ABSTRACT
Purpose: To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India. Methods: The program would consist of three segments. At people抯 residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand?held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit?lamp examination and re?refract. They would refer people with vision ?6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study. Results: The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 � 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8�0) in all eye conditions except for strabismus (k = ~0.56�65). Conclusion: The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care
ABSTRACT
Purpose: To estimate seeing and other disabilities in a population cohort in a tribal district, Rayagada, in the Indian state of Orissa. Methods: A door?to?door survey was conducted to identify the disabilities. The vision was measured at the residence of the subject, and other disabilities were documented from the history obtained from the subject/household/neighbor. All people with seeing disabilities were reexamined in the community eye center (primary or secondary), and required treatment was given at no cost to the patients. People with other disabilities were transported to the public health facility for appropriate care and disability certification. The results were compared with the 2011 national census data. Results: A total of 147,699 people were enumerated, and 106,339 (72%) were examined over one year period, 2016–17. In this cohort, 47.3% (n = 50,320) were male and 27.5% (n = 29,215) were 40 years or older. We recorded systemic disease in 0.6% (n = 689) people; hypertension was two times higher than diabetes mellitus. Disability was identified in 2.8% (n = 3022). Common disabilities were seeing (46.7%; n = 1411), hearing (36.8%; n = 1112), mobility (10.4%; n = 315), and mental retardation (3.2%; n = 98). Dual sensory disability (seeing and hearing) was seen in 6.4% (n = 251), and it was higher in the older age group. Seeing and hearing disabilities were higher than the 2011 state (P =< 0.001) and national (P =< 0.001) disability census. Conclusion: The first population?based survey in Rayagada, Odisha (India) in 2017 showed a higher proportion of people with seeing and hearing disabilities. It calls for an appropriate service strategy.