Survey on avoidable blindness and visual impairment in Panama

Objective. Determine prevalence of blindness and visual impairment in adults aged >= 50 years in Panama, identify their main causes, and characterize eye health services. Methods. Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged >= 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity < 20/60 and barriers to access to surgical treatment. Results. A total of 4 125 people were examined (98.2% of the calculated sample). Age-and sex-adjusted prevalence of blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity <= 20/60 with available correction. Conclusions. Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.