Determinants of high unmet need for presbyopia correction: a community-based study in northwest Ethiopia

Lack of evidence on the magnitude of unmet presbyopia need, and barriers to uptake spectacles, limit appropriate planning and implementation of the provision of spectacles to address the backlog of uncorrected presbyopia. The purpose of this study was to determine the magnitude of unmet presbyopia need and the associated factors in Bahir Dar, Ethiopia.

A community-based cross-sectional study was conducted in 2015 in Bahir Dar. A multistage sampling technique was used to sample 729 study participants. Individuals more than 35 years of age who were unable to read the N8 line on a near vision chart unaided or with existing spectacles at 40 cm were considered as having unmet need for presbyopia correction. Distance and near visual acuities were measured by optometrists using Snellen illiterate E chart at 6 m and 40 m, respectively. Data were entered into Epi Info 2002 and analyzed using Statistical Package for Social Sciences version 16.0. Odds ratio (with 95% confidence interval [CI]) was used to determine the strength of association. P-values <0.05 were considered statistically significant.

A total of 729 people were included in the study (response rate of 99.5%). The mean age ± standard deviation of participants was 48.9±8.8 years. Unmet presbyopic need was 69.2% (95% CI: 65.8%-72.6%). Age (36-45 years [adjusted odds ratio {AOR} = 3.95; 95% CI: 1.06, 4.80]), having no eye checkup in the past 1 year (AOR = 8.36; 95% CI: 5.16, 13.7), lack of awareness about place of refraction service (AOR = 4.38; 95% CI: 1.36, 13.7), and female gender (AOR = 1.78; 95% CI: 1.68, 2.9) were determinants of unmet presbyopia need.

The burden of unmet presbyopia need is a high priority according to the World Health Organization prioritization for provision of presbyopia services. Accessible and affordable provision of spectacles with health education and promotion efforts are imperative to address the backlog of unmet presbyopia correction need in the study area.