1. Assessing the incidence and progression of age-related eye diseases in a longitudinal cohort study in Southern India Institutions involved ICARE /LVPrasad Eye Institute Institute of Community Eye health, London

2. Proposal Elements Introduction Aims Protocol GANTT chart/timeline Resources/collaborators/contracts Project leadership plan Research team biographies Literature review Letters of support Publication plan Budget

3. Project Summary This is a follow up study to be carried out on the majority of the same persons examined in the original APEDS 1 in 1996 to 2000. That study gave very useful data to not only help in advocacy but also to help plan control activities. The proposed study would provide very valuable data on the trends in disease incidence and progression which are extremely useful epidemiological data for forecasting interventions and work loads.

4. Relevance Currently estimates of future disease loads are based on empirical formulae for which reliable data is lacking. This outcome of the study would be very relevant for future priority setting both on the scale and scope of projects to be supported by SF in the Indian setting in particular. The study would also provide evidence of the outcome of past surgery eg. For cataract and of equity.

5. Approach The basic population sample is derived from the survey data from APEDS 1. Tracking of the earlier cohort has produced exceptionally high contact with cohort populations which would add reliability to the findings. In addition to lens opacities and cataract added attention is being paid to diabetic retinopathy, refractive error, glaucoma etc.

6. Investigators The PI is Dr. Rohit Khanna, MD. MPH who is working with a team experienced in survey methodology and practice under the overall guidance of Dr. G.N. Rao. Further support is being provided by staff of the LVPEI as well as the ICEH, London who have wide experience in survey methodology both in India and elsewhere. LVPEI as a WHO Collaborating Centre and a Training institution would provide opportunities for younger physician scientists to hone their skills in public health ophthalmology

7. Environment The environment wherein the study is being carried out has been the population that is experienced to population based studies and is very responsive. More over there is strong commitment by the government at State and Central level as part of the India National Programme for the Prevention and Control of Blindness

8. Budget The contribution from SightFirst is only a fraction of the total estimated budget for the study, However visible credit would be given to the contribution of the LCIF. in reports and publications. Considerable preliminary work has already been carried out with regard to enumeration and tracking the earlier cohort and completed eye examination of a proportion of the sample. (Phases 1 and 2)

9. Overall Assessment Strengths The Institution has a number of clinical and epidemiological studies to its credit. The scientific rigor and the quality of data is exceptionally high. The study is well structured and already under way. Weaknesses There are no discernible shortcomings either in the environment or the conduct of the survey.

10. Recommendation Given the immense value of the outcome of the study in terms of SightFirst Planning for the future and in advocacy, the competence of the Institution in partnership with ICEH to carry out such studies, the study proposal deserves the support of the Lions SightFirst research funds. Considering the immense task of finding members of the same cohort examined in earlier studies, is in itself a monumental task that few organizations are capable of doing such studies.