Bilateral Low Vision Research Articles

Characterization of pediatric low vision and socioeconomic determinants of health at an academic center: a 5-year analysis

PurposeTo investigate the demographics, eye surgeries, and social determinants of health in pediatric patients with low vision in one or both eyes. MethodsThis is a cross-sectional study of children 3-18 years of age examined at an academic eye center from 2014 to 2019. Low vision was present if one eye had a distance best-corrected visual acuity (BCVA) of <20/70. ZIP code was used to estimate patient income via a public third-party database. ResultsOf 47,571 children examined during the study period, 882 had at least one eye with low vision. Of the 882, 88 (10%) had BCVA of <20/400 in at least one eye, and 228 patients (26%) had bilateral low vision. The most common cause of low vision was refractive/strabismic amblyopia (n = 304). The severest forms of vision loss (BCVA<20/200) were predominantly due to retinal dystrophies or detachment (n = 91). Three hundred patients (34%) had undergone at least one ophthalmic surgery—predominantly extraocular muscle procedures in eyes with mild visual loss and vitreoretinal surgeries in those with more severe loss. The severity of vision loss was significantly associated with a higher likelihood and number of surgeries (P < 0.0001). Income and insurance coverage did not have a significant association with BCVA or the likelihood of surgery. ConclusionsRefractive and strabismic amblyopia are the predominant causes of reduced worse-eye vision in children, and retinal diseases commonly caused severe vision loss. The type and number of surgeries correlate with the severity of vision loss. We did not find any association of income and insurance type with studied outcomes.

TO EVALUATE THE SELECTION PROTOCOL OF CATARACT PATIENTS ADMITTED THROUGH OUTREACH PROGRAMS (EYE CAMPS) UNDERGOING SURGERY IN A TERTIARY CARE CENTER OF CENTRAL INDIA

Aim: To evaluate the selection protocol of Cataract patients admitted through outreach programs (EYE CAMPS) undergoing surgery in a tertiary care center of Central India Study design: It is a prospective descriptive study conducted on camp patients at a charitable tertiary eye care hospital (Central India) from January 2023 to june2023. Wirtten informed consent was taken from patients for participation in this study. Setting:A prospective observational study was performed of all cataract patients admitted through outreach program (EYE Camp) for small incision cataract surgery in the department of Ophthalmology, Sri Aurobindo institute of medical sciences, Indore from January 2023 to june2023. Material and Methods: During the study period 332 patients were screened ..all patients above 40 years of age having senile cataract were included and Patients with age less than 40 years of age, Congenital cataract, complicated cataracts like traumatic, uveitic, subluxated or dislocated cataracts, patients having undergone previously any ocular surgery in the selected eye, patients not giving written informed consent were excluded from the study. Results: Out of 332 camp patients 306 (92%) patients under went small incision cataract surgery and the surgeries of 26 patients (8%) were postponed, as the patients were unfit due to ocular and systemic reasons out of 26 patients, 5 patients had uncontrolled blood sugar, 7 patients had uncontrolled blood pressure, 2 patients had cardiac problems, 1 patient was asthmatic. Conclusion:In our study, increasing age and female gender were commonly associated with cataract. Most of the patients had bilateral cataract and low vision at presentation. Hypertension and type 2 diabetes mellitus were commonly associated systemic disorders with cataract. This study highlights that high quality cataract surgery with a low intra-operative complication rate and good visual outcome can be attained even in camp patients operated in the base hospitals with standard protocols.

EVALUATION OF DEMOGRAPHIC PROFILE AND VISUAL OUTCOMES OF CATARACT PATIENTS OPERATED IN A CHARITABLE CAMP HOSPITAL IN CENTRAL INDIA

Aim: To Study the Demographic Profile and visual Outcomes of Cataract Patients Operated in a Charitable Camp in Central India Introduction Cataract is a leading cause of preventable blindness globally. Developing countries account for three quarters of cataract blindness worldwide. Despite the large number of corrective surgeries being performed globally cataract blindness is believed to be increasing by1–2 million/year. The present study was conducted in the patients residing in a peripheral rural area of Indore division (central India) to study the demographic and clinical profile of patients with cataract. This study supplements to understand the outcomes of such patients who were operated in camp at a tertiary care center. Study Design: It is a prospective descriptive study conducted on camp patients at a charitable tertiary eye care hospital (Central India) from December 2019 to February 2020.Wirtten informed consent was taken from patients for participation in this study. Setting: Department of Ophthalmology Choithram Netralaya, Indore from December 2019 to February 2020. Material and Methods: During the study period 139 surgeries were performed by the surgeon. All patients above 40 years of age having senile cataract with stable systemic condition were included. Patients with age less than 40 years of age, uncontrolled systemic condition, Patients with other ocular comorbidities, undergone previously any ocular surgery in the selected eye or not giving written informed consent were excluded.All the patients were screened for cataracts in the camps in the periphery by the trained optometrist and referred to the base hospital. Detailed pre-operative ocular examination of all the patients was performed and medical checkup with routine pre-operative profile was also done. Patients medically fit for cataract surgery underwent small incision cataract surgery with Posterior capsular IOL implantation (PCIOL) under local anesthesia. All the cataract surgeries were performed by a single surgeon using the same technique to avoid any bias. Results: It was observed that the mean age of presentation was 61.5 years with female preponderance of nearly (56.8%) . out of 139 patients 63 patients (45.3,%) had systemic comorbidities, which included ,33 patients (23.74%) with hypertension and 28 patients(20.14%) with Diabetes mellitus. Majority of patients i.e.101 (72.66%) patients had onset of ocular symptoms between 3 to 6 months . In this study bilateral immature nuclear cataract was commonly encountered cataract in 88.48% of patients and only 8 patients had mature cataract and 7 patients presented with hyper mature cataract respectively .On post-operative day one, 19 patients and 8 patients had blood clot in anterior hamber,5 patients had cortical matter in Anterior chamber On follow up at one week, majority of patients i.e 110 (79.13%) had visual acuity between 6/9-6/12.Patients after re-surgery had visual acuity of minimum up to 6/24 with possibility of getting better on further visits. Conclusion: In our study, increasing age and female gender were commonly associated with cataract. Most of the patients had bilateral cataract and low vision at presentation. Hypertension and type 2 diabetes mellitus were commonly associated systemic disorders with cataract.This study highlights that high quality cataract surgery with a low intra-operative complication rate and good visual outcome can be attained even in camp patients operated in the base hospitals with standard protocols.

Protective and risk factors of mental health of working age adults with adventitious total bilateral blindness and low vision: A scoping review protocol.

Vision loss has been associated with mental health problems such as depression, anxiety, and post-traumatic stress disorder, which significantly impact lives of working age adults with adventitious total bilateral blindness and low vision. It is imperative, therefore, to prioritize the mental health in this population by exploring and understanding the factors that impact on their mental health. Hence, the objective of this scoping review is to identify and chart existing literature on the protective and risk factors of mental health of working age adults with adventitious total bilateral blindness and low vision. We developed this scoping review protocol in line with the Joanna Briggs Institute guidance. This scoping review will include publications in English language with no date restrictions exploring the protective and risk factors of mental health of our study population. A three-step search strategy will be employed. Searches will be carried out in the following databases: Medline, Embase, PsycInfo, PsycArticles, CINAHL and Web of Science. Search for grey literature will be conducted in Google, Google Scholar and Websites dedicated to information on visual impairment. Collated results will be imported into Endnote Basic (Clarivate) for deduplication. Two reviewers will independently conduct double screening of all the titles and abstracts in Rayyan- a web application, and full texts in Endnote while three other reviewers will conduct screening of a subset of for example 10% of titles and abstracts and full texts. Furthermore, two reviewers will independently conduct double data extraction while three other reviewers will revise, cross check, and correct any extraction errors. Extracted data will be presented in tabular formats and summarized descriptively in line with the research objectives. This scoping review will generate evidence on factors impacting the mental health of the working age adults with adventitious total bilateral blindness and low vision as well as critically highlight gaps in the literature. The findings will inform and critically underpin future empirical research which will explore the lived experiences of working age people with adventitious total bilateral blindness. Additionally, evidence from this review will inform the development of interventions in the promotion of mental health as well as assisting rehabilitation specialists and workers, public health practitioners and other relevant stakeholders in addressing the mental health needs of working age adults with adventitious total bilateral blindness and low vision.

