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Prevalence of blindness and cataract surgical coverage in Narayani Zone, Nepal: a rapid assessment of avoidable blindness (RAAB) study
  1. Sangita Pradhan1,
  2. Avnish Deshmukh1,
  3. Puspa Giri Shrestha1,
  4. Prajwal Basnet2,
  5. Ram Prasad Kandel3,
  6. Susan Lewallen4,
  7. Yuddha Dhoj Sapkota5,
  8. Ken Bassett6,7,
  9. Vivian T Yin6,7
  1. 1 Bharatpur Eye Hospital, Bharatpur, Narayani, Nepal
  2. 2 Gaur Eye Hospital, Purenwa, Nepal
  3. 3 Seva Nepal, Kathmandu, Nepal
  4. 4 Kilimanjaro Centre for Community Ophthalmology, University Cape Town Groot Schuur Hospital, Cape Town, South Africa
  5. 5 Nepal Netra Jyoti Sangh, Kathmandu, Nepal
  6. 6 British Columbia Centre for Epidemiologic and International Ophthalmology, University of British Columbia, Vancouver, Canada
  7. 7 Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
  1. Correspondence to Dr Vivian T Yin, Eye Care Center, Vancouver General Hospital, 2550 Willow St, Vancouver, BC V5Z 3N9, Canada; viviany{at}


Background The 1981 Nepal Blindness Survey first identified the Narayani Zone as one of the regions with the highest prevalence of blindness in the country. Subseuqently, a 2006 survey of the Rautahat District of the Narayani Zone found it to have the country’s highest blindness prevalence. This study examines the impact on blind avoidable and treatable eye conditions in this region after significant increase in eye care services in the past decade.

Methods The rapid assessment of avoidable blindness (RAAB) methodology was used with mobile data collection using the mRAAB smartphone app. Data analysis was done using the standard RAAB software. Based on the 2011 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled proportional to population size.

Results Of the 5000 participants surveyed, 4771 (95.4%) were examined. The age-adjusted and sex-adjusted prevalence of bilateral blindness, severe visual impairment (SVI) and moderate visual impairment (MVI) were 1.2% (95% CI 0.9% to 1.5%), 2.5% (95% CI 2.0% to -3.0%) and 13.2% (95% CI 11.8% to 14.5%), respectively. Cataract remains the primary cause of blindness and SVI despite cataract surgery coverage (CSC) of 91.5% for VA<3/60. Women still account for two-thirds of blindness.

Conclusion The prevalence of blindness in people over the age of 50 years has decreased from 6.9% in 2006 to 1.2%, a level in keeping with the national average; however, significant gender inequity persists. CSC has improved but continues to favour men.

  • epidemiology
  • public health

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  • Contributors All authors have substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. The authors draft the work or revised it critically for important intellectual content and gave final approval of the version published. The authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Nepal Health Research Proposal.

  • Provenance and peer review Not commissioned; externally peer reviewed.