Prevalence Of Visual Impairment Research Articles

Prevalence and Cause of Loss of Visual Acuity and Visual Field in Highly Myopic Eyes: The Beijing Eye Study

To explore prevalence and causes of loss of visual acuity and visual field in highly myopic eyes. Population-based study. The participants (n=4439) of the Beijing Eye Study underwent an ophthalmological and systemic examination including frequency doubling technology perimetry (FDT). High myopia was defined by a refractive error of ≤-6Dpt or axial length >26.0 mm. Prevalence of vision impairment causes. The study included 212 highly myopic eyes (154 participants;mean age:56.2±9.6 years;refractive error:-9.87±3.70 Dpt;range:-20.87 to -6.00Dpt; axial length:27.2±1.3mm;range:26.01-30.88mm). Moderate/severe vision impairment (MSVI) (best corrected visual acuity (BCVA) from <6/18 to 3/60) and blindness (BCVA <3/60 or <10° visual field around central fixation) was present in 40/212 (18.9%;95%CI:13.6,24.2) eyes, and in 10/212 (4.7%;95%CI:1.8, 7.6) eyes, respectively. BCVA decreased with more myopic refractive error (beta:-0.55;B:-0.08;95%CI:-0.09,-0.06;P<0.001). Primary (i.e., most influential) causes for MSVI and blindness were myopic macular degeneration (MMD) (29/50;58%), age-related macular degeneration (1/50;2%), and branch macular retinal vein occlusion (1/50;2%). Secondary causes were MMD (4/50;8%) and optic nerve atrophy (14/50 (28%), differentiated into a non-glaucomatous type (NGOA) (9/50;18%) and glaucomatous type (GOA) (5/50;10%). Prevalence of MMD as vision impairment cause (mean:40/212 (18.9%;95%CI:13.6,24.2) increased from 1/61 (1.6%;95%CI:0.00,4.9) in the group of -6.00 to ≥-7.00Dpt, to 16/25 (64.0%;95%CI:43.8,84.2) in the group of <-15.0Dpt. Higher MMD prevalence correlated with higher myopic refractive error (OR:0.70;95%CI:0.61;0.81;P<0.001) and higher prevalence of concomitant optic neuropathy (OR:86.2;95%CI:16.1,463;P<0.001). Optic neuropathy prevalence as cause of vision impairment (mean:19/212;9.0%;95%CI:5.0,13.0) increased from 0/61 (0%) in the refractive error group of -6.00Dpt to ≥-7.00Dpt, to 9/25 (36.0%;95%CI:16.0,56.0) in the group of <-15.0Dpt. Higher optic neuropathy prevalence correlated with more myopic refractive error (P<0.001) and older age (P=0.02). GOA prevalence (mean:6/212;2.8%;95%CI:1.0,5.0) and NGOA prevalence (mean:13/212 (6.1%;95%CI:3.0,9.0) increased from 0/61 (0%) in the group of -6.00 to ≥-7.00Dpt, to 4/25 (16.0%;95%CI:1.0,31.0) and 5/25 (20%;95%CI:3.0,37.0), respectively, in the group of <-15.0Dpt. In this population-based recruited, highly myopic cohort, prevalence of optic neuropathy (9.0%) as vision impairment cause was lower than MMD prevalence (18.9%), and it was an important reason for vision impairment in the group of <-15Dpt. MMD was vision impairment cause in 16/25 (64.0%) eyes with <-15.0Dpt refractive error.

Development and validation of parental knowledge, attitude and practice in eye problem among children questionnaire (PEPC-KAPQ).

