Cataract Blindness and Surgery among the Elderly in Rural Southern Harbin, China

Purpose: The purpose of this study was to examine the prevalence of cataract blindness, cataract surgical coverage, and surgical outcome by a population-based survey in an elderly rural Chinese population. Methods: Cluster sampling was used to select samples (>= 50 years of age). The protocol consisted of participant interviews, a study to assess inter-observer agreement in cataract grading, visual acuity (VA) testing, and clinical examinations of selected participants. The prevalence of cataract blindness and cataract surgical coverage were calculated. The associations of these parameters by age, gender, and education were also calculated. Results: A total of 5057 eligible subjects agreed to participate, providing an attendance rate of 91.0%. Of individuals who were examined, 2383 were men. The overall prevalence of bilateral cataract blindness was 1.3% (95% confidence interval: 0.7%-2.6%). We found that aging, female gender, and illiteracy were associated with prevalence of bilateral cataract blindness. The average surgical coverage was 9.3% with trends lower among older persons and higher prevalence in females, but which did not reach statistical significance. Only 44.1% (30/68) of operative eyes had a presenting VA of 20/60 or better. Conclusions: Cataract surgical needs are currently not being met. The high rate of cataract blindness calls for the establishment of cataract surgical services that are gender sensitive.