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Gleny Hughes ghughes@btinternet.com

BLINDNESS AND VISUAL IMPAIRMENT IN PAKISTAN

Data on blindness and visual impairment in Pakistan have been very limited, with an earlier survey by the National Committee for the Prevention of Blindness (NCPB) estimating the main cause of blindness to be cataract (66.7%). A second study carried out between 2002 and 2004 applied more rigorous survey methodologies to produce accurate data. In all, 16 507 adults (aged 30 years and older) were examined. Causes of visual impairment were classified by the accepted World Health Organization methodology. Cataract was still the most common cause of blindness (51.5%; defined as <3/60 in the better eye), followed by corneal opacity (11.8%), uncorrected aphakia (8.6%) and glaucoma (7.1%). Posterior capsular opacification accounted for 3.6% of blindness. Among the moderately visually impaired (<6/18 to ⩾6/60) refractive error was the most common cause (43%) followed by cataract (42%). Overall, 85.5% of cases of blindness were considered to be avoidable. An estimated 904 000 adults in Pakistan have cataract requiring surgical intervention. Services for refractive errors need to be further expanded and integrated into eye care services, particularly among the rural population of Pakistan. (Br J Ophthalmol published online 17 January 2007; doi: 10.1136/bjo.2006.108035)

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