title: [National survey of blindness and avoidable visual impairment in Honduras].
abstract: OBJECTIVE
  To determine the prevalence of blindness and visual impairment in Honduras, its causes and the response by the health services to growing demand.
  
  
  METHODS
  A cross-sectional population study was conducted between June and December 2013 using the standard methodology of the Rapid Assessment of Avoidable Blindness. A random sample survey was done in 63 clusters of 50 individuals aged ≥ 50, representative of the country as a whole. Visual acuity (VA) was assessed using a Snellen eye chart, and the condition of the lens and posterior pole was examined by direct ophthalmoscopy. Cataract surgical coverage was calculated and an assessment made of its quality, the causes of VA < 20/60 and the barriers to accessing surgical treatment.
  
  
  RESULTS
  A total of 2 999 people were examined (95.2% of the forecast total). Blindness prevalence was 1.9% (confidence interval of 95%: 1.4-2.4%) and 82.2% of these cases were avoidable. The main causes of blindness were unoperated cataracts (59.2%) and glaucoma (21.1%). Uncorrected refraction error was the main cause of severe (19.7%) and moderate (58.6%) visual impairment. Cataract surgical coverage was 75.2%. 62.5% of the eyes operated for cataracts achieved a VA > 20/60 with available correction. The main barriers against cataract surgery were cost (27.7%) and the lack of availability or difficulty of geographical access to the treatment (24.6%).
  
  
  CONCLUSIONS
  The prevalence of blindness and visual impairment in Honduras is similar to that of other Latin American countries. 67% of cases of blindness could be resolved by improving the response capacity of the ophthalmological services, especially of cataract surgery, improving optician services and incorporating eye care in primary health care.
authors.affiliation: Hospital San Felipe, Tegucigalpa, Honduras.
authors.forename: Doris
authors.initials: D
authors.lastname: Alvarado
authors.affiliation: Hospital San Felipe, Tegucigalpa, Honduras.
authors.forename: Belinda
authors.initials: B
authors.lastname: Rivera
authors.affiliation: Hospital San Felipe, Tegucigalpa, Honduras.
authors.forename: Luis
authors.initials: L
authors.lastname: Lagos
authors.affiliation: Instituto Hondureño de la Seguridad Social, Tegucigalpa, Honduras.
authors.forename: Mayra
authors.initials: M
authors.lastname: Ochoa
authors.affiliation: Instituto Hondureño de la Seguridad Social, Tegucigalpa, Honduras.
authors.forename: Ivette
authors.initials: I
authors.lastname: Starkman
authors.affiliation: Centro de Salud Integral ZOE, Tegucigalpa, Honduras.
authors.forename: Mariela
authors.initials: M
authors.lastname: Castillo
authors.affiliation: Centro de Salud Integral ZOE, Tegucigalpa, Honduras.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores
authors.affiliation: Agencia Internacional para la Prevención de la Ceguera, México, México.
authors.forename: Van C
authors.initials: VC
authors.lastname: Lansingh
authors.affiliation: Health Information Services, Grootebroek, Países Bajos.
authors.forename: Hans
authors.initials: H
authors.lastname: Limburg
authors.affiliation: Organizacion Panamericana de la Salud, Bogotá, Colombia, silvajuan@paho.org.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Silva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; 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; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012494:Sampling Studies; D014786:Vision Disorders / Q000453:epidemiology / Q000628:therapy