Correctable Visual Impairment Research Articles

Uncorrected Refractive Error in the African American Eye Disease Study

Refractive error remains the largest cause of correctable visual impairment in the US. Correction of refractive error will reduce visual impairment and its associated morbidity but also improve quality of life and productivity. To determine the burden of and risk factors (RFs) associated with any uncorrected refractive error (UCRE) and unmet refractive need (URN) in a population-based sample of African American adults. This cross-sectional study, conducted from April 2014 to April 2018, included a population-based sample of self-identified African American participants 40 years and older from 30 contiguous census tracts in Inglewood, California. Participants underwent a complete ophthalmic examination and an in-home-administered questionnaire to assess sociodemographic, lifestyle, biological, medical, and health care and eye care usage RFs associated with UCRE and URN. Measurements of visual acuity (VA) were performed using a standard Early Treatment Diabetic Retinopathy Study protocol. Noncycloplegic automated refraction with supplemental subjective refraction was performed. UCRE was defined as an improvement of 2 or more lines with refraction in the better-seeing eye. URN was defined as an improvement of 2 or more lines with refraction in the better-seeing eye in those persons who were visually impaired. Sex- and age-specific burden of UCRE and URN were calculated, and multiple regression analyses were used to identify independent RFs. Study data were analyzed from May 2018 to December 2023. Presence or absence of correctable refractive error. Self-reported sex- and age-specific prevalence of and risk indicators of UCRE and URN. Of the 7957 eligible participants in the African American Eye Disease Study (AFEDS), 6347 (80%) completed both the in-home interview and the clinical examination. Of these, 6337 participants (mean [SD] age, 61 [11] years; 3997 female [63%]) with complete refractive error data were included in the analysis. Refractive error-related correctable visual impairment was present in over two-thirds of participants with visual impairment (68.7%). The overall prevalence of any UCRE was 14.6% (925 of 6337), and the overall prevalence of any URN was 5.4% (URN1 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve 20/40 or better with correction], 157 of 2893; URN2 [those with presenting VA of worse than 20/40 in the better-seeing eye but who could achieve an improvement of 2 or more lines with refractive correction], 155 of 2891). Results of this cross-sectional study suggest a high burden of refractive error-associated correctable refractive error in African American adults, making it the leading cause of visual impairment in this population. Providing universal coverage for vision care and prescription glasses is an affordable and achievable health care intervention that could reduce the burden of visual impairment in African American adults by over two-thirds and likely raise the quality of life and work productivity, especially in this vulnerable minority population.

Development and Validation of a Screening Tool for The Identification of Refractive Errors Among School Going Children In Tamil Nadu, India

Background: The inability to focus light onto the retina, known as refractive error, is a significant cause of correctable visual impairment. Unfortunately, students' ocular complaints often go unnoticed due to a lack of awareness. To address this issue, a questionnaire with high sensitivity and reasonable specificity was developed for teachers to identify students with refractive error. Methods: A questionnaire with surrogate indicators for refractive error in children was used and the data was analysed using SPSS. Significant markers were scored and a ROC curve determined a suitable cut-off. Sensitivity and specificity were calculated based on this cut-off. Results: The questionnaire was developed using five variables that had a 65% probability of identifying refractive error, including copying errors, copying from peers, eye squeezing, previous use of glasses, and eye deviation. A cut-off score of 5.5 out of 14 achieved 90% sensitivity and 50% specificity in detecting refractive errors. Conclusion: This study created a tool with five markers that demonstrated good internal consistency and content validity, it had an average sensitivity and specificity of 84% and 63%, respectively. The tool is twice as likely to identify someone with refractive error than someone without it.