Most eye problems among children can be detected and treated at an early age to reduce the prevalence of visual impairment. Understanding the knowledge, attitude, and practice (KAP) among parents about common children's eye problems is fundamental to encourage parents to seek early eye care services for their children. This study aims to develop a Parental Knowledge, Attitude, and Practice in Eye Problem among Children Questionnaire (PEPC-KAPQ) and evaluate its psychometric properties. This study involved developing a questionnaire and was conducted in Kuala Lumpur, Malaysia from July 2021 until June 2022. The questionnaire was developed based on a literature review and expert consultation. The first phase includes a systematic literature review to generate the items for the questionnaire. A group of five panels was then invited to perform content validity for the questionnaire. Face validity was conducted among ten parents to get feedback for the questionnaire. Construct validity and reliability of the questionnaire were measured by which the questionnaire was administered to a total of 134 parents and 64 parents for reliability test. The final PEPC-KAPQ consists of four main sections: demographic, knowledge, attitude, and practice with 52 items. The content validity index was 0.85 for all domains of KAP. Modified kappa showed excellent value for most items for all domains. The Kaiser-Meyer-Olkin sampling adequacy showed acceptable scores of 0.84, and Bartlett's Test of Sphericity was significant (x2 = 3172.09, p<0.0001). Kuder-Richardson-2 of the domain knowledge was 0.95. Cronbach's α coefficient of domain attitude and practice were 0.92 and 0.88, respectively and the intraclass correlation of domain attitude and practice were 0.93 and 0.94 respectively. Bland and Altman's plots show that majority of the data fell within the limits of agreement. The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring the KAP of parents regarding eye problems among children.

Mapping the Gap: Understanding the Need for Occupational Therapy Among Older Adults With Visual Impairment.

Visual impairment (VI) affects more than 9 million Americans age 65 yr and older, and it limits meaningful participation in daily living. Occupational therapy can have a considerable impact on the functional performance of those with VI; however, information is limited on the existing occupational therapy services available for older adults with VI across the United States. To calculate the prevalence of VI by U.S. county and quantify and locate the existing occupational therapy practitioners with certification in vision rehabilitation. Synthetic estimation was used to calculate the prevalence of VI among those age 65 yr and older in the United States by county. Geographic Information Systems mapping was used to illustrate the prevalence of VI and availability of occupational therapy practitioners with specialized training in vision rehabilitation by U.S. town. Communities with high concentrations of older adults with VI were more prevalent in the center of the United States, whereas occupational therapy practitioners with specialty training in vision rehabilitation were concentrated primarily on the east coast of the United States, on both Florida coasts, in selected cities in Texas and California, in western Pennsylvania, and in Alabama. The availability of occupational therapy practitioners with specialty training in vision rehabilitation does not match the visual rehabilitation needs of older adults in the United States. These findings can be used to prioritize efforts for new service provision, provide outreach to underserved populations, and guide occupational therapy education to improve access to vision rehabilitation throughout the United States. What This Article Adds: The data provided in this study can inform resource allocation, workforce development, and entry-level occupational therapy education to address the ongoing needs of older adults with VI.

Causes and Pattern of Eye Diseases in Children Attending the Pediatric Eye Unit of Ahmadu Bello University Teaching Hospital, Shika, Zaria

Aim: The purpose was to determine the causes and pattern of eye diseases in children 0-15 years of age who attended the paediatric unit of the Ophthalmology department Ahmadu Bello University Teaching Hospital Shika, Zaria with a view of obtaining data for planning of children eye care. Method: This was a descriptive cross-sectional study. All children that met the inclusion criteria were recruited. Subjects had visual acuity assessments as appropriate for age. Anterior segment examination was done using a loupe or slit lamp biomicroscope as appropriate while posterior segment was examined by direct ophthalmoscopy. Manual refraction was done using streak retinoscope (cycloplegic refraction when required). Result: A total of 12,516 patients attended the Ophthalmology out-patient clinic of the hospital during the 30- month study period (May 2014- Oct. 2016), 1,760 old and new patients (14.1%) were patients 0- 15 years of age (study population). A total of 448 children were recruited for the study. The male to female ratio M: F was 1.3:1. Allergic conjunctivitis 181 (40.4%), refractive error 42 (9.4%) and infective conjunctivitis 39 (8.7%) were the most common ocular disorders seen. The prevalence of visual impairment was 34.4%. Trauma was the most common cause of uniocular visual impairment. The proportion of blind eyes was 3.1% (n=12). Conclusion: Majority of the ocular disorders seen among the children were treatable causes of visual impairment. Public health education is necessary to create awareness on the causes of blindness. However, there was no statistically significant difference in the ocular disorders with respect to age and gender of the children.

