Uncorrected refractive error in the northern and eastern provinces of Sri Lanka.
BACKGROUND
The 2004 tsunami focused unprecedented international aid and resources on Sri Lanka. Among other responses, a program delivered by volunteer optometrists enabled many local people to access eye examinations and spectacles for the first time. The data collected from the eye-care delivery program during 2005 are summarised in this report, as an evidence base for planning future eye-care interventions in these provinces or similar areas.


METHODS
A total of 96 eye clinics were conducted by visiting volunteer optometrists in the northern and eastern provinces of Sri Lanka, at which 20,090 people were examined. Clinical records were reviewed for conditions causing visual impairment, conditions that could cause impaired vision in future if left untreated, eye-care outcomes and barriers to seeking care.


RESULTS
Complete records were available for 14,669 people. Seventy-nine per cent of this clinical population had never had an eye examination. Uncorrected refractive error including presbyopia caused visual impairment for 78 per cent (11,388) of people who presented for an eye examination. Cataract caused impaired vision for 15 per cent (2,180) of people and was the main reason for referral beyond primary eye-care, although only five per cent (695) of people presenting were referred for cataract surgery, as local capacity constraints set a visual acuity requirement of 6/36 or worse. The gender and age profiles of people attending the clinics were not consistent with equitable blindness prevention.


CONCLUSIONS
The high proportion of people who had not previously had an eye examination, particularly those with significant uncorrected refractive error, provides evidence for the acute need for further development and support of community-level eye-care services in the regions visited. Women and older people should be targeted by future programs to achieve equity of blindness prevention.
Tahhan
Nina
N
International Centre for Eyecare Education, Kensington NSW, Australia.
Fricke
Timothy R
TR
Naduvilath
Thomas
T
Kierath
Jane
J
Ho
Suit May
SM
Schlenther
Gerhard
G
Layland
Brian
B
Holden
Brien
B
D000328:Adult; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009907:Optometry / Q000379:methods; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012030:Refractive Errors / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D013188:Sri Lanka / Q000453:epidemiology; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology; D014787:Vision Tests; D014792:Visual Acuity; D014838:Volunteers