Self-reported Vision Research Articles

Relationship between Self-Reported Hearing and Vision Problems, Cognitive Decline, Depression, and Life Satisfaction in Older Adults: A Retrospective Observational Study

Relationship between Self-Reported Hearing and Vision Problems, Cognitive Decline, Depression, and Life Satisfaction in Older Adults: A Retrospective Observational Study

Impact of Vision and Hearing Impairment on Cognition and Loneliness: Evidence From the Mexican Health and Aging Study

Poor vision and hearing have been associated with lower cognitive function and greater social isolation (i.e., loneliness) among older adults. However, this evidence is based largely on data from non-Hispanic populations. Therefore, we investigated whether self-reported vision and hearing was associated with cognitive function and loneliness in a nationally-representative study of Mexican adults aged 50 and older in Wave 3 of the Mexican Health and Aging Study. The final sample included 12,426 participants. The majority were female (58%), and the mean age was 67. Self-reported vision and hearing status were categorized as excellent-very good [ref], good, and fair-poor. Measures for global cognition, memory, and non-memory cognition were calculated using z-scores based on nine cognitive tests. Participants who reported frequently feeling a lack of companionship, left out, or isolated were categorized as feeling lonely. All analyses controlled for age, sex, and years of education. Participants with fair-poor vision had lower global (β= -0.06, p <.01), memory (β= -0.07, p <.01), and non-memory cognition (β= -0.06, p <.01) than participants with excellent-very good vision. In addition, participants with fair-poor hearing had higher non-memory cognition (β= 0.03, p <.05) but not global cognition (β=0.02) or memory (β=0.001). Fair-poor vision (OR=1.53, 95% CI=1.25-1.87) but not fair-poor hearing (OR=1.16, 95% CI=0.97-1.38) was associated with higher odds of being lonely. Poor vision may be a potentially modifiable risk factor for lower cognition and loneliness among Mexican adults. Future research should incorporate robust measures of sensory health and investigate the longitudinal association between vision, cognition, and loneliness.

Sensory Impairment is Associated With Recurrent Falls: Study of Women’s Health Across the Nation

This study evaluated the relationship between individual and combined sensory impairments (vision, hearing, peripheral nerve (PN)) with recurrent falls in the past year among 1951 women (mean age 65.6 years) from the Study of Women’s Health Across the Nation. Sensory impairments were defined as self-reported vision difficulty, hearing loss, or ≥4 on the Michigan Neuropathy Screening Instrument. Recurrent falls were defined as ≥2 self-reported falls. Hearing was the most commonly reported impairment (39.2%), followed by vision (22.1%) and PN (16.0%). Among those with any impairments, 7.0% of women reported impairments in all domains. Recurrent falls were more common among women with vision (19.4%), hearing (17.3%), or PN impairments (24.7%) as compared to women without sensory impairments (7.0%). The greatest burden of recurrent falls was among women with all three sensory impairments; one-third (34.6%) of women with vision, hearing and PN impairment were recurrent fallers. In an adjusted logistic regression model, vision, hearing, and PN impairments were associated with statistically significantly higher odds of recurrent falls in the past year (odds ratio (OR) = 1.58, 1.76, 2.11, respectively; all p<0.01), after adjustment for age, race/ethnicity, economic strain, and depressive symptoms. The presence of all three sensory impairments was associated with nearly 6-fold increased odds of recurrent falls (OR=5.65, 95% CI 3.25, 9.82) compared to women with no impairments. Sensory impairments often onset during mid-life and early late adulthood. This work demonstrates that these impairments are associated with falls and that women with impairments across multiple sensory domains are at greatest risk.

