The prevalence and causes of visual impairment and blindness among older adults in the city of Lodz, Poland

Tecnics Eyhance Iol as a Solution for Anisometropic Amblyopia Cataract Patient: a Case Report

Background

Amblyopia affects 1-3% of the population, leading to irreversible vision loss in children and adults. Treatment options include refractive correction, occlusion therapy, and atropine penalization. Anisometropic amblyopia, caused by a difference in refractive status between the eyes, can be treated using contact lenses, glasses, ICL implantation, or cataract surgery with intraocular lens implantation. Tecnis Eyhance IOL is a superior solution, improving vision after eye surgery with a low incidence of halo, glare, or starburst.

Objective

The aim is to present the case of a patient with anisometropic amblyopia, in whom Eyhance IOL was implanted in both eyes as a solution to refractive error and initial cataract due to intolerance for contact lenses.

Case report

A 58-year-old female patient presented to our clinic complaining of blurry vision in her left eye that had persisted for a year. The patient reported intolerance to contact lenses and a history of amblyopia in her right eye. CDVA was 0.20 with -9.00/-1.50 x 25◦ in her right and 0.80 with +4.00 sphere correction in her left eye, while her CNVA was J9 with +2.50 and J1 with +2.50. Slit-lamp examination revealed early cataracts in both eyes, with otherwise normal findings. A dilated fundus examination showed vitreous liquefaction and myopic macula in the right eye but normal results in both eyes' posterior segments. The IOP was within normal limits, and the eye's axial length was measured. Considering the patient's intolerance to contact lenses, cataract surgery with intraocular lens implantation was deemed appropriate. Given the anisometropic amblyopia, the Eyhance lens was selected to optimize the patient's visual acuity. Following the procedure, the patient's visual acuity improved significantly, with her best CDVA at 0.35 in the right eye and 0.95 in the left eye. With +1.50 sphere correction, the CNVA was also enhanced, with the patient reading at J4 and J1 for her right and left eye, respectively. These improvements may have positively impacted the patient's quality of life and ability to perform daily activities.

Conclusion

Anisometropic amblyopia in 58-year-old women was treated successfully with cataract surgery and implantation of Eyhance IOL.

Cross-sectional study investigating the prevalence and causes of vision impairment in Northwest Portugal using capture-recapture

OBJECTIVES

The aim of this study was to estimate the prevalence and causes of vision impairment (VI) in Portugal.

SETTING

Information about people with VI was obtained from primary care centres, blind association (ACAPO) and from hospitals (the PCVIP study) in the Northwest of Portugal during a period spanning years 2014-2015. Causes of VI were obtained from hospitals.

PARTICIPANTS

Administrative and medical records of people with visual acuity in the better seeing eye of 0.5 decimal (0.30logMAR) or worse and/or visual field less than 20° were investigated. Capture-recapture with log-linear models was applied to estimate the number of individuals missing from lists of cases obtained from available sources.

PRIMARY AND SECONDARY OUTCOME MEASURES

Log-linear models were used to estimate the crude prevalence and the category specific prevalence of VI.

RESULTS

Crude prevalence of VI was 1.97% (95% CI 1.56% to 2.54%), and standardised prevalence was 1% (95% CI 0.78% to 1.27%). The age-specific prevalence was 3.27% (95% CI 2.36% to 4.90%), older than 64 years, 0.64% (95% CI 0.49% to 0.88%), aged 25-64 years, and 0.07% (95% CI 0.045% to 0.13%), aged less than 25 years. The female-to-male ratio was 1.3, that is, higher prevalence among females. The five leading causes of VI were diabetic retinopathy, cataract, age-related macular degeneration, glaucoma and disorders of the globe.

CONCLUSIONS

The prevalence of VI in Portugal was within the expected range and in line with other European countries. A significant number of cases of VI might be due to preventable cases and, therefore, a reduction of the prevalence of VI in Portugal seems possible. Women and old people were more likely to have VI and, therefore, these groups require extra attention. Future studies are necessary to characterise temporal changes in prevalence of VI in Portugal.

Visual acuity of urban and rural adults in a coastal province of southern China: the Fujian Eye Study

AIM

To evaluate the vision status and sociodemographic associations of visual acuity (VA) in an urban and rural population in a coastal province of southern China.

