This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Anjum, K M Articles by Khan, M D Search for Related Content PubMed PubMed Citation Articles by Anjum, K M Articles by Khan, M D

Cataract blindness and visual outcome of cataract surgery in a tribal area in Pakistan

¹ Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex, Hayatabad, Peshawar, Pakistan
² Section of Ophthalmology, Department of Surgery, Aga Khan University, Karachi, Pakistan

Correspondence to:
Correspondence to:
Mohammad Babar Qureshi
Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex, Hayatabad, Peshawar, Pakistan; pico{at}pes.comsats.net.pk

ABSTRACT
Aim: To estimate the rates of cataract blindness and cataract surgical coverage and to assess the visual outcome of cataract surgery among individuals aged 50 years in Orakzai Agency, Pakistan.

Methods: 1600 individuals aged 50 years were selected using probability proportional to size sampling. The main outcome measure was bilateral cataract blindness which was defined as visual acuity of <3/60 in the better eye with best available correction and with obvious central lens opacities/absence of red reflex in both eyes.

Results: A total of 1549 people were examined; the coverage rate was 96.8%. Of individuals who were examined, 958 (61.8%) were men. The overall prevalence of bilateral cataract blindness was 4.8% (95% CI: 3.8% to 5.9%). Women had a 2.1-fold greater prevalence of bilateral cataract blindness than men (7.1% (5.0% to 9.2%) v 3.4% (2.3% to 4.6%); p = <0.0001). However, cataract surgical coverage rates were lower for women than men. The overall quality of previous cataract surgery was poor: 43.1% eyes with cataract surgery had VA <6/60. 73.3% people with bilateral cataract blindness reported they could not undergo cataract surgery because they were too poor to afford its cost.

Conclusion: The unacceptably high rates of cataract blindness and poor affordability and visual outcome of cataract surgery calls for the establishment, in the agency, of static cataract surgical services that are high quality, affordable, and gender sensitive.

Abbreviations: CSC, cataract surgical coverage; IOL, intraocular lens; RACSS, Rapid Assessment of Cataract Surgical Services; VA, visual acuity

Keywords: cataract blindness; cataract surgery; cataract surgical coverage; Pakistan

This article has been cited by other articles:

				Z Jadoon, S P Shah, R Bourne, B Dineen, M A Khan, C E Gilbert, A Foster, M D Khan, and on behalf of the Pakistan National Eye Survey Stud Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan: the Pakistan National Blindness and Visual Impairment Survey Br. J. Ophthalmol., October 1, 2007; 91(10): 1269 - 1273. [Abstract] [Full Text] [PDF]

				R. Bourne, B. Dineen, Z. Jadoon, P. S Lee, A. Khan, G. J Johnson, A. Foster, and D. Khan Outcomes of cataract surgery in Pakistan: results from The Pakistan National Blindness and Visual Impairment Survey Br. J. Ophthalmol., April 1, 2007; 91(4): 420 - 426. [Abstract] [Full Text] [PDF]

				M. T Masoud East and West: worlds apart in cataract surgery BMJ, July 29, 2006; 333(7561): 260 - 260. [Full Text]