Vision Difficulty and Engagement in Care Among Aging Men Living With HIV

For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (> 2 questions at a medical visit). A modified version of the National Eye Institute vision function questionnaire was administered at three semi-annual visits (from October 2017 to April 2018) to assess difficulty performing vision-dependent tasks (no, a little, moderate to extreme difficulty). We included 1063 AALH participants (median age 60 years, 24% Black). Data were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for fixed race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task (18%) had 1.95 times higher odds (95% CI: 1.36, 2.79) of having less than optimal ART adherence and 1.92 times higher odds [95% CI: 1.06, 3.47]) of avoiding necessary medical care, but 1.6 times higher odds [95%CI: 0.93, 2.72] of asking more questions. These findings suggest that vision impairment plays a role in medical care engagement among older adults living with HIV, and may contribute to poorer management of HIV and chronic comorbidities.

Eye and Visual Health in New England: Findings from the Healthy Aging Data Reports

Eye and visual health issues in older adults are prevalent, often undetected and untreated, but can contribute to poor physical and mental health issues, and higher mortality rates. The study describes state and local community rates of eye and visual health indicators (cataract, glaucoma, self-reported vision difficulty, and clinical diagnosis of blindness or visual impairment) of older adults 65+ in MA, NH, RI, and CT. Data sources used to calculate rates were: the American Community Survey (2014-2018 RI, 2012-2016 MA and NH, 2014-2018 CT) and the Medicare Current Beneficiary Summary File (2016-2017 RI, 2015 MA and NH, 2016-2017 CT). Small area estimation techniques were used to calculate age-sex adjusted community rates for more than 150 health indicators (https://healthyagingdatareports.org/). Disparities in rates were examined for 4 eye and visual health indicators: cataract, glaucoma, self-reported vision difficulty, and clinical diagnosis of blindness or visual impairment. Results showed variability in rates across states. MA had the highest rates of self-reported vision difficulty (5.8%) and blindness or visual impairment (1.5%), and the greatest differences in rates of self-reported vision difficulty (0.00-40.91%). CT had the highest rates of glaucoma (28.3%), and the greatest differences in rates of glaucoma (19.51-41.91%) and blindness or visual impairment (0.44-4.39%). RI had the highest rates of cataract (67.5%). Understanding the distribution of community rates makes disparities evident, and may help practitioners and policymakers to allocate resources to areas of highest need.

Association of vision and hearing impairments with quality of life among older adults: Mediation by psychosocial factors.

Vision impairment (VI) and hearing impairment (HI), alone or in combination (dual sensory impairment [DSI]), are common in older adults. We determined (i) the association of vision and hearing, and of VI only, HI only and DSI, with three psychosocial variables (social network, loneliness, depressive symptoms) and with quality of life (QoL), and (ii) whether the considered psychosocial variables mediate the association of VI only, HI only and DSI with QoL among older adults. Cross-sectional survey data for 4077 older adults (≥60 years) from Singapore were analyzed. Those with self-reported fair or poor vision and hearing were considered to have an impairment in that sense. Standard scales were used to assess the psychosocial variables and QoL. Regression and mediation models were used. Those with fair and poor vs. good, vision and hearing generally had poorer psychosocial outcomes and lower QoL. VI only, HI only and DSI were all associated with lower social network, more depressive symptoms and lower QoL. VI only and DSI were associated with more loneliness. Social network, loneliness and depressive symptoms partially mediated the association of VI only, HI only and DSI with QoL, with depressive symptoms being the strongest mediator. VI and HI, particularly in combination, are associated with poorer psychosocial status and QoL among older adults. Older adults with VI or HI should be screened for depressive symptoms and social risks. Improving social network, loneliness and depressive symptoms among older adults with sensory impairments may enhance their QoL. Geriatr Gerontol Int 2022; 22: 56-62.

