title: [National survey on the prevalence and causes of blindness in Peru].
abstract: OBJECTIVE
  To estimate the prevalence of blindness and visual impairment among adults in Peru and to determine their causes, to evaluate the coverage and quality of the cataract surgical services and to investigate the barriers that inhibit access to these services.
  
  
  METHODS
  A cross-sectional population study with two-stage random cluster sampling of individuals of ≥ 50 years old, representative of the entire country, using the standard methodology of the Rapid Assessment of Avoidable Blindness. Visual acuity was assessed and the condition of the lens and posterior pole examined by direct ophthalmoscopy. Cataract surgical coverage was calculated. Its quality, as well as the causes of visual acuity < 20/60 and the barriers to accessing surgical treatment were assessed.
  
  
  RESULTS
  A total of 4 849 people were examined. Blindness prevalence was 2.0% (confidence interval of 95%: 1.5-2.5%). The main causes of blindness were cataract (58.0%), glaucoma (13.7%) and age-related macular degeneration (11.5%). Uncorrected refraction errors were the principal cause of moderate visual impairment (67.2%). Cataract surgical coverage was 66.9%. 60.5% of the eyes operated for cataracts achieved a visual acuity ≥ 20/60 with available correction. The main barriers to cataract surgery were the high cost (25.9%) and people being unaware that treatment was possible (23.8%).
  
  
  CONCLUSIONS
  The prevalence of blindness and visual impairment in Peru is similar to that of other Latin American countries. Given the low cataract surgical coverage and the aging of the population, access to the services could be improved by increasing the population education on eye health and the response capacity of the ophthalmological and cataract surgical services, and by reducing the costs of the latter.
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Betty
authors.initials: B
authors.lastname: Campos
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Amelia
authors.initials: A
authors.lastname: Cerrate
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Enrique
authors.initials: E
authors.lastname: Montjoy
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Víctor
authors.initials: V
authors.lastname: Dulanto Gomero
authors.affiliation: Asociación Divino Niño Jesús, Lima, Perú
authors.forename: César
authors.initials: C
authors.lastname: Gonzales
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Aldo
authors.initials: A
authors.lastname: Tecse
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Andrés
authors.initials: A
authors.lastname: Pariamachi
authors.affiliation: Visión 2020, Agencia Internacional para la Prevención de la Ceguera, México, D.F., México, vlansingh@iapb.org.
authors.forename: Van C
authors.initials: VC
authors.lastname: Lansingh
authors.affiliation: Visión 2020, Agencia Internacional para la Prevención de la Ceguera, México, D.F., México, vlansingh@iapb.org.
authors.forename: Víctor
authors.initials: V
authors.lastname: Dulanto Reinoso
authors.affiliation: Instituto Nacional de Oftalmología, Lima, Perú
authors.forename: Jean
authors.initials: J
authors.lastname: Minaya Barba
authors.affiliation: Organización Panamericana de la Salud, Bogotá, Colombia.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Silva
authors.affiliation: Health Information Services, Grootebroek, Países Bajos.
authors.forename: Hans
authors.initials: H
authors.lastname: Limburg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D002386:Cataract / Q000150:complications / Q000453:epidemiology; D002387:Cataract Extraction; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012494:Sampling Studies