Methods for a population-based Comprehensive Eye care Workload Assessment (CEWA) study in Southern India

Area of Science:

• Public Health
• Ophthalmology
• Epidemiology

Background:

• Current eye care planning in developing nations relies on blindness prevalence, often from Rapid Assessment of Avoidable Blindness (RAAB) surveys.
• This approach overlooks annual eye care demands and leads to arbitrary targets based on capacity rather than actual need.
• A novel study design was implemented to address this gap by estimating comprehensive eye care requirements for a large population.

Purpose of the Study:

• To estimate the annual need for comprehensive eye care in a population of 1.2 million.
• To develop a more accurate model for public health intervention planning in eye care.
• To inform resource allocation and service delivery for eye health in resource-limited settings.

Main Methods:

• A population-based longitudinal study was conducted in Theni district, Tamil Nadu, India.
• The study involved household enumeration, basic eye examination (BEE) one year post-enrollment, and full eye examination (FEE) at central locations.
• Participants aged 40 and above were invited for FEE, as were younger individuals with indicated needs.

Main Results:

• 24,327 subjects were enrolled, with 58% under 40 and 42% aged 40 and above.
• 72% of those under 40 completed BEE, with 20% referred for FEE.
• 70% of individuals aged 40 and above underwent FEE.

Conclusions:

• The novel study design provides crucial insights for effective long-term public health intervention planning in eye care.
• This approach supports appropriate resource allocation and the design of efficient eye care services.
• The findings are particularly relevant for resource-limited settings aiming to improve eye health outcomes.