Abstract
Older adults living in remote areas with limited access to health services are at higher risk to develop visual impairment and blindness. We conducted a population-based survey to determine the vision status in subjects 45 years of age and older from urban and rural areas of Parintins city, Brazilian Amazon Region. Participants underwent ophthalmic examination, including uncorrected (UCVA), presenting (PVA) and best-corrected visual acuity (BCVA). Vision status was described as lines of visual acuity (VA) impairment and lines of VA improvement from UCVA to BCVA and from PVA to BCVA in the better-seeing eye. A total of 2384 subjects were enumerated, 2041 (85.6%) were examined, with reliable VA measurements obtained from 2025 participants. Vision status in lines of VA impairment was (mean ± standard deviation): 3.44 ± 3.53 for UCVA, 2.85 ± 3.52 for PVA and 1.50 ± 3.51 for BCVA. Female gender, older age and lower education were associated with ≥6 lines of UCVA impairment. Lines of improvement ≥3 was found in 626 (30.9%) participants and associated with female gender and rural residency. In conclusion, a third of participants could have at least three lines of VA improvement with proper refraction. Strategies to improve access to eye care and affordable glasses are needed.
Highlights
Over the last decade there was a shift between the use of “best corrected” to a current use of “presenting” distance visual acuity for blindness[4,5], but most studies do not report uncorrected VA
Examination response was associated with female gender
The limitations to perform this survey were: (a) the distance and costly access to the city of Parintins; (b) the fact that the whole survey had to be executed during only four visits to maximize the permanence of the study team, the transport of equipment and availability of infrastructure for the ophthalmic exam and (c) the need to use a large boat to accommodate study team and equipment for 18 consecutive days to achieve the goal of testing residents in rural areas
Summary
Over the last decade there was a shift between the use of “best corrected” to a current use of “presenting” distance visual acuity (visual acuity measurement using the refractive correction in use, if any) for blindness[4,5], but most studies do not report uncorrected VA. The present data come from a recent population-based survey of visual impairment and blindness among adults in the city of Parintins located in the Brazilian Amazon Region (BARES)[6]. (The Brazilian Amazon Region has a total population of 24,700,000 with 72.2% living in urban areas.) Adults 45 years or older were 17.1% of the population in Parintins city (Census 2010) and 24% in the BARES sample with 44.7% of these male vs 44.9% throughout urban areas of the Brazilian Amazon Region.
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