A survey of blindness and cataract surgery in Doumen County, China

Purpose: To assess blindness prevalence and that caused specifically by cataract in rural southern China. Design: Population-based, cross-sectional study. Participants: A total of 5342 persons older than 50 years of age. Methods: Visual acuity and eye examinations were performed in the summer of 1997 in a random sample of villages in Doumen County. Differences in blindness prevalence associated with age, gender, and education were explored using logistic regression, The survey was preceded by a pilot study in which operational methods were refined and quality assurance measures were performed. Main Outcome Measures: Distance visual acuity and lens status. Results: Bilateral blindness (presenting visual acuity < 0.10) was found in 4.37% (95% confidence interval, 3.67%-5.06%). Blindness was associated with increasing age (P < 0.001) and with the lack of education (P < 0.01). Cataract was the principal cause of blindness in at least one eye in 61.5% of blind people, with refractive error responsible for another 10%. An estimated 40% of the cataract blind were operated on; surgical coverage was lowest among the elderly, women, and those without schooling, although not at statistically significant levels. Conclusions: Despite the increased attention given to eye care in Doumen County, blindness remains a major public health problem. Cataract surgery is reaching fewer than half of those who could benefit from it.