1.The Kuala Pilah cluster cataract study: Accessible eye care reduces cataract blindness
Nur Hanis Yusri ; Puspha Raman ; Premala Devi Sivagurunathan ; Khairul Husnaini Mohd Khalid
The Medical Journal of Malaysia 2019;74(4):296-299
Objective: The Ministry of Health introduced the cluster
hospital project in Kuala Pilah district in 2016 to allow
sharing of resources between the hospitals in the same
vicinity. The aim of this study is to compare the
demographic profile, prevalence of cataract blindness and
low vision among patients who presented for cataract
surgery before and after the programme.
Methodology: This is a retrospective cohort study of
patients who underwent cataract surgery in Kuala Pilah
Cluster Hospitals between 2010 and 2017. A total of 2539
records of patients were reviewed. Patients were assigned
into two groups: Group 1 (2010-2012)- before the programme
(2010-2012) and Group 2 (2015-2017) after the introduction of
the programme.
Results: There was a significant increase in number of
cataract cases in the district hospital after the cluster
initiative. The mean age of patients undergoing cataract
surgery was similar in both groups. The common
comorbidities were hypertension (Group 1=57.3%; Group
2=70.8%) and diabetes mellitus (Group 1=40.6%; Group
2=51.1%). In 2010-2012, most of the patients were one eye
blind (34.4%), whereas in 2015-2017 majority of patients
presented with vision better than 6/18 (43.5%). The
proportion of patients with cataract blindness reduced from
6% in 2010-2012 to 4.3% in 2015-2017 (p<0.01).
Conclusion: There is a significant decrease in percentage of
patients with cataract blindness and low vision after the
introduction of Kuala Pilah Cluster Hospital Program. We
believe that that cluster hospital system is effective in
improving accessibility to eye care and therefore increases
the cataract detection rate.