METHODS

The Fujian Eye Study, a population-based cross-sectional study, was performed from May 2018 to October 2019. Totally 10 044 participants over 50 years old from all nine cities in Fujian Province were enrolled, and underwent a questionnaire and a series of standard physical and ocular examinations. VA was measured by E Standard Logarithmic Visual Acuity Chart (GB 11533-1989). Data was double entered with EpiData v3.1 for data collation and Stata/SE statistical software v15.1 was used to analyze the data.

RESULTS

Totally 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects), rural populations (n=3533), coastal residents (n=6434), and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39±8.87y (median 64y; range 50-98y). The mean presenting VA was 0.61±0.30 (0.23±0.27 logMAR), and the mean best corrected visual acuity (BCVA) was 0.82±0.28 (0.08±0.19 logMAR). In the multiple regression analysis, BCVA was significantly correlated with several socioeconomic and biologic factors, including age (P<0.001), education level (P<0.001), income (P=0.005), rural residency (P<0.001), inland residency (P=0.001) and refractive error (P<0.001), while sex (P=0.194) was independent with BCVA.

CONCLUSION

Accessible services and eye health policies targeting the elderly, people with high myopia and people living in rural or inland areas are needed.

Common causes of visual impairment in the elderly

Background

Aging is not a disease; rather, it is a process. As people age, visual impairment (VI) becomes more common. In 2010, the overall prevalence rate of vision impairment in all races was 25.66% in individuals aged ≥ 80 years, according to the estimate of the National Eye Institute at the National Institutes of Health. This review aimed to address the common causes of VI in the elderly.

Methods

In this narrative review, an electronic search of the PubMed/MEDLINE database was conducted using "visual impairment" and "elderly" for the period between January 2010 and April 2021, to include randomized clinical trials and observational studies concerning VI in the elderly. The selected time period was chosen to provide an updated review.

Results

The search yielded 2955 articles published over the period of more than 11 years. The relevant randomized clinical trials or observational studies were included and reviewed. Cataracts, refractive errors, open-angle glaucoma, age-related macular degeneration, and diabetic retinopathy were the most common age-related ocular disorders leading to VI if untreated in the elderly. The loss of visual acuity can adversely affect quality of life in the elderly. Difficulty with activities of daily living related to VI can lead to social isolation, depression, and anxiety. Loss of vision in the elderly is linked to an increased risk of falls, hip fracture, depression, and poor quality of life.

Conclusions

The most common causes of VI in the elderly are cataracts and refractive errors. VI in most ocular diseases is more prevalent in women than in men due to longer lifespan. The overall prevalence of the main causes of VI in the elderly is expected to increase; therefore, health policymakers should consider this when planning for the health-enhancement program of the population.

Visual impairment and its associated factors among medical and health sciences students at the University of Gondar, Northwest Ethiopia

Background

Visual impairment (VI) is a decreased ability to see things which is critical problem for health professionals and students to whom normal vision is essential for their daily activity. If it is not timely managed, visual impairment leads to physical, psychological, and socio-economic malfunctions to the victims and nation. Despite the above impacts, currently there is no study in Ethiopia on this topic. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among Medical and Health Science students at the University of Gondar.

Methods

A cross-sectional study was conducted from January to March 2020 among Medical and Health Science students. After recruiting study participants using systematic random sampling technique, we applied pre-tested self-administered questionnaire for sociodemographic variables and also visual acuity measurement was performed using Snellen chart placed at a distance of 6 meters. Visual acuity tested separately for each eye and for both eyes in a well- illuminated area. Pinhole was used for those participants with a visual acuity of < 6/9. Participants with a presenting visual acuity of < 6/12 in the better eye were diagnosed as having visual impairment. Epi data version 3.1 and stata version 14 were used for data entry and statistical analysis, respectively. Binary logistic regression was used, and the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of association between VI and independent variables.

Results

A total of 654 students were screened for visual acuity. The prevalence of visual impairment was 12.5% (95% CI: 10.21, 15.31). Age above 25 years (AOR = 1.8; 95% CI: 1.02, 3.26) and current alcohol drinking (AOR = 2.9; 95% CI: 1.7, 5.00), were statistically significant factors of visual impairment.

Conclusion

The prevalence of visual impairment among medical and health science students was high. Age of study participant and current alcohol consumption were statically significant factors. This study warrants the routine screening of Medical and Health science students for visual impairment.

Population-Based Projection of Vision-Related Disability in Australia 2020 - 2060: Prevalence, Causes, Associated Factors and Demand for Orientation and Mobility Services

PURPOSE

To project the prevalence, causes, associated factors of vision-related disability and demand for orientation and mobility (O&M) services in Australia from 2020 to 2060.

METHODS

The age-specific prevalence and main causes of vision-related disability were estimated based on primary data of 74,862 participants in 2015 Survey of Disability, Ageing and Carers. Logistic regression analyses were performed to identify associated factors for the outcome variables including vision-related disability, cataract, macular degeneration and glaucoma. Future prevalence of vision-related disability and demand for O&M services were forecasted using the population projections by the Australian Bureau of Statistics through 2060.

RESULTS

The main causes of vision-related disability are non-specific sight loss, cataracts, macular degeneration and glaucoma. Health-related associations for vision-related disability are older age, having a history of stroke, having diabetes, depression, heart disease and hearing impairment. The number of Australians with vision-related disability (283,650, 1.10%) and demand for O&M services (123,317, 0.48%) in 2020 will increase to 559,161 (1.38%) and 237,694 (0.59%) respectively in 2060.

CONCLUSIONS

The number of people with vision-related disability and in need of O&M services in Australia will grow exponentially over the coming decades. General health promotion and specific strategies of early detection and timely treatments of the major eye diseases may ameliorate the trend in vision-related disability.

Curcumin Metabolite Tetrahydrocurcumin in the Treatment of Eye Diseases

Curcumin is one of the most valuable natural products due to its pharmacological activities. However, the low bioavailability of curcumin has long been a problem for its medicinal use. Large studies have been conducted to improve the use of curcumin; among these studies, curcumin metabolites have become a relatively new research focus over the past few years. Additionally, accumulating evidence suggests that curcumin or curcuminoid metabolites have similar or better biological activity than the precursor of curcumin. Recent studies focus on the protective role of plasma tetrahydrocurcumin (THC), a main metabolite of curcumin, against tumors and chronic inflammatory diseases. Nevertheless, studies of THC in eye diseases have not yet been conducted. Since ophthalmic conditions play a crucial role in worldwide public health, the prevention and treatment of ophthalmic diseases are of great concern. Therefore, the present study investigated the antioxidative, anti-inflammatory, antiangiogenic, and neuroprotective effects of THC on four major ocular diseases: age-related cataracts, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). While this study aimed to show curcumin as a promising potential solution for eye conditions and discusses the involved mechanistic pathways, further work is required for the clinical application of curcumin.

Diet and risk of visual impairment: a review of dietary factors and risk of common causes of visual impairment

Age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma remain the leading causes of visual impairment in developed nations, resulting in a substantial treatment burden on sufferers and health care systems. Despite significant advances in diagnostic testing and therapeutics, population-based strategies to reduce the burden of these diseases remain limited. However, there is some evidence that these diseases may share overlapping risk factors, particularly in regard to dietary intake and antioxidant status, and it is thus possible that dietary modification may reduce both the prevalence and severity of these conditions. In particular, dietary intake of green leafy vegetables, hyperglycemia/glycemia index, and omega-3 fatty acid intake, as well as overall dietary patterns, may affect risk of one or more of these conditions. In this review, we analyse the evidence for dietary intake and the association with these conditions, and provide insights into possible modifications that may thus simultaneously reduce the risk of visual impairment from multiple causes, including improving dietary intake of green leafy vegetables and reducing dietary glycemic index, both of which have been associated with a decreased risk of multiple causes of visual impairment.

First nation-wide study of diabetic retinopathy in Poland in the years 2013-2017

AIMS

To assess the prevalence and time trends of diabetic retinopathy (DR) in the overall population of Poland from 2013 to 2017 and diagnose the risk factors of occurring DR among patients with diabetes mellitus (DM).

METHODS

Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify DM type 1 and type 2 patients, DR and treatment procedures including laser photocoagulation, pars plana vitrectomy (PPV), anti-VEGF and steroid intravitreal injections.

RESULTS

The overall registered prevalence of DR in the entire population of Poland was 0.81%. The mean prevalence of DR was 20.01% in the population with type 1 DM and 9.70% in the population with type 2 DM. In the study period, women represented 56.36% of all individuals registered with DR and 55.09% of all DM patients. In Poland, only 6.34% of all DM patients with DR received specific treatment with laser photocoagulation of the retina (82.32%), PPV (11.56%), anti-VEGF or steroid injections (5.15% and 0.97%, respectively). Cox regression hazard analysis showed that the risk of DR was associated with DM treatment only by GPs, female sex, coexisting systemic diseases and urban residence in both type 1 and type 2 DM.

CONCLUSIONS

A 5-year retrospective analysis reveals the mean prevalence of DR in the population with type 1 and type 2 DM in Poland was rather low.

