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Yelagondula VK, Marmamula S, Banerjee S, Khanna RC. Near vision impairment and effective refractive error coverage for near vision in Andhra Pradesh, India - The Akividu Visual Impairment Study (AVIS). Clin Exp Optom 2024:1-6. [PMID: 38616051 DOI: 10.1080/08164622.2024.2333769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/17/2024] [Indexed: 04/16/2024] Open
Abstract
CLINICAL RELEVANCE Near Vision Impairment (NVI) is common in developing countries. A substantial proportion of NVI can be addressed by providing spectacles. Innovative eye care programmes are needed to address NVI. Population-based epidemiological studies can provide vital data to plan such eye care service delivery models. BACKGROUND To report the prevalence of NVI and effective Refractive Error Coverage (eREC) for near vision in West Godavari and Krishna districts in Andhra Pradesh, south India. METHODS A population-based cross-sectional study was carried out using a Rapid Assessment of Visual Impairment methodology. Presenting and pinhole distance visual acuity were assessed followed by near vision assessment using a N notation chart at a fixed distance of 40 cm. If the presenting near vision was worse than N8, the best corrected near visual acuity was recorded with age appropriate near vision correction. NVI was defined as presenting near vision worse than N8 among those without distance vision impairment (6/18 or better in the better eye). Effective Refractive Error Coverage for near was calculated as the proportion of individuals with an adequate correction to the total participants, including those with inadequate, adequate, and no correction for near vision. RESULTS Data of 2,228 participants aged ≥40 years were analysed. The mean age of these participants was 54.0 ± 10.4 years; 53.8% were women; 44.5% had no formal education. The prevalence of NVI was 27.1% (95% CI: 25.2-29.0%). NVI significantly associated with 70 and above age group (adjusted OR: 1.97; 95% CI: 1.45-3.70). Participants with formal education had lower odds for NVI (adjusted OR: 0.75; 95 % CI: 0.68-0.83). The eREC for near vision was 48.0%. CONCLUSION NVI affects over a quarter of people aged ≥40 years in the West Godavari and Krishna districts of Andhra Pradesh. However, eREC is under 50% and there is scope for improving this by establishing eye care services to achieve universal eye health for all.
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Affiliation(s)
- Vijay Kumar Yelagondula
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Srinivas Marmamula
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- Allen Foster Community Eye Health Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Saptak Banerjee
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, L V Prasad Eye Institute, Hyderabad, India
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Källstrand J, Lindgren EC, Carlsson IM. Perpetuating ability to live life as usual: a grounded theory study of persons living with age-related macular degeneration. BMC Geriatr 2024; 24:82. [PMID: 38254006 PMCID: PMC10804715 DOI: 10.1186/s12877-024-04689-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Age-Related Macular Degeneration (AMD) is an eye disease associated with age that causes progressive and irreversible loss of central vision, while the peripheral visual ability remains. The occurrence of and especially late AMD is estimated to increase extensively to 2040 among persons aged ≥ 65 in Scandinavia, due to an increasing aging population. OBJECTIVES The present study explored what it means to live with AMD through the eyes of those living with the condition. METHODS This is an explorative interview study. People who were ≥ 65 years old, living in their own homes, and diagnosed with advanced dry AMD in one or both eyes, causing a visual acuity of no more than 0.3 or worse in the best eye, were invited to participate in the study. The method chosen was the constructivist grounded theory, where reality is seen as fundamentally social and processual and a way of accessing the participants' experiences, thoughts, and feelings. RESULTS In total, 12 interviews were conducted. Living with dry AMD confronted different problems and challenges. The substantive theory, Perpetuating ability to live life as usual, is characterised by a desire to continue life as usual, which requires an acceptance of the disease's progress, self-acceptance of the new me, and an acceptance that the new life needs to be lived a little more carefully. Moreover, the participants used three strategies to resolve their main concern by maintaining an everyday life 1) Navigating the new normal, 2) Trusting own ability, and 3) Interdepending. CONCLUSION Maintaining an everyday life is the primary concern among people with AMD. In supporting self-care, gaining information about the subjective experience to support their everyday living is of the utmost importance. This grounded theory captures valuable knowledge of how the older adults resolved their main concern "you got to keep on" despite their affected vision by "facing the fact" live life as usual since since life goes on. Our study also gives rise both to implications for research and practice in order to strengthen older people with AMD facing their future challenges. TRIAL REGISTRATION The Swedish Ethical Review Authority (EPN 2021/02877).
