The prevalence and risk factors of visual impairment among the elderly in Eastern Taiwan

Risk of visual impairment according to the comorbidity of systemic and ocular diseases

PURPOSE

To investigate the risk of visual impairment (VI) based on the presence or absence of four diseases: hypertension (HTN), diabetes mellitus (DM), glaucoma, and diabetic retinopathy (DR).

METHODS

This retrospective population-based study included 1,000,000 randomly selected participants from the National Health Checkup Program database between 2015 and 2016. VI was defined as a presenting visual acuity ≤ 0.5 in the better eye. The participants were divided into 12 groups according to the presence or absence of disease. Adjusting for age and sex, the risk of VI in each disease group was analyzed and compared with the others.

RESULTS

Among the 1,000,000 participants, 88,931 (8.89%) had VI. The odds ratios (ORs) of age, male sex, HTN, DM, glaucoma, and DR for VI were 1.06 (95% CI, 1.05-1.06), 0.52 (95% CI, 0.52-0.53), 1.11 (95% CI, 1.09-1.13), 1.07 (95% CI, 1.05-1.09), 0.92 (95% CI, 0.90-0.74), and 1.29 (95% CI, 1.25-1.34), respectively (all P < 0.001). The group with HTN, DM, glaucoma, and DR had the highest OR of 1.98 (P < 0.001) compared to the healthy group. HTN, DM, and DR were positively correlated with VI in all groups. Glaucoma was positively correlated in the group with DM and DR and in the group with HTN, DM, and DR (ORs 1.18, 1.11, all P < 0.05); however, it demonstrated a negative correlation in the other groups (ORs 0.85-0.93, all P < 0.05).

CONCLUSION

HTN, DM, and DR, either alone or in combination, increase the risk of VI. Glaucoma also increases the risk when combined with DR; however, it has a negative correlation with VI in the absence of DR. Periodic ophthalmologic examinations for glaucoma, which primarily affects the peripheral visual field and not central visual acuity, might help prevent VI caused by other diseases.

Prevalence and associated factors of visual impairment among adults aged 40 and above in Southern Ethiopia, 2022

Visual impairment is a functional limitation of the eye caused by a disorder or disease that can reduce one's ability to perform daily activities. Many studies in Ethiopia have focused on childhood visual impairments. We assessed the prevalence and factors associated with visual impairment among adults aged 40 and above. Community-based cross-sectional study was done and a systematic sampling technique was used to select 655 participants. Data were collected by interviewer administered questionnaire, E-Snell chart, pinhole, torch light, and magnifying loupe. SPSS version 25 was used for analysis. Bivariate and multivariate analyses were performed to identify factors associated with outcome variable. The overall prevalence of visual impairment was found to be 36.95% (95% CI 33.2-40.8%). Factors associated with a higher odds of visual impairment included aged 51-60 years (AOR 2.37, 95% CI 1.29-4.44), aged 61 and above (AOR 8.9, 95% CI 4.86-16.3), low wealth index (AOR 1.91, 95% CI 1.14-3.2), divorced and widowed (AOR 4.67, 95% CI 2.77-7.86), no formal education (AOR 14.28, 95% CI 2.82-71.46), not utilizing eyeglass (AOR 3.94, 95% CI 1.65-9.40). The prevalence of visual impairment was relatively high compared to other studies. Age, marital status, occupation, educational status, wealth index, and not using eyeglasses were significantly associated with visual impairment. Refractory error is the leading cause of visual impairment. Early eye care service interventions are needed in this area.

Prevalence of Visual Impairment and Associated Factors Among Older Adults in Southern Ethiopia, 2022

Background

Visual impairment is a functional limitation of the eye brought on by a disorder or disease that can make it more difficult to carry out daily tasks. Visual impairment causes a wide range of public health, social, and economic issues, particularly in developing nations, where more than 90% of the world's visually impaired people reside. Although many studies conducted in Ethiopia related with the topic, there were focused on childhood visual impairments.

Objectives

To assess the prevalence and factors associated with visual impairment among older adults.

