Frequency and causes of visual impairment in people attending outreach clinics in Zambia
Saunders, C. Barrett, Brendan T. Swystun, Alexander G. Davey, Christopher J.
Saunders, C.
Barrett, Brendan T.
Swystun, Alexander G.
Davey, Christopher J.
Publication Date
2025
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© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/
licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not
altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the
author(s) or with their consent.
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openAccess
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2025-07-02
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Abstract
Clinical relevance: Preventable visual impairment and blindness represent significant global public health challenges. Expanding access to high-volume eye care services in underserved areas may reduce visual impairment and blindness.
Background: Visual impairment negatively impacts quality of life, education, and employability, but is often treatable with management following a basic eye examination. Access to basic eyecare in Zambia is limited. Vision Action, a UK-based nongovernmental organisation, facilitates eyecare services in Zambia to reduce rectifiable visual impairment by supporting government outreach clinics in underserved communities. This study examines the frequency of presenting visual impairment, uncorrected refractive error, and ocular pathology among outreach clinic attendees in Zambia.
Methods: A retrospective analysis of outreach clinic records between 2012 and 2015 was performed. The available data include patient demographics, presenting symptoms, presenting level of vision, and classification of any ocular pathology present. Levels of visual impairment were categorised according to the World Health Organization's classification for blindness and visual impairment.
Results: Data from 5809 patients were collected (58.5% female, mean age = 41.9 years, SD = 20.7 years). Presenting vision, in the better eye, was classified as ‘moderate visual impairment’ in 14.2% (n = 766), ‘severe visual impairment’ in 0.3% (n = 15) and ‘blind’ in 4.3% (n = 234) of individuals. Uncorrected refractive error was responsible for 62.4% and 57.0% of blindness and severe visual impairment, respectively. Cataract, corneal scarring, and glaucoma were the most common non-refractive ocular pathologies associated with visual impairment.
Conclusion: Uncorrected refractive error is the leading cause of blindness and visual impairment in patients presenting to outreach clinics in Zambia and is particularly significant in a predominantly working-age population. Outreach clinics are an effective method of detecting and treating correctable visual impairment in this population. However, there is a need to expand and enhance primary eyecare services to reduce the burden of visual impairment, through management of uncorrected refractive error.
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Saunders C, Ghorbani-Mojarrad N, Barrett BT et al (2025) Frequency and causes of visual impairment in people attending outreach clinics in Zambia. Clinical and Experimental Optometry. Accepted for Publication.
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