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Affiliation(s)
- J Källstrand
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.
| | - E-C Lindgren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - I M Carlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Shojaei S, Sabbaghi H, Mehrabi Y, Daftarian N, Etemad K, Ahmadieh H. Vision-Related Quality of Life in Patients with Inherited Retinal Dystrophies. J Curr Ophthalmol 2022; 34:80-86. [PMID: 35620379 PMCID: PMC9128428 DOI: 10.4103/joco.joco_172_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 01/17/2023] Open
Abstract
Purpose To evaluate the effect of inherited retinal dystrophies (IRDs) on vision-related quality of life (VRQoL) among IRDs' patients in Iran. Methods This cross-sectional study was conducted on 192 patients with different types of IRDs who were randomly selected from registered patients in the Iranian National Registry for Inherited Retinal Dystrophy (IRDReg®). All ophthalmic findings were collected based on the recorded data in IRDReg®. Moreover, the eligible participants were interviewed to fill out the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) to assess their VRQoL. Ordinal logistic regression was used to evaluate the possible association of the different clinical and nonclinical factors such as demographic information, socioeconomic status, and visual function with VRQoL. Results The overall mean of a composite score of VRQoL was 45. All subscales obtained from the NEI VFQ-25 questionnaire except general health, mental health, and ocular pain had a significant negative correlation with logMAR best corrected visual acuity (BCVA) and near visual acuity variables. There was a statistically significant relationship between VRQoL and factors like age (odds ratio [OR] = 0.91, 95% confidence interval [CI]: 0.87-0.94), employment status (OR = 1.37, 95% CI: 1.05-4.74), logMAR BCVA (OR = 0.31, 95% CI: 0.19-0.49) and normal color vision (OR = 1.92, 95% CI: 1.74-5.01). Conclusion The VRQoL of patients with IRDs in this study was low. BCVA could be an indicator to show VRQoL.
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Affiliation(s)
- Saeideh Shojaei
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narsis Daftarian
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Address for correspondence: Koorosh Etemad, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail:
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Marmamula S, Keeffe J, Challa R, Mohd J, Khanna RC. Near-vision impairment and effective near-vision spectacle coverage in two districts in Telangana, India: a population-based cross-sectional study. BMJ Open 2021; 11:e047131. [PMID: 33820793 PMCID: PMC8030469 DOI: 10.1136/bmjopen-2020-047131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of near-vision impairment (NVI) and effective spectacle coverage for near vision in those aged ≥40 years in Khammam and Warangal district in Telangana, India. DESIGN A population-based cross-sectional study. SETTING Khammam and Warangal district in Telangana, India. PARTICIPANTS Of 6000 people enumerated, 5357 were examined (89%). 4526 participants without distance vision impairment were included in the analysis. MAIN OUTCOME MEASURES The study teams visited selected households and conducted eye examinations. NVI was defined as binocular presenting near vision worse than N6. 'Unmet need' was deemed to be present if the unaided near vision was worse than N6 and improved to N6 with near correction among the participants who did not have spectacles for near vision. 'Met need' was deemed to be present when unaided near vision was worse than N6 but improving to N6 with their spectacles. The 'undermet need' was deemed to be present when aided near vision was worse than N6 but improved to N6 with correction. Based on these definitions, e-near-vision coverage (%) is calculated as follows: e-NVC (%)=met need/(met need+undermet need+unmet need) × 100. RESULTS The mean age was 53.5 years (SD: 10.8 years), 2534/4526 (55.8%) were women, 1819/4526 (41.8%) had at least primary school education and 2368/4526 (52.3%) were from the Khammam district. The prevalence of NVI was 55.8% (95% CI 72.5 to 75.1; n=3343). Overall, the e-NVC (%) was 31.8%. It was 40.0% in Khammam and 23.2% in Warangal. CONCLUSION NVI is common in Khammam and Warangal districts in Telangana with inadequate effective near-vision coverage. Effective service delivery models are needed to reach out and provide services to address NVI to achieve universal eye health coverage in the region.
