The Gambia National Eye Health Survey 2019: survey protocol

Two national surveys of vision impairment and blindness were undertaken in The Gambia in 1986 and 1996. These provided data for the inception of The Gambia’s National Eye Health Programme (NEHP) within the Ministry of Health and Social Welfare. There have been important developments in the eye health services provided by the NEHP in the last 20 years. At the same time, the population has also undergone major demographic changes that may have led to substantial changes in the burden of eye disease. We conducted a National Eye Health Survey of vision impairment, blindness and its comorbidities in adults in The Gambia in 2019. We examined a nationally representative population-based sample of adults 35 years and above to permit direct comparison with the data available from the previous surveys. Alongside a comprehensive vision and eye examination, the survey provides nationally representative data on important comorbidities in this population: diabetes, hypertension, obesity, hearing impairment, disability and mental health. Secondly, it estimates access to assistive technologies and eye health services. Thirdly, it is powered to allow a five-year follow up cohort study to measure the incidence and progression of eye disease.

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Prevalence of blindness and distance vision impairment in the Gambia across three decades of eye health programming

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-320008 ◽

2021 ◽

pp. bjophthalmol-2021-320008

Author(s):

Abba Hydara ◽

Islay Mactaggart ◽

Suzannah J Bell ◽

John A Okoh ◽

Segun I Olaniyan ◽

...

Keyword(s):

Risk Ratio ◽

Population Based ◽

The Gambia ◽

Vision Impairment ◽

Eye Health ◽

Current State ◽

Increased Risk ◽

Health Programming ◽

Nationally Representative ◽

Health Programme

Background/aimsThe 1986 Gambia National Eye Health Survey provided baseline data for a National Eye Health Programme. A second survey in 1996 evaluated changes in population eye health a decade later. We completed a third survey in 2019, to determine the current state of population eye health, considering service developments and demographic change.MethodsWe estimated prevalence and causes of vision impairment (VI) in a nationally representative population-based sample of adults 35 years and older. We used multistage cluster random sampling to sample 10 800 adults 35 and above in 360 clusters of 30. We measured monocular distance visual acuity (uncorrected and with available correction) using Peek Acuity. Participants with either eye uncorrected or presenting (with available correction) acuity <6/12 were retested with pinhole and refraction, and dilated exams were completed on all eyes by ophthalmologists using a direct ophthalmoscope, slit lamp and 90 D lens.ResultsWe examined 9188 participants (response rate 83%). The 2013 census age–sex adjusted prevalence of blindness (presenting acuity<3/60 in better seeing eye) was 1.2% (95% CI 0.9 to 1.4) and of moderate or severe VI (MSVI,<6/18 to ≥3/60) was 8.9% (95% CI 9.1 to 9.7). Prevalence of all distance VI (<6/12) was 13.4% (12.4–14.4). Compared with 1996, the relative risk of blindness decreased (risk ratio 0.7, 95% CI 0.5 to 1.0) and MSVI increased (risk ratio 1.5, 95% CI 1.2 to 0.17).ConclusionSignificant progress has been made to reduce blindness and increase access to eye health across the Gambia, with further work is needed to decrease the risk of MSVI.

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The Refractive Error and Vision Impairment Estimation With Spectacle data (REVIEWS) study

10.1101/2021.06.15.21258945 ◽

2021 ◽

Author(s):

Michael Moore ◽

James Loughman ◽

John S Butler ◽

Arne Ohlendorf ◽

Siegfried Wahl ◽

...

