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Diamond DF, Kresch YS, Gorroochurn P, Park L, Horowitz JD, Wang Q, Maruri SC, Henriquez DR, Harizman N, Carrion J, Liebmann JM, Cioffi GA, Hark LA. Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): Vision and refractive error results. Clin Exp Optom 2024:1-8. [PMID: 38452798 DOI: 10.1080/08164622.2024.2322523] [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: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
CLINICAL RELEVANCE Optometrists can play a key role in providing access to eye care in underserved populations by organising community-based eye health screenings that include optometric exams to detect vision impairment and uncorrected refractive error. BACKGROUND Community-based eye health screenings and optometric exams were conducted in the NYC-SIGHT Study. METHODS A sub-analysis of vision impairment and refractive error results within a 5-year prospective, cluster-randomised clinical trial. Eligible individuals (age ≥40 years) were recruited from 10 affordable housing developments in Upper Manhattan. Developments were randomised into usual care (received glasses prescription only) and intervention (free glasses) groups. Participants with 6/12 visual acuity or worse, intraocular pressure 23-29 mmHg, or an unreadable fundus image were scheduled with the study optometrist for refraction and a non-dilated exam. Visual improvement data were obtained by comparing the presenting acuity at screening compared to the best corrected acuity after refraction by the optometrist. Chi-square, two-sample t-tests, and a stepwise multivariate logistic regression model were used to determined factors associated with improvable visual impairment. RESULTS Seven hundred and eight participants completed screening, 308 received an optometric exam. Those with improvable vision impairment (n = 251), mean age: 69.8 years, 70.5% female, 53% African American, 39.8% Hispanic, >95% had health insurance. Refractive error diagnosed in 87.8% of the participants; lines of improvement: 2 lines (n = 59), 3 to 5 lines (n = 120), and ≥6 lines (n = 72). Stepwise multivariate logistic regression analysis showed that participants with visual acuity 6/12 or worse (odds ratio 16.041, 95% confidence interval 6.009 to 42.822, p = 0.000) or a normal fundus image (odds ratio 2.783, 95% confidence interval 1.001 to 7.740, p = 0.05) had significantly higher odds of improvable vision impairment. CONCLUSION This innovative, targeted community-based study included an optometrist who detected high rates of refractive error and improvable vision impairment in an underserved population living in New York City.
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Affiliation(s)
- Daniel F Diamond
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Yocheved S Kresch
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
- Michigan Contact Lens Specialists, Oak Park, MI, USA
| | - Prakash Gorroochurn
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lisa Park
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Jason D Horowitz
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Qing Wang
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Stefania C Maruri
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Desiree R Henriquez
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Noga Harizman
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Jailine Carrion
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Jeffrey M Liebmann
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - George A Cioffi
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Lisa A Hark
- Department of Ophthalmology, Columbia University, New York, NY, USA
- Edward S Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA
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Abdolalizadeh P, Mehrdad R, Saberzadeh-Ardestani B, Pouragha H, Alipour F, Esmaili M. Prevalence of uncorrected distance refractive errors and associated risk factors in employees of an academic centre. Clin Exp Optom 2023; 106:869-875. [PMID: 36372555 DOI: 10.1080/08164622.2022.2133988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Uncorrected refractive error (RE) may affect the work performance of adults in the workplace. The aim of current study was to determine the prevalence of corrected and uncorrected RE, and the determinants of uncorrected RE in adult employees of a university. METHODS This was a cross-sectional study of Tehran University Medical Sciences' staff. Besides demographic and some specific questionnaires, ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best spectacles corrected visual acuity (BCVA), and presenting visual acuity were performed for all participants. The need for spectacles was defined as UCVA worse than 6/12 in the better eye that could be corrected to better than 6/12 with spectacles based on subjective refraction. RESULTS In total, 4460 individuals with mean age of 42.32 ± 8.80 were included in the study. The VA of the better eye was 0.01 ± 0.05 logMAR for BCVA, 0.13 ± 0.26 for UCVA, and 0.05 ± 0.12 for presenting VA. Prevalence of RE was 15.7%, including uncorrected RE of 5% and spectacles coverage (corrected RE) of 10.7%. The proportion of individuals with elementary education and poor-fair status of general health were 1.62 times higher in the uncorrected group. In the univariate analysis, type of occupation (office versus non-office workers), socioeconomic status, and insurance of employees were not related to uncorrected RE (all P > 0.4). Myopia was the only factor associated with uncorrected RE in logistic regression analysis (odds ratio = 2.73, 95%CI = 1.02-7.31, P = 0.04). CONCLUSION The prevalence of uncorrected RE and spectacle coverage were 5% and 10.7%, respectively. Myopia was almost three times more likely to be associated among employees with uncorrected RE.
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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
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Esmaili
- Optometry Department, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cao H, Cao X, Cao Z, Zhang L, Han Y, Guo C. The prevalence and causes of pediatric uncorrected refractive error: Pooled data from population studies for Global Burden of Disease (GBD) sub-regions. PLoS One 2022; 17:e0268800. [PMID: 35776717 PMCID: PMC9249246 DOI: 10.1371/journal.pone.0268800] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 05/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background
There are limited systematic reviews on the prevalence of uncorrected refractive errors in children. We aimed to summarize the prevalence and causes of pediatric uncorrected refractive error (URE) from studies in the Global Burden of Disease (GBD) sub-regions.
Methods
The pooled analysis used the individual participant data (ages less than 20 years old) from population-based studies around the world by regions. URE was defined as presenting VA < 6/18 and improving to ≥ 6/18 or ≥1 line on using a pinhole in either eye, with main causes of myopia, hyperopia or astigmatism. Each study provided data on any URE, myopia, hyperopia or astigmatism by age, gender, and ethnicity. Prevalence rates were directly age and gender standardized to the 2020 world population with all age groups. Estimates were calculated by study and sub-regions after pooling. Summary estimates included studies in which URE was assessed from a pinhole-corrected refraction in the better eye.
Results
The combined pooled data contained 302,513,219 patients including 8 963 URE cases individuals from 57 studies. Prevalence varied by age and GBD sub-regions and differed by gender. The age- and region-standardized prevalence of URE was 3.41 per 1000 (CI, 1.53~7.62) in Western Pacific region (12 studies), 2.26 per 1000 (CI, 0.85~6.01) in South-East Asia region (14 studies), 5.85 per 1000 (CI, 3.75~9.13) in Americans (11 studies) and 4.40 per 1000 (CI, 3.0~6.45) in Eastern Mediterranean region (13 studies). On the basis of these data, myopia was the first-leading cause in female children with 12~17 age group, with the prevalence rate 18.2 per 1000 (CI, 11.52~23.61). Astigmatism was detected in 27.2 per 1000 male children with 6~11 age group (CI: 19.12–30.68).
Conclusions
Prevalence of URE available data within these sub-regions are widely disparate. Myopia and astigmatism in young age children continue as the leading cause of URE worldwide. Providing appropriate refractive correction to those individuals whose vision can be improved is an important public health endeavor with implications for safety and quality of life.
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Affiliation(s)
- He Cao
- Department of Ophthalmology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, People’s Republic of China
| | - Xiang Cao
- Emergency Department, The First Affiliated Hospital of Jiamusi University, Heilongjiang Province, People’s Republic of China
| | - Zhi Cao
- VPL Department, Mentor Graphics Technology (Shenzhen) CO. LTD., Guangdong Province, People’s Republic of China
| | - Lu Zhang
- Department of Ophthalmology, No. 4 Hospital of Xi’an City, Xi’an, Shanxi Province, People’s Republic of China
| | - Yue Han
- Nangang Branch, The Second Hospital of Heilong jiang Province, Harbin City, Heilongjiang Province, People’s Republic of China
| | - Changchun Guo
- Pingshan District People’s Hospital of Shenzhen, Shenzhen, Guangdong Province, People’s Republic of China
- * E-mail:
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Hashemi H, Malekifar PM, Pourmatin R, Sajadi M, Aghamirsalim M, Khabazkhoob M. Prevalence of Uncorrected Refractive Error and Its Risk Factors; Tehran Geriatric Eye Study (TGES). Ophthalmic Epidemiol 2021; 29:216-222. [PMID: 33913793 DOI: 10.1080/09286586.2021.1919311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To determine the age-sex-standardized prevalence of uncorrected refractive error and its determinantsMethods: This population-based cross-sectional study was conducted on 3310 people aged≥ 60 years in Tehran, Iran in 2019. Need for spectacles was defined as uncorrected visual acuity worse than 20/40 in better eye that could be corrected to more than 20/40 with suitable spectacles. Met need was defined as proportion of individuals with need for spectacles whose visual acuity was 20/40 or better with current spectacles. Unmet need was defined as proportion of individuals with need for spectacles who needed but did not have spectacles or their visual acuity was worse than 20/40 with current spectacles while suitable spectacles improved their visual acuity to 20/40 or better.Results: The age-sex-standardized prevalence of need for spectacles, met need, and unmet need was 16.67% (95% CI: 15.33-18.09), 7.81% (95% CI: 6.95-8.78), and 8.85% (95% CI: 7.77-10.07), respectively. Myopic subjects had the highest prevalence of need for spectacles (24.06%, 95% CI: 21.47-26.87). The odds ratio of met and unmet need in subjects≥ 80 years versus those aged 60-65 years was 0.36 (p-value: 0.009) and 2.34 (p-value: <0.001), respectively. The odds ratio of met and unmet need in subjects with a university education versus illiterate subjects was 1.72 (p-value: 0.045) and 0.42 (p-value: 0.007), respectively.Conclusion: The prevalence of uncorrected refractive error was lower in this study compared to previous studies. The met need rate was lower in subjects with older age and lower education levels.