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Affiliation(s)
- Srinivas Marmamula
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- Wellcome Trust, Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jill Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rajesh Challa
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Javed Mohd
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C Khanna
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
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Berdahl J, Bala C, Dhariwal M, Lemp-Hull J, Thakker D, Jawla S. Patient and Economic Burden of Presbyopia: A Systematic Literature Review. Clin Ophthalmol 2020; 14:3439-3450. [PMID: 33116396 PMCID: PMC7588278 DOI: 10.2147/opth.s269597] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/22/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose The objective of this systematic literature review (SLR) was to collate, report, and critique published evidence related to epidemiology and patient and economic burden of presbyopia. Patients and Methods A systematic literature search was conducted in MEDLINE®, Embase®, and Cochrane Library databases from the time of inception through October 2018 using Cochrane methodology. Studies published in English language reporting on epidemiology and patient and economic burden of presbyopia were included. Results Initial systematic literature search yielded 2,228 citations, of which 55 met the inclusion criteria (epidemiology, 44; patient burden, 14; economic burden, 1) and were included in this review. Globally, 1.09 billion people are estimated to be affected by presbyopia. The reported presbyopia prevalence varied across regions and by age groups, with the highest prevalence of 90% reported in the Latin America region in adults ≥35 years. Presbyopic patients report up to 22% decrease in quality-of-life (QoL) score, and up to 80% patients with uncorrected presbyopia report difficulty in performing near-vision related tasks. About 12% of presbyopes required help in performing routine activities, and these visual limitations reportedly induce distress and low self-esteem in presbyopia patients. Uncorrected presbyopia led to a 2-fold increased difficulty in near-vision-related tasks and a >8-fold increased difficulty in very demanding near-vision-related tasks. Further, uncorrected presbyopia leads to a decrement in patients’ QoL, evident by the low utility values reported in the literature. Annual global productivity losses due to uncorrected and under-corrected presbyopia in working-age population (<50 years) were estimated at US$ 11 billion (0.016% of the global domestic product (GDP) in 2011, which increased to US$ 25.4 billion if all people aged <65 years were assumed to be productive. Conclusion Uncorrected presbyopia affects patients’ vision-related quality of life due to difficulty in performing near-vision-related tasks. In addition, un-/under-corrected presbyopia could lead to productivity losses in working-age adults.
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Affiliation(s)
| | - Chandra Bala
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Mukesh Dhariwal
- Global Health Economics & Outcomes Research, Alcon Vision LLC, Fort Worth, TX, USA
| | - Jessie Lemp-Hull
- Clinical Development and Medical Affairs, Alcon Vision LLC, Fort Worth, TX, USA
| | - Divyesh Thakker
- Patient Access Services, Novartis Healthcare Pvt Ltd., Hyderabad, Telangana, India
| | - Shantanu Jawla
- Patient Access Services, Novartis Healthcare Pvt Ltd., Hyderabad, Telangana, India
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Vision-Related Quality of Life among Adult Patients with Visual Impairment at University of Gondar, Northwest Ethiopia. J Ophthalmol 2020; 2020:9056097. [PMID: 32280539 PMCID: PMC7125459 DOI: 10.1155/2020/9056097] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/25/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study was to assess vision-related quality of life and associated factors among adult patients with visual impairment at the University of Gondar Tertiary Eye Care and Training Center, Northwest Ethiopia. Methods The institution-based cross-sectional study was conducted from April 24 to May 12, 2017, at the University of Gondar Tertiary Eye Care and Training Center among 484 patients with visual impairment. Pretested, structured National Eye Institute Visual Function Questionnaire-25 was used to collect data by interviewing. Data were entered using EPI-INFO version 3.5.1 and analyzed with SPSS version 20. Binary logistic regression was used to determine factors associated with vision-related quality of life. Variables with p value <0.05 in multivariable logistic regression were considered as statistically significant. Result A total of 484 study subjects participated with a response rate of 98.9%. The median age of the participants was 60 years with the interquartile range of 25 years. The proportion of poor vision-related quality of life was 238 (49.2%) (95% CI: 44.2%–53.3%). Age >75 years (AOR = 1.87 (95% CI: 1.02–3.40)), rural residency (AOR = 1.71 (95% CI: 1.13–2.60)), severe visual impairment/blindness (AOR = 2.76 (95% CI: 1.80–4.23)), and history of visual impairment longer than 3 years (AOR = 2.85 (95% CI: 1.61–5.04)) had statistically significant association with poor vision-related quality of life. Conclusion Almost half of the patients with visual impairment had poor vision-related quality of life. Severe visual impairment/blindness, long duration of visual impairment, older age, and rural residency had a statistically significant association with poor vision-related quality of life.