Prevalence and Awareness of Diabetic Retinopathy in Diabetic Patients Visiting Tertiary Care Hospitals in Central India.

Background Diabetes presents a significant and ever-growing burden worldwide, impacting populations across the globe. However, this burden is particularly pronounced in developing economies like India. The rise of diabetes in such regions can largely be attributed to two key factors: the increasing prevalence of overweight/obesity and the adoption of unhealthy lifestyles. Aim and objectives The study's objectives encompassed identifying patients with type 2 diabetes mellitus through the oral glucose tolerance test and the diagnosis of diabetic retinopathy (DR) among them, followed by classification based on the severity of the disease. Furthermore, the study aimed to evaluate the factors associated with DR among the patients, focusing on the duration of diabetes and age group, both of which were deemed highly significant. Methods This cross-sectional study was conducted for two months in 2019 among 40 patients. The tests performed were an oral glucose tolerance test, ocular examination including slit lamp biomicroscopy, and fundus examination. The data were analyzed using the Chi-square test and Student T-test. Results About 42.5% of the patients were positive for diabetic retinopathy, of which 29.41% had mild NPDR, 41.18% had moderate non-proliferative diabetic retinopathy (NPDR), and 29.41% had diabetic maculopathy. No cases of severe NPDR and proliferativediabetic retinopathy (PDR) were found. Conclusion Longer duration of diabetes corresponded to a higher prevalence of diabetic retinopathy. The frequency of diabetic retinopathy was higher in ages above 60 years. Diabetic retinopathy is a concern for patients with a long history of diabetes, high blood sugar levels, and unilateral or bilateral low vision. Thirty percent of the total were newly diagnosed diabetics. Timely screening of patients and intervention can go a long way in reducing morbidity or vision loss.

Nationwide Rapid Assessment of Avoidable Blindness (RAAB) in Armenia

ABSTRACT Purpose This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. Methods The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants’ demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. Results Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0–2.1), 1.6% (95% CI: 1.0–2.2) and 6.6% (95% CI: 5.5–7.7), respectively. The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. Conclusion The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.

Visual Status of Patients with Retinitis Pigmentosa: A Multicenter Study

Aim: To determine the degree of visual loss associated with retinitis pigmentosa (RP) in Nigerians at first ophthalmic clinic presentation&#x0D; Methodology: Multicenter, prospective, cross-sectional study in four collaborating retina clinics within Nigeria between January and December 2018. The primary outcome measure was the World Health Organization’s visual status classification at presentation. Clinical examination, including a Snellen’s visual acuity, refraction, anterior segment examination using a slit lamp biomicroscope, and dilated fundus examination using a +90D or +78D, was done in all consecutive RP patients. We analyzed the data using SPSS (version 22), P &lt; 0.05.&#x0D; Results: Of 8614 patients seen within the study period, fiftyfour eyes of 27 patients diagnosed to have RP with a mean age of 44.1years ± 17.6 years (ranging between 5–73 years) constituted the study population. Eighteen (66.7%) were males and 9 (33.3%) females. The hospital-based prevalence of RP was 0.31%. Ten patients (37.0%) presented with myopia. RP was bilateral in all cases and non-syndromic. Bilateral low vision and blindness were noted in 44.4% and 22.2% of patients respectively.&#x0D; Conclusion: About a quarter of patients with RP presenting to the retina clinics would have some degree of visual morbidity. Educating eye care providers and patients about the disease would improve understanding, encourage early clinic visits, manage visual morbidity and enhance rehabilitation when necessary.&#x0D; Keywords: Retinitis Pigmentosa; Nigeria; Low Vision; Blindness.

Prevalence and Causes of Low Vision and Blindness among Adult Patients Attending Eye Clinic in a Tertiary Hospital in South East, Nigeria

Background: Low vision and blindness are significant public health issues worldwide. They result in educational, occupational, and social challenges in the affected persons. Their care givers/ families are also severely affected. There is however limited data on the magnitude of visual impairment in Aba, South East Nigeria.&#x0D; Objective: To determine the prevalence and causes of low vision and blindness among adult patients attending eye clinic in a tertiary hospital in South East Nigeria.&#x0D; Materials and Methods: This was an institutional-based retrospective, descriptive study involving 457 patients who attended Abia State University Teaching Hospital eye clinic between April and September 2018. Data was obtained from patient’s hospital records within the period under study and analyzed using IBM SPSS version 25.0. Statistical significance was set at a P-value of &lt; 0.05.&#x0D; Results: Data of 457 ophthalmic patients who met the inclusion criteria for this study were analyzed. Mean age of respondents was 48.5 ± 17.7 years. A total 5.4% of the patients had bilateral low vision, while 30.2% and 7% had monocular and bilateral blindness respectively. Cataract-related diagnosis, refractive errors and glaucoma (28.4%, 28.2% and 14.7%) respectively were the major causes of low vision and blindness among the patients. Statistically significant association was found between respondent’s diagnosis and age as well as occupation (P&lt;0.001).&#x0D; Conclusion: Results from this study will aid in planning low vision &amp; blindness preventive programs and improving eye care services.

Screening for Open-Angle Glaucoma and Its Effect on Blindness

To evaluate the effect of population screening on low vision and blindness from open-angle glaucoma. Retrospective cohort study. A large population-based screening for glaucoma was conducted in Malmö, Sweden, from 1992 to 1997. A total of 42,497 subjects were invited, of which 32,918 were screened, and 9,579 were non-responders (ie, did not participate). The records of glaucoma patients who had visited the Department of Ophthalmology at Malmö University Hospital from January 1, 1987, to December 31, 2017, were reviewed. Patients diagnosed at or after the screening were assessed for moderate or severe vision impairment, here called low vision, or blindness by the World Health Organization definition. Selection bias was corrected by creating a group of potential screening participants from a comparison group of clinical patients. Main outcome measures were the risk ratios of the cumulative incidence for bilateral low vision or blindness caused by glaucoma in screened patients compared with the potential participants. The cumulative incidence of blindness was 0.17%in the screened population versus 0.32%among the potential participants; and forlow vision 0.25% versus0.53%.The risk ratio (95% confidence interval) between the two was 0.52 (0.32-0.84) for blindness and 0.46 (0.31-0.68) for low vision. There were no differences between the proportions of potential confounders in the comparison group and those in the non-responders. The results suggest that population screening may reduce bilateral low vision and blindness caused by glaucoma by approximately 50%.

Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design

BackgroundGlobally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020.MethodsA community-based cross-sectional study design was conducted among randomly selected 599 adult’s age 18 years and above from May 10–30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables.ResultsOf the total study participants, 379 (64.7%), [(95% CI: 60.7–68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18–4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30–4.10)], High school & above [AOR = 5.55(95% CI 2.81–10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78–11.38)], Merchant [AOR = 1.72(95% CI 1.03–2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94–6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12–0.31)] was negatively associated with knowledge about cataract.ConclusionsMore than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.

The Prevalence and Causes of Visual Impairment in Type 2 Diabetes Mellitus in Northeast China.

Purpose To evaluate the prevalence and causes of visual impairment in a group of community people with type 2 diabetes mellitus (T2DM) in Northeast China. Methods Population-based cross-sectional survey. Patients diagnosed with T2DM residing in 15 communities in Fushun, Northeast China, were enrolled between July 2012 and May 2013. All participants underwent an extensive and standardized eye examination (visual acuity testing, slit-lamp, and fundus examination). Low vision was defined as presenting VA of better-seeing eye <20/60 and ≥20/400, and blindness was defined as VA <20/400, according to the World Health Organization (WHO) definitions. The primary causes of blindness and low vision were assessed by senior ophthalmologists. Results Visual acuity measurements were available for 1998 (89.8%) of 2224 subjects in the study. The prevalence of bilateral blindness and low vision defined was 0.90% and 10.81%. Uncorrected refractive error was the first leading cause of low vision (75.0%) and blindness (38.9%). After correcting the refractive error, the first leading cause of low vision was cataract (44.4%), followed by diabetic retinopathy (29.6%) and myopic maculopathy (18.5%), while the first leading cause of blindness was proliferative DR (45.4%), followed by cataract (36.4%) and myopic maculopathy (18.2%). Conclusions This study suggested a high prevalence of low vision and blindness in this study cohort. Uncorrected refractive error and cataract remain the leading cause of visual impairment, but the major challenge is the early diagnosis and intervention of diabetic retinopathy to reduce diabetes-related blindness.

Profile of retinal diseases in adult patients attending two major eye clinics in Kinshasa, the Democratic Republic of Congo.

To determine the frequency and types of retinal diseases and the extend of the related visual loss in adult patients attending two public eye clinics of Kinshasa, Democratic Republic of Congo. Review of medical records of patients with retinal diseases seen in the major eye clinics in Kinshasa, the University Hospital of Kinshasa (UHK) and Saint Joseph Hospital (SJH), from January 2012 to December 2014. Demographics and diagnoses were retrieved and analyzed. Outcome measures were frequency and prevalence of retinal diseases, blindness and low vision. A total of 40 965 patients aged 40y or older were examined during this period in both clinics. Of these, 1208 had retinal disease, giving a 3-year and an annual prevalence of 3% and 1%, respectively. Mean age was 61.7±10.7y, and 55.8% of the patients were males. Arterial hypertension (68.1%) and diabetes (43.3%) were the most common systemic comorbidities. Hypertensive retinopathy (41.8%), diabetic retinopathy (37.9%), age-related macular degeneration (AMD; 14.6%), and chorioretinitis and retinal vein occlusion (7.3% each) were the most common retinal diseases, with 3-year prevalence rates of 1.3%, 1.0%, 0.43%, and 0.21% respectively. Bilateral low vision and blindness were present in 26.8% and 8.4% of the patients at presentation. Major causes of low vision and blindness were diabetic retinopathy (14.8%), AMD (4.9%), retinal detachment (2.8%), and retinal vein occlusion (2.5%). The prevalence was significantly higher among males than females, and at the UHK than SJH. Retinal diseases are common among Congolese adult patients attending eye clinics in Kinshasa. They cause a significant proportion of low vision and blindness.

Prevalence and causes of bilateral visual impairment in rural areas of Tianjin, China - The Tianjin Eye Study.

To estimate the prevalence, causes and risk factors of bilateral visual impairment in rural areas of Tianjin, China. A large population-based, cross-sectional study. A stratified random cluster sampling method was used to investigate 12233 participants in all age groups living in rural Tianjin. Participants completed questionnaires and received professional ophthalmology examinations. According to World Health Organization best-corrected visual acuity (BCVA) criteria, the crude prevalence of bilateral visual impairment (BCVA<20/63), bilateral low vision (BCVA<20/63 to ≥20/400) and bilateral blindness (BCVA<20/400) was 2.53%, 2.40% and 0.14% (age- and gender-standardized prevalence was 1.86%, 1.76% and 0.11%). The prevalence increased with age and was higher in women than men. The most common causes of bilateral visual impairment in the total population were cataract (48.39%), refractive error/amblyopia (17.74%), age-related macular degeneration (AMD) (10.00%), diabetic retinopathy (5.81%) and glaucoma (3.87%). For participants younger than 50years, refractive error/amblyopia was the leading cause of low vision and blindness, while cataract was the major cause in the participants over 50. Female gender, older age and self-reported diabetes were associated with increased risks of visual impairment. The age- and gender-standardized prevalence of low vision, especially in the older group (50+), was higher in this study compared with previous studies in China. Refractive error/amblyopia was the leading cause of bilateral visual impairment in younger group, while cataract was the primary cause in the older group. These findings will provide useful information for planning comprehensive eye healthcare programmes in China.