Keyword(s):

Health Survey ◽

Refractive Error ◽

Population Distribution ◽

Risk Estimation ◽

Population Based ◽

Vision Impairment ◽

Cross Sectional ◽

Bootstrap Analysis ◽

Spectacle Lens ◽

Sales Data

Objective: To investigate whether spectacle lens sales data can be used to estimate the population distribution of refractive error amongst ametropes and hence estimate the current and future risk of vision impairment. Design: Cross Sectional Study Subjects: A total 141,547,436 spectacle lens sales records from an international European lens manufacturer between the years 1998 and 2016. Methods: Anonymized patient spectacle lens sales data including refractive error information was provided by a major European spectacle lens manufacturer. Data from the Gutenberg Health Survey was digitized to allow comparison of a representative, population-based sample to the spectacle lens sales data. A bootstrap analysis was completed to assess the comparability of both datasets. The expected level of vision impairment due to myopia at age 75 was calculated for both datasets using a previously published risk estimation equation combined with a saturation function. Main Outcome Measures: Comparability of spectacle lens sales data on refractive error to typical population surveys of refractive error and its potential utility to predict vision impairment due to refractive error. Results: Equivalent estimates of the population distribution of spherical equivalent refraction can be provided from spectacle lens data within limits. For myopia, the population distribution was equivalent to the Gutenberg Health Survey (≤ 5% deviation) for levels ≤-2.0 dioptres, while for hyperopia the distribution was equivalent (≤ 5% deviation) for levels ≥ +3.0 diopters. The estimated rates of vision impairment due to myopia were not statistically significantly different (χ2 = 182, DoF = 169, p = 0.234) between the spectacle lens data and Gutenberg Health Survey data. Conclusions: The distribution of refractive error and hence the risk of vision impairment due to refractive error within a population can be determined using spectacle lens sales data. Pooling this type of data from multiple industry sources could provide a cost effective, timely and globally representative mechanism for monitoring the evolving epidemiology of refractive error and associated vision impairment.

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Population-based Assessment of Vision Impairment in the Elderly Population in Telangana State in India – Policy Implications for Eye Health Programmes

Ophthalmic Epidemiology ◽

10.1080/09286586.2020.1797122 ◽

2020 ◽

pp. 1-8

Author(s):

Srinivas Marmamula ◽

Rajesh Challa ◽

Rohit C Khanna ◽

Eswararao Kunkunu ◽

Gullapalli N Rao

Keyword(s):

Elderly Population ◽

The Elderly ◽

Population Based ◽

Vision Impairment ◽

Policy Implications ◽

Eye Health ◽

Telangana State ◽

Health Programmes

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Temporal Trends over a Decade in Serious Vision Impairment in a Large, Nationally Representative Population-based Sample of Older Americans: Gender, Cohort and Racial/Ethnic Differences

Ophthalmic Epidemiology ◽

10.1080/09286586.2021.1889001 ◽

2021 ◽

pp. 1-10

Author(s):

ZhiDi Deng ◽

Esme Fuller-Thomson

Keyword(s):

Ethnic Differences ◽

Temporal Trends ◽

Population Based ◽

Vision Impairment ◽

Older Americans ◽

Nationally Representative ◽

Racial Ethnic

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Eye health and quality of life: an umbrella review protocol

BMJ Open ◽

10.1136/bmjopen-2020-037648 ◽

2020 ◽

Vol 10 (8) ◽

pp. e037648

Author(s):

