title: Ophthalmological disorders in rural areas of Crete: a geospatial analysis.
abstract: BACKGROUND
  Estimation of the prevalence of vision impairment in a population can be performed using epidemiological research. The purpose of this study was to measure, using spatial statistics, the prevalence of ophthalmologic disease identified at visits of the Mobile Ophthalmologic Unit (MOU) of the Vardinogiannion Eye Institute of Crete (VEIC) to villages in Crete. The study also aimed to estimate increased 'risk' of ophthalmological disease according to demographic and location factors and, thus, use the present findings as a basis for planning future services.
  
  
  METHODS
  Estimation of risks for cataract, glaucoma, and refractive errors were assessed by multiple logistic regression models in order to measure the effect of demographic (age, sex) and location (province, distance from nearest ophthalmologist) parameters. Spatial analysis was applied in order to produce a density and probability density map of ophthalmologic disorders using kriging interpolation methods.
  
  
  RESULTS
  Newly diagnosed cataracts and refractive errors were found more frequently in locations greater than 70 km from the nearest ophthalmologist (respectively, OR = 6.0 [95% CI = 1.637-9.482]; OR = 27.4 [20.038-39.028] <em>p</em>-value = 0.004). Those aged >60 years had higher risk for all eye abnormalities: cataracts (OR = 0.7; 95% CI = 0.238-0.938), glaucoma (OR = 1.6; 95% CI = 1.227-2.037), and refractive errors (OR = 0.5; 95% CI = 0.183-0.829).
  
  
  CONCLUSIONS
  The present study supports the use of local policies and preventive measures in rural areas of Crete in order to improve rural health standards. Some insights concerning the effectiveness of future visits of MOUs are provided, guided by spatial analysis.
authors.affiliation: Department of Social Medicine, University of Crete, Heraklion, Crete, Greece. geopist@gmail.com
authors.forename: Georgia
authors.initials: G
authors.lastname: Pistolla
authors.forename: Miltiadis K
authors.initials: MK
authors.lastname: Tsilimparis
authors.forename: Poulicos
authors.initials: P
authors.lastname: Prastacos
authors.forename: Dimitra
authors.initials: D
authors.lastname: Sifaki-Pistolla
authors.forename: Anastas
authors.initials: A
authors.lastname: Philalithis
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Pallikaris
mesh_terms: D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D003941:Diagnostic Techniques, Ophthalmological; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006115:Greece / Q000453:epidemiology; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D014195:Travel / Q000706:statistics & numerical data; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy