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Purohit N, Goyal A, Gupta PC, Soundappan K, Kotwal A, Prinja S. Analysis of quality of life of patients with refractive errors in India. J Healthc Qual Res 2024:S2603-6479(24)00063-0. [PMID: 39242342 DOI: 10.1016/j.jhqr.2024.08.001] [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: 06/05/2024] [Revised: 07/18/2024] [Accepted: 08/05/2024] [Indexed: 09/09/2024]
Abstract
INTRODUCTION It is important to determine the health-related quality of life (HRQoL) to devise population-based cost-effective service delivery models. The present study aimed to evaluate the HRQoL of patients with refractive errors (RE) using generic and vision-specific instruments, identify the determinants of HRQoL, and examine the validity between the quality-of-life instruments for refractive errors. METHODS Face-to-face interviews were conducted with 515 participants with RE using generic as well as vision-specific HRQoL measures. Mean EuroQol-five dimensions-five levels (EQ-5D-5L) utility value, National Eye Institute-Visual Function Questionnaire-25 (NEI-VFQ-25) composite score, and EuroQol-Visual analogue scale (EQ-VAS) score were computed, and determinants of quality of life were determined using generalized linear regression model. The validity between generic and disease-specific measures was ascertained using Pearson's coefficient. RESULTS The mean EQ-5D-5L utility score for patients with RE was estimated as 0.72 (95% CI: 0.70-0.75). The mean NEI-VFQ-25 composite score and EQ-VAS score were 71.3 (95% CI: 69.8-73), and 74.7 (95% CI: 73.4-76.1), respectively. Visual acuity, gender, and presence of co-morbidities were significantly associated with quality of life. The concurrence between the generic and vision-specific instruments was found to be low to moderate. CONCLUSION The findings of the study indicate the importance of the value of quality of life for patients with RE, which could be taken into account by health administrators, doctors and researchers to carry out economic evaluations, since these measures provide a basis for an evaluation more precisely the impact of RE and guide the determination of efficient ways to alleviate the burden of treatable visual impairment. More research is required to explore the potential integration of a vision component, the sixth dimension, into the EQ-5D-5L instrument, given the moderate agreement observed between the generic and specific assessment tools.
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Affiliation(s)
- Neha Purohit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aarti Goyal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Chawla Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kathirvel Soundappan
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Kotwal
- National Health Systems Resource Centre, New Delhi, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Abebe MG, Alemayehu AM, Munaw MB, Tilahun MM, Alemayehu HB. Prevalence and associated factors of refractive error among adults in South Ethiopia, a community-based cross-sectional study. PLoS One 2024; 19:e0298960. [PMID: 38527026 PMCID: PMC10962790 DOI: 10.1371/journal.pone.0298960] [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: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION The increasing prevalence of refractive error has become a serious health issue that needs serious attention. However, there are few studies regarding the prevalence and associated factors of refractive error at the community level in Ethiopia as well as in the study area. Therefore, providing updated data is crucial to reduce the burdens of refractive error in the community. OBJECTIVE To assess the prevalence and associated factors of refractive error among adults in Hawassa City, South Ethiopia, 2023. METHOD A community-based cross-sectional study was conducted on 951 adults using a multistage sampling technique from May 8 to June 8, 2023, in Hawassa City, South Ethiopia. A pretested, structured questionnaire combined with an ocular examination and a refraction procedure was used to collect data. The collected data from the Kobo Toolbox was exported to a statistical package for social sciences for analysis. Binary and multivariable logistic regression analyses were performed. A P-value of less than 0.05 was considered statistically significant in the multivariable analysis. RESULT A total of 894 study participants were involved in this study with a 94.1% response rate. The prevalence of refractive error was 12.3% (95% CI: 10.2, 14.5%). Regular use of electronic devices (adjusted odds ratio = 3.64, 95% CI: 2.25, 5.91), being diabetic (adjusted odds ratio = 4.02, 95% CI: 2.16, 7.48), positive family history of refractive error (adjusted odds ratio = 2.71, 95% CI 1.59, 4.61) and positive history of cataract surgery (adjusted odds ratio = 5.17, 95% CI 2.19, 12.4) were significantly associated with refractive error. CONCLUSION AND RECOMMENDATION The overall magnitude of refractive error in our study area was high. Regular use of electronic devices, being diabetic, positive family history of refractive error, and a positive history of cataract surgery were associated with refractive error.
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Affiliation(s)
- Marshet Gete Abebe
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Minychil Bantihun Munaw
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Mikias Mered Tilahun
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Henok Biruk Alemayehu
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
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Marmamula S, Bhoopalan D, Kumbham TR, Yelagondula VK, Keeffe J. Prevalence, pattern, and compliance with spectacles use among the elderly in homes for the aged in South India: The Hyderabad Ocular Morbidity in Elderly Study (HOMES). Indian J Ophthalmol 2023; 71:263-267. [PMID: 36588247 PMCID: PMC10155529 DOI: 10.4103/ijo.ijo_884_22] [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: 04/06/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 01/03/2023] Open
Abstract
Purpose This study was conducted to report on the pattern of spectacles use and compliance among the elderly (aged ≥60 years) in homes for the aged in Hyderabad region in Telangana State, India. Methods Participants were recruited from 41 homes for the aged centres for comprehensive eye health assessments. A questionnaire was used to collect information on current and past use of spectacles, type of spectacles, spectacles provider and amount paid for the spectacles. For those that reported using spectacles in the past, information was collected on the reasons for their discontinuation. Compliance with spectacles use was assessed after eight months of provision of the spectacles. Results A total of 1182/1513 participants were examined from 41 homes for the aged in Hyderabad, India. The mean age of the participants examined was 75 years (standard deviation (SD): 8.8 years; range: 60-108 years); 764 (64.6%) of them were women and 240 participants (20.3%) had no formal education. The prevalence of spectacles use was 69.9% (95% confidence interval [CI]: 67.1-72.4; n = 825). Bifocals were the most commonly used type of spectacles (86.7%) followed by single vision glasses for distance vision (7.4%). Private eye clinics were the largest service provider (85.5%) followed by local optical outlets (6.9%) and other service providers (7.7%). The prevalence of spectacles compliance was 81.5% (211/259). Conclusion Use of spectacles and compliance are high among the elderly living in residential care homes in the Hyderabad region. Spectacles use can be further improved by periodic eye assessments along the lines similar to school eye programs, which can immensely benefit this vulnerable, aged population.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, Telangana, India
- DBT/Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Dharani Bhoopalan
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Thirupathi R Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Vijay Kumar Yelagondula
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jill Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Marmamula S, Kumbham TR, Shidhaye R, Modepalli SB, Barrenkala NR, Yellapragada R, Keeffe J. Multimorbidity and multi-disability among the elderly in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES). Sci Rep 2022; 12:11779. [PMID: 35821044 PMCID: PMC9276822 DOI: 10.1038/s41598-022-15943-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022] Open
Abstract
We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60-108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8-40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2-26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
- Department of Biotechnology, Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Jill Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
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Marmamula S, Kumbham TR, Modepalli SB, Barrenkala NR, Yellapragada R, Shidhaye R. Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India. Sci Rep 2021; 11:16189. [PMID: 34376737 PMCID: PMC8355224 DOI: 10.1038/s41598-021-95576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged ≥ 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2-73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4-28.8) among those with VI only and 37.8% (95% CI: 26.6-46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, 500034, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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Marmamula S, Barrenkala NR, Khanna RC, Challa R, Bhakki M, Kumbham TR, Modepalli SB, Yellapragada R, Friedman DS. Near vision impairment among the