NCT03278587

Brief Summary

The vast majority of blindness is avoidable. The World Health Organization (WHO) estimates that 80% of cases of visual impairment could be prevented or reversed with early diagnosis and treatment. The leading causes of visual impairment are cataract and refractive error, followed by glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Loss of vision from these conditions is not inevitable; however, identifying at-risk cases and linking cases with appropriate care remain significant challenges. Eye health care systems must determine optimal strategies for reaching people outside of their immediate orbit in order to reduce visual impairment. Visual impairment can be reduced by case detection of prevalent disease like cataract and refractive error, or by screening for early disease like glaucoma, AMD, and DR and preventing progression. Systems around the world have developed numerous approaches to both case detection and screening but there is very little research to support the choice of allocating resources to case detection or screening and little data exists on the cost effectiveness of the various approaches to each. VIEW II Pilot is a cluster-randomized trial to determine the effectiveness of different approaches to community-based case detection and screening for ocular disease. Communities will be randomized to one of four arms: 1) a comprehensive ocular screening program, 2) a cataract camp-based program, 3) a community health worker-based program, and 4) no program.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
87,992

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2018

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 8, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

September 11, 2017

Completed
9 months until next milestone

Study Start

First participant enrolled

May 31, 2018

Completed
4.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 12, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 12, 2023

Completed
Last Updated

May 4, 2026

Status Verified

April 1, 2026

Enrollment Period

4.7 years

First QC Date

September 8, 2017

Last Update Submit

April 28, 2026

Conditions

Outcome Measures

Primary Outcomes (2)

  • Visual acuity

    Primary outcome for specific aim 1, comparison between screening and case detection arms

    1 year

  • Cataract surgical rate

    Primary outcome for specific aim 2, comparison between community health worker program and no program arms

    1 year

Secondary Outcomes (3)

  • Cost-effectiveness

    1 year

  • Visual acuity

    1 year

  • Number of cases of ocular disease detected

    1 year

Study Arms (4)

Community-based screening

ACTIVE COMPARATOR
Other: Community-based screening program

Cataract camp program

ACTIVE COMPARATOR
Other: Cataract camp program

Community health worker program

ACTIVE COMPARATOR
Other: Community health worker program

No intervention

NO INTERVENTION

Interventions

In communities randomized to receive the screening program, all adults aged 50 and older will be eligible to receive screening for ocular disease. Screening assessments include visual acuity, refraction, intra-ocular pressure, fundus photography, and anterior segment photography. Participants meeting criteria for referral based on screening assessments will be referred to the nearest eye care center or eye hospital for further evaluation.

Community-based screening

In communities randomized to receive the cataract camp program, all adults aged 50 and older will be eligible to participate in a routine cataract camp run by Bharatpur Eye Hospital. Trained ophthalmic personnel and assistants will perform case detection for cataract via visual acuity, pen light exam, and indirect ophthalmoscope exam per Bharatpur Eye Hospital's standard cataract camp program. Participants with cataracts will be referred to the nearest eye care center or eye hospital for further evaluation.

Cataract camp program

In communities randomized to receive the community health worker program, all adults aged 50 and older will be eligible to participate. Existing community health workers will be trained to perform case detection for cataract via visual acuity assessment. Participants with cataracts will be referred to the nearest eye care center or eye hospital for further evaluation.

Community health worker program

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Wards in the Chitwan and Nawalparasi districts that participated in the VIEW trial and have not received a cataract camp in the past 6 months.
  • Individuals aged 50 and older will be eligible to participate in the screening program, cataract camp programs, and the FCHV program

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Bharatpur Eye Hospital

Bharatpur, Chitwan, Nepal

Location

MeSH Terms

Conditions

CataractGlaucomaMacular DegenerationDiabetic RetinopathyRefractive Errors

Condition Hierarchy (Ancestors)

Lens DiseasesEye DiseasesOcular HypertensionRetinal DegenerationRetinal DiseasesDiabetic AngiopathiesVascular DiseasesCardiovascular DiseasesDiabetes ComplicationsDiabetes MellitusEndocrine System Diseases

Study Officials

  • Jeremy D Keenan, MD, MPH

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 8, 2017

First Posted

September 11, 2017

Study Start

May 31, 2018

Primary Completion

February 12, 2023

Study Completion

February 12, 2023

Last Updated

May 4, 2026

Record last verified: 2026-04

Locations