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Wang C, Wang X, Jin L, Tang B, Zhu W, Zhang G, Chen T, McAneney H, Kassalow J, Congdon N. Influence of presbyopia on smartphone usage among Chinese adults: A population study. Clin Exp Ophthalmol 2019; 47:909-917. [PMID: 31090978 DOI: 10.1111/ceo.13559] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/01/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
IMPORTANCE Presbyopia, an essentially universal, age-related loss of the ability to focus un-aided on near objects, is the world's leading cause of visual impairment. BACKGROUND Smartphone use is widespread in China, but little is known about the prevalence, determinants and correction of difficulties with smartphone use in the setting of presbyopia. DESIGN Cross-sectional data from a population-based longitudinal cohort study. PARTICIPANTS A total of 1817 persons aged ≥35 years in Guangzhou, Southern China. METHODS Participants underwent near visual acuity (NVA) testing and completed questionnaires on smartphone usage detailing knowledge of their own presbyopia status, frequency (hours/day) and subjective difficulties with use of mobile and smartphones. Presbyopia was defined as uncorrected bilateral NVA ≤6/12 with best-corrected bilateral NVA >6/12. MAIN OUTCOME MEASURES Difficulty in smartphone use associated with uncorrected presbyopia. RESULTS Among 1427 respondents (78.5%) undergoing examination, 1191 (83.5%) completed questionnaires (mean age 52.3 ± 11.6 years; 54.9% women). Among 451 persons (37.8%) with presbyopia owning smartphones, 290 (64.3%) reported difficulty using them. Multiple ordinal logistic regression modelling showed difficulty in smartphone use due to presbyopia was associated with higher educational level (P = .013), worse NVA (P < .001) and more time spent using smartphones (P = .002 for 1-3 hours/day). Among persons with presbyopia owning smartphones, 353 (78.0%) said they would pay >US$15 (median US$45) for innovations making smartphone use easier. CONCLUSIONS AND RELEVANCE Difficulty in using smartphones in the presence of presbyopia is common and affected persons are willing to pay for useful solutions to the problem.
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Affiliation(s)
- Congyao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiuqin Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,The Ophthalmology Department, The Hospital of Guangdong Medical University, Zhanjiang, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Bobby Tang
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Wenhui Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,The Ophthalmology Department, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guoshan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Tingting Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,The Ophthalmology Department, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Helen McAneney
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Public Health, Queen's University Belfast, Belfast, UK.,Orbis International, New York, New York
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Han X, Lee PY, Keel S, He M. Prevalence and incidence of presbyopia in urban Southern China. Br J Ophthalmol 2018; 102:1538-1542. [PMID: 29367202 DOI: 10.1136/bjophthalmol-2017-311073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/29/2017] [Accepted: 01/10/2018] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the prevalence and incidence of presbyopia in an urban Chinese population. METHODS 1817 subjects aged ≥35 years were identified by random cluster sampling in Yuexiu District, Guangzhou, China, at baseline in 2008, and all were invited for the follow-up examination in 2014. Distance and near visual acuity (VA) tests, as well as non-cycloplegic automated refraction were performed at each examination as per standardised protocol. Participants with presenting near VA ≤20/40 were further tested with add power at a standard distance of 40 cm to obtain their best-corrected near VA. Functional presbyopia was defined as near VA under presenting distance refraction correction of <20/50 and could be improved by at least one line with add power. RESULTS A total of 1191 (83.5% of the 2014 follow-up) participants were included in the current analysis with a mean (SD) age of 50.4 (9.7) years, and 52.9% were female. Prevalence of functional presbyopia at baseline was 25.2% (95% CI 21.5 to 28.9) and the 6-year incidence was 42.8% (95% CI 39.4 to 50.1). Older and more hyperopic subjects had both higher prevalence and incidence of presbyopia (P<0.001). Average presbyopic correction coverage (PCC) was 87.7% at baseline and was significantly lower in myopic participants (P=0.006). CONCLUSIONS Prevalence of functional presbyopia in urban China is relatively lower along with a higher PCC compared with previous population-based rural cohorts. We identified a high presbyopia incidence, and further studies are needed to understand longitudinal presbyopia progression as well as the urban-rural gap in presbyopia to throw light on future strategic planning.
