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PubMed2006

Prevalence of age-related maculopathy in the adult population in China: the Beijing eye study.

OBJECTIVE: To evaluate the prevalence of age-related maculopathy (ARM) in adult Chinese living in rural or urban regions of mainland China. DESIGN: Population-based prevalence study. METHODS: The study included 4439 subjects (aged 40 or more years) out of 5324 subjects invited to participate (response rate 83.4%). It was held in rural and urban regions of Greater Beijing. The participants underwent a detailed ophthalmic examination including fundus photography. All fundus photographs were graded by the Wisconsin Age-Related Maculopathy Grading System. RESULTS: Fundus photographs were available for 4376 (98.6%) subjects. Early ARM was present in 122 (1.4%) of 8655 (95% confidence interval [CI] 1.16% to 1.66%) eyes or 63 (1.4%) of 4376 (95% CI 1.09% to 1.79%) subjects, late ARM in 12 (0.14%) of 8655 (95% CI 0.06% to 0.22%) eyes or seven (0.2%) of 4376 (95% CI 0.04% to 0.28%) subjects, and exudative ARM as part of late ARM in seven (0.1%) of 8655 (95% CI 0.02% to 0.14%) eyes or six (0.1%) of 4376 (95% CI 0.03% to 0.25%) subjects. The prevalence of early ARM, late ARM, and exudative ARM, respectively, increased from 0.61%, 0.07%, and 0.07% in the 40-to-44-year age group, to 1.66%, 0.26%, and 0.26% in the 55-to-59-year group, and to 2.99%, 0.90%, and 0.60% in the group aged 75 years and older. ARM was causative for visual impairment (best-corrected visual acuity in the better eye, <20/60 and > or =20/400) or blindness (visual acuity <20/400) in one subject (0.023%). CONCLUSIONS: Visual impairment due to ARM was relatively uncommon in the adult Chinese population in rural and urban regions.

Adult↗
PubMed2006

Changes in visual acuity in a population over a 15-year period: the Beaver Dam Eye Study.

PURPOSE: To describe the change in visual acuity in a 15-year period. DESIGN: Population-based study. METHODS: setting: Beaver Dam, Wisconsin. participants: 4068 persons 43 to 86 years of age at the time of a baseline examination in 1988 to 1990, and with follow-up examinations every five years thereafter. observation procedures: Best-corrected visual acuity after refraction, assessed by a modification of the ETDRS protocol. main outcome measure: Doubling of the visual angle; incidence of visual impairment. RESULTS: Eight percent of the population developed impaired vision (20/40 or worse), 0.8% developed severe visual impairment (20/200 or worse), 7% had doubling of the visual angle, and 2% had improved vision. People 75 years of age or older at baseline were more likely to develop impaired vision (odds ratio [OR] 12.8, 95% confidence interval [CI] 9.6 to 17.1, P < .001), doubling of the visual angle (OR 7.8, 95% CI 5.6 to 10.7, P < .001), and severe visual impairment (OR 20.6, 95% CI 9.5 to 44.8, P<0.001) compared with people younger than 75 years of age. CONCLUSIONS: These data provide population-based estimates of the cumulative 15-year incidence of loss of vision over a wide spectrum of ages. In people 75 years of age or older the cumulative incidence of visual impairment accounting for the competing risk of death is 25%, of which 4% is severe, indicating a public health problem of considerable proportions as the US population in this age is expected to increase by 55% from 18 million in the year 2005 to 28 million by the year 2025.

Adult↗
PubMed2006

Costs of interventions for visual impairment.

PURPOSE: To quantify the economic costs of vision loss in Australia and assess the impact of a costed intervention package to prevent avoidable vision loss. DESIGN: Existing Australian population-based data on prevalence and causes of visual impairment were used, and costs were calculated from published data for the five main causes of visual impairment. METHODS: The cost of vision loss in Australia was determined from the weighted prevalence of visual impairment; unpublished data on the indirect costs of vision; and national databases on health care costs and other economic data. A costed intervention package was developed and its economic impact modeled. Outcome measures were total costs and savings from the interventions. RESULTS: The intervention package would cost AU$188.8 million to implement in its first year but would bring a net return of AU$163.1 million in direct costs in the first year and an overall savings to the country of AU$911.1 million, a 4.8-fold return on investment. CONCLUSIONS: Three-quarters of vision loss is avoidable, and many eye care interventions are cost effective. Even a developed economy cannot afford avoidable vision loss. Priority needs to be given to the prevention and treatment of avoidable vision loss.