Methodology

A community-based cross-sectional study design was conducted in Arba Minch Zuria District. Systematic sampling technique was employed to select 655 adults aged 40 and above. Data were gathered through face-to-face interviews and visual acuity measurements, and SPSS version 25 was used for analysis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with visual impairment.

Results

The overall prevalence of visual impairment was found to be 36.95% (95% CI=33.2-40.8%). Factors associated with a higher odds of visual impairment included aged 51-60 years (AOR=2.37,95%CI=1.29-4.44), aged 61 and above (AOR=8.9, 95%CI=4.86-16.3), low wealth index ((AOR=1.81, 95%CI: 1.14-3.2), divorced and widowed (AOR=4.67, 95%CI:2.77-7.86), no formal education (AOR=14.28, 95%CI: 2.82-71.46), not utilizing eyeglass (AOR=3.94, 95%CI (1.65-9.40). The most possible causes of visual impairment were found to be refractive error and cataract.

Conclusions and Recommendations

The prevalence of visual impairment among study population was relatively high, and more than three-fifths of participants had unilateral visual impairment. Age, marital status, occupation, educational status, wealth index, and not wearing of prescribed eyeglasses were significantly associated with visual impairment. Refractive error is the leading cause of visual impairment. Awareness of spectacle use and expanding cataract surgery coverage are urgently needed in this area.

Assessing low vision care and the utilisation of optical low vision aids among patients with visual impairment in Taiwan

PURPOSE

The aim of this study was to examine the quality of assessment and the utilisation of optical low vision aids (OLVAs) among people with visual impairment (VI) in Taiwan.

METHODS

The study included 577 participants between 4 and 100 years of age (314 males and 263 females). All participants had been certified by the Ministry of the Interior of Taiwan, indicating that they had undergone a thorough and comprehensive low vision assessment, including evaluation of visual acuity (VA), contrast sensitivity, colour vision, visual fields and glare disability. Furthermore, all participants who consented to refraction had received prescriptions for OLVAs.

RESULT

All participants were prescribed one or more OLVAs such as eyeglasses, tinted lenses, magnifiers, closed-circuit television magnifiers, telescopes, or screen magnifiers. Among the 577 individuals, 515 received correction for refractive errors, providing the best-corrected VA (BCVA). The improvement in VA was significant at both distance and near, improving from 1.29 ± 0.55 to 1.01 ± 0.52 logMAR (p < 0.001) and from 1.29 ± 0.56 to 1.01 ± 0.52 logMAR (p < 0.001), respectively. Eyeglasses were the primary OLVAs chosen by 333 participants (64.7%), while 53.3%-80.3% of participants combined eyeglasses with other OLVAs to enhance their visual performance.

CONCLUSIONS

The most commonly used and effective OLVA was eyeglasses. Skilfully utilising appropriate refractive and VA measurements is crucial for determining the most suitable and beneficial OLVA for individuals with VI.

Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia

Background

Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021.

Methods

An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment.

Results

The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment.

Conclusion

Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.

Development and validation of a risk prediction model for visual impairment in older adults

Objectives

This study aimed to determine the risk factors that affect visual impairment in older adults for developing and evaluating a visual impairment risk prediction model.

Methods

In this hospital-based unmatched case-control design study, we enrolled 586 participants (411 in the training set and 175 in the internal test set) from the ophthalmology clinic and physical examination center of a teaching hospital in Liaoning Province, China, from June to December 2020. Visual impairment was defined as best-corrected visual acuity <6/18 (The WHO definition). Possible influencing factors of visual impairment were assessed, including demographic factors, socioeconomic factors, disease and medication factors, and lifestyle. A visual impairment risk prediction model was developed using binary logistic regression analysis. The area under the ROC curve (AUC) was used to evaluate the effectiveness of the proposed prediction model.

