Knowledge, attitudes and practices related to seeking medical eyecare services by adults with moderate-to-severe visual impairment in rural Yueqing, Wenzhou, China: a cross-sectional survey.

Aim: To evaluate the knowledge, attitudes, and practices regarding eye-care seeking practices of visually impaired adults in a rural area Yueqing, and explore factors influencing their behavior.

Methods: A stratified sampling method was used to select 48 villages in Yueqing, from which 2400 people were selected to receive vision screenings conducted by oculists during a household visit. Those presenting visual acuity ≥0.5 logMAR in either eye completed a self-designed questionnaire investigating their knowledge about medical eye-care seeking, attitudes about eye health and eye-care-seeking behavior.

Results: Totally 165 people with moderate-to-severe visual impairment were identified (6.9%, 165/2400), and 146 eligible participants were recruited (response rate: 88.4%, mean age: 68.6±15.0y), among which 88 (60.3%) were female. They had 82 (56.2%) and 64 (43.8%) monocular and binocular visual impairments respectively. A total of 67 (45.9%) subjects demonstrated a high knowledge level about medical eye-care seeking and 88 (60.3%) had self-rated poor vision, with 23 (15%) receiving regular vision checks. The 105 (71.9%) subjects had never been to hospital for an eye examination. "No need" and "schedule conflicts" were the main reasons for not seeking eye care. Having extensive knowledge of medical eye-care seeking was positively associated with high education levels (OR=3.73, =0.045) and negatively correlated with older age (OR=0.97, =0.043). Both the self-perceived vision condition (OR=2.59, =0.03) and regular vision check behavior (OR=6.50, <0.01) were related with seeking eye care services.

Conclusion: In rural Yueqing, intervention is required to increase public knowledge about seeking medical eye care among people with moderate-to-severe visual impairment, especially for the elderly and poorly education. Regular vision checks may be useful to promote their medical eye-care utilization.