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RAPID ASSESSMENT OF REFRACTIVE ERROR (RARE)

RAPID ASSESSMENT OF REFRACTIVE ERROR (RARE). Professor Kovin Naidoo Global Programs Director IAPB AFRICA CHAIRPERSON. Uncorrected Refractive Error ( URE ) “ The Crisis”. URE is most common cause of Visual impairment (VI) worldwide and 2 nd most common cause of blindness 1,2

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RAPID ASSESSMENT OF REFRACTIVE ERROR (RARE)

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  1. RAPID ASSESSMENT OF REFRACTIVE ERROR (RARE) Professor Kovin Naidoo Global Programs Director IAPB AFRICA CHAIRPERSON

  2. Uncorrected Refractive Error (URE)“The Crisis” • URE is most common cause of Visual impairment (VI) worldwide and 2nd most common cause of blindness1,2 • URE drives children and adults further into poverty:3 • Limits opportunities to education • Employment • Seriously impacts quality of life and productivity • Link between poverty and VI due to URE places heavy economic burden on individuals  families  affected nations

  3. What is the status of URE?4 Implications Implications

  4. Historical Situation • Paucity of Data • Refractive data elicited through: • RESC studies • From community to school • Children only • Conventional Population based studies • Prohibitively expensive • High level of expertise • Few and far between • Lag between completion and Program implementation timelines

  5. CONTEXT SETTING • Why and where do we need data • National level • Planning • Evaluation • Awareness • Advocacy • Regional level • Advocacy • Establish priorities for investment in regions

  6. RAREEvolved out of RACSS and RAABS

  7. How does RARE data help? • RARE data can be used in a top-down or bottom-up approach. TOP-DOWN BOTTOM-UP

  8. METHODOLOGY

  9. Target Group • RARE studies used to assess prevalence of URE, presbyopia, spectacle coverage, and barriers to uptake of services for refractive errors and presbyopia5 Studies are focused on: • Younger age groups more affected by RE • Presbyopia • 15-49 years

  10. Definitions

  11. Definitions

  12. RARE Toolkit

  13. OUTPUTS OF RARE STUDIES What is the impact of gathering this information? ....

  14. Spectacle Coverage [met need’ ] . [(‘met need’ + ‘unmet need’) X 100]

  15. Barriers – URE6

  16. Current and future RARE studies • Studies conducted • Eritrea • Ghana • Uganda • South Africa • Tanzania • Studies in preparation • Mozambique • Gambia • Zambia • Cameroon • Ethiopia • Malawi

  17. MAJOR BARRIERS IDENTIFIED IN RARE STUDIES CONDUCTED

  18. Comparison of visual impairment and refractive error prevalence across various RARE studies

  19. References Resnikoff S, Pascolini D, Mariotti S, Pokharel P. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ 2008;86:63-70. Holden BA, Fricke T, Ho S, Wong R, Schlenther G, Cronje S, et al. Global vision impairment due to uncorrected presbyopia. Arch Ophthalmol2008;126:1731-9. Fricke TR, Holden BA, Wilson DA, SchlentherG, Naidoo KS, Resnikoff S and Frick KD. Global cost of correcting vision impairment from uncorrected refractive error. Naidoo KS, Wallace DB, Holden, BA, Minto H, FaalHB, Dube P. The challenge of uncorrected refractive error: driving the agenda of the Durban Declaration on refractive error and service development. ClinExp Opt 2010: 93(3): 131-136. Marmamula S, Keeffe JE, Rao GN. Uncorrected refractive errors, presbyopia and spectacle coverage: Results from a Rapid Assessment of Refractive Error survey. Ophthalmic Epidemiology 2009;16:269-74. Marmamulaet al. Population-based cross-sectional study of barriers to utilisation of refraction services in South India: Rapid Assessment of Refractive Errors (RARE) Study. British Medical Journal.

  20. Acknowledgements PirindhaGovender Brien Holden Vision Institute (Public Health Division) – Research Department

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