Prevalence of refractive error in rural Myanmar

Objective: To determine the prevalence of refractive error and associated risk factors in the Meiktila District of central rural Myanmar. Design: Population-based cross-sectional study. Participants: Randomized stratified cluster sampling of the inhabitants 40 years or older from villages in Meiktila was performed; 2481 eligible participants were identified, 2076 participated in the study, and adequate refractive data were obtained on 1863 individuals (75.1 %). Methods: Demographic data including age, gender, and education level were obtained from all participants. The ophthalmic examination included autorefraction, nuclear opalescence (NO) grading at the slit lamp, and applanation tonometry. Main Outcome Measures: Refractive errors were classified by type of ametropia and their prevalence was determined. Univariate and multivariate analyses were performed and odds ratios were calculated for the predictors of refractive error within the statistical models. Results: Mean refractive error measured -1.3 diopters (D) (standard deviation [SD], 2.9) and mean cylindrical error measured 1.1 D (SD, 1.5). Myopia of >-1.0 and >-6.0 D occurred in 42.7% (95% confidence interval [Cl], 40.4%-44.9%) and 6.5% (95% Cl, 5.4%-7.6%) of subjects, respectively. Myopic refractive error was associated significantly with a higher degree of NO (P<0.001) and age. Hypermetropia of >+1.0 D occurred in 15% (95% Cl, 5.4%-7.6%) of the population and was associated with higher education levels (P<0.001). Astigmatism worse than 1.0 D occurred in 30.6% (95% Cl, 28.5%-32.7%) of the population and was associated with age (P<0.001) and NO (P<0.001). Conclusion: Myopia was more prevalent in older subjects and in those with increased NO. The prevalence rates of myopia in the 40 age group are higher than those found in other Asian regions and are likely to contribute to visual impairment. Ophthalmology 2008;115:26-32 (c) 2008 by the American Academy of Ophthalmology.