Towards Automating Retinoscopy for Refractive Error Diagnosis

Refractive error is the most common eye disorder and is the key cause behind correctable visual impairment, responsible for nearly 80% of the visual impairment in the US. Refractive error can be diagnosed using multiple methods, including subjective refraction, retinoscopy, and autorefractors. Although subjective refraction is the gold standard, it requires cooperation from the patient and hence is not suitable for infants, young children, and developmentally delayed adults. Retinoscopy is an objective refraction method that does not require any input from the patient. However, retinoscopy requires a lens kit and a trained examiner, which limits its use for mass screening. In this work, we automate retinoscopy by attaching a smartphone to a retinoscope and recording retinoscopic videos with the patient wearing a custom pair of paper frames. We develop a video processing pipeline that takes retinoscopic videos as input and estimates the net refractive error based on our proposed extension of the retinoscopy mathematical model. Our system alleviates the need for a lens kit and can be performed by an untrained examiner. In a clinical trial with 185 eyes, we achieved a sensitivity of 91.0% and specificity of 74.0% on refractive error diagnosis. Moreover, the mean absolute error of our approach was 0.75±0.67D on net refractive error estimation compared to subjective refraction measurements. Our results indicate that our approach has the potential to be used as a retinoscopy-based refractive error screening tool in real-world medical settings.

Vision Impairment and Productivity Among Female Garment Workers in Bangladesh: A Cohort Study.

To assess the prevalence of near and correctable distance visual impairment among screened participants in the garment industry and to explore associations with income, age, and urban versus rural residence. Vision screenings were conducted at 4 garment factories, 2 urban and 2 rural locations during September and October 2019. Distance vision impairment was the presence of uncorrected vision of <6/12 in either eye, correctable to ≥6/7.5 with distance refraction. Near vision impairment was defined as 1 or more of the following: 1) either eye with presenting near vision <N8 at 40 cm with distance visual acuity >6/12 in the same eye; 2) having been prescribed near add spectacle power in examination records; and/or 3) clinical diagnosis of presbyopia at the time of screening. Demographic information and monthly income were self-reported by questionnaire completion. Among 915 participating workers (100% female, 18 to 70 years), 29.2% (n = 267) and 26.8% (n = 245) had correctable distance and near vision impairment respectively. Prevalence of near vision impairment was significantly higher among rural residents (34.2%, n = 160), compared to urban (19.0%, n = 85, P < 0.0001) with the largest differences in the 35 to 39 (68.2% vs 44.2%, P = 0.0019) and 40+ (85.9 vs 48.9%, P < 0.0001) year age ranges. Prevalence of near vision impairment was already high among urban (20.4%, n = 20) and rural (23.0%, n = 17) workers aged 30 to 34 years. In simple linear regression models, participants with near vision impairment earned $13.3 [standard error (SE) 2.44, P < 0.0001] less per month than those without, while urban residents earned $40.6 (SE 1.74, P < 0.0001) more than rural dwellers. In the final multivariate linear model, both near vision impairment ($6.51 lower monthly earnings, SE 1.84, P = 0.0004) and urban residence ($43.2 higher monthly earnings, SE 2.39, P < 0.0001) remained significantly associated with income. This study found high rates of near vision impairment among female garment workers, particularly rural dwellers, and at a younger age than expected. The high prevalence and association between near vision impairment and lower income suggest that focusing on industries with a high proportion of female workers, such as readymade garments, may be effective in addressing gender disparities in vision impairment and its economic impact.

Knowledge, Attitudes and Practices (KAP) about Refractive Error among Students Attending Faculty of Health Sciences at L&amp;#250;rio University in Mozambique, 2020

Introduction: Refractive error is recognized as one of the most important causes of correctable visual impairment and affects people of all ages, socioeconomic levels, and ethnic groups. The World Health Organization (WHO) estimated 285 million people globally were visually impaired, with 39 million blinds. The aim of this study is to access the knowledge, attitudes, and practices of health sciences students about the refractive error in Nampula, Mozambique. Material and Methods: Descriptive cross-sectional study including health sciences students of Lúrio University in Nampula, applying a questionnaire to access their knowledge, attitudes, and practices concerning the refractive error. The collected data were entered into SPSS version 22.0 for analysis. Frequency distribution and central tendency measures (mean, median) were used to summarize the descriptive part of the study. Results were described using tables and running text. Sample students were included after obtaining informed consent. Results: A total of 298 students participated in the study, 50.3% female, with average age of 24 ± 5.4 years. 69.8% had an eye exam and 54.7% believe they have good vision, 58.1% say that wearing glasses is the main method of correcting refractive errors. 92.3% refer to the Central Hospital as the best place to provide eye health services. The main reason for not purchasing the glasses was their cost (47.3%) and the alternative method for spectacle users was contact lenses (81.0%). The students’ attitudes were positive towards the use of glasses. Conclusion: Visual health education about the knowledge, attitudes and practices regarding refractive errors among students must be intensified to ensure good dissemination of information in the surrounding communities enrolled in the health promotion program “One Student, One Family” implemented by Lúrio University in Nampula.

