{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T21:04:42Z","timestamp":1767474282625,"version":"3.48.0"},"reference-count":28,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CRC\/19\/1\/610010"],"award-info":[{"award-number":["IA\/CRC\/19\/1\/610010"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005809","name":"Hyderabad Eye Research Foundation","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100005809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,5,1]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence, causes and risk factors associated with visual impairment (VI) in the Nirmal district of Telangana, India, using extended Rapid Assessment of Visual Impairment (RAVI) methodology.<\/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>Participants aged \u226516 years were enumerated from 90 randomly selected clusters and 4629\/5400 (85.7%) participants were examined. Presenting visual acuity (VA) was assessed using a Snellen chart with E optotypes at a 6 m distance. Near vision was assessed binocularly using an N notation chart with tumbling E optotypes at a 40\u2009cm distance. An anterior segment examination done followed by distance direct ophthalmoscopy at 50\u2009cm. Non-mydriatic fundus images were obtained. VI was defined as presenting VA worse than 6\/12 in the better eye. The prevalence of VI in the current study was compared with a RAVI study conducted in 2014 to assess the trends in VI among those aged \u226540 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>Prevalence, causes and risk factors for VI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among those examined, 55% were women, 53% had at least school-level education, 2.3% self-reported diabetes and 8.7% self-reported hypertension. The prevalence of VI was 8.81% (95% CI 8.01% to 9.67%). Overall, uncorrected refractive errors (49.5%) were the leading cause of VI, followed by cataracts (40.2%) and posterior segment diseases (4.9%). Among those aged \u226540 years, the prevalence of VI declined by 19.3% compared with the 2014 baseline study (from 20.2% to 16.3%; p&lt;0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The extended RAVI study conducted in the Nirmal district showed a considerable decline in the prevalence of VI. Targeted interventions are needed to provide adequate eye care for the high-risk groups in this district.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083199","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T18:50:44Z","timestamp":1717095044000},"page":"e083199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cross-sectional study of prevalence, causes and trends in visual impairment in Nirmal District, Telangana, India: Nirmal Eye Evaluation for Trends study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1716-9809","authenticated-orcid":false,"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":"School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India"},{"name":"Wellcome Trust \/ Department of Biotechnology, India Alliance, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aritra","family":"Chinya","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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3983-8783","authenticated-orcid":false,"given":"Vijay Kumar","family":"Yelagondula","sequence":"additional","affiliation":[{"name":"Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajashekar","family":"Varada","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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8698-5562","authenticated-orcid":false,"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"},{"name":"School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"School of Medicine and Dentistry, University of Rochester, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Wellcome Trust \/ Department of Biotechnology, India Alliance, L V Prasad Eye Institute, Hyderabad, India"},{"name":"Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"2025121409102868000_14.5.e083199.1","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/S2214-109X(20)30425-3","article-title":"Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the global burden of disease study","volume":"9","author":"Bourne","year":"2021","journal-title":"Lancet Global Health"},{"key":"2025121409102868000_14.5.e083199.2","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of Avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the global burden of disease study","volume":"9","author":"Steinmetz","year":"2021","journal-title":"Lancet Global Health"},{"key":"2025121409102868000_14.5.e083199.3","doi-asserted-by":"publisher","DOI":"10.4103\/0301-4738.100539"},{"key":"2025121409102868000_14.5.e083199.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2020-318481"},{"key":"2025121409102868000_14.5.e083199.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314015"},{"key":"2025121409102868000_14.5.e083199.6","doi-asserted-by":"crossref","unstructured":"Marmamula S , Khanna RC , Narsaiah S , et al . 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