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Zou M, Chen A, Liu Z, Jin L, Zheng D, Congdon N, Jin G. The burden, causes, and determinants of blindness and vision impairment in Asia: An analysis of the Global Burden of Disease Study. J Glob Health 2024; 14:04100. [PMID: 38867671 PMCID: PMC11170234 DOI: 10.7189/jogh.14.04100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Methods Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). Results In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. Conclusions The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.
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Affiliation(s)
- Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Aiming Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Centre for Public Health, Queen’s University Belfast, Belfast, Belfast, UK
- Orbis International, New York, New York, USA
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Wang D, Tang T, Li P, Zhao J, Shen B, Zhang M. The global burden of cataracts and its attributable risk factors in 204 countries and territories: a systematic analysis of the global burden of disease study. Front Public Health 2024; 12:1366677. [PMID: 38932770 PMCID: PMC11199524 DOI: 10.3389/fpubh.2024.1366677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction The global distribution and trends in the attributable burden of cataract risk have rarely been systematically explored. To guide the development of targeted and accurate cataract screening and treatment strategies, we analyzed the burden of cataract disease attributable to known risk factors. Method This study utilized detailed cataract data from the Global Burden of Disease e 2019, and we analyzed disability-adjusted life years (DALYs) e each risk factor from 1990 to 2019. Additionally, we calculated estimated annual percentage changes (EAPCs) during the study period. Results The results revealed that from 1990-2019, the global age-standardized DALYs of e attributable to particulate matter pollution, smoking, high fasting glucose plasma and high BMI showed steady downward trends (1990-2009: EAPC = -0.21 [-0.57 -0.14]); 2000-2009: EAPC = -0.95 [-1.01 -0.89]; 2010-2019: EAPC = -1.41 [-1.8 -1.02]). The age-standardized DALYs and mortality caused by each risk factor were highest in the low-middle sociodemographic index (SDI) region (EAPC = -1.77[(-2.19--1.34)]). The overall disease burden of cataracts is lower in males than in females. When analyzing the EAPCs of cataract disease burden for each risk factor individually, we found that the age-standardized disability-adjusted life years caused by particulate matter pollution and smoking decreased (PMP1990-2009: EAPC = -0.53 [-0.9--0.16]; 2000-2009: EAPC = -1.39 [-1.45--1.32]; 2010-2019: EAPC = -2.27 [-2.75--1.79]; smoking 2000 to 2009: EAPC = -1.51 [-1.6--1.43], 2009 to 2019: EAPC = -1.34 [-1.68--1])), while high fasting plasma glucose and high body mass index increased annually (HFPG1990 to 1999: EAPC = 1.27 [0.89-1.65], 2000 to 2009: EAPC = 1.02 [0.82-1.22], 2010-2019: EAPC = 0.44 [0.19-0.68]; HBMI 1990 to 1999: EAPC = 1.65 [1.37-1.94], 2000 to 2009: EAPC = 1.56 [1.43-1.68], 2010-2019: EAPC = 1.47 [1.18-1.77]). Disscussion The burden of cataracts caused by ambient particulate matter and smoking is increasing in low, low-middle SDI areas, and specific and effective measures are urgently needed. The results of this study suggest that reducing particulate matter pollution, quitting smoking, controlling blood glucose, and lowering BMI could play important roles in reducing the occurrence of cataracts, especially in older people.
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Affiliation(s)
- Dongyue Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Tong Tang
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peiheng Li
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhao
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bairong Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Center for High Altitude Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Sharma O, Jones L, Sii F, Whittaker J, Dulku S, Lee G, Kirwan J, Sharma T, Shah P. Mapping vision loss of patients in a glaucoma backlog following the COVID-19 pandemic: a real-world analysis using the Glauc-Strat-Fast risk stratification tool. Eye (Lond) 2024; 38:1005-1011. [PMID: 37980397 DOI: 10.1038/s41433-023-02821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023] Open
Abstract
INTRODUCTION Glauc-Strat-Fast is a clinical tool recommended by The Royal College of Ophthalmologists to classify glaucoma patients into strata of risk for significant future sight loss and an estimate of resource requirement. The aim of this study was to map the movement of glaucoma patients across stratification boundaries on Glauc-Strat-Fast during the COVID-19 pandemic. SUBJECTS AND METHODS Glauc-Strat-Fast was applied to a consecutive sample of 100 primary open angle glaucoma patients in a backlog at Worcestershire Acute Hospitals NHS Trust. Stratification outcomes were compared between clinic visits prior to the COVID-19 pandemic versus the follow-up visit. Patients were stratified twice separately based on their worse eye (i.e., most affected) and better eye (i.e., least affected) according to Glauc-Strat-Fast. RESULTS Amount of slippage (difference between target follow-up and actual follow-up) ranged from 2 to 32 months. There was a statistically significant average reduction in visual field mean deviation for better and worse eyes between visits (p = <0.001). At follow-up, no worse eyes were classified as being low risk (green), while 96 were classified as high risk (red). For better eyes, elevation of risk into the highest strata of Glauc-Strat-Fast observed a three-fold increase in patients (19 versus 56) between visits. DISCUSSION This retrospective real-world analysis highlights patients' movement into the highest strata on the Glauc-Strat-Fast tool and demonstrates a significant deterioration in visual outcomes during a period of extensive appointment slippage. The findings demonstrate the utility of Glauc-Strat-Fast as a tool for improved patient management.
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Affiliation(s)
- Ojasvi Sharma
- Medical School, University of Nottingham, Nottingham, UK
| | - Lee Jones
- University College London, Institute of Ophthalmology, London, UK
- BRAVO VICTOR, Department of Research, London, UK
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
| | - Freda Sii
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jonathan Whittaker
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Simon Dulku
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Graham Lee
- Department of Ophthalmology, Mater Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - James Kirwan
- Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK
| | - Tarun Sharma
- Worcestershire Acute Hospitals NHS Trust, Ophthalmology Department, Worcester, UK.
| | - Peter Shah
- University College London, Institute of Ophthalmology, London, UK
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- University of Wolverhampton, Centre for Health and Social Care Improvement, Wolverhampton, UK
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Philippin H, Matayan EN, Knoll KM, Macha E, Mbishi S, Makupa A, Matsinhe CD, da Gama IV, Monjane MJ, Ncheda JA, Mulobuana FAF, Muna E, Guylene NF, Gazzard G, Marques AP, Shah P, Macleod D, Makupa W, Burton MJ. Differentiating stages of functional vision loss from glaucoma using the Disc Damage Likelihood Scale and cup:disc ratio. Br J Ophthalmol 2024; 108:349-356. [PMID: 36653163 PMCID: PMC10894823 DOI: 10.1136/bjo-2022-321643] [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: 04/11/2022] [Accepted: 01/07/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Glaucoma staging is critical for treatment planning but has rarely been tested in severe/end-stage disease. We compared the performance of the Disc Damage Likelihood Scale (DDLS) and cup:disc ratio (CDR) using a functional glaucoma staging system (GSS) as the reference standard. METHODS Post hoc analysis of a randomised controlled trial at the Eye Department of Kilimanjaro Christian Medical Centre, Tanzania. Eligible participants (aged ≥18 years) with open-angle glaucoma, intraocular pressure (IOP) of >21 mm Hg, were randomised to timolol 0.5% eye drops or selective laser trabeculoplasty. Fundoscopy established vertical and horizontal CDRs and DDLS. Visual acuity and static visual fields were graded (GSS). The study used area under the receiver operating characteristic (AROC) curves and Spearman's rank correlation coefficients to compare staging systems. Logistic regression with generalised estimating equations determined risk factors of functional severe/end-stage glaucoma. RESULTS 382 eyes (201 participants) were evaluated; 195 (51%) had severe or end-stage glaucoma; mean IOP was 26.7 (SD 6.9) mm Hg. DDLS yielded an AROC of 0.90 (95% CI 0.87 to 0.93), vertical cup:disc ratio (vCDR) of 0.88 (95% CI 0.85 to 0.91, p=0.048) for identifying severe/end-stage disease. Correlation coefficients comparing GSS to DDLS and vCDRs were 0.73 and 0.71, respectively. Advanced structural stages, vision impairment, higher IOP and less financial resources were risk factors of functional severe/end-stage glaucoma. CONCLUSION This study indicates that both structural staging systems can differentiate severe/end-stage glaucoma from less severe disease, with a moderate advantage of DDLS over CDR. Clinical examination of the optic disc plays an important role in addition to functional assessment when managing severe/end-stage glaucoma.