The prevalence of retinopathy in diabetes mellitus and associated risk factors: a community-based cross sectional study in peri urban area

Background: Visual impairment i.e. diabetic retinopathy is the one of most common manifestation of diabetes mellitus. Globally it is becoming an increasing public health problem especially in the developing countries because of increase in number of diabetic patients.Methods: A cross sectional study was conducted in the vicinity of Urban Heath and Training Centre (UHTC), Peoples University, Bhopal over a period of 6 months through screening in camps held, which included a total of 840 participants (aged ≥25 years) by following simple random procedure and in those who had newly diagnosed or long standing diabetes were referred to ophthalmologist for further evaluation. Retinopathy was determined by ophthalmoscopy and fundus photography. Anthropometric measurements (BMI), glycosylated haemoglobin were also evaluated among the confirmed diabetic patients in the study.Results: An increased prevalence of diabetes (5.95%) and retinopathy (28%) (95% CI 11.2-32.0) was found. In all age groups prevalence of bilateral blindness, bilateral low vision, unilateral blindness and unilateral low vision were respectively 2%, 28%, 0%, 70%. Independent risk indicators for the occurrence of diabetes such as age, BMI, HbA1c, were found significant for the occurrence of retinopathy in the study population.Conclusions: Visual impairment due to diabetic retinopathy remains an important public health problem in people with diabetes so timely interventions are required to resolve this major issue.

Prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study

BackgroundThis study aims to explore the prevalence and causes of low vision and blindness focused on retinal disease in a population above 60 years in Nepal.MethodsTwo thousand one hundred subjects were enrolled in a population-based cross-sectional study. History, presenting and best corrected visual acuity after subjective refraction, anterior and posterior segment examinations was obtained in detail.ResultsAmong the total subjects, 1860 (88.57%) had complete information. Age varies from 60 to 95 (mean age: 69.64 ± 7.31) years. Low vision and blindness in both eyes at presentation was found in 984 (52.90%, 95% confidence interval (CI): 50.60–55.19) and 36 (1.94%, 95% CI: 1.35–2.66) subjects respectively. After best correction, bilateral low vision and blindness was found in 426 (22.92%, 95% CI: 21.01–24.88), and 30 (1.61%, 95% CI: 0.10–2.30) subjects respectively. As compared to 60–69 years old, risk of visual impairment was four times higher (95% CI:3.26–5.58) in the 70–79 year olds and 14 times higher (95% CI: 9.72–19.73) in the age group 80 years and above.Major causes of bilateral low vision were cataract (68.07%), followed by retinal disorders (28.64%), and for blindness; retinal disorders (46.66%), followed by cataract (43.33%). Illiteracy was significantly associated with visual impairment.ConclusionAmong the elderly population, prevalence of visual impairment was high. Refractive error, cataract and retinal disorders were the major cause of low vision. Screening the population at the age 60 years and above, focused on cataract and posterior segment diseases, providing glasses and timely referral can help reduce visual impairment.

Causes of low vision and blindness in a Turkish adult population: the Izmir eye study

Data from Turkey show that sense organ diseases were the second leading cause of years lost due to disability in 2015. However, there are no reliable data on either the baseline causative disorders of visual impairment or the burden of these disorders on the population in Izmir region. Izmir is the third most populated city of Turkey with a population of approximately 4.2 million. The purpose of this study was to define the baseline disorders causing low vision and blindness in accordance with World Health Organization criteria in an adult population in Izmir. We evaluated the ophthalmologic reports of 20 790 people in Izmir, Turkey. Age- and sex-specific causes of low vision and blindness were identified. Bilateral low vision and blindness was detected in 347 people, 172 males and 175 females. For those aged 18-50 years, retinal dystrophies (37%), congenital eye anomalies (14%) and myopic degenerations (13%) were the most common causes. For those aged 50+ years, age-related macular degeneration (21%) was the leading cause. Diabetic retinopathy (17%), corneal opacities (14%), cataract (12%) and glaucoma (9%) were also important. Sex was not a significant determinant. The specific causes of visual impairment vary greatly with age, however, unavoidable retinal pathologies were the predominant causes at all ages.

Prevalence and Causes of Visual Impairment in Adults in Binhu District, Wuxi, China

