title: Rapid assessment of refractive error in the eThekwini Municipality of KwaZulu-Natal, Durban, South Africa.
abstract: BACKGROUND
  Population-based studies involving refractive error in South Africa are few because they are expensive to conduct and require a high level of expertise. Rapid assessment of refractive error (RARE) is a relatively less resource-intensive method designed to assess the magnitude of uncorrected refractive error (URE), spectacle coverage and barriers to access of services. This information is useful for designing and implementing programs as well as for policy development.
  
  
  OBJECTIVE
  The purpose of this study was to determine the prevalence of uncorrected refractive error and spectacle coverage and to explore the barriers to uptake of refractive services in persons 15 to 35 years old in the eThekwini municipality, Durban, South Africa.
  
  
  METHODS
  A cross-sectional epidemiological study was conducted using the RARE protocol. A total of 1,543 participants were enumerated and 1,516 were examined. Uncorrected refractive error was defined as presenting visual acuity less than 6/12 that could be corrected to 6/12 or better using a pinhole. Spectacle coverage was defined as the proportion of need that was already met with spectacle correction.
  
  
  RESULTS
  The prevalence of age and sex adjusted URE was 1.5% (95 per cent CI: 0.7 -2.3). Odds for uncorrected refractive error in women were 0.5 (95 per cent CI: 0.3-0.9) lower compared to men. There was a statistically significant association between uncorrected refractive error and respondents 15 to 24 years old (p < 0.001). The spectacle coverage (6/12 cut-off) was 51.4 per cent (95 per cent CI: 28.1-74.7). The prevalence of spectacle use among participants was 3.8 per cent.
  
  
  CONCLUSIONS
  The low prevalence of uncorrected refractive error found in this study agrees with previous studies that indicate that despite uncorrected refractive error being the most common cause of visual impairment and the second most common cause of blindness worldwide, its prevalence is relatively low in South Africans.
authors.affiliation: Brien Holden Vision Institute, Durban, South Africa.|African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa.|Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Kovin S
authors.initials: KS
authors.lastname: Naidoo
authors.affiliation: African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Farai S
authors.initials: FS
authors.lastname: Chinanayi
authors.affiliation: Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Prasidh
authors.initials: P
authors.lastname: Ramson
authors.affiliation: African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa. mashigek@ukzn.ac.za.|School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia. mashigek@ukzn.ac.za.
authors.forename: Khathutshelo P
authors.initials: KP
authors.lastname: Mashige
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D012030:Refractive Errors / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology; D014792:Visual Acuity
keywords: South Africa; avoidable blindness; prevalence; rapid assessment of refractive error; refractive errors; spectacle coverage