Reasons for Encounters and Comorbidities in Adolescents with Intellectual Disability in General Practice: A Retrospective Analysis of Data from the Ask Study.

Adolescents with intellectual disability have substantial health needs. This retrospective analysis of data from the Ask Study describes reasons for primary care encounters and the prevalence and incidence of chronic physical and mental conditions among a cohort of community-dwelling adolescents with intellectual disability. Participants attended secondary schools in southern Queensland, Australia. Primary care data were extracted from primary care records. Demographic and health information was collected using carer-completed questionnaires. Reasons for primary care encounters, disease prevalence at age 16 years, and disease incidence through adolescence were reported. Data were obtained for 432 adolescents with intellectual disability (median follow-up: 4.1 years). Skin problems (29.4 per 100 encounters) were the most common reason patients presented for primary care, followed by psychological and behavioural problems (14.4 per 100 encounters) and musculoskeletal problems (13.8 per 100 encounters). Conditions with the highest prevalence were autism spectrum disorder (18.6%) and asthma (18.1%). The prevalence of epilepsy, visual impairment, and cerebral palsy were 14.7, 11.1, and 8.0%, respectively. Gastroesophageal reflux had the highest incidence (9.4 cases per 1000 person-years). Adolescents with intellectual disability have significant healthcare needs, which general practitioners need to be aware of and address. Study findings should inform the development of training programs for general practitioners.

Methods for a population-based Comprehensive Eye care Workload Assessment (CEWA) study in Southern India.

Eye care programs, in developing countries, are often planned using the prevalence of blindness and visual impairment, often estimated from Rapid Assessment of Avoidable Blindness (RAAB) surveys. A limitation of this planning approach is that it ignores the annual overall eye care requirements for a given population. Moreover, targets set are arbitrary, often influenced by capacity rather than need. To address this lacunae, we implemented a novel study design to estimate the annual need for comprehensive eye care in a 1.2 million populations. We conducted a population-based longitudinal study in Theni district, Tamil Nadu, India. All permanent residents of all ages were included. We conducted the study in three phases, (i) household-level enumeration and enrollment, (ii) basic eye examination (BEE) at household one-year post-enrollment, and (iii) assessment of eye care utilization and full eye examination (FEE) at central locations. All people aged 40 years and above were invited to the FEE. Those aged <40 years were invited to the FEE if indicated. In the main study, we enrolled 24,327 subjects (58% aged below 40 years and 42% aged 40 years and above). Of those less than 40 years, 72% completed the BEE, of whom 20% were referred for FEE at central location. Of the people aged ≥40 years, 70% underwent FEE. Our study design provides insights for appropriate long-term public health intervention planning, resource allocation, effective service delivery, and designing of eye care services for resource-limited settings.

The Burden of Pediatric Visual Impairment and Ocular Diagnoses in Barbados.

Visual impairment (VI) negatively affects a child's quality of life. The prevalence of VI in the Caribbean is nearly three times higher than in the United States, but the causes remain uncertain. This study leverages Barbados' unique eye care system to survey the eye diseases and VI prevalence in Barbadian children. Medical records of all patients aged <19 years who received ophthalmic care in Barbados' two public eye care centers between January and December 2019 were reviewed, capturing the entirety of public pediatric eye care within the study period. Age at the first visit to the clinic and at the final visit in 2019, sex, best-corrected visual acuity (BCVA), past medical history, and clinical diagnoses were extracted and analyzed. VI was defined as a BCVA of 6/12 or worse in the better-seeing eye. There were 3278 patient records with a mean age at the first visit of 7.8 ± 3.9 years. There were 80 (2.4%) children with VI, 62.5% of which were attributed to amblyopia. A total of 94% of VI was preventable or treatable. The most common diagnoses were refractive error (87.5%), strabismus (27.5%), and allergic eye disease (20.0%). Amblyopia is the major cause of pediatric VI in Barbados and is largely avoidable.