Prevalence of impaired functional reading ability and its association with quality of life, daily activity, mobility and social participation among general older adults in Germany

Background

The prevalence of visual impairment and of impaired functional reading ability rapidly increase with age. However, functional reading ability is essential for an autonomous lifestyle. We analyzed the prevalence of impaired functional reading ability in the general elderly population and the association of impaired functional reading ability with quality of life, daily activities, mobility, and social participation.

Methods

Cross-sectional data from a population-based cohort were analyzed. Participants aged ≥65 years were tested for their functional reading ability using (1) Nieden charts (cognitive reading ability) and (2) a test in which a telephone number had to be found (reading comprehension). Prevalences of impaired functional reading ability were calculated. In multivariable regression models, the associations of cognitive reading ability (1) with quality of life, daily activities, mobility, and social participation were examined.

Results

60 of 780 participants (7.69%) were able to read the third last text of the Nieden test (good cognitive reading ability), whereas 7 participants (0.9%) were unable to read any of the texts. 716 participants (91.8%) identified the phone book entry successfully (good reading comprehension). Multivariable regression models revealed no significant associations of the cognitive reading ability (1) with quality of life, daily activities, social participation, and mobility.

Conclusion

Our results showed a high prevalence of impaired cognitive reading ability (1). Reading comprehension (2) was slightly affected. The loss of cognitive reading ability usually progresses over years; signs and symptoms might remain unrecognized when compensated by other functions.

Prevalence of visual impairment and related factors in Nangarhar Province of Afghanistan: a cross sectional study

AIM

To determine the prevalence, main causes, and related factors of visual impairment (VI) among people aged 50y and over in Jalalabad City and four surrounding districts of Nangarhar Province of Afghanistan.

METHODS

The data for the population based cross-sectional study was collected in 2015. The calculated sample size was 1353, allocated to urban-rural strata using probability proportion to size method. At the end of the study, 1281 people participated in to the study. VI was defined as presenting visual acuity (VA) of less than 6/18 and blindness as VA less than 3/60 in the better eye by using Snellen chart only. Data was analyzed using IBM SPSS 21.0 software.

RESULTS

The prevalence of VI was 22.6% (95%CI, 20%-25%) of which 13.9% (95%CI, 12%-16%) was low vision and 8.7% (95%CI, 7%-10%) was blindness. The most common causes of the VI were cataract (52.8%), followed by uncorrected refractive error (URE) (26.9%) and glaucoma (8.6%). Number one cause of the low vision was URE (42%), followed by cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR), while for blindness they are cataract (72%), other posterior segment disorders, glaucoma, URE and AMD. Illiteracy, bad economic status, hypertension and overweight were factors independently associated with both VI and low vision, whereas, age, illiteracy, bad economic status, hypertension and using of sunglasses were independently associated with blindness.

CONCLUSION

Cataract, URE, glaucoma, AMD and DR are the leading causes of VI and blindness in the study area. They are mostly avoidable. In order to decrease the burden of VI and blindness in the study area as well as the whole country, it is strongly recommended to apply the prevention policies of VI and blindness.

Global prevalence and causes of visual impairment with special reference to the general population of Saudi Arabia

Objective:

This review was undertaken to highlight the worldwide prevalence and causes of visual impairment (VI), on the basis of a wide range of recent and clearly defined data and in comparison with published articles from the Kingdom of Saudi Arabia.

Methods:

These data are mainly based on PubMed indexed journal articles. Some representative surveys from each of the six WHO regions across the globe were included in this review with special reference to Saudi Arabian studies.

Results:

Published literature show that the prevalence and causes of VI varies markedly in different parts of the world and from region to region within the same country. Cataract, uncorrected refractive errors and glaucoma were shown to be the leading causes of VI worldwide and in Saudi Arabia. Diabetic retinopathy was found to have more contribution in Saudi Arabia due the higher prevalence of diabetes mellitus in this country.

Conclusion:

Epidemiological surveys about the prevalence and causes of VI are crucial for the formulation of preventive and curative measures. Data about VI are still scarce with a need to make wider population based surveys, worldwide and in Saudi Arabia for in-depth evaluation of the problem and better strategies to reduce the burden of VI.