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Affiliation(s)
- Hassan Hashemi
- Noor Eye Hospital, Noor Research Center for Ophthalmic Epidemiology, Tehran, Iran
| | - Pooneh Malekifar Malekifar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rama Pourmatin
- Noor Eye Hospital, Noor Ophthalmology Research Center, Tehran, Iran
| | - Massomeh Sajadi
- Noor Eye Hospital, Noor Ophthalmology Research Center, Tehran, Iran
| | | | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Napper GA, Truong M, Anjou MD. There are people in Australia who have poor vision or eye disease that is avoidable. What more can we do? Clin Exp Optom 2021; 95:569-71. [DOI: 10.1111/j.1444-0938.2012.00790.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Mandy Truong
- McCaughey Centre, Melbourne School of Population Health, The University of Melbourne, Parkville, Australia,
| | - Mitchell D Anjou
- Indigenous Eye Health Unit, Melbourne School of Population Health, The University of Melbourne, Parkville, Australia,
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Giloyan A, Khachadourian V, Petrosyan V, Harutyunyan T. Prevalence and determinants of uncorrected refractive error among a socially vulnerable older adult population living in Armenia. Public Health 2020; 190:30-36. [PMID: 33338900 DOI: 10.1016/j.puhe.2020.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study estimated the prevalence of uncorrected refractive error (URE) and its determinants in a socially vulnerable older population living in Armenia. STUDY DESIGN The study design used in the stidy is a cross-sectional study. METHODS A total of 485 people responded to a survey on sociodemographic characteristics, spectacle use, and ophthalmic services' use. All participants underwent a comprehensive ophthalmic examination including assessment of presenting and best-corrected visual acuity, measuring intraocular pressure and dilated eye fundus examination. Patients who had presenting visual acuity (<6/12) but improved ≥ one line with/without available spectacles after refraction in the better eye were considered to have URE. Descriptive statistics described the sample and estimated the prevalence of the URE in the population. Logistic regression models were used to evaluate its determinants. RESULTS The mean age of participants was 74.5 (7.27) years, ranging from 51 to 94 years. Women constituted the majority of participants (86%). The prevalence of URE in the better eye was 26%. In bivariate analysis, those who were older and who had less than 10 years of education had higher odds of URE than younger and more educated respondents. In multivariable analysis, only education remained associated with URE (OR = 3.71; 95% CI: 1.10-12.5). The rate of normal vision (≥6/12) improved from 58.9% to 81.5%, whereas the rate of visual impairment (<6/12) decreased from 41.1% to 18.5% after best correction in the better eye. CONCLUSION The prevalence of URE was high in this study population. The findings warrant the need for eye screening and provision of affordable spectacle correction to the target population in Armenia.
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Affiliation(s)
- A Giloyan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia.
| | - V Khachadourian
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia.
| | - V Petrosyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia.
| | - T Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan, 0019, Armenia.
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Comment on “Pterygium Is Related to Short Axial Length”. Cornea 2020; 39:e19-e20. [DOI: 10.1097/ico.0000000000002365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tetteh J, Fordjour G, Ekem-Ferguson G, Yawson AO, Boima V, Entsuah-Mensah K, Biritwum R, Essuman A, Mensah G, Yawson AE. Visual impairment and social isolation, depression and life satisfaction among older adults in Ghana: analysis of the WHO's Study on global AGEing and adult health (SAGE) Wave 2. BMJ Open Ophthalmol 2020; 5:e000492. [PMID: 32626826 PMCID: PMC7326267 DOI: 10.1136/bmjophth-2020-000492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 12/17/2022] Open
Abstract
AIM To estimate the prevalence of visual impairment (VI) and associated factors and further quantify its association with social isolation, depression and life satisfaction among older adults in Ghana. METHODS WHO Study on Global AGEing and Adult Health Ghana dataset for older adults 50 years and above was used for this study. Social isolation, depression and life satisfaction were our primary outcomes with VI being our secondary outcome. We employed negative binomial, Poisson and generalised negative binomial regression models individually modified with Coarsened Exact Matching method of analysis. All analysis was performed by adopting robust SE estimation using Stata V.15. RESULTS The prevalence of VI was 17.1% (95% CI14.3 to 20.2) and the factors associated include age groups, educational level, religion, region, where the participant was born, and difficulty in work/households activity (p<0.05). The inferential analysis shows that the significant log-likelihood score of social isolation and life satisfaction for older adults with VI was 0.25 more (95% CI 0.03 to 0.47) and 0.04 less (95% CI -0.08 to -0.01), respectively, compared with those without VI. The prevalence of depression among older adults with VI was significantly 90% higher compared with non-VI (adjusted prevalence ratio (95% CI) = 1.90 (1.17 to 3.09), p<0.001). CONCLUSION The prevalence of VI is associated with increasing age, educational level and self-rated health. VI was identified to be associated with social isolation, depression and diminishing life satisfaction. In order to achieve sustainable development goal #3, a national focus on geriatric care as part of the implementation of the National Ageing Policy will garner improvement in the quality of life of older adults with visual VI in Ghana. Eye health practitioners at all levels of the health systems should consider the psychosocial consequences of VI for the optimum care of the older adult client.
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Affiliation(s)
- John Tetteh
- Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Gladys Fordjour
- Ophthalmology Unit, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | - George Ekem-Ferguson
- Psychiatry Unit, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
- National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | | | - Vincent Boima
- Medicine and Therapeutics, School of Medicine, University of Ghana College of Health Sciences, Accra, Greater Accra, Ghana
| | - Kow Entsuah-Mensah
- National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | - Richard Biritwum
- Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Akye Essuman
- Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - George Mensah
- Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Naël V, Moreau G, Monfermé S, Cougnard-Grégoire A, Scherlen AC, Arleo A, Korobelnik JF, Delcourt C, Helmer C. Prevalence and Associated Factors of Uncorrected Refractive Error in Older Adults in a Population-Based Study in France. JAMA Ophthalmol 2019; 137:3-11. [PMID: 30326038 DOI: 10.1001/jamaophthalmol.2018.4229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Importance Uncorrected refractive error (URE) is a common cause of visual impairment, but its prevalence in groups of older adults who could be pragmatic targets for improving optical correction remains unknown. Objectives To estimate the prevalence of URE in older adults, particularly in those with age-related eye disease and those who are unable to attend an outpatient clinic, and to identify the factors associated with URE. Design, Setting, and Participants This population-based cross-sectional analysis included 707 adults 78 years or older from the Alienor Study in Bordeaux, France. Data were collected from February 12, 2011, through December 21, 2012, and analyzed from November 1, 2017, through July 7, 2018. Main Outcomes and Measures Uncorrected refractive error was defined as the presenting distance visual acuity in the better-seeing eye improved by at least 5 letters on the Early Treatment Diabetic Retinopathy Study chart (≥1 line on the logMAR chart) using the best-achieved optical correction. Multivariate logistic regressions were used to determine the factors associated with URE. Results The study population of 707 adults 78 years or older (64.8% women; mean [SD] age, 84.3 [4.4] years) had a prevalence of URE of 38.8% (95% CI, 35.2%-42.5%). Prevalence was high for participants with eye disease (range, 35.0% [95% CI, 28.4%-42.0%] to 44.1% [95% CI, 27.2%-62.1%], depending on the disease) and those without eye disease (30.1%; 95% CI, 24.0%-36.7%). Prevalence was higher in participants who were examined at home (because they could not come to the clinic) than in those examined at the clinic (49.4% [95% CI, 42.8%-55.9%] vs 33.5% [95% CI, 29.2%-37.9%]; P < .001). Having an eye examination performed at home (odds ratio [OR], 1.64; 95% CI, 1.13-2.37), living alone (OR, 0.65; 95% CI, 0.47-0.90), and having the perceptions that the ophthalmologist consultation fees are too expensive (OR, 1.94; 95% CI, 1.12-3.36) and that declining visual acuity is normal with aging (OR, 1.47; 95% CI, 1.04-2.08) were all associated with URE. Conclusions and Relevance These study results show that the prevalence of URE was high in this population and suggest that preventive strategies aimed at enhancing optical correction could be directed to all older adults and to specific groups by implementing at-home eye examinations for those who have difficulties attending an outpatient clinic and by focusing on those with eye disease who probably already have a regular ophthalmologic follow-up. More studies are needed to evaluate prevalence of URE in different populations and countries with various eye care systems.
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Affiliation(s)
- Virginie Naël
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France.,R&D Life and Vision Science, Essilor International, Paris, France.,Sorbonne University, INSERM, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Gwendoline Moreau
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France
| | - Solène Monfermé
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France
| | - Audrey Cougnard-Grégoire
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France
| | | | - Angelo Arleo
- Sorbonne University, INSERM, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Jean-François Korobelnik
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France.,Department of Ophthalmology, Bordeaux University Medical Center, Bordeaux, France
| | - Cécile Delcourt
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France
| | - Catherine Helmer
- Institut National de la Santé et de la Recherche Medicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherché 1219, University of Bordeaux, Bordeaux, France
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Keel S, McGuinness MB, Foreman J, Scheetz J, Taylor HR, Dirani M. Prevalence, associations and characteristics of severe uncorrected refractive error in the Australian National Eye Health Survey. Clin Exp Ophthalmol 2019; 48:14-23. [PMID: 31574581 DOI: 10.1111/ceo.13647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/20/2019] [Accepted: 09/21/2019] [Indexed: 11/26/2022]
Abstract
IMPORTANCE In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. BACKGROUND To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. DESIGN Population-based cross-sectional study. PARTICIPANTS A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. METHODS Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. MAIN OUTCOME MEASURE Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. CONCLUSIONS AND RELEVANCE Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.
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Affiliation(s)
- Stuart Keel
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Joshua Foreman
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Scheetz
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Hugh R Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mohamed Dirani
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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eHealth tools for the self-testing of visual acuity: a scoping review. NPJ Digit Med 2019; 2:82. [PMID: 31453377 PMCID: PMC6706420 DOI: 10.1038/s41746-019-0154-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/08/2019] [Indexed: 01/30/2023] Open
Abstract
Uncorrected refractive error is a major cause of vision impairment, and is indexed by visual acuity. Availability of vision assessment is limited in low/middle-income countries and in minority groups in high income countries. eHealth tools offer a solution; two-thirds of the globe own mobile devices. This is a scoping review of the number and quality of tools for self-testing visual acuity. Software applications intended for professional clinical use were excluded. Keyword searches were conducted on Google online, Google Play and iOS store. The first 100 hits in each search were screened against inclusion criteria. After screening, 42 tools were reviewed. Tools assessed near and distance vision. About half (n = 20) used bespoke optotypes. The majority (n = 25) presented optotypes one by one. Four included a calibration procedure. Only one tool was validated against gold standard measures. Many self-test tools have been published, but lack validation. There is a need for regulation of tools for the self-testing of visual acuity to reduce potential risk or confusion to users.
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The reduction of horizontal inequity in unmet refractive error: The Shahroud Eye Cohort Study, 2009-2014. J Curr Ophthalmol 2019; 31:188-194. [PMID: 31317098 PMCID: PMC6611932 DOI: 10.1016/j.joco.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 11/14/2022] Open
Abstract
Purpose To measure Horizontal Inequity Index (HI) of unmet refractive error and its changes between 2009 and 2014 in Iran. Methods The data used in this study was taken from population-based study, Shahroud Eye Cohort Study. The number of participants analyzed in first (2009) and second phases of study (2014) were 5190 and 4737, respectively, and individuals between 40 and 64 years were included. The HI was determined by using the Concentration Index (C) based on the nonlinear (Probit) model, and C was decomposed to identify and quantify the contribution of each factor. Results After adjusting for need variables, the results demonstrated that the HI in unmet refractive need decreased from −0.288 (95% CI: 0.370, −0.206) in the 2009 to −0.132 (95% CI: 0.290, −0.028) in 2014. Decomposition of the C showed that level of education and economic status were the greatest contributors with shares of 26.2% and 17.9%, respectively, in reducing the amount of HI in unmet refractive error between 2009 and 2014. Conclusions The current study demonstrated that unmet refractive error did not have an equal distribution among economic quintiles, despite the same need for correcting refractive errors. Reducing the amount of HI in unmet refractive error between 2009 and 2014 indicated an improvement in the unmet need in the five years period between two phases of study.
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Wang L, Zhao Y, Han X, Huang W, Huang G, He M. Five-year visual outcome among people with correctable visual impairment: the Liwan Eye Study. Clin Exp Ophthalmol 2018; 46:462-467. [PMID: 29215179 DOI: 10.1111/ceo.13127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Longitudinal data on visual outcome of correctable visual impairments (VI) are of paramount importance for decision-maker to estimate burden and demand to treat avoidable VI. BACKGROUND To assess the 5-year visual outcome among participants with correctable VI and to identify associated risk factors. DESIGN Population-based longitudinal cohort study. PARTICIPANTS Participants with correctable VI at baseline attended the 5-year follow-up visit of the Liwan Eye Study. METHODS Presenting visual acuity (PVA) with habitual refractive correction was assessed using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Then participants with PVA <6/12 in either eye underwent further non-cycloplegic subjective refraction to obtain their best-corrected visual acuity. Correctable VI was defined as having a PVA of <6/12 in the better eye which could be improved to ≥6/12 after refractive correction. MAIN OUTCOME MEASURES The 5-year visual outcome among participants with correctable VI. RESULTS Among 1405 participants at baseline examination, 188 (13.4%) had correctable VI, of whom 118 (62.8%) were re-examined at the 5-year follow-up, including 39 (33.9%) who progressed to non-correctable VI, 43 (37.4%) who had persistent correctable VI and 33 (28.7%) who were converted to normal vision. In multivariate logistic regression, compared with participants who were no longer visual impaired, significant risk factors for participants with persistent VI were older, had income <1000 RMB/month, and more myopia spherical equivalent. CONCLUSIONS AND RELEVANCE Over two of three participants with correctable VI remained to have VI after 5 years, among whom 50% are correctable by spectacles, highlighting the need to improve the refractive care accessibility to treat avoidable VI in China.
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Affiliation(s)
- Lanhua Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yanzhi Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,The Third Affiliated Hospital, Nanchang University, Nanchang, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Guofu Huang
- The Third Affiliated Hospital, Nanchang University, Nanchang, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Zhu M, Tong X, Zhao R, He X, Zhao H, Zhu J. Prevalence and associated risk factors of undercorrected refractive errors among people with diabetes in Shanghai. BMC Ophthalmol 2017; 17:220. [PMID: 29183275 PMCID: PMC5704578 DOI: 10.1186/s12886-017-0620-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 11/20/2017] [Indexed: 01/19/2023] Open
Abstract
Background To investigate the prevalence and risk factors of undercorrected refractive error (URE) among people with diabetes in the Baoshan District of Shanghai, where data for undercorrected refractive error are limited. Methods The study was a population-based survey of 649 persons (aged 60 years or older) with diabetes in Baoshan, Shanghai in 2009. One copy of the questionnaire was completed for each subject. Examinations included a standardized refraction and measurement of presenting and best-corrected visual acuity (BCVA), tonometry, slit lamp biomicroscopy, and fundus photography. Results The calculated age-standardized prevalence rate of URE was 16.63% (95% confidence interval [CI] 13.76–19.49). For visual impairment subjects (presenting vision worse than 20/40 in the better eye), the prevalence of URE was up to 61.11%, and 75.93% of subjects could achieve visual acuity improvement by at least one line using appropriate spectacles. Under multiple logistic regression analysis, older age, female gender, non-farmer, increasing degree of myopia, lens opacities status, diabetic retinopathy (DR), body mass index (BMI) index lower than normal, and poor glycaemic control were associated with higher URE levels. Wearing distance eyeglasses was a protective factor for URE. Conclusion The undercorrected refractive error in diabetic adults was high in Shanghai. Health education and regular refractive assessment are needed for diabetic adults. Persons with diabetes should be more aware that poor vision is often correctable, especially for those with risk factors.
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Affiliation(s)
- Mengjun Zhu
- Shanghai Eye Disease Prevention and Treatment Center, No. 380 Kangding Road, Jingan District, Shanghai, 200040, China
| | - Xiaowei Tong
- Shanghai Eye Disease Prevention and Treatment Center, No. 380 Kangding Road, Jingan District, Shanghai, 200040, China
| | - Rong Zhao
- Shanghai Hospital Development Center, Shanghai, 200040, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, No. 380 Kangding Road, Jingan District, Shanghai, 200040, China
| | - Huijuan Zhao
- Center of Disease Control and Prevention of Baoshan District, Shanghai, 201901, China
| | - Jianfeng Zhu
- Shanghai Eye Disease Prevention and Treatment Center, No. 380 Kangding Road, Jingan District, Shanghai, 200040, China.
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Foreman J, Xie J, Keel S, Taylor HR, Dirani M. Treatment coverage rates for refractive error in the National Eye Health survey. PLoS One 2017; 12:e0175353. [PMID: 28407009 PMCID: PMC5391052 DOI: 10.1371/journal.pone.0175353] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/08/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To present treatment coverage rates and risk factors associated with uncorrected refractive error in Australia. METHODS Thirty population clusters were randomly selected from all geographic remoteness strata in Australia to provide samples of 1738 Indigenous Australians aged 40 years and older and 3098 non-Indigenous Australians aged 50 years and older. Presenting visual acuity was measured and those with vision loss (worse than 6/12) underwent pinhole testing and hand-held auto-refraction. Participants whose corrected visual acuity improved to be 6/12 or better were assigned as having uncorrected refractive error as the main cause of vision loss. The treatment coverage rates of refractive error were calculated (proportion of participants with refractive error that had distance correction and presenting visual acuity better than 6/12), and risk factor analysis for refractive correction was performed. RESULTS The refractive error treatment coverage rate in Indigenous Australians of 82.2% (95% CI 78.6-85.3) was significantly lower than in non-Indigenous Australians (93.5%, 92.0-94.8) (Odds ratio [OR] 0.51, 0.35-0.75). In Indigenous participants, remoteness (OR 0.41, 0.19-0.89 and OR 0.55, 0.35-0.85 in Outer Regional and Very Remote areas, respectively), having never undergone an eye examination (OR 0.08, 0.02-0.43) and having consulted a health worker other than an optometrist or ophthalmologist (OR 0.30, 0.11-0.84) were risk factors for low coverage. On the other hand, speaking English was a protective factor (OR 2.72, 1.13-6.45) for treatment of refractive error. Compared to non-Indigenous Australians who had an eye examination within one year, participants who had not undergone an eye examination within the past five years (OR 0.08, 0.03-0.21) or had never been examined (OR 0.05, 0.10-0.23) had lower coverage. CONCLUSION Interventions that increase integrated optometry services in regional and remote Indigenous communities may improve the treatment coverage rate of refractive error. Increasing refractive error treatment coverage rates in both Indigenous and non-Indigenous Australians through at least five-yearly eye examinations and the provision of affordable spectacles will significantly reduce the national burden of vision loss in Australia.
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Affiliation(s)
- Joshua Foreman
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, Melbourne, Australia
| | - Jing Xie
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, Melbourne, Australia
| | - Stuart Keel
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, Melbourne, Australia
| | - Hugh R. Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Mohamed Dirani
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, Melbourne, Australia
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Sharma A, Wong AM, Colpa L, Chow AH, Jin YP. Socioeconomic status and utilization of amblyopia services at a tertiary pediatric hospital in Canada. Can J Ophthalmol 2016; 51:452-458. [DOI: 10.1016/j.jcjo.2016.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 04/16/2016] [Accepted: 05/11/2016] [Indexed: 11/27/2022]
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Zocher MT, Rozema JJ, Oertel N, Dawczynski J, Wiedemann P, Rauscher FG. Biometry and visual function of a healthy cohort in Leipzig, Germany. BMC Ophthalmol 2016; 16:79. [PMID: 27268271 PMCID: PMC4895813 DOI: 10.1186/s12886-016-0232-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/05/2016] [Indexed: 11/23/2022] Open
Abstract
Background Cross-sectional survey of ocular biometry and visual function in healthy eyes across the life span of a German population aged 20 to 69 years (n = 218). Subject number in percent per age category reflected the percentage within the respective age band of the population of Leipzig, Germany. Methods Measurements obtained: subjective and objective refraction, best-corrected visual acuity, accommodation, contrast sensitivity, topography and pachymetry with Scheimpflug camera, axial length with non-contact partial coherence interferometry, and spectral-domain optical coherence tomography of the retina. Pearson correlation coefficients with corresponding p-values were given to present interrelationships between stature, biometric and refractive parameters or their associations with age. Two-sample T-tests were used to calculate gender differences. The area under the logarithmic contrast sensitivity function (AULCSF) was calculated for the analysis of contrast sensitivity as a single figure across a range of spatial frequencies. Results The results of axial length (AL), anterior chamber depth (ACD) and anterior chamber volume (ACV) differed as a function of the age of the participants (rho (p value): AL −0.19 (0.006), ACD −0.56 (< 0.001), ACV-0.52 (< 0.001)). Longer eyes had deeper ACD (AL:ACD 0.62 (< 0.001), greater ACV (AL:ACV 0.65 (< 0.001) and steeper corneal radii (AL:R1ant; R2ant; R1post; R2post 0.40; 0.35; 0.36; 0.36 (all with (< 0.001)). Spherical equivalent was associated with age (towards hyperopia: 0.34 (< 0.001)), AL (−0.66 (< 0.001)), ACD (−0.52 (< 0.001)) and ACV (−0.46 (< 0.001)). Accommodation was found lower for older subjects (negative association with age, r = −0.82 (< 0.001)) and contrast sensitivity presented with smaller values for older ages (AULCSF −0.38, (< 0.001)), no change of retinal thickness with age. 58 % of the study cohort presented with a change of refractive correction above ±0.50 D in one or both eyes (64 % of these were habitual spectacle wearers), need for improvement was present in the young age-group and for older subjects with increasing age. Conclusion Biometrical data of healthy German eyes, stratified by age, gender and refractive status, enabled cross-comparison of all parameters, providing an important reference database for future patient-based research and specific in-depth investigations of biometric data in epidemiological research. Trial registration ClinicalTrials.gov # NCT01173614 July 28, 2010
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Affiliation(s)
- Maria Teresa Zocher
- Department of Ophthalmology, Leipzig University Hospital, Liebigstrasse 10-14, 04103, Leipzig, Germany
| | - Jos J Rozema
- Department of Ophthalmology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Department of Medicine and Health Science, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Nicole Oertel
- Department of Ophthalmology, Leipzig University Hospital, Liebigstrasse 10-14, 04103, Leipzig, Germany
| | - Jens Dawczynski
- Department of Ophthalmology, Leipzig University Hospital, Liebigstrasse 10-14, 04103, Leipzig, Germany
| | - Peter Wiedemann
- Department of Ophthalmology, Leipzig University Hospital, Liebigstrasse 10-14, 04103, Leipzig, Germany
| | - Franziska G Rauscher
- Department of Ophthalmology, Leipzig University Hospital, Liebigstrasse 10-14, 04103, Leipzig, Germany.
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Fisher DE, Shrager S, Shea SJ, Burke GL, Klein R, Wong TY, Klein BE, Cotch MF. Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort. Ophthalmic Epidemiol 2016; 22:321-32. [PMID: 26395659 DOI: 10.3109/09286586.2015.1066395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the prevalence of visual impairment and examine its association with demographic, socioeconomic, and health characteristics in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. METHODS Visual acuity data were obtained from 6134 participants, aged 46-87 years at time of examination between 2002 and 2004 (mean age 64 years, 47.6% male), from six communities in the United States. Visual impairment was defined as presenting visual acuity 20/50 or worse in the better-seeing eye. Risk factors were included in multivariable logistic regression models to determine their impact on visual impairment for men and women in each racial/ethnic group. RESULTS Among all participants, 6.6% (n = 421) had visual impairment, including 5.6% of men (n = 178) and 7.5% of women (n = 243). Prevalence of impairment ranged from 4.2% (n = 52) and 6.0% (n = 77) in white men and women, respectively, to 7.6% (n = 37) and 11.6% (n = 44) in Chinese men and women, respectively. Older age was significantly associated with visual impairment in both men and women, particularly in those with lower socioeconomic status, but the effects of increasing age were more pronounced in men. Two-thirds of participants already wore distance correction, and not unexpectedly, a lower prevalence of visual impairment was seen in this group; however, 2.4% of men and 3.5% of women with current distance correction had correctable visual impairment, most notably among seniors. CONCLUSION Even in the U.S. where prevalence of refractive correction is high, both visual impairment and uncorrected refractive error represent current public health challenges.
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Affiliation(s)
- Diana E Fisher
- a Division of Epidemiology and Clinical Applications , Intramural Research Program, National Eye Institute (NEI), National Institutes of Health (NIH) , Bethesda , MD , USA
| | - Sandi Shrager
- b Department of Biostatistics , University of Washington , Seattle , WA , USA
| | - Steven J Shea
- c Departments of Medicine and Epidemiology , Columbia University , New York , NY , USA
| | - Gregory L Burke
- d Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Ronald Klein
- e Department of Ophthalmology and Visual Sciences , University of Wisconsin--Madison , Madison , WI , USA
| | - Tien Y Wong
- f Department of Ophthalmology , Yong Loo Lin School of Medicine, National University of Singapore , Singapore , and.,g Singapore Eye Research Institute, Singapore National Eye Centre , Singapore
| | - Barbara E Klein
- e Department of Ophthalmology and Visual Sciences , University of Wisconsin--Madison , Madison , WI , USA
| | - Mary Frances Cotch
- a Division of Epidemiology and Clinical Applications , Intramural Research Program, National Eye Institute (NEI), National Institutes of Health (NIH) , Bethesda , MD , USA
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Kang MJ, Rim TH, Kim SS. Prevalence and Risk Factors for Undercorrected Refractive Errors among South Korean: KNHANES 2008-2012. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.8.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Min Jae Kang
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Tyler Hyungtaek Rim
- Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore. PLoS One 2015; 10:e0142302. [PMID: 26555141 PMCID: PMC4640712 DOI: 10.1371/journal.pone.0142302] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022] Open
Abstract
Purpose To investigate the independent relationship of individual- and area-level socio-economic status (SES) with the presence and severity of visual impairment (VI) in an Asian population. Methods Cross-sectional data from 9993 Chinese, Malay and Indian adults aged 40–80 years who participated in the Singapore Epidemiology of eye Diseases (2004–2011) in Singapore. Based on the presenting visual acuity (PVA) in the better-seeing eye, VI was categorized into normal vision (logMAR≤0.30), low vision (logMAR>0.30<1.00), and blindness (logMAR≥1.00). Any VI was defined as low vision/blindness in the PVA of better-seeing eye. Individual-level low-SES was defined as a composite of primary-level education, monthly income<2000 SGD and residing in 1 or 2-room public apartment. An area-level SES was assessed using a socio-economic disadvantage index (SEDI), created using 12 variables from the 2010 Singapore census. A high SEDI score indicates a relatively poor SES. Associations between SES measures and presence and severity of VI were examined using multi-level, mixed-effects logistic and multinomial regression models. Results The age-adjusted prevalence of any VI was 19.62% (low vision = 19%, blindness = 0.62%). Both individual- and area-level SES were positively associated with any VI and low vision after adjusting for confounders. The odds ratio (95% confidence interval) of any VI was 2.11(1.88–2.37) for low-SES and 1.07(1.02–1.13) per 1 standard deviation increase in SEDI. When stratified by unilateral/bilateral categories, while low SES showed significant associations with all categories, SEDI showed a significant association with bilateral low vision only. The association between low SES and any VI remained significant among all age, gender and ethnic sub-groups. Although a consistent positive association was observed between area-level SEDI and any VI, the associations were significant among participants aged 40–65 years and male. Conclusion In this community-based sample of Asian adults, both individual- and area-level SES were independently associated with the presence and severity of VI.
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Durr NJ, Dave SR, Lage E, Marcos S, Thorn F, Lim D. From Unseen to Seen: Tackling the Global Burden of Uncorrected Refractive Errors. Annu Rev Biomed Eng 2014; 16:131-53. [DOI: 10.1146/annurev-bioeng-071813-105216] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nicholas J. Durr
- Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139;
| | - Shivang R. Dave
- Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139;
| | - Eduardo Lage
- Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139;
| | - Susana Marcos
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas, 28006 Madrid, Spain
| | - Frank Thorn
- New England College of Optometry, Boston, Massachusetts 02115
| | - Daryl Lim
- Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139;
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Ferraz FH, Corrente JE, Opromolla P, Schellini SA. Influence of uncorrected refractive error and unmet refractive error on visual impairment in a Brazilian population. BMC Ophthalmol 2014; 14:84. [PMID: 24965318 PMCID: PMC4076252 DOI: 10.1186/1471-2415-14-84] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 06/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) definitions of blindness and visual impairment are widely based on best-corrected visual acuity excluding uncorrected refractive errors (URE) as a visual impairment cause. Recently, URE was included as a cause of visual impairment, thus emphasizing the burden of visual impairment due to refractive error (RE) worldwide is substantially higher. The purpose of the present study is to determine the reversal of visual impairment and blindness in the population correcting RE and possible associations between RE and individual characteristics. METHODS A cross-sectional study was conducted in nine counties of the western region of state of São Paulo, using systematic and random sampling of households between March 2004 and July 2005. Individuals aged more than 1 year old were included and were evaluated for demographic data, eye complaints, history, and eye exam, including no corrected visual acuity (NCVA), best corrected vision acuity (BCVA), automatic and manual refractive examination. The definition adopted for URE was applied to individuals with NCVA > 0.15 logMAR and BCVA ≤ 0.15 logMAR after refractive correction and unmet refractive error (UREN), individuals who had visual impairment or blindness (NCVA > 0.5 logMAR) and BCVA ≤ 0.5 logMAR after optical correction. RESULTS A total of 70.2% of subjects had normal NCVA. URE was detected in 13.8%. Prevalence of 4.6% of optically reversible low vision and 1.8% of blindness reversible by optical correction were found. UREN was detected in 6.5% of individuals, more frequently observed in women over the age of 50 and in higher RE carriers. Visual impairment related to eye diseases is not reversible with spectacles. Using multivariate analysis, associations between URE and UREN with regard to sex, age and RE was observed. CONCLUSION RE is an important cause of reversible blindness and low vision in the Brazilian population.
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Affiliation(s)
| | | | | | - Silvana A Schellini
- Ophthalmology Department, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Cep: 18618-970 Botucatu, SP, Brazil.
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Deák GG, Lammer J, Prager S, Mylonas G, Bolz M, Schmidt-Erfurth U. Refractive changes after pharmacologic resolution of diabetic macular edema. Ophthalmology 2014; 121:1054-8. [PMID: 24439462 DOI: 10.1016/j.ophtha.2013.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/08/2013] [Accepted: 11/12/2013] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To determine precisely the mean change in refractive power induced by treatment in patients with diabetic macular edema (DME). DESIGN Prospective, randomized study. PARTICIPANTS Fifty eyes of 50 consecutive patients with clinically significant macular edema receiving all 3 types of current state-of-the-art treatment with intravitreal antiedematous substances (ranibizumab, bevacizumab, or triamcinolone). METHODS Patients were followed up at monthly intervals and were treated following a standardized pro re nata regimen according to protocol. Best-corrected visual acuity (BCVA) was determined by certified visual acuity examiners. The refractive power of the treated eyes was determined using a push-plus technique. The change in refraction between baseline and the visit when the macula was completely dry or when the central subfield thickness (CST) measured by optical coherence tomography had reached the thinnest level was analyzed. MAIN OUTCOME MEASURES Spherical equivalent refraction (SER) and CST. RESULTS Fifty eyes of 50 patients received intravitreal therapy using ranibizumab (n = 11), bevacizumab (n = 20), or triamcinolone (n = 19). Mean BCVA was 0.33±0.23 logarithm of the minimum angle of resolution (logMAR) and mean CST was 492±130 μm. The mean SER was 0.41±2.06 diopters (D) at baseline. The BCVA at the time of optimal retinal morphologic features was 0.24±0.2 logMAR, mean CST was 300±78 μm, and mean change in SER was -0.01±0.46 D. Changes is BCVA and CST were statistically significant (P < 0.0001), but the SER change was not (P = 0.824). CONCLUSIONS Appropriate spectacle correction can be prescribed to patients with DME any time during ongoing therapy using antiedematous substances because resolution of retinal thickening is not associated with an increased risk of a myopic shift.
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Affiliation(s)
- Gábor G Deák
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Jan Lammer
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Sonja Prager
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Georgios Mylonas
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Matthias Bolz
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Chou CF, Frances Cotch M, Vitale S, Zhang X, Klein R, Friedman DS, Klein BEK, Saaddine JB. Age-related eye diseases and visual impairment among U.S. adults. Am J Prev Med 2013; 45:29-35. [PMID: 23790986 PMCID: PMC4072030 DOI: 10.1016/j.amepre.2013.02.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/07/2012] [Accepted: 02/25/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Visual impairment is a common health-related disability in the U.S. The association between clinical measurements of age-related eye diseases and visual impairment in data from a national survey has not been reported. PURPOSE To examine common eye conditions and other correlates associated with visual impairment in the U.S. METHODS Data from the 2005-2008 National Health and Nutrition Examination Survey of 5222 Americans aged ≥40 years were analyzed in 2012 for visual impairment (presenting distance visual acuity worse than 20/40 in the better-seeing eye), and visual impairment not due to refractive error (distance visual acuity worse than 20/40 after refraction). Diabetic retinopathy (DR) and age-related macular degeneration (AMD) were assessed from retinal fundus images; glaucoma was assessed from two successive frequency-doubling tests and a cup-to-disc ratio measurement. RESULTS Prevalence of visual impairment and of visual impairment not due to refractive error was 7.5% (95% CI=6.9%, 8.1%) and 2.0% (1.7%, 2.3%), respectively. The prevalence of visual impairment not due to refractive error was significantly higher among people with AMD (2.2%) compared to those without AMD (0.8%), or with DR (3.5%) compared to those without DR (1.2%). Independent predictive factors of visual impairment not due to refractive error were AMD (OR=4.52, 95% CI=2.50, 8.17); increasing age (OR=1.09 per year, 95% CI=1.06, 1.13); and less than a high school education (OR=2.99, 95% CI=1.18, 7.55). CONCLUSIONS Visual impairment is a public health problem in the U.S. Visual impairment in two thirds of adults could be eliminated with refractive correction. Screening of the older population may identify adults at increased risk of visual impairment due to eye diseases.
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Affiliation(s)
- Chiu-Fang Chou
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, National Eye Institute, NIH, Bethesda
| | - Susan Vitale
- Division of Epidemiology and Clinical Applications, National Eye Institute, NIH, Bethesda
| | - Xinzhi Zhang
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - David S Friedman
- Wilmer Eye Institute , Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Jinan B Saaddine
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Robinson B, Feng Y, Woods CA, Fonn D, Gold D, Gordon K. Prevalence of Visual Impairment and Uncorrected Refractive Error – Report from a Canadian Urban Population-based Study. Ophthalmic Epidemiol 2013; 20:123-30. [DOI: 10.3109/09286586.2013.789915] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zhu M, Tong X, Zhao R, He X, Zhao H, Liu M, Zhu J. Visual impairment and spectacle coverage rate in Baoshan district, China: population-based study. BMC Public Health 2013; 13:311. [PMID: 23566106 PMCID: PMC3626875 DOI: 10.1186/1471-2458-13-311] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 03/25/2013] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the prevalence and risk factors of visual impairment associated with refractive error and the unmet need for spectacles in a special suburban senior population in Baoshan District of Shanghai, one of several rural areas undergoing a transition from rural to urban area, where data of visual impairment are limited. Methods The study was a population based survey of 4545 Chinese aged (age: >60 years or older ) at Baoshan, Shanghai, in 2009. One copy of questionnaire was completed for each subject. Examinations included a standardized refraction and measurement of presenting and best corrected visual acuity (BCVA) as well as tonometry, slit lamp biomicroscopy, and fundus photography. Results The prevalence of mild (6/12 to 6/18), moderate (6/18 to 6/60) and severe visual impairment was 12.59%, 8.38% and 0.44%, respectively, and 5.26%, 3.06% and 0.09% with refractive correction. Visual impairment was associated with age, gender, education and career, but not insurance . The prevalence of correctable visual impairment was 5.81% (using 6/18 cutoff) and 13.18% (using 6/12 cutoff). Senior people and women were significantly at a higher risk of correctable visual impairment, while the well-educated on the contrary. The prevalence of undercorrected refractive error (improves by 2 or more lines with refraction) was 24.84%, and the proportion with undercorrected refractive error for mild, moderate , severe and no visual impairment was 61.54%, 67.98%, 60.00% and 14.10%, respectively. The spectacle coverage rate was 44.12%. Greater unmet need for spectacles was observed among elderly people, females, non-peasant, and subjects with less education and astigmatism only. Conclusions High prevalence of visual impairment, visual impairment alleviated by refractive correction, and low spectacle coverage existed among the senior population in Baoshan District of Shanghai. Education for the public of the importance of regular examination and appropriate and accessible refraction service might be helpful to solve the problem.
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Affiliation(s)
- Mengjun Zhu
- Shanghai Eye Disease Prevention and Treatment Center, No.380, Kangding Road, Jingan, Shanghai 20040, China
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Sherwin JC, Khawaja AP, Broadway D, Luben R, Hayat S, Dalzell N, Wareham NJ, Khaw KT, Foster PJ. Uncorrected refractive error in older British adults: the EPIC-Norfolk Eye Study. Br J Ophthalmol 2012; 96:991-6. [PMID: 22535330 PMCID: PMC4624257 DOI: 10.1136/bjophthalmol-2011-301430] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To investigate the prevalence of, and demographic associations with, uncorrected refractive error (URE) in an older British population. METHODS Data from 4428 participants, aged 48-89 years, who attended an eye examination in the third health check of the European Prospective Investigation into Cancer-Norfolk study and had also undergone an ophthalmic examination were assessed. URE was defined as ≥1 line improvement of visual acuity with pinhole-correction in the better eye in participants with LogMar presenting visual acuity (PVA) <0.3 (PVA <6/12). Refractive error was measured using an autorefractor without cycloplegia. Myopia was defined as spherical equivalent ≤-0.5 dioptre, and hypermetropia ≥0.5 dioptre. RESULTS Adjusted to the 2010 midyear British population, the prevalence of URE in this Norfolk population was 1.9% (95% CI 0.6% to 3.1%). Lower self-rated distance vision was correlated with higher prevalence of URE (p(trend)<0.001). In a multivariate logistic regression model adjusting for age, gender, retirement status, educational level and social class, independent significant associations with URE were increasing age (p(trend)<0.001) and having hypermetropic or myopic refractive error. Wearing distance spectacles was inversely associated with URE (OR 0.34, 95% CI 0.21 to 0.55, p<0.001). There were 3063 people (69.2%) who wore spectacles/contact lenses for distance vision. Spectacle wear differed according to type of refractive error (p<0.001), and use rose with increasing severity of refractive error (p(trend)<0.001). CONCLUSION Although refractive error is common, the prevalence of URE was found to be low in this population reflecting a low prevalence of PVA<0.3.
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Affiliation(s)
- Justin C Sherwin
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - David Broadway
- Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Robert Luben
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Shabina Hayat
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nichola Dalzell
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Paul J Foster
- Division of Genetics & Epidemiology, UCL Institute of Ophthalmology, University College London, London, UK
- National Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK
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Sundling V, Platou CGP, Jansson RW, Bertelsen G, Wøllo E, Gulbrandsen P. Retinopathy and visual impairment in diabetes, impaired glucose tolerance and normal glucose tolerance: the Nord-Trøndelag Health Study (the HUNT study). Acta Ophthalmol 2012; 90:237-43. [PMID: 20809910 DOI: 10.1111/j.1755-3768.2010.01998.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE The aim of the study was to describe the prevalence of visual impairment and retinopathy and to investigate risk factors for retinopathy in persons with diabetes, screen-detected diabetes, impaired glucose tolerance and normal glucose tolerance in a subpopulation of the HUNT study. METHODS We used a sample (n = 163) from a population-based screening survey of hyperglycaemia, undertaken in 2004-2005 in Verdal, Norway. Baseline information was accessible through the second Nord-Trøndelag Health Study (HUNT2), 1995-97. Data collection was made in 2005 and included patient history, refraction, visual acuity, cataract assessment and single-field, nonmydriatic retinal photography. Retinal photographs were graded independently by two graders blinded to patient information. Data were analysed with standard statistical methods, and p < 0.05 was considered significant. RESULTS In all, 126 (77%) persons participated, 55% were women. The mean (SD) age was 59 (± 14) years. Four (3%) had correctable visual impairment, and none were visually impaired. Retinal photographs were gradable for both eyes in 109 (87%) participants. The prevalence of retinopathy was 11% in persons with known diabetes, 4% in persons with screen-detected diabetes, 3% in persons with impaired glucose tolerance and 10% in persons with normal glucose tolerance. Retinopathy was not associated with known history of diabetes or current glycaemic status. Nonfasting plasma glucose (in 1995-97) was an independent risk factor for retinopathy (in 2005), OR (95% CI) 1.5 (1.01, 2.13), p = 0.046. CONCLUSION The prevalence of diabetic retinopathy in persons with diabetes in this study was low. Appropriate optical correction and regular eye examination can prevent unnecessary visual impairment in both persons with and without diabetes.
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Affiliation(s)
- Vibeke Sundling
- Department of Optometry and Visual Science, Buskerud University College, Kongsberg, Norway.
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Ayanniyi AA, Adepoju FG, Ayanniyi RO, Morgan RE. Challenges, attitudes and practices of the spectacle wearers in a resource-limited economy. Middle East Afr J Ophthalmol 2011; 17:83-7. [PMID: 20543943 PMCID: PMC2880380 DOI: 10.4103/0974-9233.61223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To evaluate challenges, attitudes and practices among spectacle wearers to effect positive change when necessary, and determine positive change in a resource-limited economy. Materials and Methods: A multi-hospital descriptive, cross sectional survey of spectacle wearers was conducted between May 2007 and December 2008 in Nigeria. Results: A total of 214 wearers comprising 43.5% males and 56.5% females aged 18-84 years were surveyed. The majority of subjects (92.6%) had at least secondary education. The wearers’ challenges included expensive spectacles (43.0%), falling/scratched/broken lenses (29.4%) and fear that spectacles would damage the eyes (23.8%). The wearers’ attitudes were comprised of consultations with ‘road side dispensers’ (7%) and permitting other individuals to select spectacle frames for them (26%). Care and maintaince practices included use of handkerchief, tissue paper, fingers and water to clean spectacles (49.5%) and placing spectacles inside spectacle cases (30.4%). There were no associations (P > 0.05) between gender or literacy levels and who selected the frames for the subjects, caregivers consulted for spectacles, and cleaning materials for spectacles. The placement of spectacles when not in use was significantly associated (P < 0.05) with the wearers’ gender and literacy levels but not with the length of spectacle wear. Conclusion: Attitudes and practices requiring positive change crossed gender and educational levels among spectacle wearers. The cost of spectacles should be regulated and availability of standard eye care practices would reduce challenges including lens-related defects and quackery. During consultation with a recognized eye care professional, counseling of wearers on positive attitudes/practices as well as allaying fear of spectacle wear is required.
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Schneider J, Leeder SR, Gopinath B, Wang JJ, Mitchell P. Frequency, course, and impact of correctable visual impairment (uncorrected refractive error). Surv Ophthalmol 2010; 55:539-60. [PMID: 20850856 DOI: 10.1016/j.survophthal.2010.02.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 02/15/2010] [Accepted: 02/19/2010] [Indexed: 11/24/2022]
Abstract
Uncorrected refractive error has been identified by the World Health Organization (WHO) as one of the priorities for Vision 2020 and a frequent cause of visual impairment. In the past, only the terms presenting visual impairment (PVI) and visual impairment after best refractive correction (BCVI) were used, so that PVI also included BCVI cases. In the more recent literature, visual impairment has been subdivided into two mutually exclusive entities: that which is correctable by refraction (which we now term correctable visual impairment, CVI) and that which cannot be corrected by refraction due to ocular or neurological disease (which we now term non-correctable visual impairment, NCVI, and which is identical to BCVI). PVI remains a useful concept as it includes both types of impairment. Although CVI is reported to be the major form of visual impairment worldwide, its impacts are not yet well understood. CVI has a higher prevalence among vulnerable groups such as older people, less well educated people and those living alone or in rural areas. Systematic data on barriers to refractive correction remain scant, but these may be present at the individual level, within the health service context, or at a social level. Our review indicates that research on CVI is at a relatively early stage and that more detailed research, particularly determining whether it has impacts on independent living and quality of life, is needed before CVI can be justifiably prioritized in health policy.
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Affiliation(s)
- Julie Schneider
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
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Patel I, Munoz B, Mkocha H, Schwarzwalder AW, McHiwa W, West SK. Change in function and spectacle-use 2 months after providing presbyopic spectacles in rural Tanzania. Br J Ophthalmol 2010; 94:685-9. [PMID: 20508042 PMCID: PMC3820013 DOI: 10.1136/bjo.2008.145607] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To examine near vision spectacle retention and use, and changes in self-reported and performance-based near vision, 2 months after the provision of near vision spectacles. METHODS We conducted a 2-month follow-up of a population-based cohort of persons in rural Tanzania with near vision impairment who had received spectacles. Previously, residents age >or=40 years were examined for distance and near vision acuity. Those with presbyopia and hyperopia ('functional presbyopia') were given near vision spectacles. At baseline, subjects were asked to thread a needle; they were also asked questions on the perception of their near vision, ability to be independent and general health. At 2 months, subjects were again queried. Questions on the perceived affordability of replacement spectacles were also asked. RESULTS Of the 866 people provided with spectacles, 89% were seen at 2 months. Ninety-two per cent were still using the spectacles. Users were more likely to have any education (51.8%) than non-users (28.3%) (p<0.001). Only 31% had successfully threaded a needle at baseline, increasing to 91% at follow-up (p<0.001). Spectacle-users showed a significant improvement in satisfaction with near vision and ability to be independent, but no change in perception of general health, from baseline to follow-up. Men were more likely than women to be able to afford spectacles and to know where to get them. CONCLUSIONS Our cohort maintained their spectacles and reported tangible improvements associated with their use. The value of simple reading spectacles for those with near vision impairment suggests that a greater emphasis on near vision is needed in the Vision 2020 agenda.
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Affiliation(s)
- Ilesh Patel
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Baltimore, MD 21287, USA.
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Jee J, Wang JJ, Rose KA, Lindley R, Landau P, Mitchell P. Vision and Hearing Impairment in Aged Care Clients. Ophthalmic Epidemiol 2009; 12:199-205. [PMID: 16036479 DOI: 10.1080/09286580590969707] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the frequency of sensory impairments among aged care clients. METHODS We examined 188 persons aged 65-99 years being evaluated for aged care services at a geriatric assessment center, west of Sydney, Australia. Visual acuity was measured using a LogMAR chart. Visual impairment was defined in the better eye: mild < 20/40 to > or = 20/80, moderate < 20/80 to > or = 20/200, and severe < 20/200. Hearing function was assessed by portable pure-tone air-conduction audiometry. Hearing loss was defined using average hearing thresholds in the better ear: mild > 25 to < or = 40 decibels (dB), moderate > 40 to < or = 60dB, and severe > 60dB. RESULTS Vision, hearing, or both were randomly tested in 96, 93, and 49 aged care clients, respectively. Vision impairment was found in 30.2% of clients. Distance vision could be improved with pinhole in 16.7% of 84 clients with presenting VA < 20/20. Moderate to severe hearing loss was present in 50.5%. Combined sensory impairment was detected in 22.5% of persons having both tests. The age-standardized proportions with vision impairment was 25.6%, higher than the rate (17.4%) found in the Blue Mountains Eye Study (BMES) community population, but lower than the 37.7% prevalence reported from the BMES nursing home sample. Hearing impairment was also more common in aged care clients (28.1% vs 17.5%). CONCLUSIONS This study suggests a high prevalence of sensory impairment among older persons transitioning from independent community living to institutionalized care.
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Affiliation(s)
- Jeanette Jee
- School of Applied Vision Sciences, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Varma R, Wang MY, Ying-Lai M, Donofrio J, Azen SP. The prevalence and risk indicators of uncorrected refractive error and unmet refractive need in Latinos: the Los AngelesLatino Eye Study. Invest Ophthalmol Vis Sci 2008; 49:5264-73. [PMID: 18441303 DOI: 10.1167/iovs.08-1814] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the age- and sex-specific prevalence and risk indicators of uncorrected refractive error and unmet refractive need among a population-based sample of Latino adults. METHODS Self-identified Latinos 40 years of age and older (n = 6129) from six census tracts in La Puente, California, underwent a complete ophthalmic examination, and a home-administered questionnaire provided self-reported data on potential risk indicators. Uncorrected refractive error was defined as a >or=2-line improvement with refraction in the better seeing eye. Unmet refractive need was defined as having <20/40 visual acuity in the better seeing eye and achieving >or=20/40 after refraction (definition 1) or having <20/40 visual acuity in the better seeing eye and achieving a >or=2-line improvement with refraction (definition 2). Sex- and age-specific prevalence and significant risk indicators for uncorrected refractive error and unmet refractive need were calculated. RESULTS The overall prevalence of uncorrected refractive error was 15.1% (n = 926). The overall prevalence of unmet refractive need was 8.9% (n = 213, definition 1) and 9.6% (n = 218, definition 2). The prevalence of uncorrected refractive error and either definition of unmet refractive need increased with age (P < 0.0001). No sex-related difference was present. Older age, <12 years of education, and lack of health insurance were significant independent risk indicators for uncorrected refractive error and unmet refractive need. CONCLUSIONS The data suggest that the prevalence of uncorrected refractive error and unmet refractive need is high in Latinos of primarily Mexican ancestry. Better education and access to care in older Latinos are likely to decrease the burden of uncorrected refractive error in Latinos.
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Affiliation(s)
- Rohit Varma
- Doheny Eye Institute and the Department of Ophthalmology, Los Angeles, CA 90033, USA.
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Age-specific changes in the prevalence and management of optically correctable visual impairment between 1988 and 2000: the Ponza Eye Study. Eye (Lond) 2008; 23:522-9. [PMID: 18425068 DOI: 10.1038/eye.2008.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To obtain age-specific data on changes in the prevalence and management of optically correctable visual impairments (OCVIs) in Ponza, Italy. METHODS Ophthalmologic examinations were carried out to 1000 Ponzans aged 40-87 years in 1988 and to 836 persons in 2000. Visual acuity (VA) was evaluated under uncorrected (VA(UC)), presenting (VA(PR)), and best-corrected (VA(BC)) conditions. We calculated the prevalence of total OCVIs (subjects with VA(UC)>0.5 logMAR and VA(BC)<or=0.5 logMAR in the better eye), uncorrected OCVIs (VA(PR)>0.5 logMAR), and corrected OCVIs (VA(PR)<or=0.5 logMAR) as well as the OCVI correction rate ((corrected OCVI/total OCVI) x 100). Subjects with uncorrected OCVIs were compared to those with corrected OCVIs to evaluate possible associations with some risk factors. RESULTS Among 52- to 63-year olds there were increases in the prevalence of total OCVI (from 15.7 to 22.7%, P=0.051), corrected OCVI (from 10.9 to 19.9%, P=0.005), and OCVI correction rate (from 69.2 to 87.8%, P=0.045). Among 64- to 75-year olds decreases were observed in the prevalence of total OCVI (from 28.5 to 20.0%, P=0.029) and uncorrected OCVI (from 12.6 to 4.8%, P=0.003) while the OCVI correction rate increased from 55.9 to 76.1% (P=0.033). The overall prevalence of uncorrected OCVIs dropped from 7.5 to 4.1%. In 2000, uncorrected OCVI was associated with limited education, very advanced age, retirement, and refractive error associated with eye diseases. CONCLUSIONS Refractive error management has improved in Ponza since 1988, and these changes may be, in part, due to higher education levels, increased frequency of cataract surgery, and slower progression of cataract-related disability.
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Ntim-Amponsah C. Contribution of refractive errors to visual impairment in patients at korle-bu teaching hospital. Ghana Med J 2007; 41:68-71. [PMID: 17925845 PMCID: PMC1976298 DOI: 10.4314/gmj.v41i2.55304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
SUMMARY OBJECTIVE To determine the contribution of refractive error to visual impairment in visually impaired patients attending Korle-Bu Teaching Hospital, Ghana. METHOD This study was conducted over a period of 1 year beginning October 2002 at Korle-Bu Teaching Hospital. Every 4th consecutive new case attending the eye clinic, aged 6 years and above was selected and interviewed using a structured questionnaire. A Snellen's chart was used to determine the unaided visual acuity, visual acuity with spectacles where the patient was wearing one, and visual acuity with pin hole with or without spectacles. Improvement in visual acuity by 2 or more lines on the Snellen's chart when looking through the pin hole was regarded as an indication of refractive error. RESULTS A total of 1,069 respondents, 594 female and 475 male were recruited into the study. One hundred and fifteen (115) patients (10.76%) were found to have impaired vision (Visual acuity worse than 6/18 to PL in the better eye). The vision of 51 of those with impaired vision improved when looking through the pin hole. Refractive error with Visual Acuity worse than 6/18 was present in 4.8% of all patients who attended the eye clinic. Refractive error was present in 44.3% of patients with visual impairment. CONCLUSION Visual impairment was a common presentation and uncorrected refractive error was a major cause of visual impairment.
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Affiliation(s)
- Ct Ntim-Amponsah
- Ophthalmology Unit, Department of Surgery, University of Ghana Medical, P.O. Box GP 4236, Accra, Ghana
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Lindqvist S, Vik T, Indredavik MS, Brubakk AM. Visual acuity, contrast sensitivity, peripheral vision and refraction in low birthweight teenagers. ACTA ACUST UNITED AC 2007; 85:157-64. [PMID: 17305728 DOI: 10.1111/j.1600-0420.2006.00808.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess visual acuity (VA), contrast sensitivity, visual fields, refractive errors and use of correction in adolescents with very low birthweight (VLBW; birthweight < 1500 g) and adolescents born at term but small for gestational age (SGA; birthweight < 10th percentile) in a population-based study. METHODS Ophthalmological examination including VA, Vistech contrast sensitivity and Humphrey two-zone, 120-point perimetry was performed in 51 VLBW, 59 SGA and 77 control adolescents. RESULTS The VLBW adolescents had reduced VA, reduced contrast sensitivity, and were more often anisometropic compared with control adolescents. They had started wearing glasses earlier, but were not more likely to use correction as teenagers. However, they were more often undercorrected (for refractive status) than control adolescents. Hypermetropia was more common in the SGA group than in the control group, but otherwise the SGA group did not differ from the control group. CONCLUSIONS Being born SGA may be a risk factor for hypermetropia in adolescence. Prematurely born adolescents present lower VA and contrast sensitivity and are more prone to anisometropia than adolescents born at term. It may be noteworthy that a higher proportion of VLBW than control adolescents were undercorrected, despite the well known vulnerability of visual function associated with preterm birth.
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Affiliation(s)
- Susanne Lindqvist
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
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Fotouhi A, Hashemi H, Raissi B, Mohammad K. Uncorrected refractive errors and spectacle utilisation rate in Tehran: the unmet need. Br J Ophthalmol 2006; 90:534-7. [PMID: 16488929 PMCID: PMC1857067 DOI: 10.1136/bjo.2005.088344] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2006] [Indexed: 11/03/2022]
Abstract
AIM To determine the prevalence of the met and unmet need for spectacles and their associated factors in the population of Tehran. METHODS 6497 Tehran citizens were enrolled through random cluster sampling and were invited to a clinic for an interview and ophthalmic examination. 4354 (70.3%) participated in the survey, and refraction measurement results of 4353 people aged 5 years and over are presented. The unmet need for spectacles was defined as the proportion of people who did not use spectacles despite a correctable visual acuity of worse than 20/40 in the better eye. RESULTS The need for spectacles in the studied population, standardised for age and sex, was 14.1% (95% confidence interval (CI), 12.8% to 15.4%). This need was met with appropriate spectacles in 416 people (9.3% of the total sample), while it was unmet in 230 people, representing 4.8% of the total sample population (95% CI, 4.1% to 5.4%). The spectacle coverage rate (met need/(met need + unmet need)) was 66.0%. Multivariate logistic regression showed that variables of age, education, and type of refractive error were associated with lack of spectacle correction. There was an increase in the unmet need with older age, lesser education, and myopia. CONCLUSION This survey determined the met and unmet need for spectacles in a Tehran population. It also identified high risk groups with uncorrected refractive errors to guide intervention programmes for the society. While the study showed the unmet need for spectacles and its determinants, more extensive studies towards the causes of unmet need are recommended.
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Affiliation(s)
- A Fotouhi
- Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Iran.
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Abstract
BACKGROUND A recent estimate by the World Health Organization (WHO) suggests that 161 million persons worldwide have visual impairment, including 37 million blind (best-corrected visual acuity less than 3/60 in the better eye) and 124 million with visual impairment less severe than blindness (best-corrected acuity less than 6/18 to 3/60 in the better eye). This estimate is quoted widely, but because it is based on definitions using best-corrected visual acuity, uncorrected refractive error as a cause of visual impairment is excluded. METHODS We reviewed data from population-based surveys of visual impairment worldwide published 1996 onwards that included presenting visual acuity, and estimated the proportion of visual impairment caused by uncorrected refractive error in different sub-regions of the world. We then extrapolated these data to estimate the worldwide burden of visual impairment including that caused by uncorrected refractive error. RESULTS The total number of persons with visual impairment worldwide, including that due to uncorrected refractive error, was estimated as 259 million, 61% higher than the commonly quoted WHO estimate. This includes 42 million persons with blindness defined as presenting visual acuity less than 3/60 in the better eye, and 217 million persons with less severe visual impairment level defined as presenting visual acuity less than 6/18 to 3/60 in the better eye, 14% and 75% higher, respectively, than the WHO estimates based on best-corrected visual acuity. Sensitivity analysis, taking into account the uncertainty of the proportion of visual impairment caused by refractive error, revealed that the number of persons in the world with visual impairment due to uncorrected refractive error could range from 82 to 117 million. CONCLUSION The actual burden of visual impairment worldwide, including that caused by uncorrected refractive error, is substantially higher than the commonly quoted WHO estimate that is based on best-corrected visual acuity. We suggest that the indicative estimate of 259 million persons with visual impairment worldwide, which includes 42 million blind with visual acuity less than 3/60 in the better eye, be used for further planning of the VISION 2020 initiative instead of the often quoted 161 million estimate that includes 37 million blind.
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Affiliation(s)
- Lalit Dandona
- Health Studies Area, Centre for Human Development, Administrative Staff College of India, Hyderabad, India
| | - Rakhi Dandona
- Health Studies Area, Centre for Human Development, Administrative Staff College of India, Hyderabad, India
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Black A, Wood J. Vision and falls. Clin Exp Optom 2005; 88:212-22. [PMID: 16083415 DOI: 10.1111/j.1444-0938.2005.tb06699.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2004] [Revised: 04/13/2005] [Accepted: 05/13/2005] [Indexed: 11/26/2022] Open
Abstract
Falls occur in about one third of older people living independently in the community every year. This can lead to significant physical, psychological and financial costs to the individual and the community. While the risk factors for falls in older people are multifactorial, poor vision is considered to be an important contributing factor. The aim of this review is to evaluate current research linking impaired visual function with falls and to review current intervention strategies for the prevention of falls in older individuals. The evidence from the current literature indicates that impairment of visual functions, such as visual acuity, contrast sensitivity, visual fields and depth perception, is associated with an increased risk of falls. Recent studies have also demonstrated that falls can be reduced following cataract surgery as a visual intervention. Optometrists need to be aware of these associations and through appropriate treatment, referral and/or education, they can play a major role in optimising visual function in older people, as part of a multidisciplinary approach to falls prevention.
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Affiliation(s)
- Alex Black
- School of Optometry, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
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