Prevalence of refractive errors and visual impairment due to refractive errors among school children in Cairo, Egypt

Aim The aim of this research was to study the distribution and patterns of refractive errors (REs) among school children and the incidence of amblyopia in each type. Patients and methods This is an observational nonrandomized population-based cross-sectional study that included children aged 6-18 years attending the Outpatient Clinic of Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt. All children were subjected to comprehensive eye examination including best corrected visual acuity (BCVA), expressed in LogMAR, cycloplegic REs that was documented using a NIDEK auto-refractometer-keratometer, cover-uncover testing, and fundus examination. The prevalence of REs, amblyopia, and anisometropia was estimated. Results The study included 960 children (1920 eyes), with a mean age of 13.08±3.41 years. Emmetropia was found in 834 (43.4%) eyes, while myopia was reported in 587 (30.6%) eyes, hypermetropia in 114 (5.9%) eyes, and myopic astigmatism in 385 (20%) eyes. Anisometropia was reported in 65 (6.77%) children, while amblyopia was found in 49 (5.1%) eyes. The amblyopia prevalence was statistically significantly higher among the hypermetropic group (3.9%) than the myopic astigmatism group (1.2%), (P = 0.031). Conclusion The overall prevalence of REs among the examined children was 56.6% mainly myopia followed by myopic astigmatism and lastly hypermetropia. This draws the attention to the increased incidence of myopia which needs further social studies.

Prevalence of visual impairment among primary and secondary school children in Delta State, Nigeria

Purpose: Visual impairment (VI) being a state of physiological or pathological disorders of vision posesa burden on human activities globally. The purpose of this study was to determine the prevalence and risk factors of VI among school children in Delta State.&#x0D; Methods: A descriptive cross-sectional study of 201 respondents aged 6 to 19 years were randomly selected from primary and secondary schools in the three senatorial districts of Delta State. Participants were evaluated using a structured questionnaire, distance Snellen chart, ophthalmoscope, and torchlight. Vision status was defined using World Health Organization categories of visual impairment based on presenting visual acuity (PVA). Data were presented in frequency tables, charts and analysed with Chi-Square statistics. All p-values reported were two-tailed and statistical significance was defined as P &lt; 0.05.&#x0D; Results: The mean age of participants was 12.30± 3.14 years, while 118 (58.7%) were females. The overall prevalence of VI (PVA of &lt;6/18 in the better eye) was 58 (28.9%). The prevalence of mild, moderate, and severe VI was 40 (19.9%), 13 (6.5%), and 5 (2.5%) respectively. Refractive error 47 (23.4%) was the leading cause of VI. The prevalence of VI was higher in females, children 13-19 years, and respondents whose parents’ income per month was &gt;100,000. These observed differences were not statistically significant (p&gt;0.05)&#x0D; Conclusion: Untreated refractive error was the leading cause of VI among school children in Delta State. This is an avoidable cause of VI that can be treated with spectacle prescription to ease the burden of visual loss.

Uncorrected refractive errors are important causes of avoidable visual impairment in Hungary: re-evaluation of two existing national data sets.

