the schools. Among these 97 suspected trachoma endemic areas in only three was the prevalence of TT more than 0.2%. Conclusions/significance: This large study suggested that trachoma was not a public health problem in 16 provinces that had been previously suspected to be endemic. These findings will facilitate planning for elimination of trachoma from PR China. [ABSTRACT FROM AUTHOR]

Many low- and middle-income countries use national eye-care plans to guide efforts to strengthen eye-care services. The World Health Organization recognizes that evidence is essential to inform these plans. We assessed how evidence was incorporated in a sample of 28 national eye-care plans generated since the Universal eye health: a global action plan 2014-2019 was endorsed by the World Health Assembly in 2013. Most countries (26, 93%) cited estimates of the prevalence of blindness and 18 countries (64%) had set targets for the cataract surgical rate in their plan. Other evidence was rarely cited or used to set measurable targets. No country cited evidence from systematic reviews or solution-based research. This limited use of evidence reflects its low availability, but also highlights incomplete use of existing evidence. For example, despite sex-disaggregated data and cataract surgical coverage being available from surveys in 20 countries (71%), these data were reported in the eye health plans of only nine countries (32%). Only three countries established sex-disaggregated indicators and only one country had set a target for cataract surgical coverage for future monitoring. Countries almost universally recognized the need to strengthen health information systems and almost one-third planned to undertake operational or intervention research. Realistic strategies need to be identified and supported to translate these intentions into action. To gain insights into how a country can strengthen its evidence-informed approach to eye-care planning, we reflect on the process underway to develop Kenya's seventh national plan (2019-2023). [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to assess the impact of the eye care programme on cataract blindness and cataract surgical services in Sokoto, Nigeria over a 12 year period 2005–2016. Methods: Data from the 2005 population based cross-sectional study of blindness in Sokoto state was re-analysed to obtain baseline estimates of the prevalence of cataract blindness and cataract surgical coverage for persons 50 years and over in Wurno health zone. A population based survey of a representative sample of persons 50 years and over in Wurno health zone was conducted in July 2016. Data on eye health workforce, infrastructure and cataract surgical services between 2005 and 2016 were analysed from relevant documents. Results: In 2005 the unadjusted prevalence of bilateral cataract blindness (<3/60) in people 50 years and over in Wurno health zone was 5.6% (95% CI: 3.1, 10.1). By 2016 this had fallen to 2.1% (95% CI 1.5%, 2.7%), with the age-sex adjusted prevalence being 1.9% (95% CI 1.3%, 2.5%). The CSC for persons with visual acuity <3/60, <6/60, <6/18 for Wurno health zone was 9.1%, 7.1% and 5.5% respectively in 2005 and this had increased to 67.3%, 62.1% and 34.7% respectively in 2016. The CSR in Sokoto state increased from 272 (1005 operations) in 2006, to 596 (2799 operations) in 2014. In the 2005 survey, couching (a procedure used by traditional practitioners to dislocate the lens into the vitreous cavity) accounted for 87.5% of all cataract interventions, compared to 45.8% in the 2016 survey participants. In 2016 18% of eyes having a cataract operation with IOL implantation had a presenting visual acuity of <6/60 (poor outcome) with the main causes being postoperative complications (53%) and uncorrected refractive error (29%). Conclusion: Between 2005 and 2016 there was a doubling in cataract surgical rate, a 7 times increase in cataract surgical coverage (<3/60), and a decrease in cataract blindness and the proportion of eyes being couched. However, there remains a high prevalence of un-operated cataract in 2016 indicating a need to further improve access to affordable and good quality cataract surgical services. [ABSTRACT FROM AUTHOR]

Objective: Cross-sectional blindness prevalence surveys are essential to plan and monitor eye care services. Incomplete or inaccurate reporting can prevent effective translation of research findings. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement is a 32 item checklist developed to improve reporting of observational studies. The aim of this study was to assess the completeness of reporting in blindness prevalence surveys in low and middle income countries (LMICs) using STROBE. Methods: MEDLINE, EMBASE and Web of Science databases were searched on April 8 2016 to identify cross-sectional blindness prevalence surveys undertaken in LMICs and published after STROBE was published in December 2007. The STROBE tool was applied to all included studies, and each STROBE item was categorized as ‘yes’ (met criteria), ‘no’ (did not meet criteria) or ‘not applicable’. The ‘Completeness of reporting (COR) score’ for each manuscript was calculated: COR score = yes / [yes + no]. In journals with included studies the instructions to authors and reviewers were checked for reference to STROBE. Results: The 89 included studies were undertaken in 32 countries and published in 37 journals. The mean COR score was 60.9% (95% confidence interval [CI] 58.1–63.7%; range 30.8–88.9%). The mean COR score did not differ between surveys published in journals with author instructions referring to STROBE (10/37 journals; 61.1%, 95%CI 56.4–65.8%) or in journals where STROBE was not mentioned (60.9%, 95%CI 57.4–64.3%; p = 0.93). Conclusion: While reporting in blindness prevalence surveys is strong in some areas, others need improvement. We recommend that more journals adopt the STROBE checklist and ensure it is used by authors and reviewers. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of cataract surgery and postoperative vision-related outcomes, especially with respect to sex, socioeconomic status (SES) and site of first contact with eye care, in a rural area of South India. Methods: In a population-based cross-sectional survey of 5530 individuals aged 50 years or older from 10 villages selected by cluster sampling, individuals who had undergone cataract surgery in one or both eyes were identified. Consenting participants were administered a questionnaire, underwent vision assessment and ophthalmic examination. Outcomes were classified as good if visual acuity of the operated eye was 6/18 or better, fair if worse than 6/18 but better than or equal to 6/60, and poor if worse than 6/60. Results: Prevalence of cataract surgery in this age group (771 persons) was 13.9% (95% confidence interval, CI, 13.0–14.9%). In the 1112 eyes of 749 persons studied, at presentation, 53.1% (95% CI 50.1–56.1%) of operated eyes had good, 38.1% (95% CI 35.2–41.0%) had fair, and 8.8% (95% CI 7.1–10.5%) had poor outcomes. With pinhole, 75.2% (95% CI 72.6–77.8%) had good, 17.2% (95% CI 14.9–19.5%) had fair, and 7.4% (95% CI 5.8–9.0%) had poor outcomes. In 76.3% of eyes with fair and poor presenting outcomes we detected an avoidable cause for the suboptimal visual acuity. Place of surgery and duration since surgery of 3 years or more were risk factors for blindness, while SES, sex and site of first eye care contact were not. Conclusion: The high prevalence of avoidable causes of visual impairment in this rural setting indicates the scope for preventive strategies. [ABSTRACT FROM PUBLISHER]

