Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model

Frontiers in Medicine

Meiping Xu²  Yuanbo Liang³  Haishuang Lin³  Shanshan Liu⁵  Hailin Wang⁵  Jing Sun⁵  Shaodan Zhang⁵  Nathan Congdon⁶ 

[1]Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom

[2]Department of Glaucoma, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China

[3]Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China

[4]National Clinical Research Center for Ocular Diseases, Zhejiang, China

[5]Shenyang Key Lab of Ophthalmology, Department of Ophthalmology, The Fourth Peoples' Hospital of Shenyang, Liaoning, China

[6]Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

关键词: uncorrected refractive error;    spectacle coverage;    opportunistic screening;    health examination center;    refractive service;   

DOI  :  10.3389/fmed.2021.753257

来源: DOAJ

【 摘 要 】

Purpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual acuity, noncycloplegic autorefraction, noncontact tonometry, fundus photography, and slit-lamp examination were performed. Refractive error was defined as having spherical equivalent ≤ -0.75 D or ≥ +1 D and uncorrected refractive error was considered as refractive error combined with presenting visual acuity < 6/12 in the better eye. Costs for the screening were assessed.Results: A total of 5,284 participants (61 ± 14 years) were included. The overall prevalence of myopia and hyperopia was 38.7% (95% CI, 37.4–40.0%) and 23.5% (95% CI, 22.3–24.6%), respectively. The prevalence of uncorrected refractive error was 7.85% (95% CI, 7.13–8.58%). Women (p < 0.001 and p = 0.003), those with age ≥ 70 years (p < 0.001 and p = 0.003), and myopia (p < 0.001 and p < 0.001) were at higher risk of uncorrected refractive error and uncorrected refractive error-related visual impairment. Spectacle coverage rate was 70.6% (95% CI, 68.2–73.0%). The cost to identify a single case of refractive error and uncorrected refractive error was US$3.2 and US$25.2, respectively.Conclusion: The prevalence of uncorrected refractive error is high in the urban Chinese adults. Health examination center-based refractive error screening is able to provide an efficient and low-cost model to improve the refractive services in China.

【 授权许可】

Unknown