Survey of visual impairment in an Indian tertiary eye hospital

A retrospective survey of 4,122 consecutive patient records was performed in a tertiary care eye hospital in Hyderabad, India. Data collected included age, gender, visual acuity after completion of treatment and diagnosis. 62.8% of the patients were male. After completion of treatment, 10.8% had low vision (best corrected visual acuity < 6/18 to 3/60 in the better eye) and 2.6% were blind (best correct visual acuity < 3/60 in the better eye). Most cases of low vision were found in the 50 to 70 year age group (42.9%). The most common visual acuity range after treatment amongst patients with vision loss was < 6/18 to 6/60 (71%). The 4 main causes of low vision were cataract (21.4% of low vision group), glaucoma (14.0%), diabetic retinopathy (13.0%), and retinitis pigmentosa (10.7%). The 4 main causes of blindness were glaucoma (16.3% of blind group), diabetic retinopathy (13.2%), corneal opacities (11.6%) and retinitis pigmentosa (11.6%). It is suggested that patients with low vision at the conclusion of treatment be referred to a vision rehabilitation centre. Referral should be made in cases with a best corrected visual acuity < 6/18 to 3/60 or with visual field loss to within 15 degrees of fixation. Patients aged under 50 years of age are expected to achieve maximal rehabilitation success. Motivation and vocational requirements should be assessed in older or more complex cases before referral. The data of this study show that about 10% of patients seen at a tertiary care eye hospital in India could benefit from low vision rehabilitation.