Burden Of Cataract Research Articles

Evaluation and model to achieve sex parity in cataract surgical coverage in Theni district, India

Background/aimsTo propose an approach to determine the target ratio of cataract surgical rates (CSRs) of female to male subpopulations to increase sex parity in cataract surgical coverage (CSC), based on...

Monovision versus multifocal intraocular lens implantation in cataract patients: a systematic review and meta-analysis

Abstract
 Introduction & Objectives : Modern cataract surgery technique entails replacing the crystalline lens with an artificial intraocular lens (IOL). While the standard monofocal IOL implantation with monovision technique has been cost- effective and provided patients with good visual acuity, multifocal IOLs present the prospect of spectacle-free vision despite various adverse outcomes. It remained contentious whether multifocal IOLs were superior to monovision. Our review provide an up-to-date assessment of monovision vs. multifocal IOL implantation's visual acuity and spectacle independence following cataract surgery.
 Methods : A systematic search was performed in April 2023 on six databases (Medline, SCOPUS, Proquest, EBSCO, Embase, and PubMed). Studies were extracted for the following outcome of interest: monovision, multifocal intraocular lens, spectacle independence, and visual acuity. All studies published up to April 2023 were reviewed. Cochrane risk of bias tool (RoB 2) was used to screen studies for risk of bias where appropriate. A meta-analysis was done to quantify any reported quantitative data.
 Results : Ten studies were identified. Pooling analysis for uncorrected binocular distance visual acuity and binocular uncorrected near visual acuity showed no difference between monovision vs. multifocal IOL (SMD 0,31; 95% CI -0,21 to 0,82 and SMD 0,41; 95% CI -0,58 to 1,40, respectively). Spectacle independence showed monovision was inferior to multifocal IOL (OR 0,22; 95% CI 0,08 to 0,61; heterogeneity I2=75%).
 Conclusion : Current evidence showed that multifocal IOL had comparable visual acuity to monovision with slightly higher likelihood of being spectacle-free. Despite that, monovision can be an efficacious and affordable option to be implemented in countries with high cataract burden.

Changing Trends in the Global Burden of Cataract Over the Past 30 Years: Retrospective Data Analysis of the Global Burden of Disease Study 2019.

Cataracts now account for the largest proportion of the global burden of blindness and vision loss. Understanding the changing trends in the global burden of cataracts over the past 30 years and the next 15 years is of clear significance for the prevention and control of cataracts in key populations. As far as we know, research on the future burden of cataracts is lacking. This study aims to assess the global burden of cataracts over the past 30 years by using age-period-cohort modeling and to estimate trends in the next 15 years. Data were obtained from the Global Burden of Disease Study 2019, the United Nations Development Programme, and the WHO (World Health Organization) Global Health Observatory data repository. The assessment of trends and disparities in the number and rate of disability-adjusted life years (DALYs) for cataracts from 1990 to 2019 was conducted. The association between the age-standardized DALY rate (ASDR) and the socio-demographic index (SDI), human development index (HDI), national levels of particulate matter <2.5 μm in diameter (PM2.5), and ambient ultraviolet radiation (UVR) was determined using linear regression analysis. Additionally, we used the Nordpred (Harald Fekjær and Bjørn Møller) age-period-cohort model to predict the cataract burden from 2020 to 2034. Globally, the number of DALYs due to cataract increased from 3,492,604 (95% uncertainty interval [UI] 2,481,846-4,719,629) in 1990 to 6,676,281 (95% UI 4,761,210-9,006,193) in 2019. The ASDRs due to cataract decreased from 93.17 (95% UI 66.14-125.32) in 1990 to 82.94 (95% UI 59.06-111.75) in 2019, with an average annual percentage change of -0.37 (95% CI -0.44 to -0.3; P<.001). Age, female sex, air pollution, smoking, high fasting plasma glucose levels, and a high body mass index were risk factors for the burden of cataracts. SDI and HDI were negatively correlated with ASDRs of cataracts, while PM2.5 and UVR were positively associated with them. Higher DALY rates were also associated with lower SDI (R2=0.1939; P<.001), lower HDI (R2=0.2828; P<.001), national PM2.5 concentration (R2=0.1874; P<.001), and ambient UVR levels (R2=0.2354; P<.001). The prediction model suggested that the number of DALYs due to cataract will continue to rise globally, while the cataract DALY rate will continue to decrease. While the ASDR of cataracts has decreased, there has been a notable increase in the number of DALYs over the past 30 years. Projections suggest that the global burden of cataracts will continue to rise over the next 15 years. To address this challenge, appropriate prevention and treatment policies must be implemented.