To review existing data for the prevalence of corrected, uncorrected, and inadequately corrected refractive errors and spectacle wear in Hungary. Data from two nationwide cross-sectional studies were analysed. The Rapid Assessment of Avoidable Blindness study collected population-based representative national data on the prevalence of visual impairment due to uncorrected refractive errors and spectacle coverage in 3523 people aged ≥50y (Group I). The Comprehensive Health Test Program of Hungary provided data on the use of spectacles in 80 290 people aged ≥18y (Group II). In Group I, almost half of the survey population showed refractive errors for distant vision, about 10% of which were uncorrected (3.2% of all male participants and 5.0% of females). The distance spectacle coverage was 90.7% (91.9% in males; 90.2% in females). The proportion of inadequate distance spectacles was found to be 33.1%. Uncorrected presbyopia was found in 15.7% of participants. In all age groups (Group II), 65.4% of females and 56.0% of males used distance spectacles, and approximately 28.9% of these spectacles were found to be inappropriate for dioptric power (with 0.5 dioptres or more). The prevalence of inaccurate distance spectacles was significantly higher in older age groups (71y and above) in both sexes. According to this population-based data, uncorrected refractive errors are not rare in Hungary. Despite recent national initiatives, further steps are required to reduce uncorrected refractive errors and associated negative effects on vision, such as avoidable visual impairment.

United States Population Disparities in Ophthalmic Care: Blindness and Visual Impairment in the IRIS® Registry (Intelligent Research in Sight)

To evaluate associations of patient characteristics with United States eyecare utilization and likelihood of blindness. Retrospective observational study. 19,546,016 patients with 2018 visual acuity (VA) records in American Academy of Ophthalmology IRIS® Registry (Intelligent Research In Sight). Legal blindness (20/200 or worse) and visual impairment (VI) (worse than 20/40) were identified from corrected distance acuity in the better-seeing eye and stratified by patient characteristics. Multivariable logistic regression models evaluated blindness and visually impaired (VI) associations. Blindness was mapped by state and compared to population characteristics. Eyecare utilization was analyzed by comparing population demographics to US Census estimates, and proportional demographic representation among blind/VI patients versus a nationally-representative US population sample (National Health and Nutritional Examination Survey, NHANES). Prevalence and odds ratios for VI and blindness; proportional representation in IRIS Registry, Census, and NHANES by patient demographics. VI was present in 6.98% (n=1,364,935) and blindness in 0.98% (n=190,817) of IRIS Registry patients. Adjusted odds of blindness were highest among patients 85+ years old (OR=11.85, 95%CI=10.33-13.59, versus 0-17 year-olds). Blindness was also positively-associated with smoking (OR=1.13, 95%CI=1.08-1.17), rural location (OR=1.09, 95%CI=1.04-1.14) and Medicaid (OR=3.85, 95%CI=3.57-4.15), Medicare (OR=1.66, 95%CI=1.53-1.82), or no insurance (OR=1.77, 95%CI=1.37-2.27) versus commercial insurance. Hispanic (OR=1.59, 95%CI=1.46-1.74) and Black patients (OR=1.73, 95%CI=1.63-1.84) had higher odds of blindness versus white non-Hispanic patients. Proportional representation in IRIS Registry relative to Census was higher for white than Hispanic (2-4 fold) or Black patients (11-85%) (p<0.001). Blindness was overall less prevalent in NHANES than IRIS Registry; however, prevalence in adults aged 60+ was lowest among Black participants in NHANES (0.54%) and second highest among comparable Black adults in IRIS Registry (1.57%). Legal blindness from low VA was present in 0.98% of IRIS patients and associated with smoking, rural location, public or no insurance, and older age. Compared to US Census estimates, minorities may be underrepresented among ophthalmology patients, and compared to NHANES population estimates, Black individuals may be overrepresented among blind IRIS Registry patients. These findings provide a snapshot of US ophthalmic care and highlight need for initiatives to address disparities in utilization and blindness.

The prevalence, incidence, and persistence of self-reported visual impairment among Chinese population with diabetes mellitus: evaluation from a nationally representative survey, 2015-2018.

