Prevalence of refractive error, presbyopia, and unmet need of spectacle coverage in a northern district of Bangladesh: Rapid Assessment of Refractive Error study.

Purpose: To determine the prevalence of refractive error (RE), presbyopia, spectacle coverage, and barriers to uptake optical services in Bangladesh. Method: Rapid assessment of refractive error (RARE) study following the RARE protocol was conducted in a northern district (i.e., Sirajganj) of Bangladesh (January 2010-December 2012). People aged 15-49 years were selected, and eligible participants had habitual distance and near visual acuity (VA) measured and ocular examinations were performed in those with VA <6/18. Those with phakic eyes with VA <6/18, but improving to 6/18 with pinhole or optical correction, were considered as RE and people aged >= 35 years with binocular unaided near vision of = 35 years (n = 1402), 869 had presbyopia (62.0, 95% CI: 59.4-64.5). Spectacle coverage for RE and presbyopia were 13.3% (95% CI 7.7-18.9) and 3.2% (95% CI 2.2-4.6), respectively. "Unaware of the problem" was the main reason for not utilizing any optical services among the people with RE (92.8%) and presbyopia (89.5%). Extrapolating the survey findings to the 2011 national census data, the magnitude of RE among people aged 15-49 years in Bangladesh is estimated to be 3,493,980 people (95% CI 2,899,260-4,088,700), of whom 3,029,280 people do not use any spectacles. Conclusion: The burden of RE and presbyopia is substantial in Bangladesh. Improving awareness and availability of refraction services is required to correct REs and presbyopia in Bangladesh.