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Affiliation(s)
- Heiko Philippin
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine Department of Clinical Research, London, UK
- Eye Centre, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Einoti Naino Matayan
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Kilimanjaro Christian Medical University College, Moshi, Tanzania, United Republic of
| | - Karin Marianne Knoll
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Edith Macha
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Sia Mbishi
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Andrew Makupa
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Kilimanjaro Christian Medical University College, Moshi, Tanzania, United Republic of
| | - Cristóvão Daniel Matsinhe
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Provincial Hospital of Pemba, Pemba, Mozambique
| | - Isac Vasco da Gama
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Hospital Central de Quelimane, Quelimane, Mozambique
| | - Mário Jorge Monjane
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Joyce Awum Ncheda
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Presbyterian Eye Hospital, Bafoussam, Cameroon
| | | | - Elisante Muna
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Nelly Fopoussi Guylene
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Eye Department, Cameroon Baptist Convention Health Services, Douala, Cameroon
| | - Gus Gazzard
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine Department of Clinical Research, London, UK
| | - Peter Shah
- Institute of Ophthalmology, University College London, London, UK
- Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - David Macleod
- MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - William Makupa
- Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Kilimanjaro Christian Medical University College, Moshi, Tanzania, United Republic of
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine Department of Clinical Research, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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England L, O’Connor A. Do Socioeconomic Inequalities Exist Within Ophthalmology and Orthoptics in the UK?: A Scoping Review. Br Ir Orthopt J 2024; 20:31-47. [PMID: 38250169 PMCID: PMC10798172 DOI: 10.22599/bioj.338] [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: 09/06/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction It is well documented that socioeconomic disadvantage adversely affects general health and ocular health worldwide. Within orthoptics, while clinicians recognise a relationship between socioeconomic situation and treatment outcome, no previous literature review was found to address this issue. Neither was a UK-specific literature review found to address the same issue for ophthalmology as a whole. Aim This literature review evaluates evidence for an association between socioeconomic situation and ophthalmic/orthoptic conditions and their treatment outcomes, specifically within the UK. Methods Keyword searches were conducted on Google Scholar and the University of Liverpool library catalogue. Results for the main analyses were limited to full papers, specific to the UK, written in English. Literature was only included from pre-2000 if more recent evidence was insufficient. Results There is evidence of socioeconomic disadvantage being associated with the following: reduced visual acuity; reduced attendance at diabetic retinopathy screening appointments; and delayed presentation of glaucoma, cataracts, and diabetic retinopathy. However, evidence linking socioeconomic disadvantage to AMD is mixed. There is limited evidence of the increased prevalence of amblyopia and subsequent barriers to its treatment for socioeconomically underserved children. There is also evidence of a reduction in quality of life for socioeconomically underserved adults with strabismus. Conclusions Health inequalities within ophthalmology and orthoptics are reported, but with confounding results for some conditions. Further research should explore the reasons behind the inequalities that are found and identify methods of reducing them.
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Rathore M, Shweikh Y, Kelly SR, Crabb DP. Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data. Eye (Lond) 2023; 37:3615-3620. [PMID: 37165010 PMCID: PMC10686257 DOI: 10.1038/s41433-023-02567-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND/OBJECTIVES To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES). METHODS 602,439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean Deviation (MD) worse than -12 dB was used as a surrogate definition for advanced VF loss at diagnosis in patients with ≥2 reliable VF records. MD loss worse than -1 dB per year was used to define rapid VF progression in patients with ≥6 VFs. Patient data were stratified into deciles of the Index of Multiple Deprivation (IMD) from residential postcodes. RESULTS There was an association between IMD and advanced VF loss at diagnosis in 44,956 patients with 18% (293/1608) and 11% (771/6929) in the most and least deprived IMD decile, respectively. Age-corrected odds ratio (OR) for having advanced VF loss at entry into HES was 1.42 (95% confidence interval [CI] 1.21-1.67) and 0.75 (95% CI: 0.66-0.85) in the most and least deprived IMD decile respectively (reference = fifth decile). In 15,094 patients with follow up data (median [interquartile range] of 6.9 [4.5, 10.0] years), the proportion having rapid VF progression did not differ across the IMD spectrum. CONCLUSION Large-scale VF data from clinics indicates that glaucoma severity at presentation to English HES is associated with levels of multiple deprivation. We found no evidence to suggest likelihood of having rapid VF progression during follow-up is associated with IMD; this hints at equity of glaucoma care and outcomes once patients are in English HES.
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Affiliation(s)
- Mehal Rathore
- Department of Optometry and Visual Sciences, School of Health & Psychological Sciences, City, University of London, London, UK
| | - Yusrah Shweikh
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, West Sussex, UK
| | - Stephen R Kelly
- Department of Optometry and Visual Sciences, School of Health & Psychological Sciences, City, University of London, London, UK
| | - David P Crabb
- Department of Optometry and Visual Sciences, School of Health & Psychological Sciences, City, University of London, London, UK.
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Shalaby WS, Shukla AG, Shiuey EJ, Rapuano CJ, Nagra PK, Syed ZA. Demographic and Socioeconomic Determinants of Penetrating Keratoplasty Outcomes. Cornea 2023; 42:1274-1279. [PMID: 36729026 DOI: 10.1097/ico.0000000000003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to determine possible associations between demographic and socioeconomic factors and graft survival after penetrating keratoplasty (PK). METHODS This study was a retrospective chart review of patients undergoing PK at a tertiary-care corneal practice at Wills Eye Hospital between May 1, 2007, and September 1, 2018. The first PK of the first eye was included. The primary outcome measure was graft failure, defined as irreversible and visually significant graft edema, haze, or scarring. Demographic and socioeconomic factors included yearly average adjusted gross income (AGI) based on residential zip code, age, sex, and race. Two income groups were created: 1) individuals from neighborhoods with the lowest 10% of AGI (N = 82, AGI=$32,100 ± 4000) and 2) the remaining 90% of individuals (N = 740, AGI=$86,900 ± 52,200). Logistic regression analysis was performed to identify factors predictive of graft prognosis. RESULTS The 822 patients (822 eyes) included had a mean age of 57.1 ± 22.1 years at the time of PK. Over an average of 4.2 ± 3.1 years of follow-up, graft failure occurred in 35.3%. Age, sex, and follow-up duration were comparable between income groups (all P > 0.05). Black race was disproportionately represented in the lower-income group (50.0% vs. 11.5%, P < 0.001). Multivariable analysis identified predictors of graft failure including residing in a lower-income neighborhood [hazard ratio (HR) = 2.27, 95% confidence interval (CI) = 1.24-4.19, P = 0.008], younger age (HR = 0.99, 95% CI = 0.98-1.00, P = 0.046), and Black race (HR = 1.63, 95% CI = 1.03-2.56, P = 0.035). CONCLUSIONS Individuals with a lower income, younger age, and Black race may be more vulnerable to graft failure after PK. Further studies are warranted to identify reasons for these associations.
