title: Eye care use among rural adults in China: the Handan Eye Study.
abstract: OBJECTIVE
  To assess the use of eye care services in a rural population in North China and to analyze the factors associated with underuse of these services.
  
  
  METHODS
  In a cross-sectional population-based study, demographic, health and vision-related information including use of eye care services were determined during a face-to-face interview. A single visit to an eye care provider qualified as "use" of eye care services.
  
  
  RESULTS
  Of 6612 participants, 754 (11.4%, 95% confidence interval, CI, 8.7-14.1%) had used eye care services. The most common reason cited for not seeing an eye care provider was "no need" (n = 5754). Of the 5754 who thought that there was no need to see an ophthalmologist, 3458 (60.1%) were found to have one or more type of eye disease, including glaucoma (56, 1.0%), cataract (1056, 18.4%), age-related macular degeneration (AMD; 164, 2.9%) and refractive error (3048, 53.0%). Also, 74 (1.3%) and 409 (7.1%) of the 5754 participants had visual impairment (<20/60) according to best-corrected visual acuity and presenting visual acuity, respectively. In a multiple regression model, participants who had glaucoma (adjusted odds ratio, OR, 4.0, 95% CI 3.0-5.4), AMD (adjusted OR 1.6, 95% CI 1.2-2.3) or refractive error (adjusted OR 1.4, 95% CI 1.1-1.8), were more likely to visit an eye care provider.
  
  
  CONCLUSIONS
  A high proportion of the Chinese rural population had never used eye care services although three fifths had eye diseases. Further efforts towards better education of the general population about common eye problems as well as increasing the number of ocular health providers would be necessary in future.
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab , Beijing , China .
authors.forename: Yi
authors.initials: Y
authors.lastname: Peng
authors.forename: Qiu Shan
authors.initials: QS
authors.lastname: Tao
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Xiao Hui
authors.initials: XH
authors.lastname: Yang
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Xin Rong
authors.initials: XR
authors.lastname: Duan
authors.forename: Lan Ping
authors.initials: LP
authors.lastname: Sun
authors.forename: Ning Li
authors.initials: NL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000208:ethnology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D014792:Visual Acuity / Q000502:physiology