People in Bangladesh have one of the poorest levels of access to spectacles in the world according to a recent study.1 Conducted in the northern district of Sirajganj, the research found that only around 3% of people with presbyopia and 13% of those with refractive error, had the glasses they need to see clearly at near or distance, respectively.
A similar study in India found that 29.0% of people who needed corrective lenses for refractive error had them (19% for presbyopia), while in Eritrea it was 22.2% (9.9% for presbyopia). Population based studies in Tanzania, China and India have all reported higher rates of coverage.
Around 4.7% of people examined in the 15-49 year age group in the Bangladesh study had some form of refractive error. Significantly, among those 35 years and over, 62% had presbyopia, yet only 3% of those had the corrective lenses needed to see clearly up close. It has been demonstrated that uncorrected presbyopia, which results in poor near vision, can impact on quality of life and economic opportunity. Uncorrected refractive error can have a similar impact.
The authors extrapolated the findings to estimate that almost 3.5 million people aged 15-49 years in Bangladesh had refractive error, of whom more than 3 million do not use any spectacles.
The study highlights the need for development of human resources and infrastructure for eye care services but it also provides another insight into the solution. Over 90% of those people with vision impairment due to uncorrected refractive error or uncorrected presbyopia weren’t aware that they had a vision problem.
Consequently, the authors strongly suggest that health promotion will be critical to raising awareness of eye health issues, as well as increased ophthalmic capacity for diagnosis and resources for refractive correction.
Rapid assessments are an efficient way to collect data to plan appropriate eye care programs. In a sector with limited resources, typically focused on areas where services are urgently needed, the RARE methodology provides a cost-effective and quicker alternative to classical population-based surveys to determine the prevalence of refractive error.
References
1. Mohammad Muhit, Hasan Minto, Afroza Parvin, Mohammad Z. Jadoon, Johurul Islam, Sumrana Yasmin & Gulam Khandaker (2017): Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study, Ophthalmic Epidemiology, DOI: 10.1080/09286586.2017.1370119 To link to this article: http://dx.doi.org/10.1080/09286586.2017.1370119