Objective To estimate prevalence and causes of blindness and vision impairment and assess cataract surgical coverage and quality of cataract surgery in Kabul. Methods and analysis A total of 3751 adults aged 50 years and above were recruited from 77 randomly selected clusters. Each participant underwent presenting and pinhole visual acuity assessment and lens examination. Those with pinhole visual acuity <6/12 in either eye had a dilated fundus examination to determine the cause of reduced vision. Those with apparent lens opacity were interviewed on barriers to cataract surgery. Results The age-adjusted and sex-adjusted prevalence of blindness was 2.4% (95% CI: 1.8% to 3.0%). Prevalence of severe, moderate and mild vision impairment was 2.2% (95% CI: 1.7% to 2.7%), 6.9% (95% CI: 6.0% to 7.9%) and 8.7% (95% CI: 7.5% to 9.8%), respectively. Cataract was the main cause of blindness (36.8%), severe (54.4%) and moderate (46.1%) vision impairment. Uncorrected refractive error was the leading cause of mild vision impairment (20.3%). Age-related macular degeneration was the second leading cause of blindness (23.0%). In people with a presenting visual acuity of <3/60, cataract surgical coverage was 89.7%, and effective cataract surgical coverage was 67.8%. The major barriers to uptake of the available cataract surgical services were the need for surgery was not felt (23.7%) and cost (22.0%). Conclusion Kabul province has a high prevalence of blindness, largely due to cataract and age-related macular generation. The quality of cataract surgery is also lagging in terms of good visual outcomes. This calls for immediate efforts to improving the reach and quality of existing eye services and readiness to respond to the increasing burden of posterior eye disease. Data are available upon reasonable request.

中文翻译：

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阿富汗喀布尔省失明率和白内障手术率的快速评估

目的 估计喀布尔失明和视力障碍的患病率和原因，并评估白内障手术覆盖率和白内障手术质量。方法与分析 从 77 个随机选择的群体中招募了 3751 名 50 岁及以上成年人。每个参与者都接受了针孔视力评估和晶状体检查。对于单眼针孔视力<6/12的患者进行散瞳眼底检查以确定视力下降的原因。那些晶状体明显浑浊的人接受了关于白内障手术障碍的采访。结果 年龄调整和性别调整后的失明率为 2.4%（95% CI：1.8% 至 3.0%）。重度、中度和轻度视力障碍的患病率分别为 2.2%（95% CI：1.7% 至 2.7%）、6.9%（95% CI：6.0% 至 7.9%）和 8.7%（95% CI：7.5% 至 9.8%） ）， 分别。白内障是导致失明（36.8%）、严重（54.4%）和中度（46.1%）视力障碍的主要原因。未矫正的屈光不正是轻度视力障碍的主要原因（20.3%）。年龄相关性黄斑变性是导致失明的第二大原因（23.0%）。在视力<3/60的人群中，白内障手术覆盖率为89.7%，有效白内障手术覆盖率为67.8%。接受现有白内障手术服务的主要障碍是没有感觉到手术的需要（23.7%）和费用（22.0%）。结论 喀布尔省失明率较高，主要原因是白内障和年龄相关性黄斑生成。白内障手术的质量在良好的视觉效果方面也落后。这就需要立即努力提高现有眼科服务的范围和质量，并做好应对日益增加的后眼病负担的准备。数据可根据合理要求提供。