Prevalence and Associated Factors of Vision Impairment Combined With Distance and Near Vision: A Cross Sectional Study in Coastal Province of Southern China Among Urban and Rural Adults

Background: Visual impairment (VI) and blindness remain the major public health problems worldwide and have a profound impact on an individual’s health and quality of life as well as on society. To broaden the mode of ophthalmologic epidemiological survey, and evaluate the prevalence and demographic associations of distance and near vision impairment in urban and rural population in a province of Southern China in which includes both coastal and inland areas. Methods: The Fujian Eye Study was a population-based cross-sectional study during 2018-2019. Residents aged ≥ 50 years in randomly sampled communities were recruited (10090 subjects). The survey covered urban and rural populations, and coastal and inland populations. Participants underwent a questionnaire about socioeconomic and biological factors and a series of standard examinations both physical and ocular.  Findings: 8211 (81·4%) were eventually enrolled, including rural (3533 subjects) and urban (4678) population, or coastal (6434) and inland (1777) groups. Mean age was 64·39 (SD 8·87) years. Mean uncorrected distance visual acuity (UDVA) was 0·61 (0·30), best corrected visual acuity (BCVA) was 0·82 (0·28) and uncorrected near visual acuity (UNVA) was 0·28 (0·17). 0·45% of the participants were blind, 3·33% had distance vision impairment (DVI), 68·58% had present near vision impairment (PNVI), presbyopia was noted in 68·33% participants and 2·85% had combined vision impairment (CVI). The rate of PNVI was higher in rural population compared with urban population (70·48% vs 67·13%). DVI rate was higher in inland population compared with coastal population (5·08% vs 2·79%). CVI rate was higher in both rural and inland population (3·43% vs 2·33%, 3·97% vs 2·50%). VI was significantly correlated with socioeconomic or biological factors, including age, urban and rural region, coastal and inland area, educational background, income and refractive error, whereas sex was not significantly associated with VI. Interpretation: There was still high prevalence of blindness and VI in China. The percentage of PNVI was higher in rural population, DVI rate was higher in inland population, and CVI rate was higher in both rural and inland populations, which suggesting a need for increasing accessible services with improvement resources and advocacy for enhancing eye health literacy. Funding Statement: The National Natural Science Foundation of China. Declaration of Interests: XXL’s institute received financial support of the National Natural Science Foundation of China (no·81870672) from the National Natural Science Foundation Committee. All authors declare no competing interests. Ethics Approval Statement: The 2018–2019 FJES protocol was approved by the Ethics Committee of Xiamen Eye Center affiliated with Xiamen University, and informed consent was obtained from all participants.