BackgroundPreviously reported data has guided the treatment and prevention of blindness. This study aimed to evaluate the current prevalence and causes of visual impairment among adults who were 50 years old and older in the Binhu District of Wuxi City, China.Material/MethodsA randomized sample of stratified clusters was used to analyze individuals from 30 basic sampling units in Wuxi Binhu District. Visual impairment was defined according to World Health Organization (WHO) standards.ResultsA total of 6725 people who were at least 50 years old participated in this study. According to WHO standards, bilateral low vision and blindness prevalence were both higher in women than in men (low vision: 6.5% vs. 5.2%; and blindness: 1.4% vs. 0.8%; P=0.022 and P=0.039, respectively). The incidence of bilateral visual impairment increased significantly with age (P<0.001 and P<0.001, respectively). Further studies showed that the main causes of bilateral low vision were cataract, high myopic macular degeneration (MMD), and age-related macular degeneration (AMD). The main causes of bilateral blindness were cataract, MMD, and eye loss/atrophy, while the main causes of monocular low vision were cataract, MD, and AMD. The main causes of monocular blindness were cataract, eye loss/atrophy, and AMD.ConclusionsThe prevalence of low vision and blindness remains high in the Binhu District of Wuxi City in China, especially among older women. In our study, cataracts were the leading cause of visual impairment. Our study highlights that some efforts should be initiated to prevent and treat blindness and low vision. Additional causes of visual impairment were MMD, AMD, and eye loss/atrophy.

Prevalence and causes of low vision and blindness in a Chinese population with type 2 diabetes: the Dongguan Eye Study

To assess the prevalence and causes of low vision and blindness in type 2 diabetes patients, a population-based cross-sectional study including 8952 rural-dwelling residents aged 40 years or older from Hengli Town in Southern China was conducted. Participants underwent standard interviews, physical measurements, laboratory tests, and comprehensive eye examinations. Low vision and blindness were defined based on WHO criteria. Visual acuity data were available for 1348 (89.9%) of the 1500 subjects with type 2 diabetes. Age-standardized prevalence of bilateral low vision and blindness assessed in the better-seeing eye was 2.9% (95% confidence interval [CI]: 2.0–3.8) and 0.7% (95% CI: 0.2–1.1) based on best-corrected visual acuity (BCVA). Cataracts were the primary cause of low vision and blindness. Visual impairment was associated with age (odds ratio [OR]: 3.73, 95% CI: 2.39–5.83), education level (OR: 3.21, 95% CI: 1.63–6.29), duration of diabetes (OR: 1.14, 95% CI: 1.04–1.25) and body mass index (OR: 0.86, 95% CI: 0.77–0.95). Our data suggest that approximately 70% of visual impairment in this diabetic population could be eliminated with appropriate cataract surgery or spectacle correction. Greater consideration should be given to older type 2 diabetes patients with a level of lower education.

Five-Year Incidence of Visual Impairment in Middle-Aged Iranians: The Shahroud Eye Cohort Study

ABSTRACTPurpose: To study the 5-year incidence of visual impairment and its causes and risk factors, in the middle-aged Iranian sample of the Shahroud Eye Cohort Study (ShECS).Methods: Data from subjects who had participated in both phases of the ShECS were used to determine age- and sex-specific incidence rates of visual impairment using the World Health Organization (WHO) definitions for bilateral low vision (visual acuity, VA, >0.5 and ≤1.3 LogMAR in the better eye) and blindness (VA worse than 1.3 LogMAR in the better eye). Risk ratios (RR) and 95% confidence intervals (CIs) were calculated using multivariable log-binomial regression.Results: Of the 5079 ShECS I survivors, 4737 (93.3%) completed the 5-year follow-up. Their mean age at baseline was 50.9 ± 6.2 years, and 58.9% were female. The incidence of visual impairment was 1.12% (95% CI 0.82–1.42%) by presenting VA and 0.19% (95% CI 0.07–0.32%) by best-corrected VA; leading causes of the former were uncorrected refractive error (81.3%) and diabetic retinopathy (15.1%). In the multivariable model, risk factors for incident visual impairment by presenting VA were older age (RR 1.05, p = 0.044), lower education (RR 0.89, p = 0.002), and diabetes (RR 3.74, p < 0.001).Conclusion: This is the first incidence study of visual impairment in a middle-aged Iranian population. Since age is a major risk factor, the number of visually impaired is expected to increase as the population ages, and less treatable causes such as diabetic retinopathy begin to surface. Measures for tackling uncorrected refractive error and enhancing diabetes screening and preventive programs are recommended.

Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore.

PurposeTo 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.MethodsCross-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.ResultsThe 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.ConclusionIn this community-based sample of Asian adults, both individual- and area-level SES were independently associated with the presence and severity of VI.