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Prevalence of Refractive Error, Presbyopia, and Spectacle Coverage in Bogotá, Colombia

A Rapid Assessment of Refractive Error

Casas Luque, Luisa OD1*; Naidoo, Kovin PhD, OD, FAAO2; Chan, Ving Fai PhD, OD3; Silva, Juan Carlos MD4; Naduvilath, Thomas John PhD5; Peña, Fernando MD6; Mayorga, Myriam MSc, OD7; Ramírez, Leonardo OD1

doi: 10.1097/OPX.0000000000001409

SIGNIFICANCE Uncorrected refractive error is the leading cause of visual impairment; therefore, reducing its prevalence is important worldwide. For two decades, there has not been a comprehensive assessment of refractive error in Latin America.

PURPOSE The purpose of this study was to determine the current prevalence of refractive error, presbyopia, spectacle coverage, barriers to uptake refractive services, and spectacle correction in people 15 years and older in Bogotá, Colombia.

METHODS A cross-sectional community-based survey was conducted using 50 randomly selected clusters from 10 districts of Bogotá reflecting the socioeconomic status of the city. Respondents 15 years and older were interviewed and underwent standardized clinical eye examinations. Prevalence of uncorrected refractive error, spectacle coverage, and visual impairment were standardized to 2015 age-sex population distribution of Bogotá and further analyzed.

RESULTS A total of 2886 subjects (90% of 3206 eligible subjects) participated in the study; 39.1% were male and 60.9% were female in the age range of 15 to 96 years, with a median age of 46 years (interquartile range, 45 to 54 years). Age- and sex-standardized prevalence of visual impairment was 19.3% (95% confidence interval [CI], 17.8 to 20.8%). Prevalence of uncorrected refractive error was 12.5% (95% CI, 11.3 to 13.7%). Prevalence of presbyopia among participants 35 years and older was 55.2% (95% CI, 52.9 to 57.4%). Spectacle coverage was 50.9% for distance vision, and it was 33.9% for presbyopia. Main barrier to spectacle uptake was a limitation in affording spectacles because of economic factors (29.5%).

CONCLUSIONS This study provides a current estimate of refractive error using the Rapid Assessment of Refractive Error for Colombia and the Latin American region. The prevalence of uncorrected refractive error and presbyopia was high, and the barriers to spectacle uptake were higher in the lowest socioeconomic strata. The results obtained in the present study will help in making evidence-based decisions related to eye care service delivery in Colombia.

1Brien Holden Vision Institute Foundation, Bogotá, Colombia

2African Vision Research Institute, UKZN, Durban, South Africa

3Queen's University of Belfast, Dublin, United Kingdom

4Pan-American Health Organization, Bogotá, Colombia

5Brien Holden Vision Institute Foundation, Sydney, Australia

6El Bosque University, Bogotá, Colombia

7La Salle University, Bogotá, Colombia


Supplemental Digital Content: The Appendix, The Rapid Assessment of Refractive Error (RARE) questionnaire and recording form, is available at

Submitted: August 13, 2018

Accepted: March 29, 2019

Funding/Support: Lions Clubs International Foundation (SF1867/UND).

Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest.

Author Contributions and Acknowledgments: Conceptualization: LCL, KN, VFC; Data Curation: TJN; Formal Analysis: KN, TJN, LR; Funding Acquisition: LCL; Investigation: LCL, KN, VFC, TJN, MM, LR; Methodology: LCL, KN, VFC, JCS, TJN, LR; Project Administration: LCL; Supervision: LCL, MM; Writing — Original Draft: LCL, LR; Writing — Review & Editing: LCL, KN, VFC, JCS, TJN, FP, LR.

The authors would like to acknowledge the Secretary of Health of Bogotá, the Councilor's Office, the Pan-American Health Organization, La Salle University, and Centro de Rehabilitación para Adultos Ciegos (CRAC) foundation for supporting the implementation of the field work. Special thanks to Optica Alemana and Volver Foundation for their permanent support and donations to our projects. Management was provided by Brien Holden Vision Institute Foundation.

Supplemental Digital Content: Direct URL links are provided within the text.

Online date: July 17, 2019

© 2019 American Academy of Optometry