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The first national survey on eye health in Papua New Guinea (PNG) has found that the prevalence of blindness among people aged 50 years and older is 5.6%, which is one of the highest rates in the world.
The study, which was recently published in the British Journal of Ophthalmology, found the major causes of blindness and vision impairment are cataract and uncorrected refractive error. The authors state that an increase in services, resources and efforts to improve eye health literacy among the population are needed.1
Cataract surgical coverage (32.9%) was low compared to the median of 53.7% across low- and middle-income countries in Asia, Africa and South America. People in the Highlands are especially disadvantaged as only 9.2% of women and 25% of men had received the surgery that they need.
Lead author on the study, Dr Ling Lee from Brien Holden Vision Institute, said that the primary barriers for people getting cataract surgery were being unaware that treatment was possible, reporting that they didn’t feel a need for treatment, and the costs involved.
The study also found “poorer than expected outcomes” from cataract surgery (these outcomes are below the WHO recommended target). “We believe that difficult terrain and the absence of road infrastructure hinder patients travelling to health facilities, which could be a factor in people not receiving necessary post-operative care, and an explanation for this finding,” says Dr Lee.
Importantly, the research found a significant gender disparity – with rates of blindness in women (7.0%) significantly higher than men (4.4%). As well as the imbalance in cataract surgical coverage, 79.1% of women with refractive error did not have appropriate correction, compared with 61.3% of men.
“There is a particular need for services for women to address this imbalance, as well as improved access for people in the Highlands,” says Dr Lee. “In addition, health education on avoidable blindness targeting older patients is likely to improve outcomes.”
The RAAB survey was initiated by the PNG National Prevention of Blindness Committee and implemented with the support of PNG Eye Care and Brien Holden Vision Institute. It was supported under a research grant from The Fred Hollows Foundation.
PNG Eye Care is the first Papua New Guinean NGO to devote itself to building eye health capacity within PNG. The significant achievements made in eye health since 2008 are due to its ongoing partnership with Brien Holden Institute and strong support from the Australian Government’s starting with the Avoidable Blindness Initiative in 2010-2013 and continuing with other initiatives to the present day.
1. Lee L, D’Esposito F, Garap J, et al. Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey Br J Ophthalmol Epub ahead of print: doi:10.1136/bjophthalmol-2017-311802