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 <N8 were considered presbyopic.
Result: A total of 3,043 people were examined, of which 143 had RE (4.7%, 95% CI: 3.9-5.5). Among people aged ≥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.
Keywords: Bangladesh; Rapid assessment; presbyopia; refractive error.