Australia↗
PubMed2005

The role of blind humans' visual cortex in auditory change detection.

Several studies using brain imaging have demonstrated occipital-cortex activation in blind individuals during tactile and auditory tasks, suggesting that the visual cortex deprived of its normal input has adopted a new role in information processing. So far, however, at what stages of information processing and to which perceptual sub-processes this applies remains unclear. We determined the auditory functions of this cortical region in early-blind humans by means of functional magnetic resonance imaging. We found that these areas were not activated by the mere presence of sound, but were involved in the attentive processing of changes in the auditory environment, which is important in detecting potentially dangerous or other important events in the surroundings, for example.

Acoustic Stimulation↗
PubMedDate not supplied

The parietal distance effect appears in both the congenitally blind and matched sighted controls in an acoustic number comparison task.

Visual world experience is thought to play a significant role in the development of an abstract representation of quantity in the human brain. Nevertheless, some congenitally blind individuals demonstrate excellent numerical abilities. We show that blind adults have a phenomenologically normal semantic representation of number. Electro-encephalography data demonstrate that the numerical distance effect has similar parietal correlates both in the blind and in matched sighted controls. Our interpretation is that number comparison in the blind relies on a compensation network in the initial phase of number comparison. In a second phase, an evolutionarily hardwired parietal system is exploited. The representation of number meaning has both plastic and evolutionarily hardwired components.

Acoustic Stimulation↗
PubMed2004

Four-year incidence of visual impairment: Barbados Incidence Study of Eye Diseases.

OBJECTIVE: To describe the 4-year incidence of visual impairment and causes of blindness among black participants of the Barbados Eye Studies. DESIGN: Population-based incidence study. SETTING AND PARTICIPANTS: The Barbados Incidence Study of Eye Diseases (BISED) followed the cohort of the Barbados Eye Study (BES), a prevalence study based on a simple random sample of Barbadians 40 to 84 years of age. BISED included 3193 black participants from the original cohort (85% of those eligible). MAIN OUTCOME MEASURES: Best-corrected visual acuity (Ferris-Bailey chart) at baseline and follow-up was measured according to a modified Early Treatment of Diabetic Retinopathy Study protocol. By use of World Health Organization (WHO) criteria, low vision and blindness for an individual were defined as visual acuity (VA) <6/18 to 6/120 and <6/120, respectively, in the better eye. By commonly used US criteria, low vision and blindness were defined as VA < or = 20/40 and < or = 20/200, respectively. Vision loss was defined as a doubling of the visual angle (i.e., decrease of 15 letters or more read correctly between baseline and follow-up examinations). Progression was defined as vision loss among those with low vision at baseline. RESULTS: On the basis of WHO criteria, the overall 4-year incidence was 3.6% (95% confidence interval [CI], 3.0%-4.4%) for low vision and 0.6% (95% CI, 0.4%-1.0%) for blindness. Incidence rates were higher using US criteria: 5.3% (95 % CI, 4.5%-6.2%) and 1.5% (95% CI, 1.1%-2.0%), respectively, reaching 21.5% and 7.3% for persons aged 70 years or older at baseline. One tenth of the cohort had vision loss, and 28.6% of those with low vision progressed. About one half of incident blindness was due to age-related cataract. Nearly one fifth was caused by open-angle glaucoma (OAG) alone or combined with cataract, and approximately 10% was caused by diabetic retinopathy (DR). CONCLUSIONS: The incidence of visual impairment was high in this Afro-Caribbean population, particularly in older age groups, indicating the public health significance of visual loss for this and similar black populations. Cataract, OAG, and DR were among the leading causes of incident blindness, paralleling their high prevalence in this population.

Adult↗
PubMed2004

Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults: the Copenhagen City Eye Study.

PURPOSE: To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: The study population was composed of 9980 persons, ages 20 to 84, from the general population of Copenhagen, Denmark. METHODS: This study is based on the third Copenhagen City Heart Study (CCHS III). Participants who reported visual impairment or blindness or had difficulty reading newspaper type and used prescribed eye medications were contacted from 1999 through 2000 and asked to complete a standardized interview concerning their ophthalmologic history. Verification of objective ophthalmologic data was done with a validated questionnaire response method. MAIN OUTCOME MEASURES: Best-corrected visual acuity in the better eye and primary causes of visual impairment and blindness. Visual impairment was defined as visual acuity worse than 20/40 but better than 20/200, and blindness was defined as visual acuity of 20/200 or worse. RESULTS: The age-standardized prevalence rates of visual impairment and blindness were 0.66% and 0.20%, respectively, and rose significantly with age (P<0.001). For persons 20 to 64 years, myopia-related retinal disorders, diabetic retinopathy, optic neuropathy, and retinitis pigmentosa were the most common causes of impaired vision. For persons 65 to 84 years, cataract was the most common cause of visual impairment, whereas age-related macular degeneration was the major cause of blindness. CONCLUSIONS: Visual impairment and blindness are strongly associated with increasing age, and the causes are determined by age. Among persons aged 20 to 64 years, an intervention for the predominating eye diseases might have some effect. Among those aged 65 to 84 years, cataract surgery could reduce visual impairment by one third.

Adult↗
PubMed2004

Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan: the Shihpai Eye Study.

OBJECTIVE: Few population-based data on the prevalence and causes of visual impairment are available from East Asia. The purpose of this study was to determine the prevalence and causes of visual impairment in an elderly Chinese population in Taiwan. DESIGN: Population-based cross-sectional study. PARTICIPANTS: The Shihpai Eye Study was a survey of vision and ocular disease among an elderly Chinese population 65 years of age or older residing in Shihpai, Taiwan. A random sample of 2045 elderly residents was identified and selected from the household registration databank. Among them, 1361 (66.6%) underwent a detailed ophthalmic examination. METHODS: The ophthalmic examination included best-corrected visual acuity measurements using standardized protocols. Visual acuity was assessed with a Snellen E chart. The major cause of visual loss was identified for all participants who were visually impaired. MAIN OUTCOME MEASURES: Low vision and blindness were defined as a best-corrected visual acuity in the eye with better vision worse than 20/60 to a lower limit of 20/400 and worse than 20/400, respectively, according to World Health Organization categories of visual impairment. RESULTS: The mean age of the participants was 72.2 (range, 65-91) years old. A total of 40 participants met the World Health Organization criteria of low vision, and 8 were diagnosed as blind. The rate of blindness and low vision was estimated to be 0.59% (95% confidence interval, 0.25%, 1.16%) and 2.94% (95% confidence interval, 2.11%, 3.99%), respectively. There was a significant increase in the rate of low vision (P<0.001) from 0.83% at 65 to 69 years of age to 8.33% at age 80 years or older. There was no gender difference in the prevalence of blindness or low vision. The leading cause of visual impairment was cataract (41.7%), followed by myopic macular degeneration (12.5%) and age-related macular degeneration (10.4%). CONCLUSIONS: The rate of blindness and low vision is close to that reported for other developed countries. The high frequency of myopic macular degeneration as a major cause of visual loss, however, is not observed in European-derived populations. Specific prevention or low-vision rehabilitation programs should be developed for the elderly Chinese population.

Aged↗
PubMed2004

Sleep disturbances in young subjects with visual dysfunction.

PURPOSE: To determine whether the type of ophthalmic disease is predictive of sleep and wakefulness disturbances in young subjects with visual dysfunction. DESIGN: Prospective cohort study. PARTICIPANTS AND CONTROLS: Twenty-five subjects (ages 12-20) were recruited from the Missouri School for the Blind. Twelve controls with normal sight were recruited from a residential school. METHODS: Daily activity was monitored for 14 days using wrist actigraphy. Sleep and wakefulness measures were derived from actigraphy records by automated analysis. Visually impaired subjects were prospectively stratified by presence or absence of optic nerve disease. MAIN OUTCOME MEASURES: Daytime napping and regularity of awakening time (wake-up time instability). RESULTS: Subjects with optic nerve disease napped in the daytime significantly more than other visually impaired children or normal sighted controls: 28.1+/-4.0 minutes per day (mean +/- standard error) versus 11.9+/-2.4 minutes per day in equally visually impaired subjects with intact optic nerve function versus 6.2+/-2.2 minutes per day in subjects with normal sight (P<0.0001). These subjects also showed significantly more variable awakening times than the other groups. Logistic regression revealed that subjects with optic nerve disease are 9.1 times more likely to demonstrate daily napping of more than 20 minutes per day than equally blind subjects without optic nerve disease (95% confidence interval [CI] = 1.4-58.7, P = 0.02). Blind subjects with optic nerve disease are 21.3 times more likely than children with normal sight to nap more than 20 minutes on average per day (95% CI = 1.2-378, P = 0.04). CONCLUSIONS: Optic nerve disease is predictive of increased daytime napping in young visually impaired subjects, suggesting that the nature and presence of ophthalmic disease affect the probability of concomitant sleep timing disorders.

Adolescent↗
PubMed2004

Age-related macular degeneration causing visual impairment in people 75 years or older in Britain: an add-on study to the Medical Research Council Trial of Assessment and Management of Older People in the Community.

PURPOSE: Age-related macular degeneration (AMD) is the most commonly occurring cause of visual loss in people registered as blind or partially sighted. There are no nationally representative data on the prevalence of AMD in the British population. We aimed to estimate the prevalence of AMD causing visual impairment in people 75 years or older in Britain. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Thirteen thousand nine hundred people 75 years or older in 49 practices taking part in the Medical Research Council Trial of the Assessment and Management of Older People in the Community. METHODS: Trial nurses tested visual acuity in everyone 75 years or older in participating practices. We collected data on the cause of visual loss for everyone who was visually impaired. We obtained these data from review of the general practice medical notes and by sending a questionnaire to the hospital ophthalmologist. Visual impairment was defined as a binocular acuity of less than 6/18. MAIN OUTCOME MEASURE: Prevalence of AMD causing visual impairment. RESULTS: There were 976 visually impaired people for whom a cause of visual loss was established. Of these, 516 (53%) had AMD as a cause of visual loss. We estimate that 3.7% (95% confidence interval, 3.2%-4.2%) of the population 75 years or older and 14.4% (11.6%-17.2%) of the population 90 years or older are visually impaired due to AMD. There are an estimated 192 000 people 75 years or older visually impaired due to AMD in the United Kingdom (95% confidence interval, 144 000-239 000). CONCLUSION: Our results, from the largest and most representative study of the causes of vision loss in older people in the British population, confirm the substantial burden of AMD in people 75 years and older. As the population ages, this problem will get worse. The needs of this group for vision aids and other support in the community should be addressed; research on the causes of AMD and possible preventive measures should be given priority.

Aged↗
PubMed2004

Causes of blindness, low vision, and questionnaire-assessed poor visual function in Singaporean Chinese adults: The Tanjong Pagar Survey.