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Affiliation(s)
- Wesam Shamseldin Shalaby
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt; and
| | - Aakriti Garg Shukla
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Eric J Shiuey
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Christopher J Rapuano
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Parveen K Nagra
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Zeba A Syed
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
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Marbaniang SP, Patel R, Kumar P, Chauhan S, Srivastava S. Hearing and vision difficulty and sequential treatment among older adults in India. Sci Rep 2022; 12:19056. [PMID: 36351946 PMCID: PMC9646738 DOI: 10.1038/s41598-022-21467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [β = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [β = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.
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Affiliation(s)
| | - Ratna Patel
- grid.419349.20000 0001 0613 2600Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- grid.419349.20000 0001 0613 2600Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
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Malik M, Strang N, Campbell P, Jonuscheit S. Exploring eye care pathways, patient priorities and economics in Pakistan: A scoping review and expert consultation study with thematic analysis. Ophthalmic Physiol Opt 2022; 42:694-716. [PMID: 35318687 PMCID: PMC9310639 DOI: 10.1111/opo.12977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
Purpose As the prevalence of eye diseases increases, demand for effective, accessible and equitable eye care grows worldwide. This is especially true in lower and middle‐income countries, which have variable levels of infrastructure and economic resources to meet this increased demand. In the present study we aimed to review the literature on eye care in Pakistan comprehensively, with a particular focus on eye care pathways, patient priorities and economics. Methods A systematic scoping review was performed to identify literature relating to eye care in Pakistan. Searches of relevant electronic databases and grey literature were carried out. The results were analysed through a mixed methods approach encompassing descriptive numerical summary and thematic analysis. To consolidate results and define priority areas for future study, expert consultation exercises with key stakeholders were conducted using qualitative semi‐structured interviews. Results One hundred and thirty‐two papers (published and unpublished) were included in the final review. The majority (n = 93) of studies utilised a quantitative design. Seven interlinked themes were identified: eye care pathways, burden of eye disease, public views on eye‐related issues, workforce, barriers to uptake of eye care services, quality of eye care services and economic impact of blindness. Research priorities included investigating the eye care workforce, the quality and efficiency of current eye care services, eye care services available in rural Pakistan and the costs and benefits related to eye care provision and sustaining eye care programmes. Conclusions To the best of our knowledge, this is the first review to synthesise evidence from papers across the field relating to eye care in Pakistan. As such, this work provides new insights into the achievements of the national eye health programme, challenges in eye care in Pakistan and priority areas for future research.
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Affiliation(s)
- Manal Malik
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Sven Jonuscheit
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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10
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The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients. J Ophthalmol 2022; 2021:4694577. [PMID: 34970451 PMCID: PMC8714322 DOI: 10.1155/2021/4694577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose To determine the changes in vision-related quality of life and psychological distress after cataract surgery in monocular patients and to compared these with a control group of age- and gender-matched binocular patients. Methods We enrolled 40 monocular patients and 40 binocular patients who underwent cataract surgery from August 2017 to December 2018. All participants undertook eye examinations and answered questionnaires (the National Eye Institute Visual Function Questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale) before and after cataract surgery. Result The monocular patients had significantly worse mean CDVA than the binocular patients before and after surgery. However, there was no significant difference between the increases gained by the two groups. Mean composite VFQ-25 scores of the monocular group were significantly lower than those of the binocular group before and after surgery, but the improvement experienced by the monocular group was statistically larger than the binocular group (37.20 ± 12.84 vs. 19.11 ± 5.13, P < 0.001). Mean standard SAS scores of monocular patients were significantly higher than those of binocular controls before and after surgery, while monocular patients experienced a significant greater decline of SAS scores (−9.41 ± 5.39 VS −3.84 ± 1.61, P < 0.001). Mean standard SDS scores of the monocular group were significantly higher than those of the control group before and after surgery, but the monocular group experienced a significantly greater decline of SDS scores following cataract surgery (−11.91 ± 6.38 VS −4.78 ± 1.79, P < 0.001). There was a significant correlation between the preoperative logMAR CDVA and both the postoperative logMAR CDVA (r = 0.63, P < 0.001) and the changes in the logMAR CDVA (r = −0.881, P < 0.001) for monocular patients. Linear regression analyses suggested that higher postoperative VFQ-25 scores had significant associations with better preoperative CDVA and the absence of systemic comorbidity (both P < 0.05). Age and ocular comorbidity were significantly associated with postoperative SAS scores (both P < 0.05). Age and systemic comorbidity remained significant impact factors for SDS scores (both P < 0.05). Conclusion Monocular patients reported greater improvement in vision-related quality of life and greater decline in the level of anxiety and depression than binocular control subjects, despite having similar CDVA gains after cataract surgery. We argue that it is not a better choice for monocular patients to delay cataract surgery until the cataract is very advanced. A clear understanding of the impact of cataract surgery on vision-related quality of life and psychological distress in monocular patients is needed by ophthalmologists when making surgery decision.
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11
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Xiao B, Mercer GD, Jin L, Lee HL, Chen T, Wang Y, Liu Y, Denniston AK, Egan CA, Li J, Lu Q, Xu P, Congdon N. Outreach screening to address demographic and economic barriers to diabetic retinopathy care in rural China. PLoS One 2022; 17:e0266380. [PMID: 35442967 PMCID: PMC9020743 DOI: 10.1371/journal.pone.0266380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/04/2022] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Poor access to existing care for diabetic retinopathy (DR) limits effectiveness of proven treatments. OBJECTIVES We examined whether outreach screening in rural China improves equity of access. DESIGN, SETTING AND PARTICIPANTS We compared prevalence of female sex, age > = 65 years, primary education or below, and requiring referral care for DR between three cohorts with diabetes examined for DR in neighboring areas of Guangdong, China: passive case detection at secondary-level hospitals (n = 193); persons screened during primary-level DR outreach (n = 182); and individuals with newly- or previously-diagnosed diabetes in a population survey (n = 579). The latter reflected the "ideal" reach of a screening program. RESULTS Compared to the population cohort, passive case detection reached fewer women (50·8% vs. 62·3%, p = 0·006), older adults (37·8% vs. 51·3%, p < 0·001), and less-educated persons (39·9% vs. 89·6%, p < 0·001). Outreach screening, compared to passive case detection, improved representation of the elderly (49·5% vs. 37·8%, p = 0·03) and less-educated (70·3% vs. 39·9%, p<0·001). The proportion of women (59.8% vs 62.3%, P>0.300) and persons aged > = 65 years (49.5% vs 51.3%, p = 0.723) in the outreach screening and population cohorts did not differ significantly. Prevalence of requiring referral care for DR was significantly higher in the outreach screening cohort (28·0%) than the population (14·0%) and passive case detection cohorts (7·3%, p<0·001 for both). CONCLUSIONS AND RELEVANCE Primary-level outreach screening improves access for the poorly-educated and elderly, and removes gender inequity in access to DR care in this setting, while also identifying more severely-affected patients than case finding in hospital.