elderly in residential care-the Hyderabad Ocular Morbidity in Elderly Study (HOMES). Eye (Lond) 2021; 35:2310-2315. [PMID: 33159176 PMCID: PMC8302663 DOI: 10.1038/s41433-020-01243-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/10/2020] [Accepted: 10/16/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVE To report on the prevalence and risk factors for near vision impairment (NVI) among the elderly in residential care in Telangana State in India. METHODS Individuals aged ≥60 years were recruited from 41 'home for the aged' centres in Hyderabad, India. All participants had complete eye examinations including presenting and best-corrected visual acuity assessment for distance and near. NVI was defined as binocular presenting near vision worse than N8 (6/15) among those who had a normal presenting distance visual acuity of 6/18 in the better eye. RESULTS Of the 826 participants, the mean age was 74.4 years (standard deviation-8.4 years), 525 (63.6%) were women, 715 (86.6%) had at least school education. The prevalence of NVI was 51.2% (95% CI: 47.7-54.7) based on presenting vision. On applying multiple logistic regression analysis, the odds of NVI were higher in 80 years and older age (OR: 2.17; 95% CI: 3.44-13.6). Those with school education (OR: 0.58: 95% CI: 0.36-0.94) and higher education (OR: 0.38; 95% CI: 0.21-0.69) had lower odds for NVI. Similarly, those with self-reported diabetes (OR: 0.69; 95% CI: 0.49-0.97), those using spectacles (OR: 0.09; 95% CI: 0.05-0.16), and those who had undergone cataract surgery (OR: 0.51; 95% CI: 0.36-0.74) had lower odds for NVI. CONCLUSIONS NVI was common among the elderly in residential care in homes for the aged in Hyderabad, India. As most of this NVI is correctable, a routine screening programme and dispensing of spectacles can be undertaken to address this vision loss.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - Rajesh Challa
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Madhuri Bhakki
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - David S Friedman
- Harvard Medical School Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Marmamula S, Barrenakala NR, Challa R, Kumbham TR, Modepalli SB, Yellapragada R, Bhakki M, Reddy JC, Friedman DS, Khanna RC. Visual outcomes after cataract surgery among the elderly residents in the 'homes for the aged' in South India: the Hyderabad Ocular Morbidity in Elderly Study. Br J Ophthalmol 2021; 105:1087-1093. [PMID: 32855164 PMCID: PMC8311112 DOI: 10.1136/bjophthalmol-2020-317167] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/08/2020] [Accepted: 07/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM To report visual outcomes and factors associated with good visual outcomes after cataract surgery among the elderly residents in 'homes for the aged' in Hyderabad, India. METHODS Individuals aged ≥60 years were recruited from 41 'homes for the aged'. All participants had a detailed eye examinations including visual acuity (VA) assessment , refraction, slit-lamp examination and fundus imaging by trained professionals. A detailed history of cataract surgery was recorded. Multivariate logistic regression was used to determine the factors associated with good visual outcomes after cataract surgery which was defined as presenting VA of 6/18 or better in the operated eye. Visual impairment (VI) is defined as presenting VA worse than 6/18 in the operated eye. RESULTS 1215 eyes of 703 individuals had cataract surgery. The mean age of these participants was 77.5 years (SD: 8.2 years; range: 60-108 years), 66.8% were women, 29.9% reported diabetes and 61% reported hypertension. 406/1215 (33.4%; 95% CI 30.8 to 36.1) eyes had VI after cataract surgery. Posterior capsular opacification (31.8%; n=129) was the leading cause of VI followed by uncorrected refractive error (24.1%; n=98). The prevalence of good outcomes was 66.6% (95% CI 63.8 to 69.2). On applying multivariable analysis, younger age, self-reported hypertension, independent mobility, surgery in a non-government (as opposed to private) hospital and undergoing paid surgery were associated with good outcomes. CONCLUSIONS One-third of the eyes of elderly individuals living in homes for the aged that had previously undergone cataract surgery had VI. Regular eye examinations with the provision of laser capsulotomy and appropriate refractive correction can substantially improve their vision.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- Department of Biotechnology / Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Massachusetts Eye and Ear, Harvard Medical School Department of Ophthalmology, Boston, United States of America
