Prevalence and predictors of undercorrected refractive errors in the Victorian population

Correction of refractive error in the Victorian population: the feasibility of "off the shelf" spectacles

AIMS

To assess the feasibility of providing a stock of ready made spectacles for correction of refractive error in the general population.

METHODS

Data were collected in the Visual Impairment Project, a population based survey of Victorian residents aged 40 years or older in randomly selected urban and rural sample areas. This included a refractive eye examination and the proportion of subjects with hypermetropia, emmetropia (defined as -1.0 to +1.0D spherical equivalent), and myopia documented in the 40-60 year age group.

RESULTS

2595 (54.8%) participants were aged between 40 and 60 years. Those with a best corrected visual acuity of less than 6/12, astigmatism of more than 1.25D, and anisometropia of more than 0.5D were excluded. 516 participants had refractive error which was deemed suitable for correction by "off the shelf" spectacles. This represents 19.9% of all participants between 40 and 60 years of age. Provision of spectacles in 0.5D increments would provide suitable stock spectacles for 85.5% of a -3.0 to +3.0D range or 89.2% of a -3.50 to +3.50D range.

CONCLUSIONS

Ready made "off the shelf" spectacles could significantly alleviate visual morbidity due to refractive error in up to 20% of an urban population in Australia. This approach may also be useful in developing countries with poor access to optometric services.

Direct costs of blindness in Australia

This study calculated the direct financial costs of blindness to the Australian government and community. Three case studies, representative of Australians with severely impaired vision, were used to calculate the annual costs associated with blindness. The costs include pensions, subsidies, concessions, equipment and services. Case I was a retired person with age-related macular degeneration, case 2 a working aged person with diabetic retinopathy, and case 3 a school student with congenital vision impairment. Sensitivity analysis was used to show the possible range of costs for each case. For case I, direct cost was $ 14686 with a range from $9749 to $22507. The cost for case 2 was $17701 ranging from $9669 to $26720. Costs associated with care and education of case 3 were $15948 ranging from $5106 to $23798. In addition to the social costs to a person who is blind, there are significant financial costs to the government and the community that will increase substantially with the ageing of the Australian population.