The burden of vision loss due to cataract in China: findings from the Global Burden of Disease Study 2019.

To provide a reference for future policy and measure formulation by conducting a detailed analysis of the burden of vision loss due to cataract by year, age, and gender in China from 1990 to 2019. Data on the prevalence and disability-adjusted life-years (DALYs) due to cataract in China and neighboring and other G20 countries were extracted from the 2019 Global Burden of Disease (GBD) study to observe the changing trends of vision loss. The number and rate of all-age prevalence and DALYs for cataract in China increased significantly from 1990 to 2019. The age-standardized DALYs rate witnessed a slowly declining trend by 10.16%. And the age-standardized prevalence increased by 14.35% over the 30-year period. Higher prevalence and DALYs were observed in female population from 1990 through 2019, with little improvement over the decades(all p < 0.001). The disease burden of cataract is higher in middle-aged and elderly people. Blindness accounted for the largest proportion of vision impairment burden caused by cataract in China. The age-standardized prevalence and DALY rate of cataract in China were lower than those in India and Pakistan, but higher than those in Russia, South Korea, North Korea, Singapore, and Japan. In the past 30 years, although the age-standardized DALYs rate has decreased slightly in China, the all-age prevalence and DALYs have both increased. This study highlights the importance of reducing cataract burden by providing timely and easily accessible quality care, especially in females and the elderly population.

Time trends and gender disparities of Chinese cataract burden and their predictions.

To evaluate the trends and changes in the number and rates of disability-adjusted life years (DALYs) and prevalence of cataract in China between 1990 and 2019, and to predict the trends of cataract burden from 2020 to 2030. The Global Burden of Diseases (GBD) database was employed to collect the data on DALYs and the prevalence of cataract in China, which was distinguished by age and sex during the past three decades from 1990 to 2019, and then changes in the number and rates of cataract from 2020 to 2030 were predicted. All data were analyzed by the R program (version 4.2.2) and GraphPad Prism 9.0 statistics software. The number of DALYs of cataract increased from 449 322.84 in 1990 to 1 087 987.61 in 2019, number of cataract cases increased from 5 607 600.94 in 1990 to 18 142 568.96 in 2019. The age-standardized DALY rates (ASDR) generally increased slightly [estimated annual percentage change (EAPC=0.1; 95%CI: -0.24 to 0.45), age-standardized prevalence rates (ASPR) also increased (EAPC=0.88; 95%CI: 0.6 to 1.15). Cataract burden increased with age and female gender. Among the causes of cataract, air pollution was the most important, followed by smoking, high fasting plasma glucose, and high body mass index (BMI). The burden of cataract is predicted to grow persistently from 2020 to 2030, the number of DALYs and prevalence for cataract will rise to 2 336 431 and 43 698 620 respectively by 2030, the ASDR is predicted to be 85/100 000 and ASPR will be 1586/100 000 in 2030, females will still be at greater risk of suffering from cataract than males. The burden of cataract in China kept rising from 1990 to 2019. Increasing age and female gender are risk factors for cataract. Air pollution, smoking, high fasting plasma glucose, and high BMI are associated with cataract. The burden of cataract in China will gradually increase from 2020 to 2030, the elderly women in particular need attention. Our results may be of help for providing reference strategies to reduce cataract burden in the near future.

Awareness, prevalence and risk burden of cataract among adults in IDO/OSI local government area, a rural community of Ekiti state, southwest Nigeria

Background: Cataract is characterized by lens opacity, making images look blurred and hazy. It causes increased light sensitivity, decreased vision at night, and seeing double images, leading to total blindness. The WHO also estimates that cataract blindness will reach 40 million by 2025 due to ageing population and longer life expectancy. Developing countries, including Sub-Saharan Africa have the highest number of people who are blind due to cataract. This study aims to determine the awareness, prevalence and risk burden of cataract among adults in Ido/Osi LGA, a rural community of Ekiti State. Methods: This is a descriptive cross-sectional study. The estimated sample size is 361 and a multi stage sampling technique was used. Data collection was through ophthalmic examinations and questionnaires which were analyzed using SPSS version 25.0. Results: The mean age of respondents was 54.94±11.17. Most respondents, 287 (79.5%), had a good awareness of cataracts. The prevalence of cataract in this study is 3.9%. Cataract significant Visual Acuity was found in 49 (13.5%) of the respondents. Age (&lt;0.001), visual impairment (&lt;0.001), hypertension (&lt;0.001) and diabetes mellitus (0.003) were the factors associated with having cataracts. Conclusions: Intersectorial collaboration, health education through the mass media, evidenced based policies and research will help reduce the prevalence of cataract.

