Public Eye Health and Community Optometry
Visual Impairment is a public eye health challenge that affects millions of people worldwide. Over 80% of the visual impairment avoidable. A multi-prong approach is needed to address the burden of visual impairment which is more rampant in rural areas. Public Eye Health and Community Eye Care deals with both research to understand the burden of visual impairment using epidemiological tools and also evaluation of service delivery models to address the burden of visual impairment. Understanding the research methods used in eye health, basic understanding of epidemiology and bio statistics will form the core content of this course.
Hyderabad Ocular Morbidity among Elderly Study (HOMES)
Visual impairment is more common among the elderly people living in residential care when compared to those living in non-institutionalized environments. A significant number of them have impairment that can be corrected by simple interventions such as the use of spectacles and cataract surgery. Studies have shown that visual impairments in the elderly affect all dimensions of their life such as mobility, self-care, driving and participation in social and religious activities, general health and in overall quality of life.This research aims to investigate the prevalence and causes of visual impairment, and assess the impact of an intervention including the provision of cataract surgery and spectacles on the visual functions of elderly individuals living in residential care in India.
This study is funded by Wellcome and Department of Biotechnology India alliance (2016 - 2020) as a part of early career fellowship awarded to Dr Srinivas Marmamula
Rapid Assessment of Visual Impairment (RAVI) project
The Rapid Assessment of Visual Impairment is methodology that is developed at the institute and is being implanted in several locations in India. This is a quick and a low cost methodology that can provide the information on burden and causes of visual impairment in a given region.
Andhra Pradesh Eye Disease Study (APEDS)
The Andhra Pradesh Eye Disease Study, popularly known as APEDS has three phases:
- APEDS I : 1996 to 2000 : Population based cross section study
- APEDS II: 2009 - 2010: A study to trace the original cohort of APEDS I
- APEDS III: 2012 - 2015 (scheduled): A study to assess incidence (among non-cases) and progression (among cases) of blinding eye conditions among the surviving cohort of APEDS I participants
The Andhra Pradesh Eye Disease Study (APEDS I) was conducted by L V Prasad Eye Institute in in 3 rural (West Godavari, Adilabad, Mahbubnagar) and 1 urban area (Hyderabad) of Andhra Pradesh, India during 1996 and 2000. Multi stage sampling methodology was used to select 11,786 subjects of all ages from 24 urban clusters and 70 rural clusters and 10,293 participants were examined. A comprehensive eye examination and a detailed interview related to demographics and other risk factors were carried out.The aim of this study was to determining the prevalence and cause of visual impairment and to assess the risk factors associated with major eye diseases. The effect of blindness and VI on quality of life (QOL) and barriers that prevent the uptake of eye care services were also studied. The findings of this study were published into over 50 peer-reviewed journals.
The prevalence of blindness (presenting visual acuity <6/60> or central visual field <20> degrees in the better eye) was 1.84%, and moderate visual impairment (presenting visual acuity <6/18-6/60> or equivalent visual field loss in the better eye) was 8.1%. Cataract and refractive error were responsible for 60.3% of blindness and 85.7% of moderate visual impairment. Increasing age, decreasing socioeconomic status, female gender, and rural area of residence were associated with higher risk of blindness.
APEDS I was funded by Hyderabad Eye Research Foundation, Hyderabad,India, and CBM, Bensheim, Germany.
A tracing exercise was carried out during 2009 and 2010 in three rural locations (Tanuku, West Godavari district,Mudhol in Adilabad district and Thoodukurthy in Mahabubnagardistrict) to assess the availability of the APEDS I participants. The status of availability in Tanuku, Mudhole and Thoodukurthy were 72%, 75% and 59% respectively. Overall 69% of the original cohort was available. About 18% participants migrated from their villages, 11% died and information was not available on remaining 2% of the participants. , there was no information available. Tracing exercise in urban area of Hyderabad was not possible due to the enormous infrastructure changes happened in Hyderabad in past 14 years.
APEDS II was funded by International Centre for Eye Health (ICEH), London, UK and Hyderabad Eye Research Foundation, Hyderabad,India.
Encouraged by availability of nearly 70% of the participants of the original APEDS I cohort, APEDS III was planned with the following main objectives.
- To assess the cumulative incidence (i.e. new cases) of and risk factors for blindness, visual impairment (VI), cataract, diabetic retinopathy, refractive error and glaucoma in those 30 years and above.
- To assess the cumulative incidence (i.e. new cases) of and risk factors for refractive error (myopia) in those 10-29 years.
- To investigate progression of and risk factors for blindness/VI, refractive error, lens opacities; glaucoma; diabetic retinopathy
- Shashank Y
- Javed Nayab
- Rajesh Challa