Abstract 12561: Dietary and Lifestyle Behaviors Among Women of Reproductive Age by Disability Status

Introduction: In the United States (U.S.), 18% of women age 18-44 years report at least one physical, sensory, or cognitive disability. Compared to the general population, women with disabilities are more likely to have multiple comorbidities and experience adverse pregnancy outcomes. Diet and physical activity are important and modifiable lifestyle behaviors for women’s preconception and long-term health, as well as the health of their offspring. This study examined diet quality, physical activity, and related lifestyle factors among women of reproductive age by disability status and disability type. Hypothesis: Diet quality, physical activity, and other lifestyle factors will differ across disability status. Methods: Data were from the U.S. National Health and Nutrition Examination Survey 2013-2018 (n=3,409). Disability status was determined by the Washington Group on Disability Statistics questions regarding difficulty hearing, seeing, concentrating, walking, dressing, or running errands alone. Diet quality was evaluated using the Healthy Eating Index (HEI) 2015, with higher scores indicating better diet quality. Self-reported physical activity, food security, and fast food and ready-to-eat food consumption were also assessed. Chi-square tests and generalized linear regression evaluated differences across disability status and disability type. Results: Compared to women with no disabilities, women with any self-reported disabilities had lower HEI-2015 scores (46.8 and 50.5, respectively; p&lt;0.05), were more likely to report low/very low food security (48% and 18%, respectively; p&lt;0.05), and were less likely to report meeting physical activity recommendations of ≥150 minutes/week of moderate/vigorous activities (27% and 43%, respectively; p&lt;0.05). Differences were also observed by disability type, such that women with self-reported vision difficulty consume more fast food meals in one week compared to women with no disabilities. Conclusions: Women of reproductive age with disabilities report lower diet quality, food security, and physical activity. Future research should focus on identifying and improving modifiable lifestyle behaviors among this population to reduce disparities in maternal and child health outcomes.

Self-Reported Vision Impairment and Frailty among Older People with Low Cognitive Performance in Central Africa: EPIDEMCA Population-Based Study

Introduction: Very little is known about the impact of vision impairment (VI) on physical health in late-life in sub-Saharan Africa populations, whereas many older people experience it. We investigated the association between self-reported VI and frailty in Central African older people with low cognitive performance. Methods: It was cross-sectional analysis of data from the Epidemiology of Dementia in Central Africa (EPIDEMCA) population-based study. After screening for cognitive impairment, older people with low cognitive performance were selected. Frailty was assessed using the Study of Osteoporotic Fracture index. Participants who met one of the 3 parameters assessed (unintentional weight loss, inability to do 5 chair stands, and low energy level) were considered as pre-frail, and those who met 2 or more parameters were considered as frail. VI was self-reported. Associations were investigated using multinomial logistic regression models. Results: Out of 2,002 older people enrolled in EPIDEMCA, 775 (38.7%) had low cognitive performance on the screening test. Of them, 514 participants (sex ratio: 0.25) had available data on VI and frailty and were included in the analyses. In total, 360 (70%) self-reported VI. Prevalence of frailty was estimated at 64.9% [95% confidence interval: 60.9%–69.1%] and 23.7% [95% CI: 20.1%–27.4%] for pre-frailty. After full adjustment, self-reported VI was associated with frailty (adjusted odds ratio = 2.2; 95% CI: 1.1–4.3) but not with pre-frailty (adjusted odds ratio = 1.8; 95% CI: 0.9–3.7). Conclusion: In Central African older people with low cognitive performance, those who self-reported VI were more likely to experience frailty. Our findings suggest that greater attention should be devoted to VI among this vulnerable population in order to identify early frailty onset and provide adequate care management.

Broad and long-lasting vision improvements in youth with infantile nystagmus after home training with a perceptual learning app

