Prevalence Of Visual Disability Research Articles

Longitudinal association between visual disability and cognitive function among middle-aged and older adults in China

Background/aimsTo determine the associations between visual disability and cognitive decline in Chinese middle-aged and older adults.MethodsA total of 6748 subjects were enrolled into this longitudinal, population-based, nationally representative study from...

Clinical Investigation of Prevalence and Associated Factors of Visual Disability among the Elderly Agricultural and Fishing Population in Taiwan: Experience at a Teaching Hospital

Purpose: To discuss the prevalence and associated factors related to visual impairment and blindness amongst the elderly agricultural and fishing population. Methods: A total of 6542 healthy elderly adults voluntarily admitted to a teaching hospital for a physical check-up and eye disease in Taipei, Taiwan. Results: The overall prevalence of visual disability (the better eye visual acuity <0.5) was 13.2%, including 12.8% of visual impairment and 0.4% of blindness. From the logistic regression, the significantly independent factors of visual disability (visual impairment plus blindness) were sex (male vs. female, OR=0.68, 95%CI: 0.55-0.85), age (65-74 yrs vs. 60-64 yrs, OR=1.49, 95%CI: 1.18-1.89, 75-84 yrs vs. 60-64 yrs, OR=2.77, 95%CI: 2.11-3.65, ³85 yrs vs. 65-69 yrs, OR=4.76, 95%CI: 3.55-6.39), glaucoma (OR=1.51, 95%CI: 1.02-2.23), corneal diseases (OR=2.27, 95%CI: 1.69-3.05), myopic or diabetic retinopathy (OR=1.77, 95%CI: 1.29-2.42), age-related macular degeneration (OR=3.78, 95%CI: 2.36-6.05), and cataract (OR=3.22, 95%CI: 2.50-4.16). Conclusions: Our results revealed that visual impairment and blindness are important visual health problems in elderly agricultural and fishing population. Age-related macular degeneration, cataracts, corneal diseases, myopic or diabetic retinopathy, glaucoma, female, and increased age were the leading causes for the visual disability. Further organized preventive strategies to eye care are recommended in this sub-population.

Prevalence and Causes of Blindness, Low Vision and Status of Cataract in 50 Years and Older Citizen of Qatar—A Community Based Survey

Background: Rapid Assessment for the Avoidable Blindness (RAAB) was conducted in Qatar during 2009. We present the prevalence and determinants of visual disabilities and status of cataract among citizens aged 50 years and older.Methods: Residents of randomly selected houses and clusters participated in the survey. Opticians noted the presenting and the best corrected vision of participants from 49 clusters. Ophthalmologists examined participants with additional instruments like bio-microscope, digital camera, auto-perimeter and auto-refractor in a mobile van. World Health Organization recommended principal cause of blindness (Visual acuity [VA] < 3/60 in better eye), Severe visual impairment (SVI) (<6/60), low vision (VA < 6/18) and unilateral blindness (VA < 3/60) were designated. Persons with VA < 6/18 and cataract were interviewed to calculate coverage and barriers for cataract surgeries. Age sex adjusted prevalence of visual disabilities and their 95% Confidence Intervals (CI) were estimated.Results: We examined 2,433 (97.3%) participants. The age sex adjusted prevalence of bilateral blindness was 1.28% [95% CI 1.22–1.35], SVI (1.67%), low vision (3.66%) and unilateral blindness (3.61%) in 50 years and older population. Female and older age groups were significant risk factors of visual disabilities. Cataract and glaucoma were the main causes of visual disabilities. The coverage of cataract services was 68.2%. Believing that cataract as an aging process (25) and adequate vision in the fellow eye (15) were the reasons for delay in surgery.Conclusions: To reduce avoidable blindness, un-operated cataract should be addressed. Primary and secondary eye care systems should be strengthened to improve the care of blinding eye diseases in Qatar.

Prevalence and causes of visual impairment and blindness in Sichuan province of China.

To describe the prevalence and causes of low vision and blindness in a population within Sichuan province in southwestern China. A stratified, multi-phased and cluster probability sampling design was employed to enumerate 125641 participants from 40351 households within 38 counties/cities. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle resolution charts. Prevalence was age- and gender-standardized to the 2000 China Census. Population-weighted prevalence of blindness was 0.77% (95%CI: 0.72-0.82, n=966) and low vision was 1.22% (95%CI: 1.14-1.27, n=1513). Overall, the prevalence of visual disability was 1.40% in the urban population, and 2.22% in the rural population (P<0.01). Cataract was the leading cause of visual disability (55.7%, n=1381), and was of similar frequency in both urban and rural populations. Retinal disease was the second leading cause(9.7%, n=236), but was more common in urban than in rural participants (34.3% vs 2.7%, P<0.01). Corneal disease accounted for 6.5% (n=161) of cases of visual disability, and was more common in the rural population (7.2% vs 3.9%, P=0.006). We estimate that 1.72 million people suffer from visual disability within Sichuan province, of which 525000 are blind, the focus of blindness prevention should be in rural area.

Quality Indicators for the Care of Vision Impairment in Vulnerable Elders

Vision impairment is common in elderly people, and it increases with age. Population-based studies report functional visual impairment in 4% to 7% of persons aged 71 to 74, 16% of persons aged 80 and older, and 39% of persons aged 90 and older. Similarly, the Beaver Dam Eye Study found visual impairment worse than 20/40 vision in 5% of individuals aged 65 to 74 and 21% of individuals aged 75 and older. Approximately 90% of the population aged 65 and older requires refractive lenses to optimize vision. It is estimated that more than half of these individuals would experience better vision from alteration of refractive lenses or other appropriate treatment. Decreased vision is debilitating for elderly people. Of those aged 60 and older, distance visual acuity of 20/25 or worse is associated with greater risk of falls and fractures than for those with 20/20 or better vision. Reduced useful visual field has been associated with greater risk of motor vehicle crashes in older drivers. Worse visual function has been shown to be associated with limitations in mobility, activities of daily living (ADLs), and physical performance. Declines in subjective visual function have major negative effects on cognitive, affective, and functional status and increase the probability of nursing home residence. Functional-status and quality-of-life measurements in ophthalmic patients are lower than for controls with normal vision and no known ocular disease. Quality-of-life studies specific to cataract, glaucoma, diabetic retinopathy, and macular degeneration have all shown significantly poorer vision-related quality of life associated with vision loss from these diseases. Studies have shown that distance visual impairment worse than 20/40 is associated with a decrease across all self-reported measures of functional status in those aged 65 and older. Effective treatment or prevention is available for much of the visual disability due to common eye disorders. For example, although no randomized trials or case-control studies have proven the benefit of eyeglasses for refractive error, there is widespread consensus that functional disability due to refractive error is largely resolved using corrective lenses. Cataract extraction is also highly effective in patients with visual loss due to cataracts. Studies of patients undergoing cataract surgery showed that, by 1 year after surgery, 95% to 96% of the patients experienced improved Snellen visual acuity, and 80% to 89% experienced improved ability to perform vision-related ADLs. These patients also experienced fewer declines in overall health-related quality of life than expected. An observational evaluation of Medicare beneficiaries representative of the U.S. population demonstrated that patients with more-regular eye examinations were less likely to experience a decline in visual function or functional status over a 5-year period. Patients with advanced eye disease also can benefit from intervention. For example, for patients with diabetic retinopathy, laser treatment has been shown to reduce vision loss 50% or more, whereas many individuals with glaucomatous vision loss who undergo appropriate pressure-lowering treatments are able to reduce progression of their disease 20% to 40%. Of patients with treatable macular degeneration, antioxidant supplementation and laser treatment can retard loss of vision up to 25%. Moreover, early recognition of symptoms increases the likelihood of detecting new lesions at a treatable stage. Patients with permanent functional vision loss may benefit from vision rehabilitation programs and assistive devices. Although there are no randomized, controlled trials (RCTs) or case-control studies that directly assess the benefit of these interventions, expert consensus, as reflected in the American Academy of Ophthalmology (AAO) guidelines and prominent textbooks, indicates that these interventions increase independence and quality of life. In summary, there is abundant evidence that appropriate treatment for visual conditions can significantly reduce the overall prevalence of visual disability and improve quality of life in a large proportion of vulnerable elders (VEs). Therefore, these indicators focus on the five major causes of visual disability in elderly people: uncorrected Address correspondence to Catherine H. MacLean, MD, PhD, RAND, 1776 Main Street, Santa Monica, CA 90401. E-mail: maclean@rand.org

The prevalence of low vision and blindness in a Canadian inner city

To ascertain the prevalence and primary causes of visual impairment in a sample of patients from Vancouver's downtown eastside (VDES). A total of 200 patients seeking nonophthalmic medical care at the Vancouver Native Health Society (VNHS) clinic in Vancouver's inner city (downtown eastside) participated in this observational case-series study. For each participant, we obtained demographic information, a medical and ocular history, and performed a complete eye exam. The prevalence of visual disability using standard North American criteria was reported. Causes of visual loss were also reported based on Canadian National Institute for the Blind (CNIB) guidelines. A total of 200 patients participated in our study. The median age of our sample was 46 years, 69% were male. There were very high rates of comorbid medical conditions including HIV, Hepatitis B/C, IV drug use, and diabetes. The raw prevalence of visual disability based on best-corrected visual acuity (BCVA) was 500 per 10,000; this was over nine times greater than in the general Canadian population. The raw prevalence rate of 'presenting visual disability' based on presenting visual acuity (PVA) was 2400 per 10,000. Major causes of visual disability were cataract and retinal disease. Although age-related macular degeneration and diabetic retinopathy represent major causes of vision loss in North America, no cases were noted in our sample. The overall prevalence of visual disability was alarmingly high in this disadvantaged community. These results identify both ophthalmic disease and access to refraction and prescription spectacles as a significant health concern among people living in the VDES.

