Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study.

PURPOSE: To determine the prevalence of refractive error (RE), presbyopia, spectacle coverage, and barriers to uptake optical services in Bangladesh.

METHOD: Rapid assessment of refractive error (RARE) study following the RARE protocol was conducted in a northern district (i.e., Sirajganj) of Bangladesh (January 2010-December 2012). People aged 15-49 years were selected, and eligible participants had habitual distance and near visual acuity (VA) measured and ocular examinations were performed in those with VA<6/18. Those with phakic eyes with VA <6/18, but improving to ≥6/18 with pinhole or optical correction, were considered as RE and people aged ≥35 years with binocular unaided near vision of <N8 were considered presbyopic.

RESULT: A total of 3,043 people were examined, of which 143 had RE (4.7%, 95% CI: 3.9-5.5). Among people aged ≥35 years (n = 1402), 869 had presbyopia (62.0, 95% CI: 59.4-64.5). Spectacle coverage for RE and presbyopia were 13.3% (95% CI 7.7-18.9) and 3.2% (95% CI 2.2-4.6), respectively. "Unaware of the problem" was the main reason for not utilizing any optical services among the people with RE (92.8%) and presbyopia (89.5%). Extrapolating the survey findings to the 2011 national census data, the magnitude of RE among people aged 15-49 years in Bangladesh is estimated to be 3,493,980 people (95% CI 2,899,260-4,088,700), of whom 3,029,280 people do not use any spectacles.

CONCLUSION

The burden of RE and presbyopia is substantial in Bangladesh. Improving awareness and availability of refraction services is required to correct REs and presbyopia in Bangladesh.