title: Impact of vision impairment and self-reported barriers to vision care: The views of elders in Nuwara Eliya district, Sri Lanka.
abstract: The growing burden of vision impairment (VI) among older people is a development challenge in Asian countries. This study aimed to understand older people's views and experiences about the impact of VI and barriers to eye care to inform policies to address this challenge. We conducted 12 focus group discussions in 2013 with retired Tamil and Sinhala elders in Nuwara Eliya district, Sri Lanka (n = 107). Data were analysed thematically. Older people described the broad impacts VI has on their lives. They worry about becoming dependent. VI restricts their ability to contribute to their families and communities, access information, socialise, maintain their health, and earn. Barriers to eye care services include transport difficulties, costs of treatment, fear, lack of knowledge, waiting times, and health staff attitudes. Older people experience and fear the impacts of VI on their health and well-being. Eye health promotion and care services need strengthening and integration with the primary health care system to address the backlog and growing need among older people in an equitable way. Older people should be consulted about how to overcome the economic, social, and cultural barriers to access to eye care and to minimise the impact of VI.
  
  
  
  FGDs: focus group discussions; GBD: global burden of disease; NCDs: non-communicable diseases; VI: vision impairment.
authors.affiliation: a Centre for International Health , Burnet Institute , Melbourne , Victoria , Australia.
authors.forename: W
authors.initials: W
authors.lastname: Holmes
authors.affiliation: b PALM Foundation , Nuwara Eliya , Sri Lanka.
authors.forename: R
authors.initials: R
authors.lastname: Shajehan
authors.affiliation: b PALM Foundation , Nuwara Eliya , Sri Lanka.
authors.forename: S
authors.initials: S
authors.lastname: Kitnasamy
authors.affiliation: b PALM Foundation , Nuwara Eliya , Sri Lanka.
authors.forename: C
authors.initials: C
authors.lastname: Abeywickrama
authors.affiliation: c Berendina , Colombo , Sri Lanka.
authors.forename: Y
authors.initials: Y
authors.lastname: Arsath
authors.affiliation: c Berendina , Colombo , Sri Lanka.
authors.forename: F
authors.initials: F
authors.lastname: Gnanaraj
authors.affiliation: d Plantation Human Development Trust , Colombo , Sri Lanka.
authors.forename: S
authors.initials: S
authors.lastname: Inbaraj
authors.affiliation: e Central Province Health Department , Kandy , Sri Lanka.
authors.forename: G
authors.initials: G
authors.lastname: Jayakody
authors.affiliation: a Centre for International Health , Burnet Institute , Melbourne , Victoria , Australia.
authors.forename: K
authors.initials: K
authors.lastname: Durrant
authors.affiliation: a Centre for International Health , Burnet Institute , Melbourne , Victoria , Australia.|f Department of Obstetrics and Gynaecology , International Centre for Reproductive Health, Ghent University , Belgium.|g Department of Epidemiology and Preventive Medicine , School of Public Health and Preventive Medicine, Monash University , Victoria , Australia.
authors.forename: S
authors.initials: S
authors.lastname: Luchters
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D013188:Sri Lanka; D014786:Vision Disorders / Q000523:psychology* / Q000628:therapy*
keywords: Sri Lanka; Vision impairment; ageing; cataract surgery; eye health services