{
  "abstract": "Background/aims Corneal opacity (CO) is a significant cause of vision impairment and blindness worldwide. The first National Eye Health Survey in The Gambia (1986) and follow-up (1996) showed a decline in the crude prevalence of blindness but an increase in blindness from non-trachomatous CO. This study aimed to provide an update on the prevalence of CO and identify associated risk factors.Methods Multi-stage stratified cluster random sampling was used to select a nationally representative sample of 10 800 adults aged ≥35 years. Distance best-corrected visual acuity was assessed with Peek Acuity. Ophthalmologists examined participants to identify trachomatous trichiasis, pterygium, CO, corneal ulcers and band keratopathy. CO was graded using a previously described system. Counts and prevalence estimates were based on the weighted sample, corrected for age/sex imbalance. The main outcome was the prevalence of CO. Multivariable logistic regression identified risk factors associated with CO.Results 9188 participants were examined. CO was found in one or both eyes in 878 participants, giving an age–sex-adjusted prevalence of 9.6% (95% CI 8.7 to 10.5). CO was more likely unilateral (n=673) than bilateral (n=205). Among affected eyes, 41.0% had moderate or severe vision impairment or blindness. Risk factors independently associated with CO included trachomatous trichiasis (OR 5.22 [95% CI 3.46 to 7.86]), older age (OR 4.06 [95% CI 2.54 to 6.47]), male sex (OR 1.58 [95% CI 1.34 to 1.86]) and rural residence (OR 1.62 [95% CI 1.15 to 2.28]).Conclusion The prevalence of CO in The Gambia remains high. Focused national efforts to prevent and treat CO are urgently needed.",
  "authors": [
    {
      "affiliations": [
        "Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia",
        "Masaka Regional Referral Hospital, Masaka, Uganda"
      ],
      "name": "Denis Erima"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Elliott H Taylor"
    },
    {
      "affiliations": [
        "Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia"
      ],
      "name": "John A Okoh"
    },
    {
      "affiliations": [
        "Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia",
        "Department of Ophthalmology, University College Hospital Ibadan, Ibadan, Nigeria"
      ],
      "name": "Segun I Olaniyan"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Suzannah J Bell"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Ben Kirkpatrick"
    },
    {
      "affiliations": [
        "Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK"
      ],
      "name": "Hannaa Bobat"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Covadonga Bascaran"
    },
    {
      "affiliations": [
        "The Fred Hollows Foundation, Sydney, New South Wales, Australia"
      ],
      "name": "Andrew Cassels-Brown"
    },
    {
      "affiliations": [
        "University of Calabar Teaching Hospital, Calabar, Nigeria"
      ],
      "name": "Hannah Faal"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Min J Kim"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Islay Mactaggart"
    },
    {
      "affiliations": [
        "Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia"
      ],
      "name": "Abba Hydara"
    },
    {
      "affiliations": [
        "International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK",
        "National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK"
      ],
      "name": "Matthew J Burton"
    }
  ],
  "title": "Prevalence and risk factors associated with corneal opacity in The Gambia",
  "uid": "9c64ded4-58d8-53a3-8c61-8264c1c97d7c"
}