Exceptionally low prevalence of refractive error and visual impairment in schoolchildren from Lao People's Democratic Republic.

OBJECTIVE: Vientiane Province is an urbanizing region in Southeast Asia. We aimed to determine the prevalence of refractive error and visual impairment in primary school-aged children in this region. DESIGN: Prospective, cross-sectional survey. PARTICIPANTS: A total of 2899 schoolchildren from Vientiane Province, Lao People's Democratic Republic (Lao PDR). METHODS: Ten districts from Vientiane were randomly selected and 2 primary schools were randomly selected from each district. All children aged 6 to 11 years at selected schools were eligible to participate. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing, and anterior segment and fundus examinations in visually impaired children. MAIN OUTCOME MEASURES: Cycloplegic refraction and VA. RESULTS: There was an estimated total of 3330 children who were eligible to participate, and data were recorded from 2899 (87%) of these children. Complete refractive data were available on 2842 children (85% of eligible population). The mean spherical equivalent (SE) in the right eyes was +0.60 diopter (D) (95% confidence interval [CI], 0.49-0.72), and the mean SE in the left eyes was +0.59 (95% CI, 0.50-0.68). The prevalence of hyperopia was 2.8% (95% CI, 1.9-3.7; 88 subjects), and the prevalence of myopia was 0.8% (95% CI, 0.3-1.4; 24 subjects). The majority of children (98%; 95% CI, 97.0-99.0) had normal unaided binocular VA (at least 20/32 in their better eye). The overall prevalence of any visual impairment (presenting VA <20/32 in the better eye) was 1.9% (95% CI, 1.0-2.9; 55 subjects). In multivariate logistic regression analysis, age (P = 0.001) was a significant predictor, and female gender (P = 0.08) and Yao ethnicity (P = 0.09) were borderline significant predictors of the presence of any visual impairment. CONCLUSIONS: Visual impairment is not a public health concern in this primary school-aged population; however, visually impaired children in the community were not studied. From this baseline, future surveys could determine the effect of increasing urbanization on myopia prevalence in this population.

Geographical distribution of eye health professionals and cataract surgery in Lao People's Democratic Republic.

PURPOSE: To assess the geographical distribution of eye health professionals and cataract surgery procedures in Lao People's Democratic Republic (PDR) over the last decade. METHODS: The number of ophthalmologists (defined as physicians who have completed full education and training in ophthalmology), eye doctors (defined as physicians who have completed education and training in only cataract surgery), ophthalmic nurses, and cataract surgery procedures across 16 provinces and Vientiane municipal for the middle/late 1990s, the year 2000, and the most recent year (2005-2006) were obtained from the registration system of eye health professionals and the track record in cataract surgeries in the Ophthalmology Center, Ministry of Health. The number of cataract surgeons (total number of ophthalmologists and eye doctors) per million population, the number of ophthalmic nurses per million population, and the cataract surgical rate were calculated for various geographical units using available population data from the census in 1995, 2000, and 2005. The Gini coefficients, measures of inequality that range from 0 (total equality) to 1 (total inequality), were computed at three time points. RESULTS: The number of ophthalmologists, ophthalmic nurses, and cataract surgery procedures increased in this country as a whole, although the number of eye doctors did not change after 2000. The Gini coefficients for them also improved (Cataract surgeons: 0.792, 0.415, and 0.361; Ophthalmic nurses: 0.448, 0.354, and 0.259 and; Cataract surgery: 0.366, 0.309, and 0.248 in the 1990s, 2000, and 2005-6, respectively). CONCLUSION: Imbalances in the geographical distribution of eye health professionals and cataract surgery decreased over the last decade.