The Association Between Presenting Visual Impairment, Health, and Employment Status

Introduction: The purpose of this study was to investigate the effect of visual impairment and correctable visual impairment (i.e., uncorrected refractive errors) on being out of the labor force and on unemployment. The effect of health on labor force status was also investigated. Method: National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2008 ( N = 15,650) was used for this study. Participants were classified into three vision status groups: normal, correctable visual impairment, and visual impairment. Statistical analyses utilized were chi-square and logistic regression. Results: Having a visual impairment was significantly associated with being out of the labor force, while having a correctable visual impairment was not. Conversely, having a correctable visual impairment was associated with unemployment, while having a visual impairment was not. Being out of the labor force was not significantly associated with health for those with a visual impairment, although it was for those with correctable visual impairments and normal vision. Discussion: Given previous research, it was surprising to find that health was not associated with being out of the labor force for those with visual impairments. Perhaps other disadvantages for the people with visual impairments identified in this study contributed to their higher out-of-the-labor-force rates regardless of health. Implications for practitioners: Researchers utilizing national data sets that rely on self-reports to identify visual impairments should realize that some of those who self-identify as being visually impaired may actually have correctable visual impairments. Current research is needed to understand why a majority of people with visual impairments are not seeking employment and have removed themselves from the labor force.

Prevalence and associated factors of myopia among school children in Bahir Dar city, Northwest Ethiopia, 2019.

BackgroundMyopia is the leading cause of correctable visual impairment and preventable blindness worldwide. Genetic and environmental factors contribute to the development of myopia. Myopia is appearing with greater prevalence in young children.ObjectiveThis study aimed to assess the prevalence and associated factors of myopia among school children in Bahir Dar city, Northwest Ethiopia, 2019.Methods and materialsA school-based cross-sectional study was conducted among school children of 6 to 18 years of age in Bahir Dar city from October to November 2019. A pretested interviewer-administered structured questionnaire was used to collect data among 634 participants using a multi-stage sampling technique from primary and secondary schools. Cycloplegic refraction was performed by optometrists for each student with 1% cyclopentolate eye drop, and subjective refraction was carried out to determine the final prescription of the students. Myopia was defined as spherical equivalent refractive error of ≥ 0.5 diopter in either eye. Data were entered into Epi Info version 7 and exported to Statistical Package for Social Sciences version 23 for analysis. Tables, frequency, and mean were used for descriptive statistics. Bivariable and multivariable logistic regression analyses were done to identify risk factors of myopia. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant.ResultsAmong a total of 601 study participants, 51 (8.49%) were myopic. Age group of 10–13 years (AOR = 6.54: 95% CI = 5.56–10.86), 14–18 years (AOR = 6.32: 95% CI = 5.32–9.69), 2–4 hour per day mobile exposure (AOR = 3.69: 95% CI = 1.63–8.38), > 4 hour per day mobile exposure (AOR = 11.6: 95% CI = 4.41–30.42), near working distance of < 33 centimeter (AOR = 6.89: 95% CI = 2.71–17.56) and outdoor activity (AOR = 3.94: 95% CI = 1.87–8.31) were significantly associated with myopia.ConclusionsThe prevalence of myopia was high among school children in Bahir Dar city. Older age, longer duration of mobile exposure, shorter near working distance were the risk factors for the development of myopia whereas having outdoor activity was the protective factor.