Impact of cataract surgery on quality of life in rural areas of Jharkhand: a community based cross-sectional study

Background: Cataract is the leading cause of blindness in India, accounting for approximately 66.2% of all blindness cases and accounting for 71.2% of all visual impairment cases. This study was conducted in 5 blocks of East Singhbhum and Saraikela-Kharsawan districts of Jharkhand to determine burden of cataract and the impact of cataract surgery on quality of life in the rural population. Methods: Community based cross sectional study was conducted between January 2023 to April 2023 among individuals residing in rural areas of Jharkhand using multi-stage sampling with a sample size of 692 individuals. Results: Prevalence of cataract amongst the study population was 23% (159) and there was a statistically significant improvement in the quality-of-life post cataract surgery. Conclusions: High prevalence of cataract increases the burden on existing health care system. Ongoing research and initiatives should focus on improving early detection and referral, providing comprehensive post-operative care to reduce the burden of cataract and improve the quality-of-life outcomes among the individuals.

Changing Trends in the Disease Burden of Cataract and Forecasted Trends in China and Globally from 1990 to 2030.

To explore the trends in the prevalence and disease burden of cataract from 1990 to 2019, evaluate attributable risk factors, and predict trends over the next decade in China and globally. Data was obtained from Global Burden of Disease Study 2019. We calculated the age-standardized prevalence rate (ASR) and annual percentage change (EAPC) to show the trends of cataract in China and different regions. We calculated and reported the proportion of disability adjusted life years (DALYs) attributable to risk factors by sex in China and different regions. Then, the Bayesian age-period-cohort (BAPC) analysis model was also used to predict the prevalence trends from 2020 to 2030 in China and globally. The ASR increased from 867.09 in 1990 to 991.56 in 2019 per 100,000 with an EAPC of 0.88 in China. The age-standardized DALY rate of females was higher than males. DALY rates were correlated to household air pollution from solid fuels, tobacco, high fasting plasma glucose and high body-mass index. The projective model indicates that the ASR for cataracts will rise to 1101.35×106 for male and 1616.63×106 for female by 2030. The trends from 1990 to 2030 suggested that the burden of cataract remains high in China. Maintaining good lifestyle habits such as switching to clean energy, reducing cigar intake, controlling blood glucose and weight can reduce the risk of cataracts. As aging increases, China should pay more attention to cataract-induced low vision and blindness and develop public policies to reduce the disease burden.

Time trends and heterogeneity in the disease burden of visual impairment due to cataract, 1990-2019: A global analysis.

This study aimed to estimate the disease burden of cataract and evaluate the contributions of risk factors to cataract-associated disability-adjusted life years (DALYs). Prevalence and DALYs of visual impairment due to cataract were extracted from the Global Burden of Disease (GBD) study 2019 to explore time trends and annual changes. Regional and country-level socioeconomic indexes were obtained from open databases. The time trend of prevalence and DALYs was demonstrated. Stepwise multiple linear regression was used to evaluate associations between the age-standardized rate of DALYs of cataract and potential predictors. Global Prevalence rate of visual impairment due to cataract rose by 58.45% to 1,253.9 per 100,000 population (95% CI: 1,103.3 to 1,417.7 per 100,000 population) in 2019 and the DALYs rate rose by 32.18% from 65.3 per 100,000 population (95% CI: 46.4 to 88.2 per 100,000 population) in 1990 to 86.3 per 100,000 population (95% CI: 61.5 to 116.4 per 100,000 population) in 2019. Stepwise multiple linear regression model showed that higher refractive error prevalence (β = 0.036, 95% CI: 0.022, 0.050, P < 0.001), lower number of physicians per 10,000 population (β = -0.959, 95% CI: -1.685, -0.233, P = 0.010), and lower level of HDI (β = -134.93, 95% CI: -209.84, -60.02, P = 0.001) were associated with a higher disease burden of cataract. Substantial increases in the prevalence of visual impairment and DALYs of cataract were observed from 1990 to 2019. Successful global initiatives targeting improving cataract surgical rate and quality, especially in regions with lower socioeconomic status, is a prerequisite to combating this growing burden of cataract in the aging society.

Commentary: Protecting the protector.

Manual small-incision cataract surgery (MSICS) is a more cost-effective and financially viable option for many settings in the developing world. Excellent effectiveness makes MSICS the most appropriate technique for performing high-volume cataract surgeries, especially in developing countries.[1] Tabin et al. reported that cataract accounts for almost 75% of cases of avoidable blindness in developing countries. With a large amount of avoidable blindness due to cataract prevailing in our country and most of the population not being able to afford phacoemulsification, MSICS has become an important tool for eliminating it.[2] Learning the correct and safe technique of MSICS is of utmost importance to tackle the huge burden of cataract in our country. Endothelial protection during MSICS is critical to maintain the cornea transparent postoperatively. The authors of this review article have given nice tips as to how one can meticulously prevent endothelial cell loss during each step of MSICS surgery. Handling the instruments that are introduced in the anterior chamber is a continuous learning process, so all surgeons at every level of their career should emphasize on improving one’s own technique.[3] The surgical techniques in cataract surgery are evolving toward a safer side in terms of endothelial protection, so one should not hesitate in adapting a new and safer technique. The most common step where the endothelium gets damaged is during nucleus delivery.[4] There are various methods of nucleus delivery. The surgeon should practice that method which is safe in his/her hands. Nowadays various types of cohesive and dispersive ophthalmic viscosurgical devices (OVDs) are produced in our country and they are available at an affordable cost. Appropriate OVDs should be used depending on the type of cataract and associated ocular problems, especially during nucleus delivery and intraocular lens (IOL) implantation. Authors of this review article have mentioned different techniques of use of these OVDs to safe guard the endothelium. Maintaining the anterior chamber all through the surgery is important to minimize the endothelial cell loss in MSICS. Though MSICS has valved and self-sealing incision to maintain the depth of the anterior chamber, the chamber depth may alter during instrumentation and nucleus delivery. So one should take care to maintain the depth of the anterior chamber with the appropriate use of irrigating solutions, OVDs, the correct method of introducing the instruments into the anterior chamber, and proper use of Simcoe cannula.[5] One should also be aware of patient-related factors that alter the depth of the anterior chamber like lid squeezing and positive pressure in obese patients. One should know the safer dose and right technique of using various intraocular drugs because the toxic effect of these drugs on the endothelium can sometimes remain permanent.[6] There is also a need for standardizing the quality of the drugs at the production level; hence, the appropriate authorities should make stringent rules and monitor the drugs produced by various companies in our country.

Identification of potential barriers for timely access to pediatric sibling eye check-up in a tertiary eye care hospital.

To identify socio-economic, demographic, and clinical factors that may be associated with sibling access to ophthalmic check-up. A cross-sectional, descriptive study investigated children in the age group of 0-15 years under a project on Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS project). The siblings of pediatric patients (proband) with refractive errors, strabismus, cataract, glaucoma, and retinal pathologies were given a referral card for ophthalmic check-up. If parents do not bring siblings for check-up within 1 month of initial information and even after 2 SMS reminders, it was considered as failure to uptake of services. On follow-up later, they were provided a questionnaire. A questionnaire was given to the parent by interview through a project coordinator, and details were obtained from the parents or caretaker. Parents who were willing for telephonic interview were asked to respond to the questionnaire over phone on the scheduled date. The sibling details, parent-related details, and data from questionnaire forms were entered and analyzed. The mean age of 300 siblings was 9.3 ± 4.0 years with the majority of them being female (158). The most common reasons quoted by parents in the rural area compared with the urban area for not bringing siblings for eye exams were the travel distance from home to the hospital (n = 118, 83.7%), the travel time from home to the hospital (n = 109, 77.3%), more than one vehicle required to change (n = 111, 78.7%), and the transportation cost more than rupees 100 (INR) (n = 89, 63.1%) (p < 0.05). Unable to leave work responsibilities (n = 126, 79.3%) was stated more frequently by urban parents compared to rural (p = 0.039). Our study suggests that the financial factor, the distance factor, and social belief play an important role in timely uptake of sibling eye check-up. Targeting siblings with treatable pediatric eye diseases could help in reducing the burden of refractive error, strabismus, and cataract in the pediatric population.

The role of LncRNAs in the development of cataracts

The prevalence of eye diseases worldwide is dramatically increasing and represent a major concern in underdeveloped and developed regions, especially sight threatening diseases. Ocular diseases, previously associated with a higher depression risk, also impose a substantial economic burden on affected families and society, thus the importance of early detection and accurate treatment in order to avoid and prevent blindness should be emphasized. Cataract, a clouding (opacification) in the normally transparent of lens which leads to a decrease in vision, is most commonly due to aging but may also be present at birth and occur due to trauma or radiation exposure. With the increasing population of elderly people and cataract patients in China, the social burden of cataract is a big challenge at present and will continue to be a challenge in the future. Genetics have been shown to play an important role in the occurrence of eye diseases, with the detection of a numbers of specific gene mutations. LncRNAs have emerged as a novel class of regulatory molecules involved in numerous biological processes and complicated diseases, however the proper connections and pathways they may use to influence the susceptibility to developing cataracts have not yet been completely elucidated. In this review, we focus on the lncRNAs characteristics and its regulation, and summarize these results from separate, independent, cataract-related studies in addition to discussing possible pathways by which lncRNAs might contribute to the development of cataract.

Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019

BackgroundTo evaluate the global burden of cataracts by year, age, region, gender, and socioeconomic status using disability-adjusted life years (DALYs) and prevalence from the Global Burden of Disease (GBD) study 2019.MethodsGlobal, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by cataracts, by year, age, and gender, were obtained from the Global Burden of Disease Study 2019. Socio-demographic Index (SDI) as a comprehensive indicator of the national or regional development status of GBD countries in 2019 was obtained from the GBD official website. Kruskal-Wallis test, linear regression, and Pearson correlation analysis were performed to explore the associations between the health burden with socioeconomic levels, Wilcoxon Signed-Rank Test was used to investigate the gender disparity.ResultsFrom 1990 to 2019, global DALY numbers caused by cataracts rose by 91.2%, crude rates increased by 32.2%, while age-standardized rates fell by 11.0%. Globally, age-standardized prevalence and DALYs rates of cataracts peaked in 2017 and 2000, with the prevalence rate of 1283.53 [95% uncertainty interval (UI) 1134.46–1442.93] and DALYs rate of 94.52 (95% UI 67.09–127.24) per 100,000 population, respectively. The burden was expected to decrease to 1232.33 (95% UI 942.33–1522.33) and 91.52 (95% UI 87.11–95.94) by 2050. Southeast Asia had the highest blindness rate caused by cataracts in terms of age-standardized DALY rates (99.87, 95% UI: 67.18–144.25) in 2019. Gender disparity has existed since 1990, with the female being more heavily impacted. This pattern remained with aging among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized DALYs (equation: Y = -53.2*X + 50.0, P < 0.001) and prevalence rates (equation: Y = − 492.8*X + 521.6, P < 0.001) was negatively correlated with SDI in linear regression.ConclusionThe global health of cataracts is improving but the steady growth in crude DALY rates suggested that health progress does not mean fewer demands for cataracts. Globally, older age, females, and lower socioeconomic status are associated with higher cataract burden. The findings of this study highlight the importance to make gender-sensitive health policies to manage global vision loss caused by cataracts, especially in low SDI regions.

Immediate sequential bilateral cataract surgery: patient perceptions and preferences.

BackgroundRecent national data suggests that less than 0.5% of NHS cataract patients undergo immediate sequential bilateral cataract surgery (ISBCS). Since ISBCS improves service efficiency, increasing its practice may help tackle the ever-growing burden of cataract in the UK, and reduce the COVID-19 cataract backlog. Surgeon attitudes are known to be a significant barrier to increasing the practice of ISBCS. However, little is known about patient perceptions of ISBCS.MethodsPatients at cataract clinics across three NHS hospital sites were recruited to complete an investigator-led structured questionnaire. Open-ended and closed-ended questions were used to assess awareness of ISBCS, willingness to undergo ISBCS and attitudes towards ISBCS.ResultsQuestionnaires were completed by 183 patients. Mean participant age was 70.5 (9.9) years and 58% were female. Forty-three percent were aware of ISBCS, chiefly via clinic staff. Just over a third would choose ISBCS if given the choice, and participants that perceived they were recommended ISBCS were more likely to opt for it. The most common motivator and barrier to uptake of ISBCS was convenience and the perceived risk of complications in both eyes respectively. Concerns related to the recovery period were common, including misunderstandings, such as the need to wear eye patches that obscure both eyes.ConclusionsOur study indicates that significantly more NHS patients would be willing to undergo ISBCS if given the choice. The reluctance of surgeons to recommend ISBCS and patient misunderstandings regarding the recovery period may be limiting its uptake.

Commentary: Analyzing prevalence and risk factors of cataract: Its importance and effort.

The leading cause of avoidable blindness and the second-highest cause of visual impairment worldwide is cataract.[1] Therefore, it is important to understand the prevalence and risk factors of cataract in different parts of the world so as to reduce the same. Guo et al. in their study[2] have brought out well the importance of analyzing the prevalence of cataract. A comparison was made between the past and present prevalence of cataract in South East Asia, wherein they observed that the prevalence remained unchanged since 1990 despite an overall global reduction in cataract prevalence.[3] This indeed is an ironically striking feature because despite the overall advancement of eyecare facilities all over the world, the prevalence of cataract in South East Asia has remained unchanged over a period of 30 years, a difference well brought out.[2] As regards analysis of various risk factors, the authors have found no association of gender, diabetes mellitus, smoking, ocular trauma, and body mass index with cataract. On the other hand, increasing age, rural inhabitants, and hypertensive patients were associated with increased incidence of cataract. The authors have also compared well regarding the type of cataract and its association with the various risk factors: Patients with hypertension were associated with nuclear and cortical cataract whereas rural inhabitants had more frequently cortical cataract. This was compared with other East Asian countries as well. This kind of study definitely helps in understanding the burden of cataract in a particular region, which is an important cause of avoidable blindness. This further helps in better planning and management so as to reduce the prevalence of cataract. Like any other study, this study too has its own limitations, where sample size was calculated based on visual impairment rather than prevalence of cataract. Interestingly, the Vientiane study is first of its kind and paradoxically, there is no published data on the prevalence of cataract in the other neighboring countries of Thailand, Cambodia, Vietnam, or the Yunnan Province of China. This calls for more similar studies across the world especially so in the developing countries.

POSB177 Epidemiological Disease Burden of Other Cataract Based on Routinely Collected Health Insurance Claims DATA

Developing and developed countries have both seen an increase in the prevalence of cataract. Cataract has a wide spectrum of symptoms which may lead to functional problems and limitations in daily activities of life. The aim of our study was to determine the epidemiological disease burden of other cataract.

Age- and Sex-Standardized Prevalence of Age-Related Cataract and Its Determinants; Tehran Geriatric Eye Study (TGES)

ABSTRACT Purpose To determine the prevalence of cataract and its relationship with some determinants in individuals above 60 years. Methods Of 3792 subjects that were invited, 3310 participated in the study (response rate = 87.31%). All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, their lenses were evaluated according to the World Health Organization cataract grading system after pupil dilation. Results Age- and sex-standardized prevalence with 95% confidence interval (CI) of nuclear, cortical, posterior subcapsular cataracts (PSC), any type cataract, and all lens change was 53.09% (49.80 to 56.35), 23.02% (20.87 to 25.32), 5.57% (4.62 to 6.70), 58.78% (55.65 to 61.83), and 72.49% (70.14 to 74.71), respectively. Any type, nuclear, cortical, and PSC cataracts, had a positive association with age and an inverse association with education. Moreover, the prevalence of cortical and PSC cataract had an inverse association with economic status. Among all variables, age was the strongest determinant for cataract and its subtype. Conclusion This study found a higher prevalence of cataract compared to some previous studies such that about two-thirds of the geriatric population had cataract in the past or at the time of the study. Considering the association of cataract with variables such as economic status and education level, it seems that training and increased awareness and knowledge of the elderly population regarding the importance of eye care by physicians plays an important role in reducing the burden of cataract.

The Burden of and Factors Associated with Age-Related Eye Diseases in Arab American Adults.

To estimate the age- and sex-adjusted proportions of cataract, diabetic retinopathy, glaucoma, and macular degeneration among the Arab American community, a notably understudied minority that is aggregated under whites. The Arab American Eye Study is a multicenter retrospective chart review involving 10 years of electronic medical records (1/1/2010 through 1/1/2020). The study sample included 1390 Arab Americans and 4950 whites 45years of age and older, totaling 6340 subjects. Arab Americans were identified using an Arab American name algorithm. Subjects with race variables other than white or Arab American or those under age 45 were excluded from the study. Age- and sex-adjusted proportions of cataract, diabetic retinopathy, glaucoma, and macular degeneration were determined. Odds ratios with 95% confidence intervals were used to examine the association between race/ethnicity and eye diseases. Of the 6340 participants (4950 whites and 1390 Arab Americans), males comprised 46.3% and the median age group was 55-64years. Arab Americans displayed higher age- and sex-adjusted proportions of cataracts (45.4% versus 40.7%), dry age-related macular degeneration (10% versus 8.9%), glaucoma (8% vs 6%), and diabetic retinopathy (11.7% versus 4.2%). Fully adjusted logistic regression revealed that Arab Americans were 19% more likely to have cataracts (OR 1.19; 95% CI 1.05, 1.35) and 272% more likely to have diabetic retinopathy (OR 2.72; 95% CI 2.17; 3.41). Results from the Arab American Eye Study suggest that the burden of cataract and diabetic retinopathy is significantly higher among Arab Americans in comparison to whites.

Socio-economic disparity in visual impairment from cataract.

To investigate the association of visual impairment from cataract with human development index (HDI) by years lived with disability (YLDs). Published data on national age-standardized YLD rates caused by cataract and national HDIs in 2019 were obtained. Age-standardized YLD rates from 1990 to 2019 were analyzed to explore cataract burden among patients with different income levels. Age-standardized YLD rates in different HDI groups were compared by different degrees of visual impairment. Association between national age-standardized YLD rates and HDI in 2019 was analyzed. The age-standardized YLD rates of populations with visual impairment or blindness due to cataract declined from 1990 to 2019, especially among those with lower middle income. Multiple comparison tests revealed that countries with low HDI had significantly higher age-standardized YLD rates of blindness due to cataract than those with high and very high HDI (P<0.001). The age-standardized YLD rates of populations with blindness (β=-0.588, P<0.001), severe vision loss (β=-0.378, P<0.001), and moderate vision loss (β=-0.389, P<0.001) inversely correlated with HDI. Age-standardized YLD rates caused by cataract have declined since 1990. The burden of visual impairment due to cataract inversely correlate with national socioeconomic development and is more concentrated in countries with low HDI than those with high HDI, especially among the blind. These findings highlight the need to provide additional cataract services and cataract surgery coverage to developing countries to decrease the burden of avoidable blindness caused by cataract.

Barriers to Cataract Surgery Utilization Among Cataract Patients Attending Surgical Outreach Sites in Ethiopia: A Dual Center Study.

BackgroundCataract is the leading cause of avoidable blindness globally and in Africa. Various barriers limit access of cataract blind individuals to cataract surgery. This study aimed to determine the barriers to cataract surgery utilization among cataract blind patients presenting to campaign sites in Ethiopia.MethodsAn institution-based cross-sectional design study was conducted to select 209 patients. The study was conducted from July to August 2020. A structured questionnaire was used to collect socio-demographic data and barriers for not having cataract surgery. Physical examination such as visual acuity, slit lamp bio microscopy and direct ophthalmoscopy was done for all participants. Epi Info 7 was used for data entry and Statistical Package for Social Science/SPSS version 23 was used for analysis after data were exported. Descriptive methods were employed for analysis.ResultsA total of 209 subjects were recruited in the study with a mean age of 64.2 (±14.6) years, with a range of 32–99 years. From the total study subjects, 53% were males and 40.2% were over 66 years old. Upon presentation to the campaign site, 33% of study subjects had visual acuity of operable eye under blindness category and half of the study subjects (50.2%) had mature cataract. The most reported barriers were waiting until cataract becomes mature (18.7%), fear of surgery complications (16.7%), far from eye health institution (16.4%) and lack of income/cost for surgery (11.5%).ConclusionRecognizing the severity and the blindness burden of cataract in Ethiopia, creating public awareness, establishing eye health institutions, increasing the number of eye health professionals, increasing the quantity and the quality of cataract campaigns to alleviate these barriers are of paramount importance at the country level.