Our aim was to investigate the prevalence, incidence, and persistence of visual impairment (VI) and their correlates among the Chinese population with diabetes mellitus (DM) over 3 years. The China Health and Retirement Longitudinal Survey is the first nationally representative longitudinal survey of the Chinese population. A cross-sectional analysis of prevalent VI in 2015 consisted of 2,173 participants with DM. A longitudinal observation of incident and persistent VI consisted of 1,633 participants from 2015 to 2018. Risk factors of VI were identified via univariate and multivariate logistic regression analyses. Among our study population with DM, 11.8% reported VI in 2015, 4.5% had persistent VI from 2015 to 2018, and 8.9% developed VI in 2018. Factors identified to be correlated to VI (p < 0.05) were older age, being a woman, lower educational attainment, living in a rural area, application of DM medication and non-pharmacological treatment, receiving DM-related tests, use of spectacles, and poorer health status. This most recent national data provides a baseline for future public health initiatives on VI among the Chinese population with DM. With multiple risk factors identified, these could provide concurrent targets for various public health strategies and interventions with the aim of reducing the burden of VI among the population with DM in China.

Prevalence of Visual Impairment and Availability of Eye Care Providers in Florida

To determine the association between prevalence of visual impairment and density of eye care providers in Florida counties. Cross-sectional study. SETTING: Population-based STUDY POPULATION: Ophthalmologist members of the American Academy of Ophthalmology, licensed optometrists, and respondents of the 2015-2020 American Community Survey administered by the United States Census Bureau. The number of ophthalmologists collected from the American Academy of Ophthalmology member directory and the number of optometrists collected from the Florida Department of Health License registry were compared to prevalence of visual impairment in each county as reported by American Community Survey 2020 5-year Estimates. Median age, mean income, race, and percent uninsured of each county were collected from American Community Survey 2020 5-year Estimates. Number of eye care providers and prevalence of visual impairment per Florida county. Eye care provider density and mean income of each county were negatively correlated with visual impairment prevalence. Counties with zero eye care providers had significantly higher prevalence of visual impairment per 100,000 residents than those with at least one eye care provider. While adjusting for mean income, for every increase in 1 eye care provider per 100,000 people, there was an expected decrease in visual impairment prevalence by 31.15±14.58 people per 100,000 residents. For every increase in mean county income by $1,000, there was an expected mean±SE decrease in prevalence of VI by 24.02±9.90 people per 100,000 people. Increased eye care provider density and mean county income is associated with lower prevalence of visual impairment in Florida counties. Further studies may elucidate the cause for this relationship and solutions to decrease visual impairment prevalence.

Vision impairment is common in non-hospitalised patients with post-COVID-19 syndrome

ABSTRACT Clinical relevance Vision-related problems can be part of longstanding sequelae after COVID-19 and hamper the return to work and daily activities. Knowledge about symptoms, visual, and oculomotor dysfunctions is however scarce, particularly for non-hospitalised patients. Clinically applicable tools are needed as support in the assessment and determination of intervention needs. Background The purpose of this study was to evaluate vision-related symptoms, assess visual and oculomotor function, and to test the clinical assessment of saccadic eye movements and sensitivity to visual motion in non-hospitalised post-COVID-19 outpatients. The patients (n = 38) in this observational cohort study were recruited from a post-COVID-19 clinic and had been referred for neurocognitive assessment. Methods Patients who reported vision-related symptoms reading problems and intolerance to movement in the environment were examined. A structured symptom assessment and a comprehensive vision examination were undertaken, and saccadic eye movements and visual motion sensitivity were assessed. Results High symptom scores (26–60%) and prevalence of visual function impairments were observed. An increased symptom score when reading was associated with less efficient saccadic eye movement behaviour (p < 0.001) and binocular dysfunction (p = 0.029). Patients with severe symptoms in visually busy places scored significantly higher on the Visual Motion Sensitivity Clinical Test Protocol (p = 0.029). Conclusion Vision-related symptoms and impairments were prevalent in the study group. The Developmental Eye Movement Test and the Visual Motion Sensitivity Clinical Test Protocol showed promise for clinical assessment of saccadic performance and sensitivity to movement in the environment. Further study will be required to explore the utility of these tools.

AZAR eye and vision cohort study

According to World Health Organization (WHO), currently, 2.2 billion people are living with visual impairment worldwide, of which almost half could have been prevented. There are both modifiable and unmodifiable factors leading to visual disability and, ultimately, blindness. Several population-based studies in different parts of Iran have tried to determine these factors concerning their specific population and environment-related characteristics. AZAR Eye and Vision cohort is the second-largest cohort study in the whole country. AZAR Eye and Vision cohort is the ophthalmologic branch of AZAR cohort which is the largest eye cohort study in the country, which is trying to determine the prevalence and incidence of visual impairment, blindness, and other major ophthalmologic conditions and their associated risk factors in East Azerbaijan province located in Iran, a middle eastern country. A recently emerging phenomenon is the drying of the ultra-salty lake of Urmia located in the West Azerbaijan province which is a direct neighbor of our studied population and has caused recurrent salt storms in the immediate near areas. This phenomenon could adversely affect visual health via different conditions which our study will elucidate. The enrollment phase took place between 2014 and 2017 and 11,208 participants were enrolled out of 15,000 participants in the primary cohort. The resurvey phase will begin five years after the enrollment phase. In this phase, 30% of the participants are randomly selected to be reexamined and complete questionnaires. The participants showing any issues such as diabetes and being a glaucoma suspect will be included in the resurvey phase, too. Data categories gathered include demographics, lifestyle factors, past medical and drug histories, and a diet quality and quantity questionnaire including 130 edible items. Urine, hair, nail, and 25-ml blood samples, were collected from the participants. Then they were referred to an optometrist to complete an ophthalmologic questionnaire and undergo eye examination and lensometry. Then they underwent slit-lamp examinations and pictures were taken of the lens and fundus. People with suspected visual impairment were referred to an ophthalmology clinic. The data are processed and a four-level quality check is performed on each block. The most common visual impairment is cataracts. This study’s most important aim is to evaluate the effect of local environmental and ethnic factors on eye diseases in this specific population.

Regional Disparities in Prevalence and Causes of Visual Impairment and Blindness, Cataract Surgical Coverage and Ocular Findings in Adults 50 Years and Older in Brazil: A Comparative Analysis between Two Population-Based Cross-Sectional Surveys Performed Within a 10-Year Interval

ABSTRACT Purpose To investigate disparities in the prevalence and causes of visual impairment and blindness, cataract surgical coverage, and ocular findings in older adults from two Brazilian geo-socio-demographic areas, São Paulo and Parintins cities. Methods Data from two population-based studies including participants 50 years and older from the cities of São Paulo (São Paulo Eye Study – SPES, 2004) and Parintins (Brazilian Amazon Region Eye Survey – BARES, 2014) were aggregated. Results A total of 5318 participants (3677 from SPES;1641 from BARES) were included. The prevalence of severe visual impairment (SVI) and blindness were, respectively, 0.74% (0.46–1.02) and 0.77% (0.48–1.05) in SPES and 1.72% (1.09–2.35) and 3.44% (2.55–4.33) in BARES. SVI and blindness were associated with BARES study [OR = 2.27 (1.30–3.95); p = .004 - SVI] [OR:4.07 (2.51–6.60); p < .001- blindness]; and older age [OR = 10.93 (4.20–28.45); p < .001 - SPES; OR = 17.96 (8.75–36.83); p < .001 - BARES] while higher education level was a protective factor [OR = 0.21 (0.05–0.95) - SPES; p = .042; OR = 0.21 (0.05–0.91); p = .037 - BARES]. Cataract was the main cause of bilateral severe visual impairment (25.93% in SPES and 64.29% in BARES) and bilateral blindness (21.43% in SPES and 35.71% in BARES). Cataract surgical coverage was significantly lower in BARES (36.32%) compared to SPES (57.75%). Conclusion The prevalence of SVI and blindness was three times higher in older adults from the Brazilian Amazon compared to those living in São Paulo city, despite a 10-year interval between the two studies. These disparities should be mitigated by initiatives to promote access to eye care services targeting underprivileged and remote Brazilian areas.

