Original article
Prevalence of Vision Impairment in Older Adults in Rural China in 2014 and Comparisons With the 2006 China Nine-Province Survey

https://doi.org/10.1016/j.ajo.2017.10.016Get rights and content

Purpose

To estimate the prevalence of vision impairment and blindness in 2014 among older adults in rural China with comparisons with the 2006 Nine-Province Survey.

Design

Population-based, cross-sectional study.

Methods

Geographical cluster sampling was used in randomly selecting residents from a rural county or semi-rural district within 9 provinces: Beijing, Jiangsu, Guangdong, Heilongjiang, Jiangxi, Hebei, Ningxia, Chongqing, and Yunnan. Persons 50 years of age or older were enumerated through household visits and invited to examination sites for visual acuity testing and examination. Vision impairment and blindness in 2014 was compared with data from the 2006 survey.

Results

Among 51 310 examined persons, the prevalence of presenting vision impairment (<20/63 to ≥20/400) in the better-seeing eye ranged from 6.05% to 15.3% across the 9 study sites, with presenting blindness (<20/400) ranging from 0.66% to 5.35%. With best-corrected visual acuity, the prevalence of vision impairment ranged from 1.96% to 8.74%, and blindness from 0.47% to 5.01%. Vision impairment was associated with older age, female sex, and little or no education. The overall prevalence of presenting vision impairment and blindness decreased during the 2006–2014 interval by 6.31% and 29.0%, respectively; and by 16.1% and 38.0%, respectively, after standardization of 2006 prevalence rates to the 2014 population.

Conclusions

Substantial progress has been made in the reduction of vision impairment in rural China. Nevertheless, vision impairment remains an important public health problem with substantial geographic disparities and with older age, female sex, and illiteracy as risk factors.

Section snippets

Methods

The study design was a population-based cross-sectional study of the prevalence of vision impairment and blindness in previously studied rural sites using the same study protocol. Human subject research approval of the original study protocol and the scripted consent form for obtaining written informed consent was cleared by the World Health Organization Secretariat Committee on Research Involving Human Subjects. The PUMC Hospital Committee on Ethics in Research approved implementation of the

2014 Study Data

The enumerated 2014 study population of 56 630 persons aged 50 years or older with distribution across age, sex, and education level within each study site is shown in Table 1.

Overall, 90.6% (51 310) of the enumerated population was examined, including measurement of visual acuity. As shown, the examination response rate ranged from 86.0% in Heilongjiang to 94.4% in Chongqing. In multiple logistic regression modeling with age, sex, education, and study site as covariates, higher examination

Discussion

The strengths of the 2014 Nine-Province Survey were a large, randomly selected, population-based sample of rural participants in 9 counties/districts throughout China; use of the same study protocol at each site; and examination response rates that exceeded 85% at each site. The random selection of the study samples enabled calculation of confidence intervals around parameter estimates, standardized measurement methods and definitions ensured that intersite data comparisons were valid, and high

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