Prevalence of vision impairment in older adults in rural China: the China Nine-Province Survey

Abstract

Purpose: Describe the prevalence of visual impairment/blindness among older adults in rural populations in China.

Design: Population-based, cross-sectional study.

Participants: We evaluated 45 747 adults > or =50 years of age.

Methods: Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants were enumerated through village registers followed by door-to-door household visits. Eligible persons were invited to local examination sites for visual acuity (VA) testing and eye examination.

Main outcome measures: Presenting and best-corrected distance VA.

Results: Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The prevalence of presenting visual impairment <20/63 to > or =20/400 in the better eye was 10.8% and blindness (<20/400) was 2.29%. Across the 9 provinces, presenting visual impairment ranged from 6.89% to 15.8%, and blindness from 1.27% to 5.40%. With best-corrected VA, the prevalence of visual impairment was 5.30%, and 1.93% for blindness. The ranges across the 9 provinces were 3.13% to 9.51% for visual impairment and 0.74% to 4.95% for blindness. Visual impairment and blindness were associated with older age, female gender, lack of education, and geographic area (province) with both presenting and best-corrected VA.

Conclusions: Visual impairment and blindness are important public health problems in rural China, with significant regional variations in prevalence. Blindness prevention programs targeting the rural elderly should be expanded, particularly in areas with limited access and affordability of eye care services. Special emphasis should be given to reaching women and those without education. Greater attention should also be given to correction of refractive error.

Figure 1

The 9 study provinces and the geographic location of the study site (◊). BJ = Beijing municipality; CQ = Chongqing province; GD = Guangdong province; HB = Hebei province; HL = Heilongjiang province; JS = Jiangsu province; JX = Jiangxi province; XJ = Xinjiang province; YN = Yunnan province.