Incidence and Characteristics of Cataract Surgery in Poland, during 2010-2015

Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and December 2015 were evaluated. Patient data were from the national database of hospitalizations maintained by National Health Fund. Data on the population of Poland were obtained from Central Statistical Office of Poland. Results: In total, 1,218,777 cataract extractions (alone or combined with other procedures) were performed in 1,081,345 patients during 2010–2015. Overall, the incidence of cataract surgery increased from 5.22/1000 person-years in 2010 to 6.17/1000 person-years in 2015. Phacoemulsification was performed in 97.46% of cataract extractions, and 3.02% of cataract extractions were combined procedures. The rate of one-day procedures increased from 28.3% in 2010 to 43.1% in 2015. The probability of second-eye surgery 12 months after the first-eye surgery increased from 44% in 2010 to 73% in 2015 (log-rank test p < 0.0001). Conclusion: In Poland, from 2010 to 2015, the total incidence of cataract surgery, the number of people who underwent surgery, and the number of one-day cataract surgeries increased significantly.

Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland

Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤−0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35–59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40, 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.

Multiple deprivation, vision loss, and ophthalmic disease in adults: global perspectives

The association between socioeconomic position and morbidity and mortality has long been recognized. We evaluate the evidence for an association between multiple aspects of deprivation and ocular health in a global context. This is a systematic review of studies that evaluated deprivation in the adult population in the context of the major acquired causes of visual loss such as cataract, diabetic eye disease, glaucoma, age-related macular degeneration, and ocular trauma. The search strategy identified relevant studies reported between 1946 and August 2016, with randomized control trials, case-control, cohort, and cross-sectional study designs being selected for inclusion. The studies identified in this review from across the world demonstrate the extent to which the common themes such as low educational attainment and low income may be associated with increased incidence of various sight-threatening conditions and may adversely affect access to specialist assessment and delivery of treatment. Health inequality may always persist, but an increased recognition of the importance of the various impacts of deprivation may empower policy makers to target limited resources to the most vulnerable groups in order to deliver the greatest benefit.

Prevalence and causes of visual impairment among Saudi adults

Objective:

To evaluate the prevalence and causes of visual impairment (VI) among Saudi adults in Arar City, the capital of Northern Border Region of Saudi Arabia.

Methods:

This population-based cross-sectional study was conducted on 705 Saudi adults aged 18 years and older. All participants underwent ophthalmic examination including visual acuity (VA) testing, auto refraction, intraocular pressure (IOP) measurement and fundus examination.

Results:

In the present study 166 cases (23.5%) were found to have VI, while only 12 cases (1.7%) were considered as blind following the WHO definitions. Cataract was found to be the main cause of VI [51 cases (30.7%)] followed by refractive error (RE) [41 cases (24.7%)] and diabetic retinopathy (DR) [22 cases (13.2%)]. Seventy one cases of the studied subjects (10.07 %) had shown unilateral VI, while 13 cases (1.8%) had shown unilateral blindness with the other eye normal (VA ≥ 20/20).

Conclusion:

Visual impairment is highly prevalent among Saudi adults in Arar city. Cataract, refractive error and diabetic retinopathy are the main 3 leading causes. Better plans for diagnosis and treatment should be considered to decrease the magnitude of the problem.

Confocal scanning laser ophthalmoscopy versus modified conventional fundus camera for fundus autofluorescence

INTRODUCTION

Fundus autofluorescence (FAF) is a noninvasive imaging method to detect fundus endogenous fluorophores, mainly lipofuscin located in the retinal pigment epithelium (RPE). The FAF provides information about lipofuscin distribution and RPE health, and consequently an increased accumulation of lipofuscin has been correlated with ageing and development of certain retinal conditions. Areas covered: An exhaustive literature search in MEDLINE (via OVID) and PUBMED for articles related to ocular FAF in retinal diseases and different devices used for acquiring FAF imaging was conducted. Expert commentary: This review aims to show an overview about autofluorescence in the RPE and the main devices used for acquiring these FAF images. The knowledge of differences in the optical principles, acquisition images and the image post-processing between confocal scanning laser ophthalmoscopy and modified conventional fundus camera will improve the FAF images interpretation when are used as a complementary diagnosis and monitoring tool of retinal diseases.

The prevalence and causes of visual impairment and blindness among older adults in the city of Lodz, Poland: erratum

[In the article "The Prevalence and Causes of Visual Impairment and Blindness Among Older Adults in the City of Lodz, Poland", which appeared in Volume 94, Issue 5 of Medicine, the authors' affiliation line was omitted. The affiliation line should read as follows: From the Department of Ophthalmology and Visual Rehabilitation (MSN), and the Department of Geriatrics (JS), Medical University of Lodz, Lodz, Poland.].