Current treatments for infantile nystagmus (IN), focused on dampening the oscillating eye movements, yield little to no improvement in visual functioning. It makes sense, however, to treat the visual impairments associated with IN with tailored sensorimotor training. Recently, we therefore developed a letter discrimination training embedded in an eye movement task. This training improved visual performance of children with IN, but most children had not reached plateau performance after 10 training sessions (3,500 trials). Here, we test the effects of prolonged visual perceptual learning (14,000 trials) in 7-18-year-old children with IN, targeting visual crowding as an important bottleneck in their visual functioning. Children (n=36) were assessed before and after training and we performed follow up measurements after 6 months. The training program not only improved performance on the trained letter-discrimination tasks (uncrowded and crowded acuity improvement 0.08±0.03 logMAR and 0.19±0.05 logMAR, respectively; reduction crowding extent 0.31±0.05 logMAR). It also improved visual acuities measured with clinical vision charts at distance (5m, uncrowded 0.15±0.02 logMAR; crowded 0.18±0.02 logMAR) and at near (40cm, uncrowded 0.09±0.02 logMAR, crowded 0.10 ± 0.02 logMAR). We also observed transfer of training effects to untrained tasks such as reading (improvements in reading acuity and reading speed 0.07±0.02 logMAR and 16±2 wpm respectively) and even stereopsis (improvement of 0.22 ± 0.06 log10arcsec). In addition, we found that the training effects translated into improvements of daily-life functioning (as assessed with a functional vision questionnaire), and that they were long lasting (no significant decline after 6 months). The transfer to untrained conditions did not result from improved contrast sensitivity. We conclude that training with an engaging perceptual learning app at home elicits broad and long-lasting vision improvements in youth with IN. Improvements on self-reported functional vision scores underline the clinical relevance of perceptual learning with e-health apps for individuals with IN.

Broad and Long-Lasting Vision Improvements in Youth With Infantile Nystagmus After Home Training With a Perceptual Learning App.

Current treatments for infantile nystagmus (IN), focused on dampening the oscillating eye movements, yield little to no improvement in visual functioning. It makes sense, however, to treat the visual impairments associated with IN with tailored sensory training. Recently, we developed such a training, targeting visual crowding as an important bottleneck in visual functioning with an eye-movement engaging letter discrimination task. This training improved visual performance of children with IN, but most children had not reached plateau performance after 10 supervised training sessions (3,500 trials). Here, we evaluate the effects of prolonged perceptual learning (14,000 trials) in 7-18-year-old children with IN and test the feasibility of tablet-based, at-home intervention. Results demonstrate that prolonged home-based perceptual training results in stable, long lasting visual acuity improvements at distance and near, with remarkably good transfer to reading and even stereopsis. Improvements on self-reported functional vision scores underline the clinical relevance of perceptual learning with e-health apps for individuals with IN.

This issue of ACTA

This issue of ACTA

Diagnostic Accuracy of Monitoring Tests of Fellow Eyes in Patients with Unilateral Neovascular Age-Related Macular Degeneration: Early Detection of Neovascular Age-Related Macular Degeneration Study

PurposeTo evaluate the diagnostic accuracy of routinely used tests of visual function and retinal morphology compared with fundus fluorescein angiography (FFA) to detect onset of active macular neovascularization in unaffected fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD).DesignProspective diagnostic accuracy cohort study conducted in 24 eye clinics in the United Kingdom over 3 years.ParticipantsOlder adults (>50 years) with recently diagnosed unilateral nAMD with a fellow (study) eye free of nAMD.MethodsSelf-reported vision, Amsler, clinic-measured visual acuity (VA), fundus assessment, and spectral domain OCT. The reference standard is FFA.Main Outcome MeasuresSensitivity and specificity of the 5 index tests.ResultsOf 552 participants monitored for up to 3 years, 145 (26.3%) developed active nAMD in the study eye, of whom 120 had an FFA at detection and constituted the primary analysis cohort. Index test positives at nAMD detection in those confirmed by FFA were self-reported vision much worse (5), distortion on Amsler (33), 10-letter decrease in acuity from baseline (36), fundus examination (64), and OCT (110). Percentage index test sensitivities were: self-reported vision 4.2 (95% confidence interval [CI], 1.6–9.8); Amsler 33.7 (95% CI, 25.1–43.5); VA 30.0 (95% CI, 22.5–38.7); fundus examination 53.8 (95% CI, 44.8–62.5); and OCT 91.7 (95% CI, 85.2–95.6). All 5 index test specificities were high at 97.0 (95% CI, 94.6–98.5), 81.4 (95% CI, 76.4–85.5), 66.3 (95% CI, 61.0–71.1), 97.6 (95% CI, 95.3–98.9), and 87.8 (95% CI, 83.8–90.9), respectively. The combination of OCT with one other index test that was a secondary outcome measure increased sensitivity marginally and decreased specificity for all combinations except fundus examination.ConclusionsTests of self-reported change in vision, unmasking of new distortion, measurements of acuity, and fundus checks to diagnose active nAMD performed poorly in contrast to OCT. Our findings support a change to guidelines in clinical practice to monitor for onset of nAMD.

