Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model

Abstract

Purpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual acuity, noncycloplegic autorefraction, noncontact tonometry, fundus photography, and slit-lamp examination were performed. Refractive error was defined as having spherical equivalent ≤ -0.75 D or ≥ +1 D and uncorrected refractive error was considered as refractive error combined with presenting visual acuity < 6/12 in the better eye. Costs for the screening were assessed.Results: A total of 5,284 participants (61 ± 14 years) were included. The overall prevalence of myopia and hyperopia was 38.7% (95% CI, 37.4–40.0%) and 23.5% (95% CI, 22.3–24.6%), respectively. The prevalence of uncorrected refractive error was 7.85% (95% CI, 7.13–8.58%). Women (p < 0.001 and p = 0.003), those with age ≥ 70 years (p < 0.001 and p = 0.003), and myopia (p < 0.001 and p < 0.001) were at higher risk of uncorrected refractive error and uncorrected refractive error-related visual impairment. Spectacle coverage rate was 70.6% (95% CI, 68.2–73.0%). The cost to identify a single case of refractive error and uncorrected refractive error was US$3.2 and US$25.2, respectively.Conclusion: The prevalence of uncorrected refractive error is high in the urban Chinese adults. Health examination center-based refractive error screening is able to provide an efficient and low-cost model to improve the refractive services in China.

Barriers to the Utilization of Low-Vision Rehabilitation Services among Over-50-Year-Old People in East and Southeast Asian Regions: A Scoping Review

“…Of the 1662 articles, 81 were categorized as definitely relevant or possibly relevant. The full text of these 81 articles was reviewed and 18 promising articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were extracted.…”

“…Of the 1662 articles, 81 were categorized as definitely relevant or possibly relevant. The full text of these 81 articles was reviewed and 18 promising articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were extracted. Of the 18 articles, 4 [23,24,30,32] included only insufficient information on participants' ages and had ambiguity regarding whether the age of study participants met our Of the 18 articles, 4 [23,24,30,32] included only insufficient information on participants' ages and had ambiguity regarding whether the age of study participants met our inclusion criteria or not (≥50 years).…”

“…Two additional articles [36,37] were extracted through a manual search of the reference lists of 18 eligible articles. Finally, a set of 20 articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] was included as eligible articles for this scoping review. Detailed information extracted from each eligible article is provided in Table S2 (Supplementary Materials).…”

“…Seventeen potential barrier factors were from the individual category, while two were each from the healthcare settings and society categories. 6 [19,25,26,29,30,36] 0 1 [18] 8 (62) 13 [18][19][20]22,[24][25][26][27][28][29][30]36,37] Non-barriers 2 [24,37] 3 [20,27,28] 0 0 5 (38) 3 Education (Lower) Barriers 1 [24] 5 [19,25,26,29,36] 0 1 [18] 7 (70) 10 [ [18][19][20][24][25][26]28,29,36,37] Non-barriers 1 [37] 2 [20,28] 2 [25,30] 0 1 [18] 4 (100) 4…”

Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost-effectiveness at scale

“… 28 This study concerned the use of telemedicine for diagnosing diabetic retinopathy. Only a handful of studies have examined the costs of other case finding strategies such as health facilities 29 , 30 or community outreach. 31 , 32 In these instances, the geographical scope has been limited to a particular facility, hospital or locality with uncertainty about how these might generalize at scale.…”