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Prevalence and Causes of Blindness and Visual Impairment Among the Elderly in Rural Southern Harbin, China


Zhijian Li, Hao Cui, Ping Liu, Liqiong Zhang, Hongbin Yang & Lu Zhang





Ophthalmic Epidemiology


  • The purpose of this study was to estimate the prevalence and causes of visual impairment(VI) and blindness by a population-based survey in an elderly rural Chinese population.

  • Cluster sampling was used to select samples. The protocol consisted of an interview, pilot study, visual acuity (VA) testing and a clinical examination.

  • The definitions of blindness (VA < 20/400) and visual impairment (VA < 20/60 to ≥ 20/400) were based on the presenting VA in the better eye. The major causes of VI and blindness were identified.

  • The associations of bilateral VI and blindness by age, gender and education were calculated through multiple logistic regression. Cataract surgical coverage (CSC) was also calculated. Results: Among the 5559 people entered in the project, 5057 were examined (91.0%), and of these 2383(47.1%) were men.

  • The mean age was 60.5 (range, 50–96) years old. The prevalence of bilateral blindness and VI was 1.9% (95% confidence interval (CI): 1.6 % to 2.3%) and 8.3%(95% CI: 7.5 % to 9.1%), respectively. We found that age, female gender, and illiteracy were associated with bilateral blindness.

  • The leading cause of bilateral blindness was cataract (70.4%), followed by corneal opacity (8.2%) and glaucoma (5.1%).

  • The main causes for bilateral VI were refractive error (35.9%) and cataract (35.7%). The average CSC was 9.3% (95%CI: 6.7% to 11.7%).

  • Cataract is the dominant cause of bilateral blindness and VI in people over 50 years old in rural southern Harbin.

  • Specific prevention and VI rehabilitation programs should be developed for the elderly rural Chinese population.