Rapid Assessment of Avoidable Blindness (RAAB)in Bangladesh: A Tool for Planning & Monitoring District VISION 2020 Programs.

Mohammad Muhit

Purpose: To assess the prevalence and causes of avoidable blindness in Jamalpur and Narail districts of Bangladesh, among people age 50 or over.

Methods: Standard methodology for Rapid Assessment of Avoidable Blindness (RAAB).

Results: A total of 3,050 and 2,450 people age 50 or over were examined in Jamalpur and Narail, respectively. Crude prevalence of blindness among people aged 50 or over was 1.91% (CI 1.22-2.61) and 2.72% (CI 1.71-3.73) in Jamalpur and Narail respectively. In Jamalpur, cataract (52.6%) and sequelae related to cataract extraction (5.3%) accounted for 57.9% of all causes of bilateral blindness; and posterior segment disease (including glaucoma, diabetic retinopathy and age-related macular degeneration) is responsible for 26.3%. In Narail, Cataract (73.8%) and sequelae related to cataract extraction (aphakia 3.1% and cataract surgical complications 1.5%) accounted for 78.5% of all causes of bilateral blindness. Posterior segment disease (20%) (including glaucoma, diabetic retinopathy and age-related macular degeneration) is the second cause of bilateral blindness in Narail. 14.4% of the 160 eyes that had undergone cataract surgery in Narail had a poor outcome with best correction (i.e VA<6/60) compared with 7.3% of the 164 eyes that had undergone cataract surgery had a poor outcome in Jamalpur.

Conclusions: Cataract remains the major cause of blindness in both districts. Visual outcome after cataract surgery is also an issue of major concern. Prevention of blindness programs in Jamalpur and Narail districts need to focus on both increasing the quantity and quality of cataract surgery.