Prevalence of blindness and cataract surgery in Shunyi County, China

To estimate the prevalence of blindness and cataract surgery among older adults in rural China.

Cluster sampling was used in randomly selecting men and women aged 50 years or older for visual acuity testing and an eye examination in 28 villages in Shunyi County. The survey, which was carried out in the fall of 1996, was preceded by a pilot study in which operational methods were refined and quality assurance evaluations carried out.

Of 5,555 enumerated subjects > or =50 years of age, 91.5% (5,084/5,555) were examined and 90.9% (5,052/5,555) were tested for visual acuity. In this population, 2.8% (139/5,052) were blind, defined as presenting visual acuity less than 6/60 in both eyes. Blindness was associated with older age and female sex. Cataract was the principal cause of blindness in at least one eye in 48.2% (67/139) of blind people. The ratio of those blind from cataract who were operated on to the those who could have been operated on, cataract surgical coverage, was estimated to be 47.8% (54/113). Cataract surgery was associated with younger age but not sex or education.

Blindness, particularly blindness related to cataract, continues to be a significant problem among the elderly, especially women, in this population-based sample of rural Chinese. Despite an active eye-care program in Shunyi County, only half of those who might benefit from cataract surgery are receiving it.