Results

Six independent influencing factors of visual impairment in older adults were identified: age, systolic blood pressure, physical activity scores, diabetes, self-reported ocular disease history, and education level. A visual impairment risk prediction model for older adults was developed, showing powerful predictive ability in the training set and internal test set with AUCs of 0.87 (95%CI 0.83-0.90) and 0.81 (95%CI 0.74-0.88), respectively.

Conclusions

The risk prediction model for visual impairment in older adults had high predictive power. Identifying older adults at risk for developing visual impairment can help healthcare workers to adopt appropriate targeted programs for early education and intervention to prevent or delay visual impairment and prevent injuries due to visual impairment in older adults.

Prevalence and predictors of vision impairment among older adults in India: evidence from LASI, 2017-18

BACKGROUND

Older adults experience a natural decline in health, physical and cognitive functionality, and vision impairment (VI) is one among them and has become an increasing health concern worldwide. The present study assessed the association of chronic morbidities such as diabetes, hypertension, stroke, heart diseases and various socioeconomic factors with VI among older Indian adults.

METHODS

Data for this study were derived from the nationally-representative Longitudinal Ageing Study in India (LASI), wave-1 (2017-18). VI was assessed using the cut-off of visual acuity worse than 20/80, and additional analysis was carried out using the definition of VI with a cut-off of visual acuity worse than 20/63. Descriptive statistics along with cross-tabulation were presented in the study. Proportion test was used to evaluate the significance level for sex differentials in VI among older adults. Additionally, multivariable logistic regression analysis was conducted to explore the factors associated with VI among older adults.

RESULTS

About 33.8% of males and 40% of females suffered from VI in India (visual acuity worse than 20/80). Meghalaya (59.5%) had the highest prevalence for VI among older males followed by Arunachal Pradesh (58.4%) and Tripura (45.2%). Additionally, Arunachal Pradesh (77.4%) had the highest prevalence for VI among females followed by Meghalaya (68.8%) and Delhi (56.1%). Among the health factors, stroke [AOR: 1.20; CI: 1.03-1.53] and hypertension [AOR: 1.12; CI: 1.01-1.22] were the significant risk factors for VI among older adults. Additionally, being oldest old [AOR: 1.58; CI: 1.32-1.89] and divorced/separated/deserted/others [AOR: 1.42; CI: 1.08-1.87] were significantly associated with VI. Moreover, older adults with higher educational status [AOR: 0.42; CI: 0.34, 0.52], currently working [AOR: 0.77; CI: 0.67, 0.88], from urban areas [AOR: 0.86; CI: 0.76-0.98] and from western region [AOR: 0.55; CI: 0.48-0.64] had lower odds of VI in this study.

CONCLUSION

This study identified higher rates of VI among those who are diagnosed with hypertension or stroke, currently unmarried, socioeconomically poorer, less educated and urban resident older people that can inform strategies to engage high risk groups. The findings also suggest that specific interventions that promote active aging are required for those who are socioeconomically disadvantaged as well as visually impaired.

Association of sunlight exposure with visual impairment in an Indian fishing community

Purpose

Indian fishermen belong to a marginalized population and are continuously exposed to extreme occupational hazards and sunlight. A high prevalence of visual impairment (VI) is reported in the coastal fishing community. We aimed to investigate the association between VI and sunlight exposure measurement (SEM).

Methods

In this cross-sectional observational study, 270 eyes of 135 participants were enrolled from a coastal fishing village. Participants underwent a comprehensive ophthalmic examination, which included best-corrected visual acuity (BCVA), and anterior and posterior segment examination. Ocular Surface Disease Index (OSDI) and SEM questionnaire were administered to estimate the level of dry eye and ultraviolet-B (UV-B) exposure, respectively. VI was defined as presenting visual acuity worse than 6/12 (logarithm of the minimum angle of resolution [logMAR] > 0.3).

Results

The mean age and spherical equivalent were 50.56 ± 11.72 years (range: 18-80 years) and 0.36 ± 1.68 diopters (D) (range: -7.0 to +3.0 D), respectively. Age, SEM, OSDI, fishing as an occupation, and cataract were significantly associated with higher odds of VI in univariate analysis. Refraction, gender, education level, smoking status, amblyopia, systematic, and other ocular diseases were not significantly associated with VI. In the multivariate analysis, age, SEM, and presence of cataract remained significantly associated with a higher risk for VI. The area under the receiver operating characteristic curve values for age and SEM scores demonstrate a fair index of discrimination for the detection of VI.