Lama Assi ◽

Lori Rosman ◽

Fatimah Chamseddine ◽

Perla Ibrahim ◽

Hadi Sabbagh ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Reviews ◽

Methodological Quality ◽

Data Extraction ◽

Vision Impairment ◽

Eye Disease ◽

Umbrella Review ◽

Eye Health ◽

The Impact

IntroductionVision impairment and eye disease are major global health concerns and have been associated with increased morbidity and mortality, and lower quality of life. Quality of life, whether generic, vision-specific or disease-specific, is an important measure of the impact of eye health on people’s daily activities, well-being and visual function, and is increasingly used to evaluate the impact of ophthalmic interventions and new devices. While many studies and reviews have examined the relationship between vision or eye health and quality of life across different contexts, there has yet to be a synthesis of the impact of vision impairment, eye disease and ophthalmic interventions on quality of life globally and across the lifespan.Methods and analysisAn umbrella review of systematic reviews will be conducted to address these two questions: (1) What is the association of vision impairment and eye disease with quality of life? (2) What is the impact of ophthalmic interventions on quality of life? A search of related literature will be performed on the 11 February 2020 in Medline Ovid, Embase.com, Cochrane Database of Systematic Reviews, Proquest Dissertations and Theses Global, and the grey literature, and repeated at the synthesis stage. Title/abstract and full-text screening, methodological quality assessment and data extraction will be conducted by reviewers working independently and in duplicate. Assessment of methodological quality and data extraction will be performed using Joanna Briggs Institute standard forms. Findings from the systematic reviews and their methodological quality will be summarised qualitatively in the text and using tables.Ethics and disseminationNo ethical approval is required. Results of this umbrella review will be published in a peer-reviewed journal and summarised in the Lancet Global Health Commission on Global Eye Health.Trial registration numberThis protocol was registered in the Open Science Framework Registries (https://osf.io/qhv9g/).

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Prevalence and associations of presenting near-vision impairment in the Australian National Eye Health Survey

Eye ◽

10.1038/eye.2017.317 ◽

2018 ◽

Vol 32 (3) ◽

pp. 506-514 ◽

Cited By ~ 2

Author(s):

S Keel ◽

J Foreman ◽

J Xie ◽

H R Taylor ◽

M Dirani

Keyword(s):

Health Survey ◽

Vision Impairment ◽

Near Vision ◽

Eye Health

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Estimating Need for Glasses and Hearing Aids in The Gambia: Results from a National Survey and Comparison of Clinical Impairment and Self-Report Assessment Approaches

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126302 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6302

Author(s):

Dorothy Boggs ◽

Abba Hydara ◽

Yaka Faal ◽

John Atta Okoh ◽

Segun Isaac Olaniyan ◽

...

Keyword(s):

Hearing Aids ◽

Population Level ◽

Population Based ◽

Accurate Estimate ◽

The Gambia ◽

Self Report ◽

Clinical Impairment ◽

Study Population ◽

Nationally Representative ◽

Low Coverage

Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0–6.3), 45.9% (95% CI 44.2–47.5) needed near glasses and 25.5% (95% CI 22.2–29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need.

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Vision impairment and differential access to eye health services in Aotearoa New Zealand: protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-048215 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048215

Author(s):

Jaymie Tingkham Rogers ◽

Joanna Black ◽

Matire Harwood ◽

Ben Wilkinson ◽

Iris Gordon ◽

...

Keyword(s):

New Zealand ◽

Health Services ◽

Scoping Review ◽

Grey Literature ◽

Vision Impairment ◽

Eye Care ◽

Pacific People ◽

Eye Health ◽

Aotearoa New Zealand ◽

Differential Access

IntroductionIn Aotearoa New Zealand, Māori and Pacific people experience worse health outcomes compared with other New Zealanders. No population-based eye health survey has been conducted, and eye health services do not generate routine monitoring reports, so the extent of eye health inequality is unknown. This information is required to plan equitable eye health services. Here we outline the protocol for a scoping review to report the nature and extent of the evidence reporting vision impairment, and the use of eye health services by ethnicity in New Zealand.Methods and analysisAn information specialist will conduct searches on MEDLINE and Embase, with no limit on publication dates or language. We will search the grey literature via websites of relevant government and service provider agencies. Reference lists of included articles will be screened. Observational studies will be included if they report the prevalence of vision impairment, or any of the main causes (cataract, uncorrected refractive error, macular degeneration, glaucoma or diabetic retinopathy) or report the use of eye health services in New Zealand among people of any age. Two authors will independently review titles, abstracts and full-text articles, and complete data extraction. Overall findings will be summarised using descriptive statistics and thematic analysis, with an emphasis on disaggregation by ethnicity where this information is available.Ethics and disseminationEthical approval has not been sought as our review will only include published and publicly accessible data. We will publish the review in an open access peer-reviewed journal. We anticipate the findings will be useful to organisations and providers in New Zealand responsible to plan and deliver eye care services, as well as stakeholders in other countries with differential access to eye care.Registration detailsThe protocol has been registered with Open Science Framework (https://osf.io/yw7xb).

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