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Prevalence of visual impairment, uncorrected refractive errors and effective refractive error coverage in Koshi Province, Nepal – Rapid Assessment of Refractive Errors

Abstract

Background/Objective

To determine the prevalence of visual impairment (VI), uncorrected refractive errors (URE), and effective refractive error coverage among individuals aged 15–50 years in Koshi Province, Nepal.

Methods

A population-based cross-sectional study was conducted in Koshi Province in which 4800 participants were selected from 80 clusters. The study teams visited the selected households and conducted eye examinations. This included monocular unaided (and aided) visual acuity assessment using a Snellen chart with tumbling E optotypes at a distance of 6 meters. Near vision was assessed binocularly using the N notation chart at a fixed distance of 40 cm for each individual. Torchlight examination and distance direct ophthalmoscopy was done. VI was defined as presenting visual acuity worse than 6/12 in the better eye. URE was defined as presenting visual acuity worse than 6/12 and improving to 6/12 or better on using a pinhole. Near Vision Impairment was defined as binocular presenting near vision worse than N8 among those age 35 years and older.

Results

In total, 4057 were examined (84.5% response rate). The prevalence of VI was 3.52% (95% CI:2.89–4.13; n = 143). The prevalence of URE in the better eye was 1.95% (95% CI:1.54–2.42; n = 79). The Refractive Error Coverage and Effective Refractive Error Coverage were 34.8% and 31.3% respectively. The prevalence of NVI was 34.24% (95% CI: 32.1–36.40; n = 666).

Conclusion

The prevalence of VI and  URE was low, attributed to the availability and uptake of services in Koshi province in Nepal.

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Fig. 1: Map of Nepal showing Koshi Province where the study was conducted.
Fig. 2: Categories of visual impairment based on unaided, presenting and pinhole visual acuity in the better eye.

Data availability

The data that support the findings of this study are not openly available as authors are analyzing  the data for other manuscripts. Data are available from the corresponding author upon reasonable request.

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Acknowledgements

We express our gratitude to Dr Chet Raj Pant, Chairman and Dr Sailesh Mishra, Executive Director of NNJS for valuable guidance and support. Mr. Kumar Prithu, Hospital Manager, Md. Rafique, Mr. Dipendra Chaudhary of BEH for logistics and HR support. The Ophthalmic Assistants (Sabin Kumar Mahato, Bijay Tamang, Indrajeet Kumar Yadav, Shivram Chaudhary) and Community Eye Health Workers (Rita Pradhan, Parshuram Shrestha, Shrawn Majhi, Manish Khawash), Optometrists (Pankaj Ray Adhikari and Sanjay Kumar Shah), Similarly, Dhiraj Mandal, Gautam Majhi, Mithlesh Meheta, Rupesh Kumar, Sanjay Kamat are acknowledged for their contributions.

Funding

This study was funded by OneSight Essilor Luxottica Foundation, USA.

Author information

Authors and Affiliations

  1. Eastern Regional Eye Care Program, Biratnagar Eye Hospital, Biratnagar, Nepal

    Rajiv Ranjan Karn & Sudhir Kumar Thakur

  2. Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India

    Srinivas Marmamula & Ranindita Saha

  3. Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India

    Srinivas Marmamula

  4. Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India

    Srinivas Marmamula

  5. School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, Australia

    Srinivas Marmamula

  6. Biratnagar Eye Hospital, Biratnagar, Nepal

    Rakshya Pant Sitoula & Amit Kumar Mehta

  7. Nepal Netra Jyoti Sangh, Kathmandu, Nepal

    Ranjan Shah

  8. Prashasa Health Consultants, Hyderabad, India

    Saibaba Saravanan

  9. OneSight Essilor Luxottica Foundation, Mason, OH, USA

    Rahul Ali

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  1. Rajiv Ranjan Karn
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Contributions

Study concept and design: SM. Acquisition, analysis, or interpretation of data: RRK, RSH, AKM, SM. Drafting of the manuscript: RRK, SM, RSA. Critical revision of the manuscript for important intellectual content: SS, RSH, SKT, RPS. Statistical analysis: SM, RRK.

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Correspondence to
Rajiv Ranjan Karn.

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Karn, R.R., Marmamula, S., Thakur, S.K. et al. Prevalence of visual impairment, uncorrected refractive errors and effective refractive error coverage in Koshi Province, Nepal – Rapid Assessment of Refractive Errors.
Eye (2023). https://doi.org/10.1038/s41433-023-02786-4

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  • Received: 14 July 2023

  • Revised: 29 September 2023

  • Accepted: 02 October 2023

  • Published: 24 October 2023

  • DOI: https://doi.org/10.1038/s41433-023-02786-4

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