title: Prevalence and correction of near vision impairment at Kaski, Nepal.
abstract: BACKGROUND
  Presbyopia is an important cause of avoidable visual disability.
  
  
  OBJECTIVE
  To estimate the prevalence of near vision impairment and spectacle coverage among middle and older-aged adults in rural Nepal.
  
  
  METHODS
  The surveys was carried out among the people of age 35 and over in randomly-selected cluster samples in rural settings of Kaski district of western Nepal, Near visual acuity, with and without presenting near correction, was measured at 40 cm using a LogMAR near vision tumbling E chart under ambient indoor lighting. Subjects with uncorrected binocular distance vision of 20/40 or worse were refracted and those with near vision of 20/40 or worse tested with plus sphere to obtain the best-corrected binocular near visual acuity.
  
  
  RESULTS
  A total of 2,360 persons aged 35 years and over were enumerated and 2,156 (91.3%) were examined. The age- and gender-standardized prevalence of uncorrected near visual impairment (vision of 20/40 or worse) in study population was found to be 66.1 %. Near vision could not be corrected (>20/40) even after distance and near vision correction in 6.4 % . Using the multiple logistic regression models, uncorrected visual impairment was associated with an older age (odds ratio [OR] = 1.13, P less than 0.001) and a lower educational level (OR = 1.11, P = 0.01) was less associated with female gender (OR = 0.72, P = 0.038). Over 90 % of people with near visual impairment did not have spectacles.
  
  
  CONCLUSIONS
  The prevalence of presbyopia appears to be higher with an earlier onset and over 90 % of people in need of near correction do not have spectacles in this setting.
authors.affiliation: Nepal Netra Jyoti Sangh, Tripureshwor, Kathmandu, Nepal. yd_sapkota@hotmail.com
authors.forename: Y D
authors.initials: YD
authors.lastname: Sapkota
authors.forename: S
authors.initials: S
authors.lastname: Dulal
authors.forename: G P
authors.initials: GP
authors.lastname: Pokharel
authors.forename: P
authors.initials: P
authors.lastname: Pant
authors.forename: L B
authors.initials: LB
authors.lastname: Ellwein
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005139:Eyeglasses / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D009390:Nepal / Q000453:epidemiology; D016017:Odds Ratio; D011305:Presbyopia / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012424:Rural Population; D017678:Sex Distribution; D014787:Vision Tests; D015354:Vision, Low / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D014792:Visual Acuity