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Affiliation(s)
- Baixiang Xiao
- Affiliated Eye Hospital of Nanchang University, Nanchang City, China
| | - Gareth D. Mercer
- Department of Ophthalmology and Visual Sciences, McGill University, Montréal, Canada
| | - Ling Jin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou City, China
| | - Han Lin Lee
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Tingting Chen
- The Ophthalmology Department of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanfang Wang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou City, China
| | - Yuanping Liu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou City, China
| | | | - Catherine A. Egan
- Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
| | - Jia Li
- Orbis International, New York, NY, United States of America
| | - Qing Lu
- Orbis International, New York, NY, United States of America
| | - Ping Xu
- Orbis International, New York, NY, United States of America
| | - Nathan Congdon
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou City, China
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Orbis International, New York, NY, United States of America
- * E-mail:
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12
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Moussa G, Kalogeropoulos D, Ch’ng SW, Lett KS, Mitra A, Tyagi AK, Sharma A, Andreatta W. Effect of deprivation and ethnicity on primary macula-on retinal detachment repair success rate and clinical outcomes: A study of 568 patients. PLoS One 2021; 16:e0259714. [PMID: 34752493 PMCID: PMC8577769 DOI: 10.1371/journal.pone.0259714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/25/2021] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Socio-economic deprivation and ethnic variation have been frequently linked to poorer health outcomes. We collected a large series of primary macula-on rhegmatogenous retinal detachment (RRD) cases and analysed the effect of socio-economic deprivation and ethnicity on both six-month retinal re-detachment rate and visual outcomes. MATERIALS AND METHODS Retrospective consecutive case series of 568 patients attending Birmingham and Midlands Eye Centre from January 2017-2020. Multiple Indices of Deprivation (IMD) deciles were used for deprivation status and split to two groups: IMD-A (Decile 1-5) and IMD-B (Decile 6-10). The two largest subgroups of ethnicities were compared, White and South Asians (SA). RESULTS We report an overall retinal re-detachment rate of 8.5%. IMD-A re-detached significantly more than IMD-B (11.2% vs 6.0% respectively, p = 0.034). No statistical significance was found between White and SA re-detachment rate (9.1% and 5.6% respectively, p = 0.604). SA median age significantly lower at 49 years (IQR: 37-61) compared to White patients at 57 years (IQR: 50-65) (p = <0.001). IMD-A median age of 55 years (IQR: 46-64) was significantly lower to IMD-B median age of 58 years (IQR: 51-65) (p = 0.011). No differences in final visual outcomes were detected across all groups. CONCLUSION We demonstrated an increased retinal re-detachment rate in our more deprived patients according to IMD and a younger cohort of SA compared to White ethnicity. Further prospective studies are required to demonstrate the link between socio-economic deprivation and surgical success.
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Affiliation(s)
- George Moussa
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom
| | - Dimitrios Kalogeropoulos
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Soon Wai Ch’ng
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Kim Son Lett
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Arijit Mitra
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Ajai K. Tyagi
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Ash Sharma
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Walter Andreatta
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
- Kantonsspital Winterthur, Winterthur, Switzerland
- University of Zurich, Zurich, Switzerland
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13
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Shalaby WS, Arbabi A, Myers JS, Moster MR, Razeghinejad R, Katz LJ, Shukla AG. Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. J Curr Glaucoma Pract 2021; 15:70-77. [PMID: 34720496 PMCID: PMC8543744 DOI: 10.5005/jp-journals-10078-1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Importance Few studies have analyzed associations between sociodemographic factors and neovascular glaucoma (NVG) outcomes. Aim and background To determine the potential impact of sociodemographic and economic factors on the NVG tube shunt surgery outcomes. Design Retrospective, single-center, comparative case series. Participants Consecutive patients who underwent tube shunt surgery for NVG and had ≥6 months of follow-up. Materials and methods Regional average adjusted gross income (AGI) was determined by cross-referencing self-reported residential zip codes with average AGI per zip code supplied by the Internal Revenue Service. Two groups were created: (1) lower-income: individuals from neighborhoods with the lowest 10% of AGI (near the United States poverty line), (2) higher-income: the remaining 90% of individuals. Main outcome measures Visual acuity (VA), intraocular pressure (IOP), and glaucoma medication number at 6 months and the most recent visit. Results The mean annual AGI in the higher-income group (130 patients) was $69,596 ± 39,700 and the lower-income group (16 patients) was $27,487 ± 1,600 (p < 0.001). Age, sex, distance to the clinic, language, and all baseline clinical variables (including VA and IOP) were comparable between groups. Lower-income was associated with non-white race (81.3 vs 52.3%; p = 0.024). At month 6, VA in the lower-income group [median: HM (20/70–NLP)] was worse than the higher-income group [median: CF (20/25–NLP)] (log MAR VA: 2.32 ± 0.8 vs 1.77 ± 1.1; p = 0.02); these trends persisted through the most recent visit (p = 0.043). Follow-up IOP and medications were similar between groups. Conclusions and relevance Lower-income may be associated with worse VA outcomes following NVG tube shunt surgery. How to cite this article Shalaby WS, Arbabi A, Myers JS, et al. Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. J Curr Glaucoma Pract 2021;15(2):70–77.
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Affiliation(s)
- Wesam S Shalaby
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Ophthalmology Department, Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt
| | - Amirmohsen Arbabi
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jonathan S Myers
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Marlene R Moster
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Reza Razeghinejad
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - L Jay Katz
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Aakriti G Shukla
- Glaucoma Research Center, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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14
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Brunes A, Heir T. Serious Life Events in People with Visual Impairment Versus the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111536. [PMID: 34770048 PMCID: PMC8583190 DOI: 10.3390/ijerph182111536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/04/2021] [Accepted: 10/29/2021] [Indexed: 12/26/2022]
Abstract
The present study aimed to examine the lifetime exposure to serious life events in people with visual impairment compared with the general population. Data were derived from a telephone survey including a probability sample of 736 adults with visual impairment (response rate: 61%). The lifetime prevalence of direct experiences with seventeen different categories of serious life events (Life Events Checklist for DSM-5 (LEC-5)) were compared to that obtained from the general Norwegian population (N = 1792, 36% response rate). Altogether, 68% of people with visual impairment had been directly exposed to at least one serious life event, with equal rates among males and females (p = 0.59). The prevalence of serious life events was higher than for the general population (60%, p < 0.001), especially for fire or explosions, serious accidents, sexual assaults, life-threatening illness or injury, and severe human suffering. In conclusion, our results indicate that people with visual impairment are more prone to experiencing serious life events. This highlights the need for preventive strategies that reduce the risk of serious life events in this population.
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Affiliation(s)
- Audun Brunes
- Section for Trauma, Catastrophes and Forced Migration—Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway;
- Correspondence: ; Tel.: +47-97-578-629
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration—Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway;
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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15
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Shah R, Edgar DF, Khatoon A, Hobby A, Jessa Z, Yammouni R, Campbell P, Soteri K, Beg A, Harsum S, Aggarwal R, Evans BJW. Referrals from community optometrists to the hospital eye service in Scotland and England. Eye (Lond) 2021; 36:1754-1760. [PMID: 34363046 PMCID: PMC8344323 DOI: 10.1038/s41433-021-01728-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 12/26/2022] Open
Abstract
Objectives This audit assesses communication between community optometrists (COs) and hospital eye service (HES) in Scotland and England. Methods Optometric referrals and replies were extracted from six practices in Scotland and England. If no reply was found, replies/records were copied from HES records. De-identified referrals, replies and records were audited against established standards, evaluating whether referrals were necessary, accurate and directed to the appropriate professional. The referral rate (RR) and referral reply rate (RRR) were calculated. Results From 905 de-identified referrals, RR ranged from 2.6 to 8.7%. From COs’ perspective, the proportion of referrals for which they received replies ranged from 37 to 84% (Scotland) and 26 to 49% (England). A total of 88–96% of referrals (Scotland) and 63–76% (England) were seen in the HES. Adjusting for cases when it is reasonable to expect replies, RRR becomes 45–92% (Scotland) and 38–62% (England) with RRR significantly greater in Scotland (P = 0.015). Replies were copied to patients in 0–21% of cases. Referrals were to the appropriate service and judged necessary in ≥90% of cases in both jurisdictions. Accuracy of referral ranged from 89 to 97% (Scotland) and 81 to 98% (England). The reply addressed the reason for referral in 94–100% of cases (Scotland) and 93–97% (England) and was meaningful in 95–100% (Scotland) and 94–99% (England). Conclusions Despite the interdisciplinary joint statement on sharing patient information, this audit highlights variable standard of referrals and deficits in replies to the referring COs, with one exception in Scotland. Replies from HES to COs are important for patient care, benefitting patients and clinicians and minimising unnecessary HES appointments.
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Affiliation(s)
- Rakhee Shah
- Centre for Applied Vision Research, City, University of London, London, UK.
| | - David F Edgar
- Centre for Applied Vision Research, City, University of London, London, UK
| | | | | | | | | | - Peter Campbell
- Centre for Applied Vision Research, City, University of London, London, UK
| | - Kiki Soteri
- University of Plymouth, Plymouth, UK.,Specsavers Opticians, St. Andrew, Guernsey
| | | | - Steven Harsum
- Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | | | - Bruce J W Evans
- Centre for Applied Vision Research, City, University of London, London, UK.,Institute of Optometry, London, UK
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16
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Abdolalizadeh P, Chaibakhsh S, Falavarjani KG. Global burden of paediatric vision impairment: a trend analysis from 1990 to 2017. Eye (Lond) 2021; 35:2136-2145. [PMID: 34131284 DOI: 10.1038/s41433-021-01598-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 03/06/2021] [Accepted: 05/06/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To assess the trend of paediatric visual impairment and its disparities by year, sex, age and national socioeconomic levels using disability-adjusted life years (DALYs). METHODS It is a retrospective analysis of data from the Global Burden of Disease (GBD) 2017. Global and national DALY numbers and rates of vision impairment in three paediatric age groups of 1-4 (preschool children), 5-9 (school children) and 10-14 years (teenagers) years were obtained from the GBD 2017 database. The socioeconomic indices for 195 countries were derived from international open databases. Main outcome measures were comparison of DALYs due to paediatric vision impairment in different age groups by socioeconomic indicators in 2017 and analysis of the trend from 1990. RESULTS The global prevalence of distance and/or near vision impairment for 1-14 years was 2.8% (95% uncertainty interval (UI): 2.5-3.1) in 2017. The highest DALYs for distance and/or near vision impairment [number=589.93 thousands (95%UI: 367.71-933.29), rate = 92.72 (95%UI: 57.79-146.68)] were observed in teenagers. DALY rate of distance and/or near vision impairment was not associated with socioeconomic indicators, however, DALY rate of refractive disorders had positive correlation with national socioeconomic development. The global trends of DALY numbers in distance and/or near vision impairment as well as refractive and other causes remained stable from 1990 to 2015 (0.128 ≤ P ≤ 0.738), however, DALY rates had a statistically significant trend of reduction in all paediatric age groups (0.003 ≤ P ≤ 0.024). CONCLUSION The global health burden of paediatric vision impairment decreased from 1990. Refractive, near vision impairment and other causes were associated with socioeconomic development.
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Affiliation(s)
- Parya Abdolalizadeh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Chaibakhsh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.,Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. .,Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
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17
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Zou M, Zhang Y, Chen A, Young CA, Li Y, Zheng D, Jin G. Variations and trends in global disease burden of age-related macular degeneration: 1990-2017. Acta Ophthalmol 2021; 99:e330-e335. [PMID: 32833305 DOI: 10.1111/aos.14589] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/17/2020] [Accepted: 07/18/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the disease burden of age-related macular degeneration (AMD) and to evaluate the risk factors of disability-adjusted life years (DALY) caused by AMD. METHODS Country-specific DALY number, rate and age-standardized rate of AMD were acquired from the Global Burden of Disease Study 2017 database. The Socio-demographic Index (SDI), Human Development Index (HDI), Inequality-adjusted Human Development Index (IA-HDI) and other related data were obtained from published data or shared databases. Regression analysis was conducted to evaluate the correlations between the potential risk factors and the age-standardized DALY rate of AMD. RESULTS The DALY number doubled from 1990 to 2017, and DALY rate increased from 4.73 (95% CI: 3.19-6.54) to 6.95 (95% CI: 4.76-9.54). However, change was small after standardizing. Females tended to have severer burden. Disability-adjusted life years (DALY) rates were correlated to annual PM2.5 concentration, gross domestic product (GDP) per capita, population with at least some secondary education (secondary education), glaucoma prevalence and gross national income (GNI) per capita. In SDI model, glaucoma, GDP, healthcare access and quality index (HAQ) and secondary education were associated with disease burden (p < 0.001). In IA-HDI model, cataract, glaucoma, PM2.5, GDP and secondary education were correlated to DALY rates (p < 0.001). In model included four components of HDI, glaucoma, PM2.5, GDP, secondary education, expected years of schooling and life expectancy at birth were associated (p < 0.001). CONCLUSION Being female, older age, poor socioeconomic status and less educated are associated with a heavier disease burden of AMD. These findings would provide a basic understanding for policy making on AMD prevention and treatment.
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Affiliation(s)
- Minjie Zou
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
- Zhongshan School of Medicine Sun Yat‐sen University Guangzhou China
| | - Yichi Zhang
- Department of Ophthalmology Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou China
| | - Aiming Chen
- The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
| | - Charlotte Aimee Young
- Department of Ophthalmology Third Affiliated Hospital Nanchang University Nanchang China
| | - Yi Li
- School of Pharmacy and Food Science Zhuhai College of Jilin University Zhuhai China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
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18
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Jones L, Callaghan T, Campbell P, Jones PR, Taylor DJ, Asfaw DS, Edgar DF, Crabb DP. Acceptability of a home-based visual field test (Eyecatcher) for glaucoma home monitoring: a qualitative study of patients' views and experiences. BMJ Open 2021; 11:e043130. [PMID: 33820785 PMCID: PMC8030466 DOI: 10.1136/bmjopen-2020-043130] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To explore the acceptability of home visual field (VF) testing using Eyecatcher among people with glaucoma participating in a 6-month home monitoring pilot study. DESIGN Qualitative study using face-to-face semistructured interviews. Transcripts were analysed using thematic analysis. SETTING Participants were recruited in the UK through an advertisement in the International Glaucoma Association (now Glaucoma UK) newsletter. PARTICIPANTS Twenty adults (10 women; median age: 71 years) with a diagnosis of glaucoma were recruited (including open angle and normal tension glaucoma; mean deviation=2.5 to -29.9 dB). RESULTS All participants could successfully perform VF testing at home. Interview data were coded into four overarching themes regarding experiences of undertaking VF home monitoring and attitudes towards its wider implementation in healthcare: (1) comparisons between Eyecatcher and Humphrey Field Analyser (HFA); (2) capability using Eyecatcher; (3) practicalities for effective wider scale implementation; (4) motivations for home monitoring. CONCLUSIONS Participants identified a broad range of benefits to VF home monitoring and discussed areas for service improvement. Eyecatcher was compared positively with conventional VF testing using HFA. Home monitoring may be acceptable to at least a subset of people with glaucoma.
