title: Utilisation of eye care services in rural south India: the Aravind Comprehensive Eye Survey.
abstract: OBJECTIVE
  To determine utilisation of eye care services in a rural population of southern India aged 40 years or older.
  
  
  METHODS
  5150 subjects aged 40 years and older selected through a random cluster sampling technique from three districts in southern India underwent detailed ocular examinations for vision impairment, blindness, and ocular morbidity. Information regarding previous use of eye care services was collected from this population through a questionnaire administered by trained social workers before ocular examinations.
  
  
  RESULTS
  3476 (72.7%) of 5150 subjects examined required eye care examinations. 1827 (35.5%) people gave a history of previous eye examinations, primarily from a general hospital (n = 1073, 58.7%). Increasing age and education were associated with increased utilisation of eye care services. Among the 3323 people who had never sought eye care, 912 (27.4%) had felt the need to have an eye examination but did not do so. Only one third of individuals with vision impairment, cataracts, refractive errors, and glaucoma had previously utilised services.
  
  
  CONCLUSIONS
  A large proportion of people in a rural population of southern India who require eye care are currently not utilising existing eye care services. Improved strategies to improve uptake of services is required to reduce the huge burden of vision impairment in India.
authors.affiliation: Lions Aravind Institute of Community Opthalmology, Aravind Eye Care System, Madurai, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Nirmalan
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: A L
authors.initials: AL
authors.lastname: Robin
authors.forename: R
authors.initials: R
authors.lastname: Krishnadas
authors.forename: R
authors.initials: R
authors.lastname: Ramakrishnan
authors.forename: R D
authors.initials: RD
authors.lastname: Thulasiraj
authors.forename: J
authors.initials: J
authors.lastname: Tielsch
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004522:Educational Status; D005128:Eye Diseases / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012423:Rural Health / Q000706:statistics & numerical data*; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology