Eye (London, England) · 2026
Utility of primary care Vision Centres in increased uptake of formal eye care following ocular injury in rural South India.
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Rajendran Vinoth Kumar, Mala Radhakrishnan, Vardhan Ashok, Ravilla Thulasiraj D
Аннотация
BACKGROUND/OBJECTIVES: To estimate the 12-month occurrence of self-reported ocular trauma, its determinants and care-seeking patterns in South India, emphasising the Vision Centres (VCs) role in service utilisation.
METHODS: A population-based, cross-sectional survey was conducted among 17,397 participants in Theni district, Tamil Nadu. Data were collected on demographics, socioeconomic status, injury characteristics, care-seeking behaviour, visual outcome and treatment adherence.
RESULTS: Annual occurrence of self-reported ocular trauma was 1.1% (n = 191; mean age 42.6 years, SD ± 17.2). Injury occurrence increased with age, peaking at 1.8% among those aged 40-59 years and was higher in men (1.4% vs 0.9%; p = 0.0015) and manual workers. In adjusted analysis, age ≥40 years (OR 1.52, 95% CI: 1.07-2.15; p = 0.018) and occupation (unskilled/semi-skilled: OR 2.53, 95% CI: 1.60-4.00, p < 0.001; farmer/agricultural coolies: OR 2.20, 95% CI: 1.12-4.34, p = 0.023) were associated with injury, while women had lower odds (OR 0.65, 95% CI: 0.48-0.87; p = 0.004). Most injuries were foreign body (33%) and blunt trauma (31%). Overall, 84.3% sought formal care, primarily at eye hospitals (50.3%) or VCs (46.0%), with 95.9% managed entirely at VCs; only 4.1% required referral. No sociodemographic factors significantly influenced utilisation. Rural and caste-related patterns shaped provider preference: rural and Most Backward Community members attended VCs, while Scheduled Caste/Scheduled Tribe participants preferred hospitals. Treatment adherence was high (93.1%).
CONCLUSIONS: Although the annual occurrence of self-reported ocular trauma was relatively low, the high rates of formal care-seeking and adherence highlight the effectiveness of community-based eye care through VCs. Sustaining and scaling such models, while addressing residual inequities, will be crucial to reducing trauma-related visual loss.
METHODS: A population-based, cross-sectional survey was conducted among 17,397 participants in Theni district, Tamil Nadu. Data were collected on demographics, socioeconomic status, injury characteristics, care-seeking behaviour, visual outcome and treatment adherence.
RESULTS: Annual occurrence of self-reported ocular trauma was 1.1% (n = 191; mean age 42.6 years, SD ± 17.2). Injury occurrence increased with age, peaking at 1.8% among those aged 40-59 years and was higher in men (1.4% vs 0.9%; p = 0.0015) and manual workers. In adjusted analysis, age ≥40 years (OR 1.52, 95% CI: 1.07-2.15; p = 0.018) and occupation (unskilled/semi-skilled: OR 2.53, 95% CI: 1.60-4.00, p < 0.001; farmer/agricultural coolies: OR 2.20, 95% CI: 1.12-4.34, p = 0.023) were associated with injury, while women had lower odds (OR 0.65, 95% CI: 0.48-0.87; p = 0.004). Most injuries were foreign body (33%) and blunt trauma (31%). Overall, 84.3% sought formal care, primarily at eye hospitals (50.3%) or VCs (46.0%), with 95.9% managed entirely at VCs; only 4.1% required referral. No sociodemographic factors significantly influenced utilisation. Rural and caste-related patterns shaped provider preference: rural and Most Backward Community members attended VCs, while Scheduled Caste/Scheduled Tribe participants preferred hospitals. Treatment adherence was high (93.1%).
CONCLUSIONS: Although the annual occurrence of self-reported ocular trauma was relatively low, the high rates of formal care-seeking and adherence highlight the effectiveness of community-based eye care through VCs. Sustaining and scaling such models, while addressing residual inequities, will be crucial to reducing trauma-related visual loss.