Prevalence and risk factors for refractive errors in the South Indian adult population: The Andhra Pradesh Eye disease study

Sannapaneni Krishnaiah^1,2,3, Marmamula Srinivas^1,2,3, Rohit C Khanna^1,2, Gullapalli N Rao^1,2,3

¹L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; ²International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; ³Vision CRC, University of New South Wales, Sydney, NSW, Australia

Aim: To report the prevalence, risk factors and associated population attributable risk percentage (PAR) for refractive errors in the South Indian adult population.

Methods: A population-based cross-sectional epidemiologic study was conducted in the Indian state of Andhra Pradesh. A multistage cluster, systematic, stratified random sampling method was used to obtain participants (n = 10293) for this study.

Results: The age-gender-area-adjusted prevalence rates in those ≥40 years of age were determined for myopia (spherical equivalent [SE] < −0.5 D) 34.6% (95% confidence interval [CI]: 33.1–36.1), high-myopia (SE < −5.0 D) 4.5% (95% CI: 3.8–5.2), hyperopia (SE > +0.5 D) 18.4% (95% CI: 17.1–19.7), astigmatism (cylinder < −0.5 D) 37.6% (95% CI: 36–39.2), and anisometropia (SE difference between right and left eyes >0.5 D) 13.0% (95% CI: 11.9–14.1). The prevalence of myopia, astigmatism, high-myopia, and anisometropia significantly increased with increasing age (all p < 0.0001). There was no gender difference in prevalence rates in any type of refractive error, though women had a significantly higher rate of hyperopia than men (p < 0.0001). Hyperopia was significantly higher among those with a higher educational level (odds ratio [OR] 2.49; 95% CI: 1.51–3.95) and significantly higher among the hypertensive group (OR 1.24; 95% CI: 1.03–1.49). The severity of lens nuclear opacity was positively associated with myopia and negatively associated with hyperopia.

Conclusions: The prevalence of myopia in this adult Indian population is much higher than in similarly aged white populations. These results confirm the previously reported association between myopia, hyperopia, and nuclear opacity.

Keywords: refractive errors, risk factors, population attributable risk percent, population-based cross-sectional study, southern India