Visual impairment is a form of visual loss that interferes with an individual’s daily activities of living and is secondary to a functional etiology in the eye or visual system.1 Based on the patient’s visual acuity and visual field, visual impairment can be classified mainly into two main categories: moderate visual impairment, defined as a best-corrected visual acuity (BCVA) between 20/70 to 20/200 or a visual field of ≤ 20 degrees diameter in the better-seeing eye, and legal blindness, defined as a BCVA between ≤ 20/200 or a visual field of ≤ 20 degrees diameter in the better-seeing eye.1

Although various etiologies can contribute to visual impairment, the primary causes are uncorrected refractive errors (43%), followed by cataracts (33%), and glaucoma (2%).1 Nevertheless, of the approximately 1.3 billion people estimated to be living with some form of visual impairment by the World Health Organization, 80% of cases are considered preventable or even avoidable due to the availability of appropriate treatment.2

Awareness and knowledge of common eye diseases, particularly those causing visual impairment, varies between communities. Numerous studies have examined factors linked to awareness in this context. For example, three factors that could be attributed to lower awareness regarding common eye diseases are increasing age, lack of schooling, and lower socioeconomic status.3 Alternatively, younger age, female gender, a higher level of formal education, recent visits to an eye practitioner, and English language fluency have been given as significant predictors of knowledge of common eye-related conditions.4

In many developing countries, the general population has low levels of knowledge of common eye problems that lead to visual impairment. This might be attributable to the lack of availability of information on this subject, especially in light of the low number of published studies highlighting this problem in these countries. In Oman, three community-based prevalence studies have been published in recent years; an analysis of these studies, conducted in 1996, 2005, and 2010, respectively, found that the projected number of Omanis with blindness would increase with time, potentially reaching 165 000 by 2050.5

In 2005, a pilot study was conducted to identify knowledge levels and attitudes regarding common eye diseases and satisfaction with ophthalmic services in Oman.6 A close-ended questionnaire was distributed to 156 citizens aged 12 or older. The study found that 70% of participants had a good level of knowledge about cataracts and diabetic retinopathy and 35% preferred using home remedies to treat minor eye diseases.6

High rates of non-compliance with medical treatment among glaucoma patients in Oman has been reported related to poor knowledge, attitudes, and practices regarding the disease.7 In contrast, a cross-sectional study of 750 diabetic individuals from seven regions of Oman found that knowledge of eye complications and care was satisfactory among this group. However, the patients’ attitudes and practices were subpar and required improvement.8

Recently, an unpublished pilot study conducted in the Family and Community Medicine Clinic at Sultan Qaboos University Hospital in Muscat demonstrated moderate levels of awareness of common eye diseases among 200 participants, including diseases such as cataracts, glaucoma, diabetic retinopathy, and age-related macular degeneration. Surprisingly, 96% of the participants reported positive attitudes regarding the concept of undergoing regular eye check-ups.

Nevertheless, despite such positive findings, the lack of knowledge among the general public in Oman regarding common eye diseases remains a challenge for public health professionals and health policy decision-makers alike. Appropriate management plans should be designed to tackle this national problem holistically. Only by gaining further understanding of the problem will we be able to understand how to eradicate or minimize the consequences of such diseases, thereby eventually reducing the burden of preventable cases of visual impairment on the national healthcare system.

references

1. 1. Maberley DA, Hollands H, Chuo J, Tam G, Konkal J, Roesch M, et al. The prevalence of low vision and blindness in Canada. Eye (Lond) 2006 Mar;20(3):341-346.
2. 2. World Health Organization. Global initiative for the elimination of avoidable blindness. 2000 [cited 2019 September 29]. Available from: https://apps.who.int/iris/handle/10665/63748.
3. 3. Islam FM, Chakrabarti R, Islam SZ, Finger RP, Critchley C. Factors associated with awareness, attitudes and practices regarding common eye diseases in the general population in a rural district in Bangladesh: the Bangladesh Population-Based Diabetes and Eye Study (BPDES). PLoS One 2015 Jul;10(7):e0133043.
4. 4. Livingston PM, McCarty CA, Taylor HR. Knowledge, attitudes, and self care practices associated with age related eye disease in Australia. Br J Ophthalmol 1998 Jul;82(7):780-785.
5. 5. Khandekar R, Raisi AA. Changing trends of population and blindness in Oman: a need for urgent action. Oman J Ophthalmol 2012 Jan;5(1):1-2.
6. 6. Khandekar R, Al-Harby S. Knowledge and attitude for eye diseases and satisfaction for services among urban citizens of Oman: a pilot study. Oman J Ophthalmol 2008;1(1):13-17.
7. 7. Khandekar R. Shama Mel-S, Mohammed AJ. Noncompliance with medical treatment among glaucoma patients in Oman: a cross-sectional descriptive study. Ophthalmic Epidemiol 2005;12(5):303-309.
8. 8. Khandekar R, Harby SA, Harthy HA, Lawatti JA. Knowledge, attitude and practice regarding eye complications and care among Omani persons with diabetes - A cross sectional study. Oman J Ophthalmol 2010 May;3(2):60-65.