Prevalence and causes of visual impairment in rural myanmar: the Meiktila Eye Study.

OBJECTIVE To determine the prevalence and causes of visual impairment in the Meiktila district of central, rural Myanmar. DESIGN Population-based cross-sectional study. PARTICIPANTS Random, stratified, cluster sampling of the inhabitants 40 years of age and older from villages in the Meiktila district was performed; 2481 eligible participants were identified and 2076 participated in the study. METHODS The ophthalmic examination included presenting and pinhole Snellen visual acuity with an illiterate E chart, slit-lamp examination of the anterior segment, and dilated stereoscopic fundus examination. The principal cause of visual impairment was recorded. MAIN OUTCOME MEASURES Visual impairment and blindness were defined by both presenting and corrected visual acuity according to World Health Organization criteria: better eye < 6/18 and < 3/60, respectively. RESULTS Comprehensive examinations, including Snellen visual acuity, were performed on 2073 participants (83.6%) The prevalence estimate of presenting visual impairment was 40.4% (95% confidence interval [CI], 36.1-44.7) and of presenting blindness was 8.1% (95% CI, 6.5-9.9). After pinhole correction, the corresponding prevalences were 26.8% (95% CI, 23.5-30.1) and 5.3% (95% CI, 4.0-6.6). Cataract, uncorrected refractive error, and glaucoma were the most common causes of visual impairment. CONCLUSIONS Visual impairment and blindness remain major public health problems in rural Myanmar. Specific programs directed toward reducing the cataract burden need to be implemented.