Prevalence of undiagnosed, preventable visual impairment in children with intellectual disability in special needs schools in Western Saudi Arab

Background: Visual disorders have been reported to be higher among children with intellectual disability (ID) than among their peers without special needs; however, prevalence data on visual problems in children in Saudi Arabia are scarce. Aims: The aim of this study is to report the prevalence and causes of undiagnosed, correctable visual impairment in children with ID. Materials and Methods: A cross-sectional study of students enrolled in special educational needs schools in the western region of Saudi Arabia in April 2018. Teller visual acuity (VA) assessment and refractive errors were noted. Participants with mild to profound ID underwent detailed ophthalmologic examinations, including cycloplegic refraction, full orthoptic workup, biomicroscopy, and funduscopy. Results: A total of 61 students participated in this study. Ocular findings in decreasing prevalence were as follows: Subnormal VA (n = 41, 67.2%), refractive errors (n = 31, 51.7%), fundus anomalies (n = 13, 22%), significant strabismus (n = 9, 14.8%), abnormal head posture (n = 8, 13.3%), nystagmus (n = 3, 4.9%), anterior segment abnormality (n = 3, 4.9%), and extraocular motility abnormality (n = 2, 3.3%). Astigmatism was found in 22 cases (36.7%), followed by hyperopia (n = 13, 21.7%), myopia (n = 10, 16.7%), and anisometropia (n = 5, 8.3%). Students with syndromic ID had significantly more moderate-to-severe subnormal VA (P < 0.001) and myopic shift on cycloplegic refraction (P = 0.014 right eyes and P = 0.004 left eyes) than those with nonsyndromic ID. Conclusions: A considerable proportion of ID children have significant visual disorders. This emphasizes the need for adequate diagnostic and therapeutic national eye care services for children with ID.

Responsibility for Funding Refractive Correction in Publicly Funded Health Care Systems: An Ethical Analysis

Allocating on the basis of need is a distinguishing principle in publicly funded health care systems. Resources ought to be directed to patients, or the health program, where the need is considered greatest. In Sweden support of this principle can be found in health care legislation. Today however some domains of what appear to be health care needs are excluded from the responsibilities of the publicly funded health care system. Corrections of eye disorders known as refractive errors is one such domain. In this article the moral legitimacy of this exception is explored. Individuals with refractive errors need spectacles, contact lenses or refractive surgery to do all kinds of thing, including participating in everyday activities, managing certain jobs, and accomplishing various goals in life. The relief of correctable visual impairments fits well into the category of what we typically consider a health care need. The study of refractive errors does belong to the field of medical science, interventions to correct such errors can be performed by medical means, and the skills of registered health care professionals are required when it comes to correcting refractive error. As visual impairments caused by other conditions than refractive errors are treated and funded within the public health care system in Sweden this is an inconsistency that needs to be addressed.

Children's visual impairment and visual care related to socioeconomic status in Catalonia (Spain).

The objective of this study is to assess the prevalence of visual impairment and visual care practices and its association with socioeconomic conditions in the infant population in Catalonia. The Catalan Institute of Statistics provided a random sample of 0 to 14-year-old non-institutionalized children whose parents were interviewed in a continuous health survey from 2011 to 2015 in Catalonia. A multistage stratified and random sampling procedure considering age, sex, county and town was followed. All results have been weighted according to the sample design and are presented as the proportion of the condition with its 95% confidence limits. Chi-square tests were performed to evaluate the association between categorical variables. To study the association of visual care with independent variables, a multiple logistic regression model was used. In 0 to 14-year-old children, a 12.9% (95% confidence interval [CI] [11.8-13.9]) prevalence of correctable visual impairment was observed. The prevalence of non-correctable visual impairment was 0.9% (95% CI [0.6-1.2]). Non-correctable visual impairment was more prevalent in families with lower education levels, manual professions or unemployed. Of children without visual impairment, 13,5% (95% CI:12.3-14.6) visited a visual care professional in the last 12 months while this proportion was 67.4% (95% CI [63.3-71.5]) among those with correctable visual impairment. When parents have a university degree or non-manual professions, a higher level of visual care was observed. In children with correctable visual impairment, visual reviews were more frequent when parents are employed in a non-manual profession. For the first time, indicators related to visual impairment in children in Catalonia have been recorded. There is an association between lower socioeconomic status and having non-correctable visual impairment, and conversely, having correctable visual impairment was significantly associated with employed parents. More visual care is associated with higher socioeconomic status.

Prevalence of myopia among secondary school students in Welkite town: South-Western Ethiopia

BackgroundRefractive error, especially myopia, is the most common eye disorder in the world and a significant cause of correctable visual impairment. The aim of this study was to assess the prevalence of myopia among secondary school students in Welkite town, South-Western Ethiopia.MethodsA school based cross sectional study was carried out among secondary school students of 13 to 26 years of age. The students were selected using a multi stage-stratified cluster sampling technique from four secondary schools. The students’ socioeconomic background, usage of eyeglasses and parental myopia was assessed by a questionnaire before visual acuity assessment. Students with visual acuity of less than or equal to 6/12 in the worse eye, who showed vision improvement with pinhole, underwent non-cycloplegic retinoscopy and subjective refraction. Myopia was defined as a spherical equivalent of less than or equal to − 0.50 diopters. Logistic regression was used to see the association of myopia with age, sex, grade level, ethnicity, parental history of myopia and severity.ResultsA total of 1271 students with a response rate of 89.4% were evaluated. The mean age was 16.56+ 1.51 years. Eighty three students were identified to have myopic refractive error making the prevalence of 6.5% (95% CI: 5.30, 8.02). Of 648 females, 50 (7.7%) had myopia while 33 (5.3%) of 623 males had myopia making females relative risk to be 1.5 times that of males. From the total students diagnosed to have refractive error (n = 92), myopia constituted 83/92 (90.2%) of the students indicating that it is the commonest type of refractive error found amongst secondary school students. Only 36.1% of students with myopia wore eyeglasses when they attended the survey. Myopia was more common among older age group 17–21 years (OR: 1.54 95% CI 0.986–2.415) and higher grade level 11–12 (OR: 1.14 95% CI 0.706–1.847).ConclusionsThe prevalence of myopia is high in our study. Attention to the correction of myopia in secondary schools students of Welkite town using eyeglasses can prevent a major proportion of visual impairment.

Visual Impairment in Fungal Versus Bacterial Corneal Ulcers 4 Years After Successful Antimicrobial Treatment

PurposeTo compare longitudinal outcomes of visual acuity after fungal corneal ulcers with those of bacterial ulcers. DesignProspective cohort study. MethodsThis study was conducted in a tertiary eye hospital in South India. The population consisted of 100 of 152 individuals whose fungal or bacterial keratitis had been diagnosed 4 years prior and had been enrolled in 1 of 2 concurrent randomized trials. Causative organisms of infectious keratitis were either bacterial or fungal. Presenting visual acuity consisted of best spectacle corrected visual acuity (BSCVA) and hard contact lens-corrected visual acuity (CLVA). ResultsFifty study participants with prior fungal keratitis and 50 with prior bacterial keratitis were enrolled. Four years after treatment for keratitis, participants' presenting vision in the better eye was worse than 20/60 for 12 individuals (24.0%) in the fungal group and 10 individuals (20.0%) in the bacterial group. Median BSCVA in the affected eye at the 4-year visit in the fungal group was similar to that in the bacterial group (Snellen equivalent, 20/32 for each), although vision worse than 20/400 was more common in the fungal ulcer group after spectacle correction (odds ratio [OR] 4.19; 95% confidence interval [CI], 1.11-15.8) and contact lens correction (OR, 5.74; 95% CI, 1.37-24.1). ConclusionsIn this South Indian population with a previous episode of fungal or bacterial keratitis, correctable bilateral visual impairment was common. Although long-term visual outcomes were, on average, similar between fungal and bacterial ulcers, fungal ulcers were more likely to produce severe visual impairment.

Time trend in the prevalence and correlates of refractive error among military conscripts between 1990 and 2013 in Austria, a descriptive study

