title: Corneal blindness in a southern Indian population: need for health promotion strategies.
abstract: OBJECTIVE
  To assess the distribution and causes of corneal blindness in a population in southern India.
  
  
  METHODS
  A total of 11 786 people of all ages from 94 clusters representative of the population of the Indian state of Andhra Pradesh were sampled using a stratified, random, cluster, systematic sampling strategy. These participants underwent a detailed interview and eye examination including measurement of visual acuity with logMAR charts, refraction, slit lamp biomicroscopy, applanation tonometry, gonioscopy, and stereoscopic dilated fundus evaluation. An eye was considered to have corneal blindness if the visual acuity was <20/200 due to a corneal disease.
  
  
  RESULTS
  Of those sampled, 10 293 (87.3%) people participated in the study. Corneal blindness in at least one eye was present in 86 participants, an age, sex, and urban-rural distribution adjusted prevalence of 0.66% (95% confidence interval 0.49 to 0.86), which included 0.10% prevalence of corneal blindness in both eyes and 0.56% in one eye. The most frequent causes of corneal blindness in at least one eye included keratitis during childhood (36.7%), trauma (28.6%), and keratitis during adulthood (17.7%). Nearly 95% of all corneal blindness was avoidable. Multivariate analysis showed that the prevalence of corneal blindness was significantly higher with decreasing socioeconomic status and with increasing age. Of the 99 eyes with corneal blindness, 51 (51.5%) had visual acuity of inaccurate projection of light or no perception of light.
  
  
  CONCLUSIONS
  There is a significant burden of corneal blindness in this population, the majority of which is avoidable. Eye health promotion strategies are warranted to raise awareness about the causes and prevention of corneal blindness.
authors.affiliation: Centre for Social Services, Administrative Staff College of India, Hyderabad, India. rakhi@asci.org.in
authors.forename: R
authors.initials: R
authors.lastname: Dandona
authors.forename: L
authors.initials: L
authors.lastname: Dandona
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D002648:Child; D003316:Corneal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005131:Eye Injuries / Q000150:complications; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007194:India / Q000453:epidemiology; D007634:Keratitis / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012423:Rural Health; D017678:Sex Distribution; D014504:Urban Health; D014792:Visual Acuity / Q000502:physiology