OBJECTIVE: To determine the prevalence rates and causes of low vision, blindness, and patient-assessed deficient visual function among Singaporean Chinese adults. DESIGN: Population-based cross-sectional survey. PARTICIPANTS: Singaporean Chinese adults 40 to 79 years old (n = 1152). METHODS: From an initial sampling frame of 40- to 79-year-old Chinese in the Tanjong Pagar district in Singapore, 2000 subjects were selected using a disproportionate, stratified, clustered, random-sampling method. Of 1717 eligible subjects, 1232 were examined (participation rate = 71.8%), and 80 adults who did not have visual acuity (VA) data were excluded from the analysis. MAIN OUTCOME MEASURES: Bilateral low vision was defined as best-corrected VA (BCVA) worse than 6/18 and 3/60 or better, and bilateral blindness as BCVA worse than 3/60 in the better eye or constriction of the visual field to within 10 degrees of fixation, in accordance with the World Health Organization criteria. Patient-assessed visual function was measured using a modified VF-14 questionnaire. RESULTS: The age- and gender-adjusted prevalence rates were 1.1% (95% confidence interval [CI], 0.6-1.8) for bilateral low vision and 0.5% (95% CI, 0.2-1.1) for bilateral blindness, and the mean visual function score was 98.6. The rates of bilateral low vision and blindness increased with age, whereas visual function scores decreased with age, even after adjusting for gender and education. Cataract accounted for 58.8% of bilateral low vision, 20.0% of bilateral blindness, and 52.0% of poor visual function (score<90). Glaucoma contributed to 60.0% of bilateral blindness. CONCLUSION: The age- and gender-adjusted rates of low vision and blindness were 1.1% and 0.5%, respectively. Glaucoma is a leading cause of blindness in Singaporean Chinese adults, in addition to well-recognized causes in the rest of Asia such as cataract.

Adult↗
PubMed2004

Prevalence of refractive error in Bangladeshi adults: results of the National Blindness and Low Vision Survey of Bangladesh.

PURPOSE: To determine the prevalence of refractive errors and to investigate factors associated with refractive error in adults 30 years of age and older in Bangladesh. DESIGN: Cross-sectional study. PARTICIPANTS: A nationally representative sample of 12 782 adults 30 years of age and older. METHODS: The sample of subjects was selected based on multistage, cluster random sampling with probability-proportional-to-size procedures. The examination protocol consisted of an interview that included measures of literacy, education, occupation, and refractive correction. Visual acuity testing (logarithm of the minimum angle of resolution [logMAR]), automated refraction, and optic disc examination were performed for all subjects. Subjects with <6/12 (0.3 logMAR) acuity in either eye were graded additionally for cataract and underwent a dilated fundal examination. Subjects for whom no refractive error was recorded (312 subjects; 2.7%) or who had undergone cataract surgery (123 subjects; 1.1%) were excluded from the analysis. MAIN OUTCOME MEASURES: Refractive error and socioeconomic variables (literacy, education, occupation). RESULTS: Eleven thousand six hundred twenty-four subjects were examined (90.9% response rate; mean age+/-standard deviation, 44+/-12.6 years). Five thousand four hundred eighty-nine subjects (49.1%) were men and 5700 subjects (50.9%) were women. Mean spherical equivalent was -0.19 diopters (D; +/-1.50 D). Six thousand four hundred twelve subjects (57.3%) were emmetropic, 2469 (22.1%) were myopic (<-0.5 D), and 2308 (20.6%) were hypermetropic (>+0.5 D). Two hundred six subjects (1.8%) were highly myopic (<-5 D). Myopia was more common in men (26.3%) than in women (21.0%), whereas hyperopia was more common in women (27.4%) than in men (15.8%). Overall, myopia increased with age (17.5% of those aged 30-39 years were myopic, compared with 65.5% of those age 70 years and older). A subanalysis of subjects without cataract showed increasing hyperopia with age and an association between myopia and higher education. Myopia was more common among the employed than in unemployed subjects. Astigmatism (>0.5 D), present in 3625 subjects (32.4%), was more common among women, illiterate subjects, and unschooled subjects. Against-the-rule astigmatism was more common (58.7%) than oblique astigmatism (29.3%), which was more common than with-the-rule (WTR) astigmatism (12.1%). Against-the-rule astigmatism and oblique astigmatism increased with age, unlike WTR astigmatism. Of 830 (7.5%) subjects, women were more commonly anisometropic (>1.0 D). Anisometropia increased with age. CONCLUSIONS: Refractive error data are described for a country and region that previously have lacked population-based data. Prevalence and factors associated with refractive error are presented, with a detailed comparison with other population-based surveys regionally and internationally.

Adult↗
PubMed2004

Prevalence of lens opacities in Latinos: the Los Angeles Latino Eye Study.