Conclusion

SEM level is directly associated with a higher risk of VI among fishermen. The fishing community might benefit from regular eye examinations and awareness about the harmful effects of sunlight exposure and preventive measures.

Mesencephalic astrocyte-derived neurotrophic factor (MANF): Structure, functions and therapeutic potential

Mesencephalic astrocyte-derived neurotrophic factor (MANF) is a novel evolutionarily conserved protein present in both vertebrate and invertebrate species. MANF shows distinct structural and functional properties than the traditional neurotrophic factors (NTF). MANF is composed of an N-terminal saposin-like lipid-binding domain and a C-terminal SAF-A/B, Acinus and PIAS (SAP) domain connected by a short linker. The two well-described activities of MANF include (1) role as a neurotrophic factor that plays direct neuroprotective effects in the nervous system and (2) cell protective effects in the animal models of non-neuronal diseases, including retinal damage, diabetes mellitus, liver injury, myocardial infarction, nephrotic syndrome, etc. The main objective of the current review is to provide up-to-date insights regarding the structure of MANF, mechanisms regulating its expression and secretion, physiological functions in various tissues and organs, protective effects during aging, and potential clinical applications. Together, this review highlights the importance of MANF in reversing age-related dysfunction and geroprotection.

Prevalence and Causes of Visual Impairment and Blindness in Elderly Population; an Urgent Geriatric Health Issue: Tehran Geriatric Eye Study (TGES)

PURPOSE

To determine the prevalence of vision impairment (VI) and blindness and their determinants in the elderly population of Tehran.

METHODS

In a cross-sectional study, multi-stage cluster sampling was used to select a sample of over 60 year population of Tehran. Optometric examinations included the measurement of uncorrected visual acuity, objective and subjective refraction, presenting and best corrected visual acuity. Vision impairment is reported according to the WHO definition. Visual acuity worse than 20/60 and 20/400 in the better eye was regarded as low vision and blindness, respectively.

RESULTS

According to presenting visual acuity, VI was found in 14.8% (95%CI: 13.1-16.5) of the participants, including low vision in 13.8% (95%CI: 12.2-15.4) and blindness in 1.1% (95%CI: 0.5-1.6). The prevalence of VI ranged between 7.8% (95%CI: 6.0-9.5) in subjects aged 60-64 years and 40.0% (95%CI: 33.0-47.0) in participants over 80 years (p < .001). Multivariable logistic regression analysis showed that older age (OR = 1.07(per year)), lower education level (illiterate versus college: OR = 3.55), and lower economic status (middle versus rich: OR = 1.30 and poor versus rich; OR = 1.72) had a significant relationship with an increase in the prevalence of VI, and older age (OR = 1.14(Per year increase)) and diabetes (OR = 2.62) had a significant relationship with blindness. Refractive errors (63.1%) was the leading cause of VI followed by cataract (22.5%). However, cataract (48.3%) was the leading cause of blindness.

CONCLUSION

Many older adults suffer from VI. Correction of refractive errors and cataract reduces a large percentage of VI. Age, education level, and economic status are other determinants of VI.

Association of Visual Impairment with Psychological Distress in Older Adults: A Survey of 105,092 Older People in Taiwan

This study aimed to evaluate the association between visual impairment (VI) and psychological distress (PD) among older adults in Taiwan. The present cohort study included participants aged >65 years who participated in a physical examination program. Participants were divided into two groups on the basis of whether they had PD at baseline. The association between PD and VI with other variables was compared using the two-sample t-test for continuous variables and chi-squared test for discrete variables. Cox regression analyses were used to calculate the hazard ratio (HR). Cumulative incidence of PD was analyzed using the Kaplan-Meier method, and differences among participants with different severities of VI were analyzed using the two-tailed log-rank test. Subgroup analyses were performed to calculate the HR for PD among participants with different severities of VI. The PD group showed a significantly high percentage of VI. In addition, participants with VI showed a significantly higher HR and seven-year cumulative incidence rate of PD than those without VI. VI was independently and significantly associated with a higher incidence of PD among older Asian people. Therefore, identifying and treating correctible VI is important to prevent PD and improve the overall quality of life.

