Rapid assessment of avoidable blindness in Bhutan

Area of Science:

• Ophthalmology
• Public Health
• Epidemiology

Background:

• Blindness and visual impairment pose significant public health challenges globally.
• Cataract remains a leading cause of reversible blindness worldwide.
• Understanding the prevalence and contributing factors is crucial for targeted interventions.

Purpose of the Study:

• To assess the prevalence of blindness and visual impairment in adults aged 50 and above in Bhutan.
• To determine cataract surgical coverage and evaluate surgical outcomes and barriers.
• To provide data for improving eye care services in Bhutan.

Main Methods:

• A rapid assessment of avoidable blindness survey was conducted using probability proportionate to size sampling across 82 clusters.
• Ophthalmic examinations were performed on 4046 participants aged 50 years and older.
• Cataract patients were interviewed regarding surgical outcomes and barriers to accessing care.

Main Results:

• The adjusted prevalence of bilateral blindness with available correction was 1.5%.
• Cataract was the primary cause of blindness (67.1%) and severe visual impairment (74.1%), followed by posterior segment diseases (22.1%).
• Cataract surgical coverage was 72.7% among the bilaterally blind, with 23.6% reporting poor surgical outcomes despite overall patient satisfaction.

Conclusions:

• Bhutan exhibits a relatively low prevalence of blindness in the elderly compared to regional estimates.
• Key areas for improvement include enhancing community outreach, optimizing surgical outcomes, and addressing posterior segment pathologies.
• The findings underscore the need for continued efforts in eye care program development and implementation.