Introduction Uncorrected refractive errors are the commonest cause of visual impairment globally. Despite this, the proportion of affected individuals who wear spectacles can be low, particularly in low and middle-income countries. No data were available for Sri Lanka. Objectives To estimate the prevalence of refractive errors and investigate their risk factors among adults aged 40 years and above. Another purpose was to calculate spectacle coverage and identify subgroups with low coverage. Methods Cluster random sampling was used to obtain a nationally representative sample. Presenting distance visual acuity was measured using a logMAR chart, with distance spectacle correction if usually worn. All underwent autorefraction and an optician measured best-corrected visual acuity after subjective refraction. Participants who had undergone cataract surgery were excluded. Spectacle coverage was assessed amongst participants with a visual acuity of <6/12 in the better eye due to refractive error who attended the examination site with spectacles. Results 5,779/6,713 (86.1%) enumerated adults were examined; 5,179 had refraction data. 67% had a refractive error: hyperopia 49.6%; myopia 17.4%. Refractive errors increased with age. Being aged 60 years and above and Sinhala ethnic group were independent risk factors. Spectacle coverage was 17.7% overall, being lower in females and the non

Introduction There is paucity of data on the epidemiology of visual impairment in Sri Lanka.Objectives Estimate the prevalence and determine causes and risk factors of visual impairment among adults aged 40 years in Sri Lanka.Methods Multistage, stratified, cluster random sampling was used to select a nationally representative sample aged 40 years. All participants underwent vision testing, autorefraction and a basic eye examination. Participants with a presenting acuity of <6/12 in either eye underwent detailed eye examination, assessment of bestcorrected acuity if required, and a cause of visual loss assigned.Results 5,779 of those enumerated (6,713) were examined (response rate 86.1%). The prevalence of blindness was 1.7% (95% confidence interval [CI]: 1.3-1.99%) and low vision was 17% (95% CI: 16.0-18.0%). Cataract (66.7%) and uncorrected refractive errors (12.5%) were the commonest causes of blindness. Uncorrected refractive errors (62.4%) and cataract (24.2%) were the commonest causes of low vision. Blindness was significantly higher in older age groups (OR 132.4: 95%

Introduction Cataract surgical coverage and visual acuity outcomes are important population level indicators for monitoring access to and the quality of cataract surgery, allowing subgroups with poorer access to be identified. Data on these indicators are not available for Sri Lanka at national level. Objectives Determine cataract surgical coverage and the outcomes of cataract surgery in a nationally representative sample of adults aged 40 years. Methods Cluster random sampling with proportionate to size procedures was used. All participants were interviewed to obtain data on education level, movable assets, and the year and place of cataract surgery, if applicable. Presenting and best corrected visual acuities were measured. All participants underwent slit lamp examination, including a dilated examination of the fundus. Cataract surgical coverage was calculated at the person level vision of <3/30, <6/60 and <6/18. Outcomes of cataract surgery were categorized as good (6/18 or better), borderline (<6/18-6/60) or poor (<6/60). Results A total of 345 persons among the 5,779 participants who were examined had undergone cataract surgery in one or both eyes (486 eyes). Cataract surgical coverage, which was high overall 85.4% for vision <3/60; 79.1% for vision <6/60), was significantly higher in younger age groups (Odds Ratio [OR] 5.65, 95% confidence interval [CI] 1.42-22.52), those in urban areas (OR 2.8, 95% CI 1.01-7.74) those with higher socioeconomic status (OR 6.0; 95% CI 1.96-18.4).

Background Cognition is the collection of an intellectual process, such as perception, thinking, reasoning and remembering for goal-directed behaviors. Recent studies have shown that obesity associated with poor cognitive functions (CFs). However, this association is not known in the Sri Lankan context. The objective was to determine the association of cognitive function and obesity among middle-aged adults in Colombo district, Sri Lanka Methods A comparative cross-sectional study was conducted among 166 middle-aged adults aged 50-60 years in a selected MOH division in Colombo District, Sri Lanka. Generalized and central obesity were determined using the WHO cutoff of Body Mass Index (BMI) and Waist Hip Ratio (WHR) values. CFs were assessed using validated Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) tools. Results The study sample consisted 83 subjects of each obese and normal weight categories while 50% were females. Obese middle-aged adults showed significantly lower CF scores in both MoCA and MMSE compared to the normal-weight adults. In addition, lower MMSE scores were significantly associated with high WHR values. Education level of the obese people was a significant predictor of the cognitive functions. Conclusion Obese middle-aged adults had poor cognition compared with their normal-weight subjects.Therefore, remedial actions need to be taken to overcome adulthood obesity for better neuropsychological functions in the brain.

Background: Cognition is the collection of an intellectual process, such as perception, thinking, and reasoning for goal-directed behaviours. The obesity-associated cognitive functions (CFs) was varied due to inconsistency of the findings and it is also context bounded. The objective was to assess the association between cognitive function and obesity among middle-aged adults in Sri Lanka.Methods: A descriptive study was conducted among middle-aged adults aged between 50-60 years in Colombo District, Sri Lanka. While Generalized obesity was estimated by the WHO cutoff of body mass index (BMI) while the central obesity was determined using and waist hip ratio (WHR). CFs was assessed using a validated Montreal cognitive assessment (MoCA) and the Mini-mental state examination (MMSE) tools.Results: The study sample consisted of 83 subjects of each obese and normal weight categories, while 50% were females. Middle-aged adults with obesity showed significantly lower CF scores in both MoCA and MMSE compared to the normal-weight adults (p<0.01). In addition, lower MMSE scores were significantly associated with high WHR values (p<0.05). The level of education of adults was a significant predictor of cognitive functions among middle-aged adults (p<0.05).Conclusions: Therefore, the results further confirmed that obesity-associated cognitive impairment among middle-aged adults and further research is warranted to clarify the cause and effect relationship between obesity and body composition.