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

Background

Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen’s illiterate “E” chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment.

Results

A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5–26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1–4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3–4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2–4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2–6.3) had higher chance of visual impairment.

Conclusion

The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.

Health insurance enrollment and vision health in rural China: an epidemiological survey

Background

Vision health is an important aspect of health worldwide. Visual impairment (VI) is associated with poor quality of life and is usually more prevalent in rural areas. To help rural populations obtain vision care, health insurance policies have emerged throughout the world. However, some existing literatures show that health insurance enrollment’s impact on the overall physical health of rural population has been minimal. Focusing on vision health among adults in rural China, our study aims to investigates the impact of health insurance on vision health, heterogeneity of the effect, and the moderating effect of health insurance enrollment on the impact of chronic physical diseases and basic eye diseases on vision health.

Methods

Primary data were collected through a nation-wide epidemiological survey of vision health conducted in rural China in 2018, with a sample size of 28,787 used in our statistical analysis. Instrumental variables regression and Heckman selection models were conducted to examine the impact of health insurance enrollment and reimbursement ratio adults’ vision health outcomes. Subsample regressions by sex, age, education level, and whether with eye diseases were further conducted to explore the heterogeneity in our results. We then examined whether health insurance enrollment moderates the impact of chronic physical diseases and basic eye diseases on vision health through the method of introducing interaction terms.

Results

Participating in health insurance reduced the probability of VI by 2.15 %. The reimbursement rate increasing by 1 % point may reduce the probability of worsening VI by 6.12 %. Men (-0.0235, P = 0.0002) benefit more from insurance enrollment than women (-0.0201, P = 0.0082) with respect to vision health. From the young adult group to the oldest group, the marginal effect of health insurance increased from − 0.0068 (P = 0.0394) to -0.0753 (P < 0.0001). The marginal effect on VI was most significant in people with lower education levels and weakened with increased education levels. People with basic eye diseases (-0.0496, P = 0.0033) benefit more from participating insurance than the people without basic eye diseases (-0.0196, P = 0.0001) with respect to vision health. The moderating effects of health insurance enrollment on the impacts of cerebral infarction (-0.1225, P < 0.0001), diabetes (-0.0398, P = 0.0245), hyperlipidemia (-0.1364, P = 0.0271), mental illness (-0.1873, P = 0.0010), glaucoma (-0.1369, P = 0.0073), diabetic retinopathy (-0.1560, P = 0.0043), and retinal vein obstruction (-0.2018, P = 0.0155) on vision health were significantly negative.

Conclusions

The results suggest that participation in health insurance and higher health insurance reimbursement ratios reduced the risk of VI in the sampled adults. Health insurance has the most significant effect in in vulnerable groups. Heath insurance enrollment moderates the impacts of several chronic physical and basic eye conditions on vision health. Our findings have potential implications for reforming health insurance policies to improve vision health conditions in rural areas of developing countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06754-0.

Prevalence and Factors Associated with Self-Reported Vision Disability among the Elderly in Malaysia: Findings from National Health and Morbidity Survey (NHMS) 2018

Introduction

Disability has adverse effects on health, wellbeing, and life quality. Vision disorder is one of the top-ranked causes of disability in the elderly population. This study aims to determine the prevalence and factors associated with vision disability among the elderly in Malaysia. Methodology. Data collection from National Health and Morbidity Survey (NHMS) 2018 was obtained. This survey focused on elderly health by using two-stage stratified cluster sampling design. The Washington Group Extended Question Set on Functioning (WG ES-F) was used to determine the vision disability. The data were analyzed using SPSS version 21.0 utilizing a complex sample design with multivariable logistic regression analysis to determine the prevalence and associated factors to vision disability.

