Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India

Abstract

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients' homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015-16 and 98.14% (n = 43,708) of them in 2018-19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18-6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.