Preventive Home Visit (PHV) Screening of Hearing and Vision Among Older Adults in Tórshavn, Faroe Islands: A Feasibility Study in a Small-Scale Community

PurposeHearing and vision loss are common in later life but often overlooked and undertreated. The study aims to examine hearing and vision as part of preventive home visits (PHV) among 76-year-old home-dwelling citizens in Tórshavn, the capital of Faroe Islands.Patients and MethodsIn this cross-sectional study, three specially trained nurses conducted the examinations and tests, for this purpose, in the community health-centre.ResultsA total of 74 individuals participated (56% participation rate) of whom 77% had some degree of hearing impairment, 89% had visual impairment and 22% had dual sensory loss. A significant correlation between self-reported hearing ability and clinical findings was found, whereas self-reported vision did not correlate significantly with test-results.ConclusionResults indicate that implementing clinical assessments of hearing and vision as part of preventive home visits would benefit people receiving visits, and society by helping maintain the conditions that allow them to stay in their own homes for as long as possible.

Head-mounted Visual Assistive Technology-related Quality of Life Changes after Telerehabilitation.

Head-mounted low vision devices have become a viable alternative to enhance residual vision. This study supports the use of a head-mounted display to improve aspects of functional vision and quality of life. Much is still unknown regarding the required frequency, duration, or potential effectiveness of this telerehabilitation training protocol or what characteristics best identify optimal users. A randomized study explored the effect of telerehabilitation on quality of life and functional vision in individuals with low vision using a head-mounted display. We recruited 57 participants (age, 21 to 82 years; mean, 54.5 years) among new prospective eSight Eyewear users, randomized 1:1 into two parallel groups; the experimental group received the telerehabilitation training provided by a low vision therapist, whereas the control group received the self-training standard offered by the device manufacturer and without involvement of a low vision therapist. The primary outcome measures were the impact of telerehabilitation on validated measures of assistive technology-related quality of life: the Psychosocial Impact of Assistive Devices Scale and the Quebec User Evaluation of Satisfaction with Assistive Technology scale. Exploratory outcomes were the assessment of self-reported functional vision using the Veterans Affairs Low Vision Visual Functioning Questionnaire-48 and cybersickness associated with head-mounted display use with the Simulator Sickness Questionnaire. Assistive technology-related quality of life was improved when measured by the satisfaction scale but not the psychosocial scale within the first 3 months, independently of training type. Overall, functional vision improvement was observed within the first 2 weeks of device use and maintained during the 6-month study, independently of group type. Cybersickness outcomes were similar between training groups and did not change significantly for 6 months. eSight Eyewear, either with telerehabilitation or with the manufacturer self-training comparison, improved functional vision and increased users' quality of life within the initial 3 months of device training and practice.