Results

A total of 3,977 elderly completed the vision disability questionnaire. The overall prevalence of vision disability among those who were 60 years old and above was 4.5%. Multiple logistic regression revealed that no formal education (AOR: 6.69, 95% CI: 1.52, 29.49), only primary education (AOR: 4.26, 95% CI: 1.01, 18.03), unemployed/retiree or homemaker (AOR: 3.25, 95% CI: 1.79, 5.89), hypertension (AOR: 1.45, 95% CI: 1.00, 2.09), and malnourished elderly (AOR: 2.84, 95% CI: 1.76, 461) had higher odds for having vision disability.

Conclusion

The findings suggest that a low education level, unemployment, hypertension, and malnourishment are significant risk factors for VD among Malaysia's elderly. Strengthening awareness campaigns to increase VD awareness and provide high-quality rehabilitation services must target specific groups, such as the elderly with a low level of education and the unemployed. Empower primary healthcare providers with the knowledge and skills necessary to improve the quality of eye care delivery and expand eye screening in settling VD issues nationally.

Clinical Characteristics of Presenile Cataract: Change over 10 Years in Southern Taiwan

Purpose

The purpose of this study is to investigate the clinical characteristics of presenile cataract and compare that to ten years ago in southern Taiwan.

Methods

The subjects who received cataract surgeries aged 30 to 54 years were recruited in Kaohsiung Chang Gung Memorial Hospital during September 2015 and August 2016. Patients with uveitis or those who received combined cataract surgeries were excluded. Retrospective chart review was performed in this study.

Results

A total number of 2439 cataract surgeries were performed, and 302 (12.38%) eyes were having presenile cataract. Mean age was 47.55 ± 5.64 years old, and mean axial length was 26.00 ± 2.89 mm. Among 302 presenile cataract eyes, the leading cause was high myopia (defined as mean axial length ≥ 26 mm, 47.02%), followed by diabetes mellitus (26.82%). In types of lens opacity analysis, 67.55% of the patients were nuclear sclerosis dominant. Compared to the previous study 10 years ago, the leading cause of presenile cataract changed from idiopathy to high myopia, whereas the lens opacity types changed from posterior subcapsular opacity dominant to nuclear sclerosis dominant.

Conclusions

High myopia has become the most important clinical characteristic associated with presenile cataract in a myopia epidemic area, and the most common type of lens opacity was nuclear sclerosis. With the increasing prevalence of high myopia, we should pay more attention to the management of presenile cataracts in high myopes to avoid complications.

Magnitude of visual impairment and associated factors among patients attending ophthalmic clinics of Debre Markos referral hospital, north West Ethiopia

BACKGROUND

Globally, visual impairment affects about 285 million (4.25%) people, of those, 266.4 million were adults aged 18 years and above. Ethiopia is one of developing countries estimated to have high prevalence of visual impairment which have an enormous socio-economic impact. Also there is limited available information regarding with the magnitude of visual impairment among adults in our country at large and east Gojjam zone in specific. Therefore the aim of this study was to assess the magnitude of visual impairment and its associated factors among patients attending Debre Markos Referral Hospital ophthalmic clinics in east Gojjam zone, North West Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted at Debre Markos Referral Hospital which is the only hospital in east gojjam zone with ophthalmic care service from March 1 to 30, 2020 by using systematic random sampling technique to select study participants after informed consent was obtained. Data were collected by interview with 5% pretested, structured questionnaire and ocular examinations. Data were cleaned, coded and entered to Epi-data version-3.1, and analyzed using Statistical Package for Social Science software version 26. The descriptive statistics was presented in tables, text and graphs. Bivariable and multivariable logistic regression analysis to identify factors associated with visual impairment was conducted. Covariates with P-value < 0.05 were considered statistically significant.

