Utilisation of eye care services in rural south India: the Aravind Comprehensive Eye Survey

Abstract

Aim: To determine utilisation of eye care services in a rural population of southern India aged 40 years or older. Methods: 5150 subjects aged 40 years and older selected through a random cluster sampling technique from three districts in southern India underwent detailed ocular examinations for vision impairment, blindness, and ocular morbidity. Information regarding previous use of eye care services was collected from this population through a questionnaire administered by trained social workers before ocular examinations. Results: 3476 (72.7%) of 5150 subjects examined required eye care examinations. 1827 (35.5%) people gave a history of previous eye examinations, primarily from a general hospital (n = 1073, 58.7%). Increasing age and education were associated with increased utilisation of eye care services. Among the 3323 people who had never sought eye care, 912 (27.4%) had felt the need to have an eye examination but did not do so. Only one third of individuals with vision impairment, cataracts, refractive errors, and glaucoma had previously utilised services. Conclusions: A large proportion of people in a rural population of southern India who require eye care are currently not utilising existing eye care services. Improved strategies to improve uptake of services is required to reduce the huge burden of vision impairment in India.

Bilateral Blindness: Prevalence and Their Utilization of Existing Eye Care Facilities in a Nigerian Rural Community

“…We observed an increasing level of eye care utilization with increasing age from 40years upward this may be due to the fact that aging is associated with an increased rate of visual impairment and ophthalmic conditions, a considerable percentage of people are motivated to seek eye care by the factor of need. However, this is contrary to some other studies that found decreasing rates with an increasing age [6,17,19]. The greater eye care seeking behaviour found with those who had formal education might be attributable to their greater knowledge, higher socioeconomic class and more affordability.…”

“…Nirmalan and colleagues [17] reported a 64.5% 'no eye care' visit among a target population of rural Indians , while at the other end of the range, Wang et al reported an impressive 99% eye care service coverage in an older Australian population [18]. We observed an increasing level of eye care utilization with increasing age from 40years upward this may be due to the fact that aging is associated with an increased rate of visual impairment and ophthalmic conditions, a considerable percentage of people are motivated to seek eye care by the factor of need.…”

Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

“…1 The prevalence of glaucoma in India has been reported by various epidemiological studies and is estimated to be approximately 11.2 million people aged Z40 years. 2 In developing countries, glaucoma is generally diagnosed at an advanced stage, only when the patient seeks advice for cataract surgery. Trabeculectomy is thus performed as a primary procedure with cataract extraction and implantation of an intraocular lens (IOL).…”

Carência de atenção à saúde ocular no setor público: um estudo de base populacional

“…Idade e escolaridade estiveram diretamente associadas à utilização de serviços de saúde ocular. Ser mulher e apresentar mais necessidades em saúde ocular, como, por exemplo, glaucoma, diabetes melito e uso de correção (óculos ou lentes de contato) também estiveram positivamente associadas com o desfecho 4,6,7,8,10,11,12,13,14 .…”

“…Nesse caso, a pessoa se responsabiliza por não ter tentado conseguir uma consulta em situação de grande dificuldade, como as longas filas, os horários específicos para marcação de consultas, muitas vezes incompatíveis com suas possibilidades, a espera para consultar, a falta de dinheiro para transporte e o risco de investir grande esforço para tentar agendar e não conseguir. Em um estudo indiano, as principais barreiras enfrentadas pelas pessoas com 40 anos ou mais ao acesso a serviços de saúde ocular também foram falta de dinheiro (78,2%) e falta de tempo (70%) 13 .…”