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. 2018 Jun 26;13(6):e0198799.
doi: 10.1371/journal.pone.0198799. eCollection 2018.

Estimates of visual impairment and its causes from the National Eye Survey in Malaysia (NESII)

Fiona L M Chew  1 , Mohamad Aziz Salowi  1   2 , Zuraidah Mustari  3 , Mohd Aziz Husni  1 , Elias Hussein  1 , Tassha Hilda Adnan  4 , Nor Fariza Ngah  5 , Hans Limburg  6 , Pik-Pin Goh  4
Affiliations

Estimates of visual impairment and its causes from the National Eye Survey in Malaysia (NESII)

Fiona L M Chew et al. PLoS One. .

Abstract

Background: Population-based data on prevalence, causes of blindness and extent of ophthalmological coverage is required for efficient implementation and evaluation of ocular health programs. In view of the scarcity of prevalence data for visual impairment and blindness in Malaysia, this study aims to estimate the prevalence and causes of visual impairment (VI) in the elderly, using Rapid Assessment of Avoidable Blindness (RAAB) survey technique.

Methods: Malaysia was divided into six regions, with each region consisting of 50 clusters. Multistage cluster sampling method was used and each cluster contained 50 residents aged 50 years and above. Eligible subjects were interviewed and pertinent demographic details, barriers to cataract surgery, medical and ocular history was noted. Subjects had visual acuity assessment with tumbling 'E' Snellen optotypes and ocular examination with direct ophthalmoscope. The primary cause of VI was documented. Results were calculated for individual zones and weighted average was used to obtain overall prevalence for the country. Inter-regional and overall prevalence for blindness, severe VI and moderate VI were determined. Causes of VI, cataract surgical coverage and barriers to cataract surgery were assessed.

Results: A total of 15,000 subjects were examined with a response rate of 95.3%. The age and gender-adjusted prevalence of blindness, severe visual impairment and moderate visual impairment were 1.2% (95% Confidence Interval: 1.0-1.4%), 1.0% (95%CI: 0.8-1.2%) and 5.9% (5.3-6.5%) respectively. Untreated cataract (58.6%), diabetic retinopathy (10.4%) and glaucoma (6.6%) were the commonest causes of blindness. Overall, 86.3% of the causes of blindness were avoidable. Cataract surgical coverage (CSC) in persons for blindness, severe visual impairment and moderate visual impairment was 90%, 86% and 66% respectively.

Conclusion: Increased patient education and further expansion of ophthalmological services are required to reduce avoidable blindness even further in Malaysia.

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Conflict of interest statement

Author HL received funding from Health Information Services in the form of salary. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Population and states in Malaysia.
Source: Department of Statistics, Malaysia.
See this image and copyright information in PMC

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