Prevalence and causes of visual impairment and use of low-vision devices at a tertiary eye hospital in western Uttar Pradesh, India

Objectives: The objective of this study was to determine the hospital-based prevalence and major causes of visual impairment in patients attending the low-vision clinic of a tertiary eye institute. Materials and Methods: This study was a retrospective non-intervention hospital-based study. Clinical records of visually impaired patients presented to the department of low vision from February 2017 to December 2021 were retrieved. Blindness has been defined as the best-corrected distance visual acuity of &lt;3/60 and/or &lt;10° visual field in the better eye. Low vision was defined as a best-corrected distance visual acuity of &lt;6/18 but equal to or better than 3/60 in the better eye. The presenting visual acuity, causes of low vision and blindness, and prescribed low-vision devices were recorded and analyzed to determine the prevalence and major causes of visual impairment. Results: Among 414 visually impaired patients, the prevalence of low vision and blindness was 52.9% (n = 219) and 47.1% (n = 195), respectively. Retinitis pigmentosa (n = 57, 13.8%) and glaucoma (n = 43, 10.4%) were the major causes of low vision; however, glaucoma (n = 55, 13.3%) and cortical visual impairment (CVI) (n = 37, 8.9%) were the major causes of blindness. A total of 229 low-vision devices were dispensed, of them 166 (40.1%) were distance and 63 (15.1%) were near devices. Conclusion: The hospital-based prevalence of low-vision patients was more as compared to blindness. The major causes of visual impairment were retinitis pigmentosa, glaucoma, and CVI. A comprehensive approach to the causes of low vision and low-vision services is needed to reduce the burden of visual impairment in the country.

Rapid Assessment of Avoidable Visual Impairment in Two Coastal Districts of Eastern India for Determining Effective Coverage: A Cross-Sectional Study.

To measure the prevalence and causes of visual impairment (VI) among the 40+ age population in two coastal districts of India and to determine the levels of effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC) in the study population. A cross-sectional study was done on 4200 people chosen using cluster sampling in two coastal districts of Odisha, an eastern state in India. A team consisting of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Overall, 3745 (89.2%) participants were examined from 60 study clusters, 30 in each district. Among those examined, 1677 (44.8%) were men, 2554 (68.2%) were educated and number? (17.8%) used distance spectacles during the survey. The prevalence of VI adjusted for age and gender was 12.77% (95% CI 11.85-13.69%). Multiple logistic regression showed that older age (OR 3.1; 95% CI 2.0-4.7) and urban residence (OR 1.2; 95% CI 1.0-1.6) were associated with VI. Being educated (OR 0.4; 95% CI 0.3-0.6) and using glasses (OR 0.3; 95% CI 0.5-0.2) were found to provide protection; therefore, resulting in lower instances of VI. Cataract (62.7%) and uncorrected refractive errors (27.1%) were the two main causes of VI. The eCSC was 35.1%, the eREC for distance was 40.0%, and the eREC for near was 35.7%. VI remains a challenge in Odisha, as the prevalence is high and the surgical coverage is poor. Nearly 90% of VI is avoidable indicating that targeted interventions are required to address this problem.

Prevalence and Incidence of Registered Severe Visual Impairment and Blindness Due to Uveitis in Germany

ABSTRACT Purpose To assess prevalence and incidence of severe visual impairment (VI) and blindness due to uveitis in Northrhine, Germany. Methods A random sample of 5088 out of 20 390 cases of the blindness registry in Northrhine was evaluated. The number of cases of severe VI and blindness were projected up to the year 2030. Results The prevalence of registered severe VI and blindness due to uveitis was 1123.9 (95% CI: 1059.5 to 1191.2) per 100 000 in our study cohort and 550.31 (95% CI: 365.98–794.38) per 100 000 in Northrhine, respectively. The incidence of registered severe VI and blindness due to uveitis was 311.8 per 100 000 PYs (95% CI: 149.6–572.7) in our study cohort and 11.1 per 100 000 (95% CI: 5.6–19.8) in Northrhine, respectively. Conclusions We report prevalence and incidence of severe VI and blindness due to uveitis in a large German cohort.

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.