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Affiliation(s)
- Xiaotong Han
- Department of Preventive Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong, China.,Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Pei Ying Lee
- Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Stuart Keel
- Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Mingguang He
- Department of Preventive Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong, China.,Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
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Associations of obesity and weight change with physical and mental impairments in elderly Chinese people. Maturitas 2017; 108:77-83. [PMID: 29290219 DOI: 10.1016/j.maturitas.2017.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/14/2017] [Accepted: 11/26/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the associations between anthropometric measurements and functional impairments in a sample of urban elderly Chinese people. METHODS In two population-based cohort studies, the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS), 11,505 men and 17,166 women aged 70-88 years at the time of the functional assessment were studied. Weight history was collected and anthropometric data were taken at study enrollment (from 1996 to 2000 for the SWHS, 2002-2006 for the SMHS). Information on functional status and current weight was collected at the most recent follow-up survey (from 2011 to 2015). Logistic regression analyses were applied to estimate the associations of body mass index (BMI), waist-hip-ratio (WHR), and weight changes with functional decline. RESULTS After a median follow-up of 14.4 years (range 5.4-18.2 years), we found that BMI/WHR at or after middle age, and weight gain during adulthood were significantly associated with impaired walking ability and mental functioning. Being underweight after age 70 was associated with poorer hearing and/or vision as well as poorer memory. The associations between obesity and functional impairment were generally not modified by sex, comorbidity or exercise. CONCLUSION Weight gain, obesity at or after middle age, and underweight after age 70 were associated with physical and mental functional impairments among elderly Chinese people. These findings highlight the importance of maintaining healthy weight to reduce age-related functional decline.
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Marmamula S, Khanna RC, Kunuku E, Rao GN. Near visual impairment and spectacle coverage in Telangana, India. Clin Exp Ophthalmol 2017; 45:568-574. [PMID: 28277623 DOI: 10.1111/ceo.12943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/29/2016] [Accepted: 02/05/2017] [Indexed: 11/30/2022]
Abstract
IMPORTANCE The study highlights the burden of near visual impairment (NVI) in India. BACKGROUND NVI is a common condition that can be addressed through provision of spectacles. The study aims to assess the prevalence of NVI and spectacle coverage among those aged ≥40 years in south Indian state of Telangana. DESIGN Population-based cross-sectional study using a rapid assessment methodology. PARTICIPANTS Five thousand one hundred forty participants enumerated from 123 clusters in two districts and have presenting distance visual acuity of ≥6/18 in the better eye. METHODS Presenting near vision was assessed binocularly at a fixed distance of 40 cm using a log MAR chart with tumbling E optotypes in ambient lighting conditions. If the presenting near vision was worse than 6/12 (log MAR 0.3), then it was re-assessed with addition lens appropriate to the age. NVI was defined as binocular presenting near vision worse than 6/12. MAIN OUTCOME MEASURES Prevalence of NVI and spectacle coverage. RESULTS The mean age of the participants was 51.1 years (standard deviation: 9.3 years), and 46.5% (n = 2392) were women. About 80% (n = 4142) of them had no education, and 21.9% (n = 1126) were using spectacles for near vision. Nearly half of the participants were from Adilabad district (n = 2665). The prevalence of NVI was 58.3% (95% confidence interval: 56.9-59.6). NVI was associated with older age groups, male gender and no education. The spectacle coverage was 26.5%. CONCLUSIONS AND RELEVANCE NVI is common in rural Telangana with low spectacle coverage. Service delivery programs should use a multi-pronged approach to address the burden of NVI.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Wellcome Trust/Department of Biotechnology India Alliance, Research Fellow, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Eswararao Kunuku
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Gullapalli N Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