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Affiliation(s)
- Lee Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Tamsin Callaghan
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Peter Campbell
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Pete R Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Deanna J Taylor
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Daniel S Asfaw
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - David F Edgar
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
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19
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Yip JLY, Muthy Z, Peto T, Lotery A, Foster PJ, Patel P. Socioeconomic risk factors and age-related macular degeneration in the UK Biobank study. BMJ Open Ophthalmol 2021; 6:e000585. [PMID: 33693059 PMCID: PMC7907888 DOI: 10.1136/bmjophth-2020-000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/26/2020] [Accepted: 01/24/2021] [Indexed: 12/26/2022] Open
Abstract
Objective There is contrasting evidence on the relationship between socioeconomic status (SES) and age-related macular degeneration (AMD), the most common cause of visual impairment (VI) in developed countries. This study examines the relationship between SES, cardiovascular risk factors and self-reported AMD. Methods and analysis Over 500000 people participated in the UK Biobank study from 2006 to 2019, with sociodemographic data and clinical measurements collected using standardised procedures. Visual acuity was measured in 117907 participants with VI defined as LogMAR ≤0.3. We used logistic regression to examine the cross-sectional associations between SES and self-reported AMD. Results Self-reported AMD was available for 133339 participants aged 50 and older. People reporting AMD had higher academic qualifications, lower income, were unable to work due to disability, have higher BMI, diabetes and vascular heart disease after adjusting for age and sex. In a multivariable analysis, higher income was protective of AMD and economic inactivity due to disability increased the odds of AMD (2.02, 95% CI 1.13 to 3.61). Both associations were independent of cardiovascular factors, but was no longer significant after adjusting for VI. Conclusions The association between education, employment and household income with AMD was independent of cardiovascular risk factors.
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Affiliation(s)
- Jennifer Lai Yee Yip
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaynah Muthy
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
| | - Tunde Peto
- Centre for Public Health, Blackwell's Queen's University Belfast, Belfast, UK
| | - Andrew Lotery
- Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
| | - Paul J Foster
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
| | - Praveen Patel
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
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20
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Evans BJW, Edgar DF, Jessa Z, Yammouni R, Campbell P, Soteri K, Hobby A, Khatoon A, Beg A, Harsum S, Aggarwal R, Shah R. Referrals from community optometrists to the hospital eye service in England. Ophthalmic Physiol Opt 2020; 41:365-377. [PMID: 33354812 DOI: 10.1111/opo.12772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE In the UK, most referrals to the hospital eye service (HES) originate from community optometrists (CO). This audit investigates the quality of referrals, replies, and communication between CO and the HES. METHODS Optometric referrals and replies were extracted from three practices in England. If no reply letter was found, the records were searched at each local HES unit, and additional replies or records copied. De-identified referrals, replies and records were audited by a panel against established standards to evaluate whether the referrals were necessary, accurate and directed to the appropriate professional. The referral rate (RR) and referral reply rate (RRR) were calculated. RESULTS A total of 459 de-identified referrals were extracted. The RR ranged from 3.6%-8.7%. The proportion of referred patients who were seen in the HES unit was 63%-76%. From the CO perspective, the proportion of referrals for which they received replies ranged from 26%-49%. Adjusting the number of referrals for cases when it would be reasonable to expect an HES reply, RRR becomes 38%-62%. Patients received a copy of the reply in 3%-21% of cases. Referrals were made to the appropriate service in over 95% of cases, were judged necessary in 93%-97% and were accurate in 81%-98% of cases. The referral reply addressed the reason for the referral in 93%-97% and was meaningful in 94%-99% of cases. The most common conditions referred were glaucoma, cataract, anterior segment lesions, and neurological/ocular motor anomalies. The CO/HES dyad (pairing) in the area with the lowest average household income had the highest RR. CONCLUSIONS In contrast with the Royal College of Ophthalmologists/College of Optometrists joint statement on sharing patient information, CO referrals often do not elicit a reply to the referring CO. Replies from the HES to COs are important for patient care, benefitting patients and clinicians, and minimising unnecessary HES appointments.
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Affiliation(s)
- Bruce J W Evans
- Institute of Optometry, London, UK.,Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - David F Edgar
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | | | | | - Peter Campbell
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK.,Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | | | | | - Steven Harsum
- Epsom and St Helier University Hospitals NHS Trust, Carshalton, UK
| | | | - Rakhee Shah
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
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21
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Jones L, Taylor DJ, Sii F, Masood I, Crabb DP, Shah P. Only eye study 2 (OnES 2): 'Am I going to be able to see when the patch comes off?' A qualitative study of patient experiences of undergoing high-stakes only eye surgery. BMJ Open 2020; 10:e038916. [PMID: 33168554 PMCID: PMC7654112 DOI: 10.1136/bmjopen-2020-038916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Ocular surgery is a source of significant concern for many patients, especially in high-stakes circumstances. The purpose of this study was to explore patient experiences of undergoing surgery on their only-seeing eye. DESIGN A qualitative investigation using semistructured face-to-face interviews. Transcripts were analysed using thematic analysis. SETTING Hospital eye service in the UK. PARTICIPANTS Twelve participants with a diagnosis of glaucoma with worse eye visual acuity <3/60± end-stage visual field loss. All participants had experience of undergoing surgery on their better-seeing (ie, 'only') eye. RESULTS Data were coded into three key themes relating to (1) emotional impact of surgery, (2) burden of visual loss and (3) coping with surgery. Patients reported depressive symptoms at all stages of their surgical journey; concern about poor visual outcomes was a common feature. Only eye surgery imposes an emotional burden due to the uncertainty regarding individuals' ability to continue daily activities and maintaining social roles. Burden extended to the inconvenience of frequent hospital visits and difficulties with follow-up care. Participants' ability to cope effectively with surgery appeared to be linked to extent of support from healthcare professionals. Key areas in developing trust and support were an open and transparent dialogue between surgeons and patients, continuity of care, patient inclusion in decision-making, and observable empathy. CONCLUSIONS The findings indicate a need for an enhanced model of care in only eye surgery to better target patient preferences and allay concerns inherent with these procedures.
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Affiliation(s)
- Lee Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City University of London, London, UK
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- NIHR Clinical Research Facility, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Deanna J Taylor
- Division of Optometry and Visual Sciences, School of Health Sciences, City University of London, London, UK
| | - Freda Sii
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Imran Masood
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Birmingham and Midland Eye Centre, Birmingham, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City University of London, London, UK
| | - Peter Shah
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK
- Institute of Ophthalmology, University College London, London, UK
- Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Centre for Health and Social Care Improvement, University of Wolverhampton, Wolverhampton, UK
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22
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Demographic trends of open globe injuries in a large inpatient sample. Eye (Lond) 2020; 35:2270-2276. [PMID: 33132385 DOI: 10.1038/s41433-020-01249-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 09/13/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate demographic trends of open globe injuries (OGIs) using a large dataset representative of United States population. METHODS Retrospective cross-sectional observational study using the National Inpatient Sample (NIS) database from 2002 to 2013. Only patients with a primary admitting diagnosis of OGI were included. Data included age (in years), gender, race, type of OGI, death rate and length and cost of stay. RESULTS During the 12-year period, 27,467 adults (age > 20) with acute OGIs were admitted to the US hospitals. The incidence of OGIs in the adult US population was 10.6 cases per 1,000,000 persons. The mean age was 50.4 years (SD 21.52); the average ages of men and women were 44.34 (SD 17.63) and 65.69 (SD 22.77), respectively. Men accounted for 71% of all cases, with 84% of patients under 60. A decrease in the number of OGIs was seen with advancing age in men, whereas the opposite was true for women. Men, elderly over 80 and Blacks were at the highest risk of sustaining an OGI. The most and least common types of injuries were penetrating injuries (73%) and IOFBs (11%), respectively. Over half of young adults in the 21-40 cohort and 43% of men were uninsured (p < 0.001). The average length of hospital stay increased with age and was significantly much higher in women than men (3.4 vs 2.5 days). CONCLUSIONS Racial, gender and age disparities are prevalent in patients with OGIs. Although the majority of cases were seen in Whites and young men age 21-40 years, the incidence of OGIs per 1,000,000 persons per year was the highest in Blacks and Hispanics, elderly over 80, and men. One-third of all cases were uninsured. These disparities should be the basis of future public health safety measures.