Introduction Refractive error is one of the most important causes of correctable visual impairments. The corrections of refractive error are associated with considerable economics and healthcare burden. In addition, uncorrected refractive error is prevalent and induces productivity loss. The prevalence of refractive error in Austria has not been studied. Using data from Austrian conscripts, we quantified the time trend in the prevalence of myopia and hyperopia over 24 years period. We also explored sociodemographic correlates of refractive error over time in our sample. Methods All Austrian men are obligated to serve military with compulsory medical investigations at conscription between 17 and 18 years of age. Medical investigations data from 1990 to 2013 were obtained from the Austrian military and used for the current analysis. Non-cycloplegic refractions were measured by an autorefractometer. Data on sphere and cylinder of left eyes were used to calculate the spherical equivalent (SE) using the standard formula [SE = sphere + cylinder/2, unit diopters (D)]. Myopic refractive errors were defined as low (−2.0 to 0 to = 2.0 D). Data on following correlates were retrieved: education, height, body mass index (BMI), provinces and smoking status. Education were classified into four categories: lower than 9 years of compulsory school; completed compulsory school; graduated from professional training or served an apprenticeship; had a general qualification for university entrance. Height was classified into three groups using the 10th and 90th percentiles: 186 cm. BMI was classified into three group using the 10th and 90th percentiles: below 10th percentile ( 27.8 kg/m2). Data on conscripts’ residences was collected and presents nine provinces in Austria and classified to Vienna and non-Vienna provinces. Finally, smoking status was classified to smokers and non-smokers. Aggregated descriptive of refractive error were calculated using frequencies and percentages by 2 years interval and categories of correlates. Results Data on 1,048,240 young men were used for analyses. The overall prevalence of myopia increased over 24 years (18.0% to 24.6%), driven by the increases in low (10.8% to 13.9%) and medium myopia (6.6% to 9.9%). The overall prevalence of hyperopia, lower than that of myopia, appeared to slightly decline (4.5% to 3.7%). We observed consistent associations of education, height, BMI and smoking status with myopia prevalence over time. Conscripts with higher education, taller than 187 cm, being smokers, with BMI below 10th percentile ( Conclusions To the best of our knowledge, this analysis is the first to report population-based prevalence of refractive errors in Austrian young men, and the largest study ever conducted worldwide. The greatest burden of refractive errors in this population is due to myopia, particularly low and medium myopia. The prevalence of myopia has been steadily increasing over the last 2.5 decades, suggesting the need of preventive measures to curb this trend. This requires future research investigating the impact of modifiable factors on myopia development and progression in specific populations.

The visual status of adolescents in Riyadh, Saudi Arabia: a population study.

PurposeThe visual status of adolescents in Saudi Arabia (SA) has not been well reported. To date, the prevalence and types of refractive errors (REs), amblyopia, strabismus, and correctable visual impairments have not been quantified. The aim of the study was to investigate the visual status in adolescents in Riyadh, SA.MethodsThis study was based on a population cross-sectional and random cluster design. After design and the sample calculations, 1,007 participants, 12–20 years of age, were screened during the study. Nine participants were excluded due to ocular disorders. The participants were assessed for REs, distance visual acuity logarithm of the minimum angle of resolution, contrast sensitivity, stereoacuity, pinhole test findings, and cover–uncover test findings.ResultsThe results showed that 55.5% of the participants had some form of REs, while correctable visual impairment was found in one-fifth of the screened participants. Myopia was the dominant type (53.3%, ranged from −0.50 DS to −14.00 DS), whereas hyperopia was found in 2.2% (+2.00 DS to +5.50 DS) and astigmatism was present in 15% (−0.75 DC to −5.25 DC). Only 43% of the participants had corrected REs; however, the noncompliance for spectacle use was 20.25%.ConclusionThis study was the first attempt to investigate the visual status in adolescents in SA. It provided estimations of the REs, amblyopia, and strabismus. The high prevalence of REs emphasizes the need to identify the best proactive strategies to detect and manage REs to reduce the incidence of visual impairment in SA. Increasing awareness about eye health and employing efficient screening programs could help to address the need for REs corrections.

Knowledge, attitude and associated factors among primary school teachers regarding refractive error in school children in Gondar city, Northwest Ethiopia.