Prevention of blindness due to diabetic retinopathy (DR) requires effective screening strategies, for which eye care providers need to know the magnitude of the burden and the risk factors pertinent in their geographical location. It is estimated that around 72 million of the global adult population (around 8.2%) has diabetes and about one-fifth of all adults with diabetes lives in the South-East Asia. In India, around 65 million people have diabetes. As the global prevalence of diabetes increases, so will the number of people with diabetes-related complications, such as DR; nearly one-third of them are likely to develop this complication. This article reviews the present status of diabetes and DR in India, the current situation of DR services and the projections on the load of morbidity associated with retinopathy. The article compiles the Indian studies elucidating the risk factors for DR. [ABSTRACT FROM AUTHOR]

In the first 12 years of VISION 2020 sound programmatic approaches have been developed that are capable of delivering equitable eye health services to even the most remote and impoverished communities. A body of evidence around the economic arguments for investment in eye health has been developed that has fuelled successful advocacy work resulting in supportive high level policy statements. More than a 100 national plans to achieve the elimination of avoidable blindness have been developed and some notable contributions made from the corporate and government sectors to resource eye health programs. Good progress has been made to control infectious blinding diseases and at the very least there is anecdotal evidence to suggest that the global increase in the prevalence of blindness and visual impairment has been reversed in recent years, despite the ever increasing and more elderly global population. However if we are to achieve the goal of VISION 2020 we require a considerable scaling up of current efforts--this will depend on our future success in two key areas: i) Successful advocacy and engagement at individual country level to secure significantly enhanced national government commitment to financing their own VISION 2020 plans. ii) A new approach to VISION 2020 thinking that integrates eye health into health system development and develops new partnerships with wider health development initiatives. [ABSTRACT FROM AUTHOR]

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Purpose: To estimate the prevalence of low vision and blindness, identify the causes, and suggest policies for an effective eye care program based on 2005 data from Sokoto State, Nigeria. Materials and Methods: A stratified two-stage cluster sampling method was used to quantify the prevalence of blindness and the causes from 4 health zones in Sokoto State. Subjects were evaluated using a magnifying loupe, direct ophthalmoscope and torchlight. Data were collected based on the World Health Organization prevention of blindness coding for an eye examination. Prevalences with 95% confidence intervals (CI) were calculated and surgical coverage for causes of blindness was also analyzed. Results: The response rate was 91%. The prevalence of bilateral blindness was 1.9% (95% CI: 1.5-2.3%) ranging from 1.6% to 2.0% across the four health zones. The prevalence was 2.1% (95% CI: 1.6-2.6%) in males and 1.6% (95% CI: 1.1-2.1%) in females. The leading cause of bilateral blindness was cataract (51.6%), followed by uncorrected aphakia (20.9%) and glaucoma (11%). The prevalence of bilateral operable cataract was 1.9% (95% CI: 1.5-2.3%). The cataract surgical coverage (individuals with visual acuity <6/60) for the study was lower than the couching coverage (4.4% vs. 14.9%, respectively). Surgical coverage for trichiasis was 4.4%. The major barrier to cataract and glaucoma management was cost. Conclusions: The prevalence of blindness in Sokoto State is high yet the main causes are largely avoidable. Barriers can be reduced by appropriate health education regarding the eye care program and the provision of integrated, sustainable, affordable and equitable services. [ABSTRACT FROM AUTHOR]

Introduction: Age-related macular degeneration (AMD) is among the fourth leading cause of blindness in India after cataract, refractive errors and glaucoma. Aim and Objective: To find out magnitude and determinants of blinding AMD among patients presenting at a tertiary level eye care centre in Dehradun with this condition. Material and methods: This was a study of eye patients above age 45 years seen from July 2010 to October 2013. After taking preliminary information, optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. AMD was confirmed by fluorescein angiography and optical coherence tomography. The age, sex, history of smoking, sun exposure, family history of AMD, diet, body mass index (BMI), history of hypertension, dyslipidemia and diabetes were noted. Results: Of the 14,698 patients seen, 221 had AMD (dry or wet) in at least one eye, the overall proportion of AMD being 1.50%. Of all AMD patients, 103 had blinding wet AMD (46.61%).Further analysis revealed that old age (71-80 years), male sex and history of hypertension, diabetes etc were significant risk factors of wet AMD. Of the 221 patients with AMD, nearly a third, that is 71 patients (32.13%) had visual acuity of better eye < 3/60, which was taken as criteria for blindness. Conclusions: AMD does not seem to be a problem of public health magnitude in the study area. Age, being male, history of hypertension, diabetes etc are significant risk factors for wet AMD. [ABSTRACT FROM AUTHOR]