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. 2015 Feb;99(2):147-52.
doi: 10.1136/bjophthalmol-2014-305945. Epub 2014 Nov 13.

Prevalence of Corneal Diseases in the Rural Indian Population: The Corneal Opacity Rural Epidemiological (CORE) Study

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Prevalence of Corneal Diseases in the Rural Indian Population: The Corneal Opacity Rural Epidemiological (CORE) Study

Noopur Gupta et al. Br J Ophthalmol. .

Abstract

Objective: The present population-based study was undertaken to estimate the prevalence, determinants and causes of corneal morbidity and blindness in a rural North Indian population.

Design: Population-based study in India with 12 899 participants of all ages.

Methods: Participants were recruited from 25 village clusters of district Gurgaon, Haryana, India using random cluster sampling strategy. All individuals were examined in detail with a portable slit lamp for evidence of any corneal disease during the door-to-door examination. Comprehensive ocular examination including logMar visual acuity, slit lamp biomicroscopy, non-contact tonometry and dilated retinal evaluation was performed at a central clinic site in the respective villages.

Results: Overall, 12 113 of 12 899 people (93.9% response rate) were examined during the household visits. Prevalence of corneal disease was 3.7% (95% CI 3.4% to 4.1%) and that of corneal blindness was 0.12% (95% CI 0.05% to 0.17%). Multivariable analysis demonstrated that corneal disease was significantly higher in the elderly (p<0.0001) and illiterates (p<0.0001). Common causes of corneal opacity in the study population were pterygium (34.5%), ocular trauma (22.3%) and infectious keratitis (14.9%). Corneal diseases contributing to blindness were post-surgical bullous keratopathy (46.2%) and corneal degenerations (23.1%).

Conclusions: The study findings demonstrate that currently ocular trauma, infectious keratitis, post-surgical bullous keratopathy, and corneal degenerations are responsible for the major burden of corneal blindness and morbidity in the Indian population. The prevalence of corneal morbidity due to vitamin A deficiency and trachoma was low in this rural population.

Keywords: Cornea; Epidemiology; Infection; Public health.

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