Introduction
Blindness is a worldwide problem with a significant social and economic impact on society. The WHO has defined blindness as a visual acuity worse than 3/60 in the better eye with best correction. It is estimated that number of visually disabled people are around 272.4 million and of them nearly 42.7 million are blind globally.1
Eighty-five percent of moderate to severe visual impairment and 80% of blindness are avoided by prevention, treatment, or cure.2 Globally, the leading causes of blindness, in order of frequency are: Cataract, uncorrected refractive errors, Glaucoma, Age-related macular degeneration. Other major causes include Corneal opacities, Diabetic retinopathy, Blinding Trachoma.2
National programme for Control of Blindness was launched in the year 1976 with the goal to reduce the prevalence of blindness from 1.4% to 0.3%. Target for the 10th plan was to reduce prevalence of blindness to 0.8% by 2007 prevalence of Blindness is 1%. During the 11th plan, the scheme aims in controlling cataract blindness and also initiate activities to prevent and control blindness due to other causes.3
Due to lack of eye care professionals, access to health care by elderly population in remote rural areas is often compromised.
Hence the present study is carried out to know the prevalence and pattern of common ocular morbidity (refractive error, cataract, diabetic retinopathy, chronic dacryocystitis, age related macular degeneration, vascular abnormalities, optic atrophy) in eye camp patients in a rural hospital.
Materials and Methods
This hospital-based cross-sectional study was conducted at Department of Ophthalmology. A total of 2912 eye camp patients aged 40 to 80 years attending Ophthalmology department with a history of ocular diseases were evaluated from July 2018 to June 2019. After obtaining approval from Institutional Ethics committee, written informed consent from the patients were taken.
Visual acuity, detailed clinical history, relavant past and family history, general physical examination, detailed ocular examination - Intraocular pressure, Slit lamp examination, Fundus examination, keratometry, A-scan, B-scan and appropriate laboratory analysis were done. Patient were treated as protocol.
Results
Out of 2912 eye camp patients, between age group of 40-80years, Males were 1759 (60.4%) and Female were 1153 (39.59%).
Most common ocular morbidity was Cataract 1967 (67.54%) and Cataract associated with comorbidity (Hypertension, Diabetes) were 391 (13.42%) followed by glaucoma 152 (5.2%), Hypertensive 92 (3.1%) and Diabetic 84 (2.8%) retinopathy, blepharitis 78 (2.6%), pterygium 69 (2.3%), Chronic dacrocystitis 41 (1.4%) [Table 1].
Less common ocular morbidity were refractive error 13 (0.4%), age related macular degeneration ten (0.3%), Phacotoxic uveitis eight (0.2%), corneal opacity five (0.1%) and Retinitis pigmentosa three (0.1%) [Table 2].
Table 1
Frequency and percentage of common ocular morbidity in eye camp patients
Discussion
Our study aimed to determine the prevalence and pattern of the different types of ocular morbidity in eye camp patients.
Overall, Most common ocular morbidity was Cataract 1967 (67.54%) and Cataract associated with comorbidity (like hypertension, diabetes) were 391 (13.42%) followed by glaucoma 152 (5.2%), hypertensive 92 (3.1%) and diabetic 84 (2.8%) retinopathy, blepharitis 78 (2.6%), pterygium 69 (2.3%), chronic dacryocystitis 41 (1.4%).
Priti Singh et al., showed in a study conducted on 900 patients, there was high prevalence of cataract 58 (42.9%) followed by refractive errors 50 (37.03%), dry eye six (4.4%) and retinopathies 12(8.8%).4 Vibha Florence Baldev et al., showed in study conducted on 900 patients, most common cause of blindness was cataract (36.1%) followed by corneal opacity (30.5%), glaucoma (11.1%), refractive error (8.3%).5 Jitendrakumar et al., showed high prevalence of refractive errors (43.4%) and cataract (41%) followed by pterygium (18.8%), aphakia (14.2%) glaucoma (3.7%) and corneal opacities (3.2%).6 Anupama Kumar et al., showed in study conducted on 812 people, prevalence of ocular morbidity was 41.3%, with 88.8% elderly affected more than 65 years and most common ocular morbidity was myopia (14.8%) followed by cataract (14.3%), hypermetropia (12.8%).7 Sadana Adala et al., showed majority of the patients belonged to 60 years & above and overall, the common morbid conditions found in this study were cataract (60.2%), refractive errors (14.5%) and allergic conjunctivitis (7.1%).8 Venkataramana et al., showed in a study conducted on 1181 population prevalence of ocular morbidity was 13.9%, most common ocular morbidity were refractive error (6.4%) in 18-45 years age group followed by cataract (4%), corneal blindness (3%) in 46-60 years age group.9 Singh et al., conducted a cross-sectionalstudy on 9736 people, most common ocular morbidity were Cataract (41.89%) followed by uncorrected refractive error (21.59%), glaucoma (4.83%) among 931 cases identified with eye diseases.10 Thus, cataract was found to be the common ocular morbid condition in elderly patients. Maurya et al reported commonest ocular morbidities as a refractive errors (39.78%) followed by conjunctivitis (30.64%), blepharitis (16.85%), computer vision syndrome (10.73%), stye (8.68%), ocular injuries (8.16%) amongst university students.11
Conclusion
Blindness is still one of the major public health problems. The results of this study suggest that cataract remains the main cause of ocular morbidity followed by Glaucoma and retinopathies. Efforts were aimed to reduce high prevalence of treatable ocular morbidity such as cataract, glaucoma in elderly rural patients. Hence, awareness programs for cataract surgery, detection of glaucoma, control of hypertension and DM, correction of refractive errors need to be targeted to further reduce the burden of ocular morbidity.