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Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain. PLoS One 2016; 11:e0159293. [PMID: 27434374 PMCID: PMC4951007 DOI: 10.1371/journal.pone.0159293] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 06/30/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose To comprehensively identify the determinants of quality of life (QoL) in a population study sample of persons aged 18–50 and 50+. Methods In this observational, cross-sectional study, QoL was measured with the WHOQOL-AGE, a brief instrument designed to measure QoL in older adults. Eight hierarchical regression models were performed to identify determinants of QoL. Variables were entered in the following order: Sociodemographic; Health Habits; Chronic Conditions; Health State description; Vision and Hearing; Social Networks; Built Environment. In the final model, significant variables were retained. The final model was re-run using data from the three countries separately. Results Complete data were available for 5639 participants, mean age 46.3 (SD 18.4). The final model accounted for 45% of QoL variation and the most relevant contribution was given by sociodemographic data (particularly age, education level and living in Finland: 17.9% explained QoL variation), chronic conditions (particularly depression: 4.6%) and a wide and rich social network (4.6%). Other determinants were presence of disabling pain, learning difficulties and visual problems, and living in usable house that is perceived as non-risky. Some variables were specifically associated to QoL in single countries: age in Poland, alcohol consumption in Spain, angina in Finland, depression in Spain, and self-reported sadness both in Finland and Poland, but not in Spain. Other were commonly associated to QoL: smoking status, bodily aches, being emotionally affected by health problems, good social network and home characteristics. Conclusions Our results highlight the importance of modifiable determinants of QoL, and provide public health indications that could support concrete actions at country level. In particular, smoking cessation, increasing the level of physical activity, improving social network ties and applying universal design approach to houses and environmental infrastructures could potentially increase QoL of ageing population.
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Burnett A, Yu M, Paudel P, Naduvilath T, Fricke TR, Hani Y, Garap J. Perceptions of Eye Health and Eye Health Services among Adults Attending Outreach Eye Care Clinics in Papua New Guinea. Ophthalmic Epidemiol 2015; 22:361-9. [DOI: 10.3109/09286586.2015.1057604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Paudel P, Khadka J, Burnett A, Hani Y, Naduvilath T, Fricke TR. Papua New Guinea vision-specific quality of life questionnaire: a new patient-reported outcome instrument to assess the impact of impaired vision. Clin Exp Ophthalmol 2014; 43:202-13. [DOI: 10.1111/ceo.12413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/04/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Prakash Paudel
- Brien Holden Vision Institute; Sydney New South Wales Australia
| | - Jyoti Khadka
- Discipline of Optometry and Vision Science; Flinders University; Adelaide South Australia Australia
| | - Anthea Burnett
- Brien Holden Vision Institute; Sydney New South Wales Australia
| | - Yvonne Hani
- PNG Eye Care; Port Moresby General Hospital; Boroko Papua New Guinea
| | | | - Tim R Fricke
- Brien Holden Vision Institute; Sydney New South Wales Australia
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Garin N, Olaya B, Lara E, Moneta MV, Miret M, Ayuso-Mateos JL, Haro JM. Visual impairment and multimorbidity in a representative sample of the Spanish population. BMC Public Health 2014; 14:815. [PMID: 25103270 PMCID: PMC4139603 DOI: 10.1186/1471-2458-14-815] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/26/2014] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In the context of population aging, visual impairment has emerged as a growing concern in public health. However, there is a need for further research into the relationship between visual impairment and chronic medical conditions in the elderly. The aim of our study was to examine the relationship between visual impairment and three main types of co-morbidity: chronic physical conditions (both at an independent and additive level), mental health and cognitive functioning. METHODS Data were collected from the COURAGE in Europe project, a cross-sectional study. A total of 4,583 participants from Spain were included. Diagnosis of chronic medical conditions included self-reported medical diagnosis and symptomatic algorithms. Depression and anxiety were assessed using CIDI algorithms. Visual assessment included objective distance/near visual acuity and subjective visual performance. Descriptive analyses included the whole sample (n = 4,583). Statistical analyses included participants aged over 50 years (n = 3,625; mean age = 66.45 years) since they have a significant prevalence of chronic conditions and visual impairment. Crude and adjusted binary logistic regressions were performed to identify independent associations between visual impairment and chronic medical conditions, physical multimorbidity and mental conditions. Covariates included age, gender, marital