IntroductionRefractive error is an important cause of correctable visual impairment in the worldwide with a global distribution of 1.75% to 20.7% among schoolchildren. Teacher’s knowledge about refractive error play an important role in encouraging students to seek treatment that helps in reducing the burden of visual impairment.ObjectiveTo determine knowledge, attitude and associated factors among primary school teachers regarding refractive error in school children in Gondar city.MethodsInstitution based cross-sectional study was conducted on 565 primary school teachers in Gondar city using pretested and structured self-administered questionnaire. For processing and analysis, SPSS version 20 was used and variables which had a P value of <0.05 in the multivariable analysis were considered as statistically significant.ResultA total of 565 study subjects were participated in this study with a mean age of 42.05 ± 12.01 years. Of these study participants 55.9% (95% CI: 51.9, 59.8) had good knowledge and 57.2% (95% CI: 52.9, 61.4) had favorable attitude towards refractive error. History of spectacle use [AOR = 2.13 (95% CI: 1.32, 3.43)], history of eye examination [AOR = 1.67 (95% CI: 1.19, 2.34)], training on eye health [AOR = 1.94 (95% CI; 1.09, 3.43)] and 11–20 years of experience [AOR = 2.53 (95% CI: 1.18, 5.43)] were positively associated with knowledge. Whereas being male [AOR = 2.03 (95% CI: 1.37, 3.01)], older age [AOR = 3.05 (95% CI: 1.07, 8.72)], 31–40 years of experience [AOR = 0.23 (95% CI: 0.07, 0.72)], private school type [AOR = 1.76 (95% CI: 1.06, 2.93)] and 5th -8th teaching category [AOR = 1.54 (95% CI: 1.05, 2.24)] were associated with attitude.ConclusionKnowledge and attitude of study subjects were low which needs training of teachers about the refractive error.

Five-year visual outcome among people with correctable visual impairment: the Liwan Eye Study.

Longitudinal data on visual outcome of correctable visual impairments (VI) are of paramount importance for decision-maker to estimate burden and demand to treat avoidable VI. To assess the 5-year visual outcome among participants with correctable VI and to identify associated risk factors. Population-based longitudinal cohort study. Participants with correctable VI at baseline attended the 5-year follow-up visit of the Liwan Eye Study. Presenting visual acuity (PVA) with habitual refractive correction was assessed using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Then participants with PVA <6/12 in either eye underwent further non-cycloplegic subjective refraction to obtain their best-corrected visual acuity. Correctable VI was defined as having a PVA of <6/12 in the better eye which could be improved to ≥6/12 after refractive correction. The 5-year visual outcome among participants with correctable VI. Among 1405 participants at baseline examination, 188 (13.4%) had correctable VI, of whom 118 (62.8%) were re-examined at the 5-year follow-up, including 39 (33.9%) who progressed to non-correctable VI, 43 (37.4%) who had persistent correctable VI and 33 (28.7%) who were converted to normal vision. In multivariate logistic regression, compared with participants who were no longer visual impaired, significant risk factors for participants with persistent VI were older, had income <1000 RMB/month, and more myopia spherical equivalent. Over two of three participants with correctable VI remained to have VI after 5 years, among whom 50% are correctable by spectacles, highlighting the need to improve the refractive care accessibility to treat avoidable VI in China.

Prevalence and associated factors of myopia among high school students in Gondar town, northwest Ethiopia, 2016.

IntroductionMyopia is an important cause of correctable visual impairment and preventable blindness worldwide. Prevalence rates are approximately 20%–35% among the older teenage population globally. It has a medical burden of pathologic complications such as maculopathy and glaucomatous optic neuropathy. High school students experience high-performance and study pressures in the preparation for the final national examination. As a result they are exposed to excessive near work and indoor activities. They are also ignored for regular screening.ObjectiveTo determine the prevalence and associated factors of myopia among high school students in Gondar town, Ethiopia.MethodsAn institution-based cross-sectional study was conducted on 498 high school students with systematic random sampling method from April 18 to April 29, 2016, in three full-cycle high schools (9th–12th grades). A standardized structured questionnaire, Snellen acuity chart, pinhole, retinoscope, trial case lenses, pen torch, and direct ophthalmoscope were used to collect data.ResultsA total of 495 study participants were included, and they had a mean age of 17.48±1.59 years. The prevalence of myopia was 11.9% (95% confidence interval [CI]: 10.2, 17.9). Family history of myopia (adjusted odds ratio [AOR]=8.08 [95% CI: 4.30, 15.16]), school being private (AOR=2.88 [95% CI: 1.02, 8.11]), longer time spent for near work (AOR=2.89 [95% CI: 1.12, 7.43]), longer time spent partaking in indoor activities (AOR=4.32 [95% CI: 1.69, 10.99]), shorter near working distance (AOR=3.06 [95% CI: 1.33, 7.06]), lack of outdoor sport activities (AOR=2.27 [95% CI: 1.05, 4.90]), use of visual display units (AOR=2.81 [95% CI: 1.30, 6.10]), and abnormal ocular findings (AOR=6.69 [CI: 3.43, 13.03]) were found to be independently associated with myopia.ConclusionThe prevalence of myopia was 11.9%. Family history for myopia, school being private, longer time spent partaking in indoor activities, shorter working distance, lack of outdoor sport activities, use of visual display units, and presence of abnormal ocular findings were positively associated with myopia.