RESULTS

A study was conducted among 312 study participants with 96% response rate. The magnitude of visual impairment was 114 (36.5%) [95% CI, (33.8, 39.2%)]. Age > 50 years [AOR = 3.82; 95% CI (1.56, 9.35)], rural residency [AOR = 4.33 95% CI (1.30, 14.44)], inability to read and write [AOR = 3.21; 95% CI (1.18, 8.73)] and Cataract [AOR = 4.48; 95% CI (1.91, 10.52)] were factors significantly associated with visual impairment.

CONCLUSIONS

The overall magnitude of visual impairment was found to be high. Older age, rural residency, inability to read and write and cataract were associated with visual impairment. Increasing literacy, expanded cataract surgery, as well as community based visual acuity screening especially for elders and rural residents is crucial. Zonal police makers should give emphasis on prevention of visual impairment to decrease economic, social and political burden of visual disability.

Sociodemographic, behavioral, and medical risk factors associated with visual impairment among older adults: a community-based pilot survey in Southern District of Hong Kong

Background

The last visual survey of older adults in Hong Kong was a district-level study in 2002, with no assessment of behavioral and medical risk factors for visual impairment (VI). Our objectives were to determine the latest VI prevalence among older adults, significance of any spatial and temporal differences on the prevalence, and any associations of sociodemographic, behavioral and medical risk factors with VI from a multi-perspective analysis.

Methods

Community-based pilot survey of residents from a suburb of Hong Kong, aged ≥50, using a standardized questionnaire, was conducted in 2016.

Results

Of the 222 subjects, crude rates of bilateral and unilateral VI were 9.46 and 32.88%, respectively, or corresponding age-and-gender-adjusted rates of 6.89 and 30.5%. Older age and lower educational were associated with higher risk for unilateral VI, while older age, temporary housing, obesity and hyperlipidemia were associated with higher risk for bilateral VI. Smoking and alcohol-drinking status were not associated with unilateral or bilateral VI. Relative changes in ORs of hypertension or educational level on unilateral or bilateral VI were >  10% after adjusting for age. Interaction term between hyperlipidemia and gender or obesity was significant for unilateral VI. Gender, hypertension and cataract were not associated with unilateral or bilateral VI in general population of pooled analysis but were identified as risk factors in specific subgroups of stratified analysis. Refractive error (myopia or hyperopia) was significantly associated with VI in the eye-level analysis after adjusting the inter-eye correlation.

Conclusions

Sociodemographic and medical risk factors contributed to VI, but behavioral risk factors did not. Sociodemographic disparities of visual health existed. Age was the confounders of the VI-hypertension or VI-educational level relationships. Gender and obesity were more likely to have multiplicative effect on unilateral VI when combined with hyperlipidemia. Stratified analysis should be conducted to provide further insight into the risk factors for VI in specific populations. Uncorrected refractive error remains a significant cause of impaired vision. The spatial and temporal differences in bilateral VI prevalence from the previous local study indicates a territory-wide survey is needed to assess regional differences and overall prevalence of VI in Hong Kong.

The relationship between self-reported sensory impairments and psychosocial health in older adults: a 4-year follow-up study using the English Longitudinal Study of Ageing

OBJECTIVES

To explore cross-sectional and longitudinal relationships between self-reported hearing and vision impairments and self-rated health, quality of life (QoL) and depressive symptoms at 4-year follow-up.

STUDY DESIGN

The study involved cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing.

METHODS

Community-dwelling adults (n = 3931) aged ≥50 years from the English Longitudinal Study of Ageing participated in this study. Self-reported hearing and vision were defined as good or poor. Self-rated health was treated as a dichotomous variable (good and poor health). QoL was based on the 19-item Critical Appraisal Skills Programme and treated as a continuous variable (score 0-57). Depressive symptoms were assessed using the eight-item Center for Epidemiologic Studies Depression Scale (CES-D8) and defined as CES-D≥3. Relationships between sensory impairments and self-rated health and depressive symptoms were analysed using logistic regression. Linear regression was used to assess the relationships between sensory impairments and QoL.