status, education level, employment status and urbanicity. RESULTS The number of chronic physical conditions was found to be associated with poorer results in both distance and near visual acuity [OR 1.75 (CI 1.38-2.23); OR 1.69 (CI 1.27-2.24)]. At an independent level, arthritis, stroke and diabetes were associated with poorer distance visual acuity results after adjusting for covariates [OR 1.79 (CI 1.46-2.21); OR 1.59 (CI 1.05-2.42); OR 1.27 (1.01-1.60)]. Only stroke was associated with near visual impairment [OR 3.01 (CI 1.86-4.87)]. With regard to mental health, poor subjective visual acuity was associated with depression [OR 1.61 (CI 1.14-2.27); OR 1.48 (CI 1.03-2.13)]. Both objective and subjective poor distance and near visual acuity were associated with worse cognitive functioning. CONCLUSIONS Arthritis, stroke and the co-occurrence of various chronic physical diseases are associated with higher prevalence of visual impairment. Visual impairment is associated with higher prevalence of depression and poorer cognitive function results. There is a need to implement patient-centered care involving special visual assessment in these cases.
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Affiliation(s)
- Noe Garin
- />Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830 Barcelona, Sant Boi de Llobregat, Spain
- />Fundació Sant Joan de Déu, Santa Rosa, 39-57, 08950 Barcelona, Esplugues de Llobregat, Spain
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
| | - Beatriz Olaya
- />Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830 Barcelona, Sant Boi de Llobregat, Spain
- />Fundació Sant Joan de Déu, Santa Rosa, 39-57, 08950 Barcelona, Esplugues de Llobregat, Spain
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
| | - Elvira Lara
- />Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830 Barcelona, Sant Boi de Llobregat, Spain
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
| | - Maria Victoria Moneta
- />Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830 Barcelona, Sant Boi de Llobregat, Spain
| | - Marta Miret
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
- />Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo s/n, 28029 Madrid, Spain
| | - Jose Luis Ayuso-Mateos
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
- />Department of Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo s/n, 28029 Madrid, Spain
- />Instituto de Investigación Sanitaria Princesa (IP), Diego de León, 62, 28006 Madrid, Spain
| | - Josep Maria Haro
- />Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Dr Antoni Pujades, 42, 08830 Barcelona, Sant Boi de Llobregat, Spain
- />Fundació Sant Joan de Déu, Santa Rosa, 39-57, 08950 Barcelona, Esplugues de Llobregat, Spain
- />Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5. Pabellón 11, 28029 Madrid, Spain
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El-Gasim M, Munoz B, West SK, Scott AW. Associations between self-rated vision score, vision tests, and self-reported visual function in the Salisbury Eye Evaluation Study. Invest Ophthalmol Vis Sci 2013; 54:6439-45. [PMID: 23812494 DOI: 10.1167/iovs.12-11461] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We attempt to understand the determinants of self-rated vision status by examining associations with vision tests, self-reported visual function, demographic, and health-status characteristics. METHODS Participants included 2467 individuals, aged 65 to 84 years, in a longitudinal, population-based cohort study. Participants rated their vision status from 0 to 10. Visual acuity, contrast sensitivity, stereoacuity, and visual fields were assessed. The Activities of Daily Vision Scale (ADVS) questionnaire was administered. Multivariate ordinal and multinomial logistic-regression models examined the association of demographic, health-status characteristics, vision tests, and ADVS subscales with self-rated vision status score. Odds ratios described the association of these characteristics with reporting better vision status. RESULTS Better visual acuity, contrast sensitivity, stereoacuity, and visual fields were associated with increased odds of reporting better vision status. Among the vision tests, a 2-line increase in visual acuity was most likely to result in an individual reporting better vision status (odds ratio, 1.49; 95% confidence interval [CI], 1.30-1.70). A 5-point increase in the near vision and far vision ADVS subscale scores was associated with increased odds of reporting good versus poor vision status. A 5-point increase in the near vision subscale was most likely to result in an individual reporting good versus poor vision status (odds ratio, 1.38; 95% CI, 1.28-1.50). CONCLUSIONS Self-rated vision status is a multidimensional measure. Near-vision visual function, visual acuity, and contrast sensitivity are important determinants of self-rated vision status in an elderly population. This understanding may improve the ability of eye care providers to maximize self-rated vision status among their patients.