Improving Access to Vision Care for People Who are Homeless through Eyeglasses Recycling.

Visual impairment disproportionately affects the health and function of people who are homeless. A common and correctable cause of visual impairment is refractive error. However, eyeglasses remain an unmet need for the poor and underinsured. This report describes eyeglasses recycling and vision screening to reduce the burden of correctable visual impairment.

Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort

Purpose: To describe the prevalence of visual impairment and examine its association with demographic, socioeconomic, and health characteristics in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.Methods: Visual acuity data were obtained from 6134 participants, aged 46–87 years at time of examination between 2002 and 2004 (mean age 64 years, 47.6% male), from six communities in the United States. Visual impairment was defined as presenting visual acuity 20/50 or worse in the better-seeing eye. Risk factors were included in multivariable logistic regression models to determine their impact on visual impairment for men and women in each racial/ethnic group.Results: Among all participants, 6.6% (n = 421) had visual impairment, including 5.6% of men (n = 178) and 7.5% of women (n = 243). Prevalence of impairment ranged from 4.2% (n = 52) and 6.0% (n = 77) in white men and women, respectively, to 7.6% (n = 37) and 11.6% (n = 44) in Chinese men and women, respectively. Older age was significantly associated with visual impairment in both men and women, particularly in those with lower socioeconomic status, but the effects of increasing age were more pronounced in men. Two-thirds of participants already wore distance correction, and not unexpectedly, a lower prevalence of visual impairment was seen in this group; however, 2.4% of men and 3.5% of women with current distance correction had correctable visual impairment, most notably among seniors.Conclusion: Even in the U.S. where prevalence of refractive correction is high, both visual impairment and uncorrected refractive error represent current public health challenges.

Longitudinal relationships among visual acuity, daily functional status, and mortality: the Salisbury Eye Evaluation Study.

Determination of the mechanisms by which visual loss increases mortality risk is important for developing interventional strategies. To evaluate the direct and indirect effects of loss of visual acuity (VA) on mortality risk through functional status changes among aging adults. Prospective longitudinal study of a population-based sample of 2520 noninstitutionalized adults aged 65 to 84 years from September 16, 1993, through July 26, 2003, in the greater Salisbury area of Maryland. Participants underwent reassessment 2, 6, and 8 years after baseline. Mortality status was ascertained from linkage with the National Death Index through 2009. Results of VA testing and self-reported functional status based on activities of daily living (ADL) and instrumental ADL (IADL). Mortality. Worse VA levels at baseline were associated with an increased the risk for mortality (hazard ratio [HR], 1.16 [95% CI, 1.04-1.28]; P < .01) through their effect on lower IADL levels at baseline. Declines in VA over time were associated with increased mortality risk (HR, 1.78 [95% CI, 1.27-2.51]; P < .001) by way of decreasing IADL levels over time. Participants experiencing the mean linear decline in VA of 1 letter on the Early Treatment Diabetic Retinopathy Study acuity chart per year are expected to have a 16% increase in mortality risk during the 8-year study exclusively through associated declines in IADL levels. In this longitudinal study of older adults, VA loss adversely affected IADL levels, which subsequently increased the risk for mortality. Prevention of disabling ocular conditions, treatment of correctable visual impairment, and interventions designed to prevent the effect of visual impairment on IADL declines may all reduce mortality risk in aging adults.