OBJECTIVE: To estimate the age- and gender-specific prevalence of posterior subcapsular (PSC), nuclear, cortical, and mixed lens opacities in a population-based sample of Latinos 40 years and older. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A population-based sample of Latinos underwent a complete eye examination, including assessment of presence and severity of lens opacification, using the slit lamp-based Lens Opacities Classification System II (LOCS II). All lens changes (including pseudophakia/aphakia); any nuclear, PSC, and cortical opacities; and nuclear-only, PSC-only, and cortical-only opacities were evaluated. Frequency distributions and chi-square test analyses were used to determine the age- and gender-specific prevalences for each opacity type. MAIN OUTCOME MEASURES: Prevalences of cortical, nuclear, and posterior subcapsular opacities. RESULTS: Of the 7789 eligible subjects, 6357 completed a clinical examination (82% participation rate). Of all participants with LOCS II grading, 20% had all lens changes, 7.6% had cortical-only opacities, 3.5% had nuclear-only opacities, 0.4% had PSC-only opacities, and 5.9% had mixed-type opacities. The prevalence of all types of lens opacities increased with age (P<0.0001). Of all participants with mixed opacities, 49% had monocular visual impairment and 20% had binocular impairment. Of all 6357 participants, 3.9% had undergone cataract extraction in at least one eye. CONCLUSION: Our data provide the first population-based estimates of the prevalence and severity of lens opacities in Latinos. Cortical opacities were the most common type. The high rate of visual impairment from lens opacities suggests that programs that increase access to cataract surgery for older Latinos could help to reduce the burden of visual impairment in the United States.

Adult↗
PubMed2004

The Los Angeles Latino Eye Study: design, methods, and baseline data.

OBJECTIVE: To describe the study design, operational strategies, procedures, and baseline characteristics of the Los Angeles Latino Eye Study (LALES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A detailed interview and eye examination were performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included a measurement of visual acuity, intraocular pressure, and visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurement of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. MAIN OUTCOME MEASURES: Prevalence of visual impairment, blindness, cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration constitute the study's primary outcome variables. Secondary outcomes include odds ratios for risk factors associated with eye disease, health-related quality of life, and vision-related quality of life. Response rates and baseline characteristics are presented. RESULTS: Of the 7789 individuals eligible for LALES, 6357 (82%) had a clinical examination; an additional 524 completed only an in-home interview. The majority of participants were female (58%), the average (+/- standard deviation) age was 54.9 (+/-10.8) years, and 80.0% were of Mexican origin and 0.4% self-identified as American Indian or Alaskan Native. The age distribution of LALES participants was similar to that of Latinos of Mexican origin in the rest of the United States. CONCLUSION: The LALES has recruited Latinos 40 and older for an ophthalmic epidemiologic study. The LALES cohort will provide information about the prevalence and risk factors of ocular disease in the largest and fastest growing minority in the United States.

Adult↗
PubMed2004

Prevalence and risk indicators of visual impairment and blindness in Latinos: the Los Angeles Latino Eye Study.

OBJECTIVE: To determine the age- and gender-specific prevalence and risk indicators of visual impairment and blindness in urban Latinos 40 years and older. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: Of the 6357 study participants, 6122 underwent a complete ophthalmologic examination at the clinical center, including measurement of best-corrected distance visual acuity (VA) using a standard Early Treatment Diabetic Retinopathy Study protocol. Age- and gender-specific prevalence of visual impairment and blindness were contrasted using Mantel-Haenszel procedures. Sociodemographic and clinical risk indicators of visual impairment were explored using stepwise logistic regression. MAIN OUTCOME MEASURES: Prevalence and odds ratios for risk indicators of visual impairment and blindness. RESULTS: The overall prevalence for visual impairment (best-corrected VA of <==20/40 in the better eye) was 3.0% (n = 182) (range, 0.9% [40-49 years]-27.8% [>/=80 years]). The overall prevalence for blindness (best-corrected VA of <==20/200 in the better eye) was 0.4% (n = 26) (range, 0.2% [40-49 years]-4.2% [>/=80 years]). Visual impairment increased with age (P<0.0001) and was greater in women (P = 0.02). Independent risk indicators (odds ratio [95% confidence interval]) for visual impairment were age 70-79 years (2.8 [1.3-5.8]) or >/=80 years (8.7 [3.9-19.6]), history of ocular disease (3.2 [2.1-4.8]), being unemployed (3.3 [1.7-6.3]), diabetes (2.2 [1.5-3.2]), and being separated/divorced (1.8 [1.0-3.1]) or widowed (2.8 [1.8-4.4]). Participants with >/=12 years of education (0.5 [0.3-0.8]) were less likely to be visually impaired. CONCLUSIONS: Rates of visual impairment and blindness in Latinos are high, especially in older individuals. Better education and employment are likely to decrease the burden of visual impairment in Latinos.

