{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:05:52Z","timestamp":1790996752614,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,5,23]]},"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the barriers to uptake of eye care services among those with avoidable impairment in the population aged \u226540\u2005years in the South Indian state of Andhra Pradesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Community setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of 7800 participants recruited from one urban and two rural locations using a two-stage cluster random sampling methodology, 7378 (95%) were examined. Eye examinations were conducted using a rapid assessment protocol. Visual impairment (VI) was defined as presenting visual acuity &lt;6\/18 in the better eye. For the purpose of this study, VI caused due to cataract or uncorrected refractive error was considered avoidable VI. A validated questionnaire was used to collect information on barriers for uptake of services among those who had avoidable VI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>Barriers to uptake of services among those with avoidable VI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of avoidable VI was 11.8% (95% CI 11.0% to 12.5%; n=868). Among these, 71.1% (n=617) individuals reported \u2018person-related\u2019 barriers whereas 28.9% (n=251) individuals reported \u2018service-related\u2019 barriers to uptake of services. Among the \u2018person-related\u2019 barriers, the leading barrier was \u2018lack of perceived need\u2019 (61.1%; n=377) for reasons such as old age, good vision in the other eye. This was followed by \u2018no one to accompany\u2019 (20.3%; n=125). Of the 251 individuals who had \u2018service-related\u2019 barriers, lack of affordability was the major barrier (76.1%; n=191) followed by lack of accessibility (12.7%; n=32). Over 11% (n=28) of the individuals were advised to wait for cataract surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Person-related barriers are more common than service-related barriers in Andhra Pradesh. As the barriers trend more towards \u2018person-related\u2019 phenomenon such as person's attitude and \u2018felt need\u2019 to improve vision, newer and much intensive awareness campaigns are needed to bring about an attitudinal\/behavioural change among individuals to improve the uptake of services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005125","type":"journal-article","created":{"date-parts":[[2014,6,13]],"date-time":"2014-06-13T20:17:09Z","timestamp":1402690629000},"page":"e005125","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["A population-based cross-sectional study of barriers to uptake of eye care services in South India: the Rapid Assessment of Visual Impairment (RAVI) project"],"prefix":"10.1136","volume":"4","author":[{"given":"Srinivas","family":"Marmamula","sequence":"first","affiliation":[{"name":"Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India"},{"name":"Bausch & Lomb School of Optometry, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit C","family":"Khanna","sequence":"additional","affiliation":[{"name":"Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konegari","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gullapalli N","family":"Rao","sequence":"additional","affiliation":[{"name":"Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India"},{"name":"Bausch & Lomb School of Optometry, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,6,12]]},"reference":[{"key":"2025121600530704000_4.6.e005125.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2011-300539"},{"key":"2025121600530704000_4.6.e005125.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.12.013"},{"key":"2025121600530704000_4.6.e005125.3","first-page":"e000172","article-title":"Population-based cross-sectional study of barriers to utilisation of refraction services in South India: Rapid Assessment of Refractive Errors (RARE) Study","volume":"1","author":"Marmamula","year":"2011","journal-title":"BMJ"},{"key":"2025121600530704000_4.6.e005125.4","first-page":"104","article-title":"Changing trends in barriers to cataract surgery in India","volume":"77","author":"Vaidyanathan","year":"1999","journal-title":"Bull World Health Organ"},{"key":"2025121600530704000_4.6.e005125.5","doi-asserted-by":"publisher","DOI":"10.1080\/01658100701486814"},{"key":"2025121600530704000_4.6.e005125.6","unstructured":"Census 2011. 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