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23
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Abbott J, Shah P. Amblyopia, deprivation and health disparities research: challenges in 2020. Eye (Lond) 2020; 34:1491-1493. [PMID: 32094471 PMCID: PMC7609316 DOI: 10.1038/s41433-020-0823-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- J Abbott
- Department of Ophthalmology, Birmingham Women's & Children's Hospital, Birmingham, UK. .,Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, University Hospitals Birmingham, Birmingham, UK.
| | - P Shah
- Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, University Hospitals Birmingham, Birmingham, UK.,University of Birmingham NHS Trust, Birmingham, UK.,Centre for Health and Social Care Improvement, School of Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.,University College London, London, UK
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24
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Zhang Y, Jin G, Fan M, Lin Y, Wen X, Li Z, Zeng P, Zheng D, Lan Y. Time trends and heterogeneity in the disease burden of glaucoma, 1990-2017: a global analysis. J Glob Health 2019; 9:020436. [PMID: 31788231 PMCID: PMC6875680 DOI: 10.7189/jogh.09.020436] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background To evaluate the disease burden of glaucoma in terms of disability-adjusted life years (DALY) and assess the contribution of risk factors to DALY due to glaucoma. Methods Global, regional, and country DALY number, rate, and age-standardized rates of glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), Inequality-Adjusted HDI, Socio-Demographic Index (SDI), and other country-level data were derived from international open databases. Regression analysis was used to assess the correlations between the age-standardized DALY rate and the variables. Results The global DALY due to glaucoma increased by 81% from 1990 to 2017 and decreased by 10% over the last two decades after adjusting for age and population size. Males had higher age-standardized DALY rates (P < 0.001). The age-standardized DALY rate was higher in countries with lower income or lower SDI (P < 0.001). The country-level age-standardized DALY rates in 2017 were negatively associated with HDI, SDI, country-level age-standardized prevalence rates of cataracts, cataract surgery rates (CRS), physician rates, and Inequality-Adjusted HDI. Stepwise multiple regressions showed that HDI, CRS, and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardized DALY rate in 2017 after adjusting for other confounding factors (P < 0.001). Conclusions Higher education, higher CRS, and diminishing the inequality in resource distribution may help reduce the disease burden of glaucoma. These findings can provide information for policymakers and could serve as an impetus for efforts toward alleviating the disease burden of glaucoma.
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Affiliation(s)
- Yichi Zhang
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,These authors contributed equally to this work
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,These authors contributed equally to this work
| | - Min Fan
- Department of General Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yifan Lin
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xin Wen
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zijing Li
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peng Zeng
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Joint equal contributions
| | - Yuqing Lan
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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25
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Raznahan M, Emamian MH, Alipour F, Hashemi H, Zeraati H, Fotouhi A. Horizontal inequity in the utilization of cataract surgery in Iran: Shahroud Eye Cohort Study, 2009-2014. Med J Islam Repub Iran 2019; 33:116. [PMID: 31934575 PMCID: PMC6946921 DOI: 10.34171/mjiri.33.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Since there was no evidence about economic inequity in utilization of cataract surgery in developing countries, such as Iran, this study was designed to measure horizontal inequity in the utilization of cataract surgery and its changes in an Iranian middleaged population in 2009 and 2014. Methods: Using data from the first and second phases of Shahroud Eye Cohort Study (2009-2014), the economic inequity in the utilization of cataract surgery in an Iranian middle-aged population aged 40-64 years in 2009 and 2014 was evaluated. The horizontal inequity index (HI) was determined using the indirect standardization method based on a nonlinear (probit) model and the concentration index (C) was decomposed into the contribution of each factor. The analyses were performed using STATA software version 12/SE, and significance level was set at less than 0.05. Results: The HI in the utilization of cataract surgery increased from 0.080 (95% CI: 0.011-0.098) in 2009 to 0.166 (95% CI: 0.0821- 0.228) in 2014. Decomposition of changes in the concentration index showed that among need and non-need variables, older age and economic status (being among the wealthiest 20%) were the greatest contributors, with shares of 67.5% and 57.5%%, respectively, which led to pro-rich inequity during the study periods. Conclusion: The present study demonstrated that utilization of cataract surgery did not have an equal distribution among economic quintiles, despite considering equal needs based on cataract severity. Results demonstrated that older age and economic status were the greatest contributors to HI increase in 2009 and 2014.
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Affiliation(s)
- Maedeh Raznahan
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
- Deputy of Research, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Emamian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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26
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Recent Development on Detection Methods for the Diagnosis of Diabetic Retinopathy. Symmetry (Basel) 2019. [DOI: 10.3390/sym11060749] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Diabetic retinopathy (DR) is a complication of diabetes that exists throughout the world. DR occurs due to a high ratio of glucose in the blood, which causes alterations in the retinal microvasculature. Without preemptive symptoms of DR, it leads to complete vision loss. However, early screening through computer-assisted diagnosis (CAD) tools and proper treatment have the ability to control the prevalence of DR. Manual inspection of morphological changes in retinal anatomic parts are tedious and challenging tasks. Therefore, many CAD systems were developed in the past to assist ophthalmologists for observing inter- and intra-variations. In this paper, a recent review of state-of-the-art CAD systems for diagnosis of DR is presented. We describe all those CAD systems that have been developed by various computational intelligence and image processing techniques. The limitations and future trends of current CAD systems are also described in detail to help researchers. Moreover, potential CAD systems are also compared in terms of statistical parameters to quantitatively evaluate them. The comparison results indicate that there is still a need for accurate development of CAD systems to assist in the clinical diagnosis of diabetic retinopathy.
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27
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Denniston AK, Lee AY, Lee CS, Crabb DP, Bailey C, Lip PL, Taylor P, Pikoula M, Cook E, Akerele T, Antcliff R, Brand C, Chakravarthy U, Chavan R, Dhingra N, Downey L, Eleftheriadis H, Ghanchi F, Khan R, Kumar V, Lobo A, Lotery A, Menon G, Mukherjee R, Palmer H, Patra S, Paul B, Sim DA, Talks JS, Wilkinson E, Tufail A, Egan CA. United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services. Br J Ophthalmol 2019; 103:837-843. [PMID: 30269098 PMCID: PMC6582816 DOI: 10.1136/bjophthalmol-2018-312568] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/20/2018] [Accepted: 07/07/2018] [Indexed: 12/21/2022]
Abstract
AIM To assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service. METHODS This is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment. RESULTS 79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58). CONCLUSIONS This large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.