Adult↗
PubMed2004

The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study.

OBJECTIVE: To assess the association between presenting binocular visual acuity (VA) and self-reported visual function as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). DESIGN: A population-based, prevalence study of eye disease in Latinos 40 years and older residing in La Puente, California (Los Angeles Latino Eye Study [LALES]). PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in La Puente. METHODS: All participants completed a standardized interview, including the NEI-VFQ-25 to measure visual functioning, and a detailed eye examination. Two definitions of visual impairment were used: (1) presenting binocular distance VA of 20/40 or worse and (2) presenting binocular distance VA worse than 20/40. Analysis of variance was used to determine any systematic differences in mean NEI-VFQ-25 scores by visual impairment. Regression analyses were completed (1) to determine the association of age, gender, number of systemic comorbidities, depression, and VA with self-reported visual function and (2) to estimate a visual impairment-related difference for each subscale based on differences in VA. MAIN OUTCOME MEASURES: The NEI-VFQ-25 scores in persons with visual impairment. RESULTS: Of the 5287 LALES participants with complete NEI-VFQ-25 data, 6.3% (including 20/40) and 4.2% (excluding 20/40) were visually impaired. In the visually impaired participants, the NEI-VFQ-25 subscale scores ranged from 46.2 (General Health) to 93.8 (Color Vision). In the regression model, only VA, depression, and number of comorbidities were significantly associated with all subscale scores (R(2) ranged from 0.09 for Ocular Pain to 0.33 for the composite score). For 9 of 11 subscales, a 5-point change was equivalent to a 1- or 2-line difference in VA. Relationships were similar regardless of the definition of visual impairment. CONCLUSION: In this population-based study of Latinos, the NEI-VFQ-25 was sensitive to differences in VA. A 5-point difference on the NEI-VFQ-25 seems to be a minimal criterion for a visual impairment-related difference. Self-reported visual function is essentially unchanged if the definition of visual impairment includes or excludes a VA of 20/40.

Adult↗
PubMed2004

Undercorrected refractive error in Singaporean Chinese adults: the Tanjong Pagar survey.

OBJECTIVE: To study the prevalence of undercorrected refractive error and associated sociodemographic factors among Singaporean Chinese adults. DESIGN: Cross-sectional, population-based survey. PARTICIPANTS: Singaporean Chinese adults aged 40 to 79 years (n = 1152). METHODS: The Singapore electoral register of Tanjong Pagar was used as a sampling frame, and disproportionate, stratified, clustered, random sampling was performed. There were 1717 eligible adults and 1232 (71.8%) participated. Analysis was performed among 1152 adults with complete habitual and best-corrected visual acuity data. MAIN OUTCOME MEASURE: Undercorrected refractive error was defined as improvement of better eye visual acuity of at least 2 lines or more with best possible refractive correction. RESULTS: The age- and gender-adjusted rate of undercorrected refractive error standardized directly by age and gender was 17.3% (95% confidence interval, 15.0, 19.5). Undercorrected refractive error rates were more common in older adults who had completed fewer years of education and in those who had cataract. People who did not wear spectacles tended to have poorer vision. CONCLUSIONS: The undercorrected refractive error rate among Singaporean Chinese is relatively common compared with data from other populations.

Adult↗