RESULTS

In cross-sectional analyses, both self-reported hearing and vision impairment were positively associated with all outcomes assessed. In longitudinal analyses, self-reported poor hearing and vision were associated with increased risks of poor self-rated health (hearing: odds ratio [OR] 1.65, 95% confidence interval [CI] 1.32, 2.05; vision: OR 1.57, 95% CI 1.16, 2.12) and depressive symptoms (hearing: OR 1.35, 95% CI 1.07, 1.71; vision: OR 1.44, 95% CI 1.09, 1.90) after adjustment for sociodemographic and lifestyle factors, chronic illness, mobility limitations and cognition. Poor hearing and poor vision were not associated with reduced QoL after adjustment for covariates.

CONCLUSIONS

The findings stress the importance of identifying and addressing sensory impairments in older adults to improve their health and well-being.

Prevalence of visual impairment and its association with vision-related quality of life among elderly persons in a resettlement colony of Delhi

Background:

The population of India is ageing. The number and percentage of elderly persons is increasing. Visual impairment is common among elderly persons and affects their vision-related quality of life. The objective of this study was to estimate the prevalence of visual impairment among elderly persons aged 60 years and above residing in a resettlement colony of Delhi and study its association with socio-demographic variables and vision-related quality of life.

Methods:

A total of 604 elderly participants were selected by simple random sampling. House-to-house visit was done, and a self-developed pre-tested semi-structured interview schedule was used to collect socio-demographic information. Visual acuity was measured using Snellen's chart, and distant direct ophthalmoscopy was done to diagnose cataract. Vision-related quality of life was assessed by Indian Vision Function Questionnaire-33 (IND-VFQ-33).

Results:

Of the 604 participants, 555 (91.9%) were available for interview. The prevalence of visual impairment was 24.5% (95% CI: 20.9% - 28.1%). Cataract was the leading cause of visual impairment (50.7%), followed by uncorrected refractive error (36.8%). Illiteracy (aOR: 3.49, 1.37-8.87), economic dependence on family members (aOR: 1.92, 1.04 – 3.54), not currently working (aOR: 1.89, 1.20-2.98) and chewing of tobacco products (aOR: 2.56, 1.48-4.42) were significantly associated with visual impairment among study participants. Vison-related quality of life was worse among those with visual impairment.

Conclusion:

Burden of visual impairment is high among elderly persons living in urban resettlement colonies. It is largely avoidable. Eye-care services should be accessible and affordable to them.

Prevalence and associated factors of low vision and blindness among patients attending St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

BACKGROUND

Low vision and blindness are major public health problems. A vast burden of worlds visually impaired live in low-income settings especially in sub Saharan Africa. In such settings the blindness is associated with considerable disability and excess mortality, resulting in huge economic and social consequence. The main purpose of this study was to determine the prevalence and associated factors of low vision and blindness among patients at St. Paul's hospital millenium medical college.

METHODS

Institution based cross sectional design study was carried out from January to April, 2017 with sample size of 904. Systematic random sampling was used to recruit the study subjects. Retrospective medical chart review was done; data was entered into and analyzed by SPSS 23. Descriptive statistics such as frequency cross tabulation and chi-square test was carried out to translate data into information. P-value less than 0.05 was considered as statistically significant.

RESULTS

A total of 881 subjects with a response rate of 97.4% selected. The mean age of the study subjects was 44.53(SD: ± 21.85) with a range of 1-100 years. The prevalence of low vision and blindness was 91 (10.3% (95% CI: 8.2, 12.3)), and 64 (7.3 95%CI: 5.7, 9.0)) respectively. Age (p-value < 0.001), cataract (p-value = 0.002), glaucoma (p-value = 0.002) and age related macular degeneration (p-value < 0.001) were significantly associated with low vision and blindness.

CONCLUSION

Low vision and blindness found in this study was high. Age, cataract, glaucoma and age related macular degeneration were significantly associated with low vision and blindness. This amount of magnitude will be reduced if prevention, early diagnosis and management will be targeted towards avoidable causes of visual impairment.