Rapid assessment of cataract at pension pay points in South Africa.
OBJECTIVE
To test a method for the rapid assessment of cataract blindness in South Africa.


METHODS
Randomised cluster-based cross-sectional survey (20 clusters of 50 each).


METHODS
Pension pay points in Moretele district, North West Province, South Africa.


METHODS
Female pensioners aged >or=60 years, and male pensioners aged >or=65 years.


METHODS
(1) Prevalence of cataract requiring surgery; (2) prevalence of blindness due to cataract; (3) cataract surgical coverage; (4) cataract surgery outcome; and (5) barriers to cataract surgery.


RESULTS
1000 pensioners were screened (681 women and 319 men). 17.2% of pensioners had operable cataract (visual acuity <6/60); 95% CI -3.4% to 3.4%); 15.6% of pensioners were blind due to cataract (95% CI -3.1% to 3.4%); and 5.6% of pensioners had had previous cataract surgery, 55.4% with intraocular lens implant and 44.6% without intraocular lens implant. The cataract surgical coverage was 24.6%. 80% of people who had had surgery were satisfied with the result, but 26.8% had a poor outcome according to the World Health Organization criteria. The main barrier to uptake of surgery was a lack of awareness of the availability of the surgery.


CONCLUSIONS
Rapid assessment of cataract at pension pay points is a useful and effective tool for our district Vision 2020 programmes in South Africa. Steps need to be taken to raise awareness of the availability of cataract surgery among indigent pensioners, and to improve the quality of visual outcome after surgery by ensuring routine monitoring of postoperative visual acuity.
Cook
Colin
C
Department of Ophthalmology, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa. myrna@mweb.co.za
Kluever
Herman
H
Mabena
Letty
L
Limburg
Hans
H
D000368:Aged; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D002386:Cataract / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000458:organization & administration*; D004812:Epidemiologic Methods; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010415:Pensions; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D015351:Vision Screening / Q000458:organization & administration*