title: Population awareness of diabetic eye disease and age related macular degeneration in Nepal: the Bhaktapur Retina Study.
abstract: BACKGROUND
  Diabetic retinopathy (DR) and age-related macular degeneration (AMD) are among the leading causes of visual impairment and blindness in developing countries. This study aims to explore the awareness of these retinal diseases in Nepal.
  
  
  METHODS
  A population based cross-sectional study conducted among individuals 60 years and older from the Bhaktapur district of Nepal. One thousand consecutive subjects were enrolled and subjected to a structured questionnaire.
  
  
  RESULTS
  Subject age ranged from 60 to 93 years with a meanof 69.5 years ± 7.1(S.D.). Males and females comprised 45.1 and 55.9 % of the population, respectively. The majority was illiterate (78.2 %), and agriculture was the predominant occupation (79.8 %). 12.1 % were aware of the effect of diabetes on the eye, and among them, 99 % were aware that diabetes was a blinding disease caused by DR.11.5 % of the subjects were aware of DR, and 10.1 % were aware that subjects with diabetes should undergo periodic eye examinations. Only 7.6 % of subjects were aware of AMD.7.5 and 7.4 % were aware about its aggravation with smoking and sunlight exposure, respectively. Younger age group, males, literates, service holders, best corrected visual acuity >0.3 LogMAR, were each significantly associated with an increase in awareness of diabetic retinopathy. Smokers and those with agricultural occupations were less aware regarding AMD. Those with diabetes,with or without DRwere significantly more aware than those not having the disease.
  
  
  CONCLUSIONS
  Among the Bhaktapur population, awareness of DR and AMD was only 11.5 and7.6 % respectively. Older age groups, females, illiterates, farmers, and those with poor visual acuity were less aware of these blinding diseases. We recommend community-based eye health education programs targeted at raising awareness of these diseases and preventive measures.
authors.affiliation: Tilganga Institute of Ophthalmology, P O Box: 561, Kathmandu, Nepal. rabathapa@live.com.
authors.forename: Raba
authors.initials: R
authors.lastname: Thapa
authors.affiliation: Tilganga Institute of Ophthalmology, P O Box: 561, Kathmandu, Nepal. sanyam.bajimaya@tilganga.org.
authors.forename: Sanyam
authors.initials: S
authors.lastname: Bajimaya
authors.affiliation: Tilganga Institute of Ophthalmology, P O Box: 561, Kathmandu, Nepal. govinda.paudyal@tilganga.org.
authors.forename: Govinda
authors.initials: G
authors.lastname: Paudyal
authors.affiliation: Central Department of Statistics, Tribhuvan University, Kirtipur, Nepal. drshankarcds@gmail.com.
authors.forename: Shankar
authors.initials: S
authors.lastname: Khanal
authors.affiliation: Vrije University Medical Center, Amsterdam, The Netherlands. h.tan@Vumc.nl.
authors.forename: Stevie
authors.initials: S
authors.lastname: Tan
authors.affiliation: Tilganga Institute of Ophthalmology, P O Box: 561, Kathmandu, Nepal. suman.thapa@tilganga.org.
authors.forename: Suman S
authors.initials: SS
authors.lastname: Thapa
authors.affiliation: Vrije University Medical Center, Amsterdam, The Netherlands. rens@vumc.nl.
authors.forename: Ger
authors.initials: G
authors.lastname: van Rens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D011795:Surveys and Questionnaires