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Population-based assessment of visual impairment and pattern of corneal disease: results from the CORE (Corneal Opacity Rural Epidemiological) study
  1. Ritika Mukhija1,
  2. Noopur Gupta2,
  3. Praveen Vashist2,
  4. Radhika Tandon2,
  5. Sanjeev K Gupta3
  1. 1Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Cornea, Cataract & Refractive Surgery Services, Rajendra Prasad Centre for Ophthalmic Science, All India Institute of Medical Sciences, New Delhi, Delhi, India
  3. 3Cornea, Cataract & Refractive Surgery Services, Centre for Community Medicine, All India Institute of Medical Sciences, Delhi, India
  1. Correspondence to Dr Noopur Gupta, R P CENTRE, AIIMS, Delhi 110029, India; noopurgupta{at}


Objective To characterise types of corneal diseases and resulting visual impairment (VI) in a rural North Indian population.

Design Cross-sectional, population-based study.

Methods The Corneal Opacity Rural Epidemiological study included 12 899 participants from 25 random clusters of rural Gurgaon, Haryana, India to determine the prevalence of the corneal disease in the general population. Sociodemographic details, presence and type of corneal morbidity, laterality, VI (presenting visual acuity (PVA) <6/18 in the better eye) and characteristics of corneal opacities were noted.

Results Overall, 12 113 participants of all ages underwent detailed ophthalmic examination and prevalence of corneal opacity was found to be 3.7% (n=452) with bilateral involvement in 140 participants (31%) during the house-to-house visits. Of the total 571 eyes of 435 patients presenting with corneal opacity at the central clinic, PVA was <3/60 in 166 (29.1%), 3/60 to <6/60 in 14 (2.5%), 6/60 to <6/18 in 164 (28.7%), 6/18 to ≤6/12 in 85 (14.9%) and 6/9 to 6/6 in 142 eyes (24.9%), respectively. Further, there were a total of 115 eyes (20.1%) with nebular corneal opacity, 263 (46.1%) with macular, 162 (28.4%) with leucomatous and 31 (5.4%) with an adherent leucoma. The odds of having VI due to corneal disease were greater for the illiterate (OR:4.26; 95% CI: 2.88 to 6.31; p<0.001) and elderly (OR:11.05; 95% CI: 7.76 to 15.74; p<0.001).

Conclusion The data from this study give an insight into the characteristics of various corneal pathologies and resulting VI in the general population. This is a pioneer study involving all age groups on the burden of VI due to corneal diseases.

  • cornea
  • public health
  • vision
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  • Contributors RM: literature search and compilation, data analysis and interpretation, drafting and writing of manuscript. NG: study conception and design, data collection and acquisition, data analysis and interpretation, critical revision of manuscript, revision of manuscript for important intellectual content, technical support. PV: study conception and design, critical revision of manuscript, administrative, technical and material support, supervision. RT: study conception and design, data interpretation, revision of manuscript for important intellectual content, supervision. SKG: study conception and design, data collection and acquisition, revision of manuscript for important intellectual content and technical support.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon request.

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