Quality of life after community-based rehabilitation for blind persons in a rural population of South India.

This study aimed to determine the impact of community-based rehabilitation on the quality of life of blind persons in a rural south Indian population. We performed a population-based survey followed by clinical examinations to identify blind persons in a rural south Indian population. Pre-and-post rehabilitation quality of life of 159 blind persons aged 15 years or above was ascertained through a questionnaire previously validated for use in this population. Post-rehabilitation quality-of-life scales showed some improvement for 151 (95.0%) subjects. The additional benefit from rehabilitation was greatest for the self-care and mobility subscales, ranging from 24.6% to 30.0% for the self care subscale and 37.6% to 44.3% for the mobility subscale with effect sizes of 21.5 and 2.38 respectively. Overall quality of life scores were not significantly different between those who did and did not receive economic rehabilitation (P = 0.1). Blind persons in this rural population benefited considerably from rehabilitation services even if economic rehabilitation is not provided. Initiatives against blindness need to consider rehabilitation of the blind as a priority.

Utilization of community-based rehabilitation services for incurably blind persons in a rural population of southern India.

PURPOSE: To identify barriers in utilisation of community based rehabilitation (CBR) services for incurably blind persons in rural South India. METHODS: A community-based rehabilitation programme for incurably blind persons was initiated in Theni district of southern Tamil Nadu in south India. After door-to-door enumeration and preliminary ocular screening by trained workers at the village, identified blind persons were categorised as either curable or incurable by an ophthalmologist. Trained workers provided rehabilitation, including mobility training (OM), training to perform activities of daily living (ADL), and economic rehabilitation for the incurably blind in their respective villages. RESULTS: Of the 460,984 persons surveyed, 400 (0.09%) were certified as incurably blind including 156 (39.00%) persons blind from birth. Social rehabilitation was provided for 268 (67.00%) incurably blind persons. Economic rehabilitation was provided to 96 persons, and integrated education to 22 children. Nearly one-fifth (n=68, 17.00%) of incurably blind persons refused the services provided. The major reasons for refusal included old age and other illnesses (41.18%), and multiple handicaps (19.12%). Twenty-seven (6.75%) persons had either migrated or died, and 29 (7.25%) persons were already able to function independently. CONCLUSION: Although CBR programmes provide useful services to the incurably blind, a better understanding of barriers is required to improve service utilisation. Developing a standardised data collection format for every CBR programme can result in the creation of a national database of ophthalmic diseases.