The current status of visual disability in the elderly population of Taiwan

This study was conducted to explore the prevalence and the associated factors of visual impairment and blindness among the elderly Taiwanese population. A nationwide population-based visual health care screening program of elderly people aged 65 years or older was conducted between 1 July 2002 and 31 December 2002 in Taiwan. Based on the same standardized protocol used by the Bureau of Health Promotion, Department of Health, and a stratified random sampling design, 3160 out of 5000 elderly subjects were selected by a two-stage visual care screening method. The overall response rate was 63.2%. The mean age of the elderly participants was 72.4 +/- 5.1 years. The overall prevalence of glaucoma, corneal diseases, trauma, cataracts, myopic or diabetic retinopathy, and age-related macular degeneration among the elderly population was 2.1%, 6.3%, 0.9%, 60.2%, 7.5%, and 2.9%, respectively. The overall prevalence of visual disability (visual acuity of the better eye <0.5) was 17.7%, including 17.1% with visual impairment and 0.6% with blindness. Based on logistic regression, the significant independent factors of visual disability (visual impairment plus blindness) were sex (male vs. female, odds ratio (OR) = 0.62, 95% confidence interval (CI), 0.51-0.76), age (70-74 years vs. 65-69 years, OR = 1.60, 95% CI, 1.24-2.06; 75-79 years vs. 65-69 years, OR = 2.52, 95% CI, 1.92-3.32, > or =80 yrs vs. 65-69 yrs, OR = 4.86, 95% CI, 3.52-6.70), corneal diseases (OR = 2.26, 95% CI, 1.61-3.16), myopic or diabetic retinopathy (OR = 1.69, 95% CI, 1.20-2.39), age-related macular degeneration (OR = 4.96, 95% CI, 3.16-7.78), and cataract (OR = 3.40, 95% CI, 2.67-4.33). The geographic difference in the prevalence of vision-related eye disease, visual impairment, and blindness point to the importance of taking actions that suit local circumstances. Our results also revealed that visual impairment and blindness are important visual health problems in the elderly Taiwanese population. Age-related macular degeneration, cataracts, corneal diseases, myopic or diabetic retinopathy, female sex, and aging were the leading causes of visual disability. Further organized preventive strategies for eye care are recommended in this population.

Preventing visual loss from chronic eye disease in primary care: scientific review

ContextVision loss is common in the United States and its prevalence increases with age. Visual disability significantly impacts quality of life and increases the risk of injury. Although at least 40% of blindness in the United States is either preventable or treatable with timely diagnosis and intervention, many people with vision loss are undiagnosed and untreated.ObjectiveTo review the evidence regarding screening and management of eye disorders and visual disability among adults in the primary care setting.Data Sources and Study SelectionMEDLINE, HealthSTAR, EMBASE, The Cochrane Database of Systematic Reviews, and the National Guidelines Clearinghouse were searched for articles and practice guidelines about screening and management of eye diseases and vision loss among adults in the primary care setting using key words and free-text terms, such as vision screening, glaucoma prevention and control, from 1985 to 2003. References in these articles and those suggested by experts in eye care, vision loss, and vision screening were reviewed as well.Data ExtractionArticles were searched for the most clinically important information and emphasized randomized controlled trials where available.Data SynthesisMost major guidelines recommend periodic referral of older adults to an eye care professional for comprehensive evaluation to detect eye diseases and visual disability. The value of routine screening for vision loss in the primary care setting has not been established. Timely identification and treatment of eye diseases can substantially reduce the incidence and prevalence of visual disability among older adults. Optimizing management of systemic diseases, such as diabetes, hypertension, and hyperlipidemia, significantly reduces the risk of related eye disorders.ConclusionsPrimary care clinicians can play a vital role in preserving vision in their patients by managing systemic diseases that impact eye health and by ensuring that patients undergo periodic evaluations by eye care professionals and receive needed eye care.

Preventing visual loss from chronic eye disease in primary care: scientific review.

Vision loss is common in the United States and its prevalence increases with age. Visual disability significantly impacts quality of life and increases the risk of injury. Although at least 40% of blindness in the United States is either preventable or treatable with timely diagnosis and intervention, many people with vision loss are undiagnosed and untreated. To review the evidence regarding screening and management of eye disorders and visual disability among adults in the primary care setting. MEDLINE, HealthSTAR, EMBASE, The Cochrane Database of Systematic Reviews, and the National Guidelines Clearinghouse were searched for articles and practice guidelines about screening and management of eye diseases and vision loss among adults in the primary care setting using key words and free-text terms, such as vision screening, glaucoma prevention and control, from 1985 to 2003. References in these articles and those suggested by experts in eye care, vision loss, and vision screening were reviewed as well. Articles were searched for the most clinically important information and emphasized randomized controlled trials where available. Most major guidelines recommend periodic referral of older adults to an eye care professional for comprehensive evaluation to detect eye diseases and visual disability. The value of routine screening for vision loss in the primary care setting has not been established. Timely identification and treatment of eye diseases can substantially reduce the incidence and prevalence of visual disability among older adults. Optimizing management of systemic diseases, such as diabetes, hypertension, and hyperlipidemia, significantly reduces the risk of related eye disorders. Primary care clinicians can play a vital role in preserving vision in their patients by managing systemic diseases that impact eye health and by ensuring that patients undergo periodic evaluations by eye care professionals and receive needed eye care.