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Affiliation(s)
- Alastair K Denniston
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospitals NHS Foundation Trust, University College London Institute of Ophthalmology, London, UK
| | - Aaron Y Lee
- University of Washington, Seattle, Washington, USA
| | | | | | - Clare Bailey
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Peck-Lin Lip
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Paul Taylor
- Institute of Health Informatics, University College London, London, UK
| | - Maria Pikoula
- Institute of Health Informatics, University College London, London, UK
| | - Esther Cook
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | - Toks Akerele
- Hinchingbrooke Health Care NHS Trust, Hinchingbrooke, UK
| | | | | | | | - Randhir Chavan
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - Louise Downey
- Hull and East Yorkshire Hospitals NHS Foundation Trust, Hull, UK
| | | | - Faruque Ghanchi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rehna Khan
- Calderdale and Huddersfield NHS Foundation Trust, Calderdale, UK
| | - Vineeth Kumar
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Aires Lobo
- Moorfields Eye Centre at Bedford Hospital, Bedford, UK
| | - Andrew Lotery
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Geeta Menon
- Frimley Park Hospital NHS Foundation Trust, Frimley, UK
| | | | - Helen Palmer
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Bobby Paul
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Dawn A Sim
- Moorfields Eye Centre at Croydon University Hospital, London, UK
| | | | | | - Adnan Tufail
- NIHR Biomedical Research Centre at Moorfields Eye Hospitals NHS Foundation Trust, University College London Institute of Ophthalmology, London, UK
| | - Catherine A Egan
- NIHR Biomedical Research Centre at Moorfields Eye Hospitals NHS Foundation Trust, University College London Institute of Ophthalmology, London, UK
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28
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Braithwaite T, Verlander NQ, Peto T, Bartholomew D, Deomansingh F, Bridgemohan P, Saei A, Sharma S, Singh D, Ramsewak SS, Bourne RRA. National Eye Survey of Trinidad and Tobago (NESTT): prevalence, causes and risk factors for presenting vision impairment in adults over 40 years. Br J Ophthalmol 2019; 104:74-80. [PMID: 30914421 DOI: 10.1136/bjophthalmol-2018-313428] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 12/26/2022]
Abstract
AIM To estimate the prevalence, causes and risk factors for presenting distance and near vision impairment (VI) in Trinidad and Tobago. METHODS This is a national, population-based survey using multistage, cluster random sampling in 120 clusters with probability-proportionate-to-size methods. Stage 1 included standardised, community-based measurement of visual acuity. Stage 2 invited all 4263 people aged ≥40 years for comprehensive clinic-based assessment. The Moorfields Eye Hospital Reading Centre graded fundus photographs and optical coherence tomography images independently. RESULTS The response rates were 84.2% (n=3589) (stage 1) and 65.4% (n=2790) (stage 2), including 97.1% with VI. The mean age was 57.2 (SD 11.9) years, 54.5% were female, 42.6% were of African descent and 39.0% were of South Asian descent. 11.88% (95% CI 10.88 to 12.97, n=468) had distance VI (logarithm of the minimum angle of resolution [logMAR] >0.30), including blindness (logMAR >1.30) in 0.73% (95% CI 0.48 to 0.97, n=31), after adjustment for study design, non-response, age, sex and municipality. The leading causes of blindness included glaucoma (31.7%, 95% CI 18.7 to 44.8), cataract (28.8%, 95% CI 12.6 to 45.1) and diabetic retinopathy (19.1%, 95% CI 4.2 to 34.0). The leading cause of distance VI was uncorrected refractive error (47.4%, 95% CI 43.4 to 51.3). Potentially avoidable VI accounted for 86.1% (95% CI 82.88 to 88.81), an estimated 176 323 cases in the national population aged ≥40 years. 22.3% (95% CI 20.7 to 23.8, n=695) had uncorrected near VI (logMAR >0.30 at 40 cm with distance acuity <0.30). Significant independent associations with distance VI included increasing age, diagnosed diabetes and unemployment. Significant independent associations with near VI included male sex, no health insurance and unemployment. CONCLUSIONS Trinidad and Tobago's burden of avoidable VI exceeds that of other high-income countries. Population and health system priorities are identified to help close the gap.
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Affiliation(s)
- Tasanee Braithwaite
- Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK .,Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | | | - Tunde Peto
- Centre for Public Health, Blackwell's Queen's University Belfast, Belfast, UK
| | - Debra Bartholomew
- Ophthalmology, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
| | - Frank Deomansingh
- Optometry, University of the West Indies at Saint Augustine Faculty of Medical Sciences, Saint Augustine, Trinidad and Tobago
| | - Petra Bridgemohan
- Ophthalmology, Sangre Grande Hospital, Sangre Grande, Trinidad and Tobago
| | - Ayoub Saei
- Biostatistics, Public Health England London Region, London, UK
| | - Subash Sharma
- Optometry, University of the West Indies at Saint Augustine Faculty of Medical Sciences, Saint Augustine, Trinidad and Tobago
| | - Deo Singh
- Caribbean Eye Institute, Valsayn, Trinidad and Tobago
| | - Samuel S Ramsewak
- Medicine, University of the West Indies at Saint Augustine Faculty of Medical Sciences, Saint Augustine, Trinidad and Tobago
| | - Rupert R A Bourne
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK.,Ophthalmology, Addenbrooke's Hospital, Cambridge, UK
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Berenson AB, Hirth JM, Chang M, Merkley KH. Knowledge and Use of Cosmetic Contact Lenses Among Reproductive-Age Women. J Womens Health (Larchmt) 2019; 28:403-409. [PMID: 30601087 DOI: 10.1089/jwh.2018.7358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To assess use, knowledge, and complications of cosmetic contact lenses (CCLs) among women of reproductive age. METHODS A cross-sectional, anonymous self-administered survey assessing cosmetic or decorative contact lens knowledge and experiences was completed by 686 women in Texas in 2017. Main outcome measures were use, knowledge, and associated complications. RESULTS Almost 1 in 4 women (164/686) reported prior use of CCLs and most had worn the lenses >3 times. Women born in the United States, who knew someone who wore cosmetic lenses, or had visited an eye doctor in the past year were more likely to have used CCLs. Knowledge scores were low and the majority of cosmetic lens users experienced complications (61%). The most frequently reported complications were eye pain and discomfort (35%); itchy, watery eyes (34%); and red, swollen eyes (28%). Borrowing lenses was significantly associated with medical complications (88% of borrowers reported complications). Among 18 respondents who sought medical attention for a CCL-related problem, only 11% obtained care within 24 hours. Few participants had discussed CCL use with an eye doctor in the past year. CONCLUSIONS Many U.S. women have used CCLs obtained from unauthorized sources. Knowledge of safe practices is very limited and most users develop complications. Interventions are needed to educate the public about the risk of CCL use to reduce adverse outcomes.
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Affiliation(s)
- Abbey B Berenson
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,2 Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Jacqueline M Hirth
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,2 Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Mihyun Chang
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas
| | - Kevin H Merkley
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,3 Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas
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Brunes A, Heir T. Sexual assaults in individuals with visual impairment: a cross-sectional study of a Norwegian sample. BMJ Open 2018; 8:e021602. [PMID: 29886448 PMCID: PMC6009623 DOI: 10.1136/bmjopen-2018-021602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/03/2018] [Accepted: 05/01/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To examine the prevalence of sexual assaults among individuals with visual impairment (VI) compared with the general population and to investigate the association between sexual assault and outcomes of self-efficacy and life satisfaction. DESIGN Cross-sectional interview-based study conducted between February and May 2017. PARTICIPANTS A probability sample of adults with VI (≥18 years) who were members of the Norwegian Association of the Blind and Partially Sighted. A total of 736 (61%) members participated, of whom 55% were of female gender. We obtained norm data for sexual assaults from a representative survey of the general Norwegian population. OUTCOME MEASURES Sexual assaults (Life Event Checklist for DSM-5), self-efficacy (General Self-Efficacy Scale) and life satisfaction (Cantril's Ladder of Life Satisfaction). RESULTS The prevalence of sexual assaults (rape, attempted rape and forced into sexual acts) in the VI population was 17.4% (95% CI 14.0 to 21.4) among women and 2.4% (95% CI 1.2 to 4.7) among men. For women, the VI population had higher rates of sexual assaults across age strata than the general population. For men, no significant differences were found. In the population of people with VI, the risk of sexual assault was greater for those having other impairments in addition to the vision loss. Individuals with VI who experienced sexual assaults had lower levels of self-efficacy (adjusted relative risk (ARR): 0.18, 95% CI 0.05 to 0.61) and life satisfaction (ARR: 0.31, 95% CI 0.19 to 0.50) than others. CONCLUSIONS The risk of experiencing sexual assault appears to be higher in individuals with VI than in the general population. Preventive measures as well as psychosocial care for those who have been exposed are needed.
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Affiliation(s)
- Audun Brunes
- Section for Trauma, Catastrophes and Forced Migration - Adults, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration - Adults, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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