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Affiliation(s)
- Mahmood El-Gasim
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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Williams S, Brian G, Toit RD. Measuring Vision-specific Quality of Life among Adults in Fiji. Ophthalmic Epidemiol 2012; 19:388-95. [DOI: 10.3109/09286586.2012.716896] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Källstrand-Eriksson J, Baigi A, Buer N, Hildingh C. Perceived vision-related quality of life and risk of falling among community living elderly people. Scand J Caring Sci 2012; 27:433-9. [DOI: 10.1111/j.1471-6712.2012.01053.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chew M, Chiang PPC, Zheng Y, Lavanya R, Wu R, Saw SM, Wong TY, Lamoureux EL. The impact of cataract, cataract types, and cataract grades on vision-specific functioning using Rasch analysis. Am J Ophthalmol 2012; 154:29-38.e2. [PMID: 22541931 DOI: 10.1016/j.ajo.2012.01.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 01/26/2012] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE To determine the impact of cataracts and their types and grades on vision-specific functioning. DESIGN Prospective population-based cross-sectional study. METHODS The Singapore Indian Eye Study examined 3400 of 4497 (75.6% response rate) ethnic Indians 40 years of age and older living in Singapore. Three thousand one hundred sixty-eight (93.2%) fulfilled inclusion criteria with complete information for final analysis. Cataracts were assessed on slit-lamp examination and were graded according to the Lens Opacity Classification System III. Vision-specific functioning scores were explored with the Visual Function scale, validated using Rasch analysis. RESULTS Two hundred sixty-nine (8.5%) and 740 (23.4%) of the study participants had unilateral and bilateral cataracts, respectively, and 329 (10.4%), 800 (25.2%), and 128 (4.1%) participants had nuclear, cortical, and posterior subcapsular (PSC) cataracts, respectively. In multivariate linear regression models, the presence of bilateral rather than unilateral cataract (β = -0.12; 95% confidence interval, -0.20 to 0.00) was associated independently with poorer vision-specific functioning, even after adjusting for undercorrected refractive error (β = -0.11; 95% confidence interval, -0.21 to 0.00). Bilateral nuclear, cortical, and PSC cataracts also were associated with poorer vision-specific functioning (β = -0.31, -0.15, and -1.15, respectively), with combinations of them having even greater impact. Significantly poorer vision-specific functioning occurred at Lens Opacity Classification System grades 4 (nuclear opalescence), 5 (nuclear color), 3 (cortical), and 1 (PSC) or higher. CONCLUSIONS People with bilateral but not unilateral cataracts experience difficulty with performing vision-specific daily activities independent of refractive error, with PSC cataracts and cataract combinations having the greatest impact. Cataract types cause poorer vision-specific functioning beginning at different severity grades.
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Finger RP, Fenwick E, Chiang PPC, Petrak M, Holz FG, Marella M, Lamoureux EL. The impact of the severity of vision loss on vision-specific functioning in a German outpatient population — an observational study. Graefes Arch Clin Exp Ophthalmol 2011; 249:1245-53. [DOI: 10.1007/s00417-011-1646-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 01/24/2011] [Accepted: 02/07/2011] [Indexed: 10/18/2022] Open
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Brian G, Pearce MG, Ramke J. Refractive Error and Presbyopia Among Adults in Fiji. Ophthalmic Epidemiol 2011; 18:75-82. [DOI: 10.3109/09286586.2010.551576] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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