| | - Navya Rekha Barrenakala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Rajesh Challa
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Madhuri Bhakki
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jagadesh C Reddy
- Cataract and Refractive Services, L V Prasad Eye Institute, Hyderabad, India
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Medical School Department of Ophthalmology, Boston, United States of America
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Marmamula S, Barrenkala NR, Challa R, Kumbam TR, Modepalli SB, Yellapragada R, Bhakki M, Khanna RC, Friedman DS. Uncorrected refractive errors for distance among the residents in 'homes for the aged' in South India-The Hyderabad Ocular Morbidity in Elderly Study (HOMES). Ophthalmic Physiol Opt 2020; 40:343-349. [PMID: 32207179 PMCID: PMC7277039 DOI: 10.1111/opo.12684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence and risk factors of Uncorrected Refractive Errors (URE) for distance in elderly residents in 'homes for the aged' in Hyderabad, India. METHODS Individuals aged ≥60 years and residing in 'homes for the aged' in Hyderabad, India for a minimum of 1 month and providing consent for participation were recruited. All participants underwent visual acuity assessment, refraction, slit lamp biomicroscopy, intraocular pressure measurement, fundus examination, and retinal imaging. Monocular presenting visual acuity was recorded using a logMAR chart. Objective and subjective refraction were performed, and best-corrected visual acuity was recorded. URE was defined as presenting visual acuity worse than 6/12 but improving to 6/12 or better with refraction. Univariable and multivariable logistic regression analyses were used to assess the risk factors associated with URE. RESULTS In total, 1 513 elderly participants were enumerated from 41 homes of which 1 182 participants (78.1%) were examined. The mean age of participants was 75.0 years (standard deviation 8.8 years; range: 60-108 years). 35.4% of those examined were men and 20.3% had no formal education. The prevalence of URE was 13.5% (95% CI: 11.5-15.5; n = 159). On applying multiple logistic regression analysis, compared to those living in private homes, the odds of URE were significantly higher among the elderly living in the aided homes (OR: 1.65; 95% CI: 1.11-2.43) and free homes (OR: 1.67; 95% CI: 1.00-2.80). As compared to those who reported having an eye examination in the last 3 years, the odds of URE were higher among those who never had an eye examination in the last three years (OR: 1.51; 95% CI: 1.07-2.14). Similarly, those who had unilateral cataract surgery (OR: 1.80; 95% CI: 1.10-2.93) or bilateral cataract surgery (1.69; 95% CI: 1.10-2.56) had higher odds of URE compared to those elderly who were not operated for cataract. Gender, self-report of diabetes, and education were not associated with URE. CONCLUSIONS A large burden of URE was found among the residents in the 'homes for the aged' in Hyderabad, India which could be addressed with a pair of glasses. Over 40% of the residents never had an eye examination in the last three years, which indicates poor utilisation of eye care services by the elderly. Regular eye examinations and provision of spectacles are needed to address needless URE for distance among the elderly in residential care in India.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
- Wellcome Trust/Department of Biotechnology India AllianceL V Prasad Eye InstituteHyderabadIndia
- School of Optometry and Vision ScienceUniversity of New South WalesSydneyAustralia
- Department of OphthalmologyMassachusetts Eye and EarHarvard Medical SchoolBostonUSA
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Rajesh Challa
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Thirupathi Reddy Kumbam
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Madhuri Bhakki
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- Brien Holden Institute of Optometry and Vision ScienceL V Prasad Eye InstituteHyderabadIndia
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research CentreGullapalli Pratibha Rao International Centre for Advancement of Rural Eye careL V Prasad Eye InstituteHyderabadIndia
- School of Optometry and Vision ScienceUniversity of New South WalesSydneyAustralia
| | - David S Friedman
- Department of OphthalmologyMassachusetts Eye and EarHarvard Medical SchoolBostonUSA
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