Aim To determine the prevalence of blindness, visual
impairment and the cataract surgical coverage for people
aged 50 years and older in the Lumbini Zone and the
Chitwan District (Narayani Zone) of Nepal.
Methods A population-based cross-sectional study in
2006 selected subjects aged 50 years and older through
a random multistage cluster sampling and door-to-door
enumeration. Ophthalmic examination included visualacuity
assessment and refraction, and anterior and
posterior segment examination of the eyes carried out by
a trained ophthalmologist and two ophthalmic assistants
at centralised locations.
Results The survey examined 5138 of 5196 persons
enumerated (response rate of 86.8%). The mean age of
the subjects was 61 (SD 9.2) years, and 2701 (52.6%)
subjects were women. The ageesex-adjusted
prevalence of blindness (best presenting vision <6/60)
and visual impairment (better-eye presenting visual acuity
of <6/18 to $6/60) were 4.6% (95% CI 3.4 to 5.8) and
18.9% (95% CI 16.4 to 21.4), respectively. Blindness was
significantly lower in the hill (3.3%) compared with the
plain (5.8%) regions (OR 0.6; 95% CI 0.4 to 0.9). The
primary causes for blind eyes were cataract (n ¼ 228,
48.1%), refractive error (n ¼ 149, 31.4%), retinal
disorders (n ¼ 19, 4.0%) and corneal opacity (n ¼ 18,
3.8%). The overall cataract surgical coverage was 66.6%.
Cataract surgical coverage was not significantly
associated with age, sex, literacy or District.
Conclusion Although the prevalence of blindness and
visual impairment is lower than 10 years ago, particularly
among women, correctable blindness due to cataract
and refractive error (79.5% of blind people) remains
a significant population health problem in Lumbini Zone
and Chitwan District.