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PURPOSE: The Beijing Eye Public Health Care Project was designed to screen all elderly subjects (age 55-85 years) of the rural region of Greater Beijing. It was developed as a preparatory step for a telemedicine-based public health care system in ophthalmology in China. DESIGN: Population-based public health care project. PARTICIPANTS: Elderly subjects (age 55-85 years) of the rural region of Greater Beijing. METHODS: Project participants were visited, interviewed, and examined by 2500 high school graduates trained as ophthalmic technicians. If visual acuity was <0.30, subjects were referred to primary health care centers where ocular photographs were taken. Using telemedicine, the photographs were transmitted to a reading center and causes for visual impairment were diagnosed. MAIN OUTCOME MEASURES: Practicability of a mass screening system in ophthalmology; prevalence of visual impairment and causes for it. RESULTS: Out of 692 323 eligible inhabitants, 562 788 (81.3%) subjects participated. Visual impairment in ≥1 eye was detected in 54 155 (9.62%) subjects, and among them, 30 164 (5.36%) subjects had bilateral visual impairment. Ocular fundus photographs were taken for 37 281 subjects. Cause for visual impairment was cataract in 19 163 (3.41%) of all screened subjects, glaucoma in 1606 (0.29%) subjects, diabetic retinopathy in 905 (0.16%) subjects, other macular diseases in 2700 (0.48%) subjects, pterygium in 1381 (0.25%) subjects, and corneal leukoma in 283 (0.05%) subjects. For 5853 (1.04%) subjects, a diagnosis of premature or mature cataract was made showing the urgent need of cataract surgery. After cataract surgery, visual acuity was ≥0.30 in 1464 (91.7%) of 1596 postoperatively reexamined subjects. CONCLUSIONS: Using a telemedicine approach, the Beijing Eye Public Health Care Project developed, applied and tested an infrastructure for ophthalmic mass screening of >500 000 elderly inhabitants with a response rate of >80%. Beside cataract, retinal diseases including diabetic retinopathy and glaucoma were major causes for visual impairment. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, P.R. China.
Full article1.1 Epidemiology (Part of: 1 General aspects)