Vision Impairment, Poor Diet, and Food Insecurity in the United States

Abstract Objectives To test the hypotheses that poor diet and food insecurity are associated with both measured and self-reported vision impairment (VI). Methods We analyzed data from adults age ≥50 years in the National Health and Nutrition Examination Survey (NHANES) between 1999–2008 in the United States (US). To assess diet quality, Healthy Eating Index 2015 scores (HEI-2015) were applied to participants’ 24-hour recall dietary intake. Participants were categorized as having full, marginal, low, or very low food security using the US Food Security Survey Module. Presenting VI (PVI) was defined as presenting distance visual acuity worse than 20/40 in the better-seeing eye. Self-reported VI (SRVI) was defined as vision reported as fair, poor, or very poor. Accounting for NHANES’ complex survey design, separate logistic regression models were constructed to assess the associations between HEI-2015 quintile and PVI, HEI-2015 quintile and SRVI, food insecurity category and PVI, and food insecurity category and SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Results Of the 10078 adults in this analysis, mean age was 63.4 years, 54% were women, and 80% were white. Mean HEI-2015 score (from 0–100) was 52.5. The prevalence of full food security was 89.9%, that of PVI was 7.2%, and that of SRVI was 20.1%. In adjusted logistic regression models, those with HEI-2015 scores in the lowest quintile (poor diet) had significantly higher odds of SRVI (OR: 1.29; 95% confidence interval [CI]: 1.04–1.61), but not PVI (OR: 1.13; CI: 0.86–1.49) compared to those in the fifth quintile. Compared to full food security, marginal (OR: 1.31; CI: 0.97–1.76), low (OR: 1.61; CI: 1.17–2.23), and very low (OR: 2.71; CI: 1.75, 4.20) food security was associated with increased odds of PVI. Similarly, marginal (OR: 1.58; CI: 1.23–2.02), low (OR: 1.46; CI: 1.11–2.92), and very low (OR: 1.85; CI: 1.41, 2.41) food security were associated with increased odds of SRVI compared to full security. Conclusions In this nationally representative sample of US adults age 50 years and older, poorer overall diet quality was associated with greater prevalence of SRVI. In a dose-response pattern, increasingly severe food insecurity was associated with greater prevalence of both PVI and SRVI. Funding Sources None

Do You See What Eye See? Measurement, Correlates, and Functional Associations of Objective and Self-Reported Vision Impairment in Aging South Africans.

Objectives: Our study investigates measurement, correlates, and functional associations of vision impairment (VI) in an aging population in rural South Africa. Methods: 1582 participants aged 40-69 reported on near (NVI) and distance vision impairment (DVI) and completed objective vision tests. Logistic and linear regression were used to evaluate sociodemographic, health, and psychosocial correlates of VI and assess relationships between VI and cognitive and physical function. Results: VI prevalence was considerably higher according to objective testing (56%) versus self-reports (18%). Older adults were especially likely to underreport impairment. Objective VI was associated with age, education, cardiometabolic disease, and female sex. Conversely, self-reported VI was associated with psychosocial factors. Objective NVI and both types of DVI were associated with worse visual cognition and slower gait speed, respectively. Discussion: Self-reported and objective VI measures should not be used interchangeably in this context. Our findings highlight extensive burden of untreated VI in this region.

Subjective vision and hearing impairment and falls among community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE).

To investigate the association between vision and hearing impairment and falls in community-dwelling adults aged ≥ 50 years. This is a prospective study on 50,986 participants assessed in Waves 6 and 7 of the Survey of Health, Ageing and Retirement in Europe. At baseline, we recorded socio-demographic data, clinical factors and self-reported vision and hearing impairment. We classified participants as having good vision and hearing, impaired vision, impaired hearing or impaired vision and hearing. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The cross-sectional and longitudinal associations between vision and hearing impairment categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. Mean age was 67.1 years (range 50-102). At baseline, participants with impaired vision, impaired hearing, and impaired vision and hearing had an increased falls risk (OR (95% CI)) of 1.34 (1.22-1.49), 1.34 (1.20-1.50) and 1.67 (1.50-1.87), respectively, compared to those with good vision and hearing (all p < 0.001). At follow-up, participants with impaired vision, without or with impaired hearing, had an increased falls risk of 1.19 (1.08-1.31) and 1.33 (1.20-1.49), respectively, compared to those with good vision and hearing (both p < 0.001); hearing impairment was longitudinally associated with falls in middle-aged women. Vision impairment was cross-sectionally and longitudinally associated with an increased falls risk. This risk was highest in adults with dual sensory impairment.

Prevalence and Factors Associated with Self-Reported Vision Disability among the Elderly in Malaysia: Findings from National Health and Morbidity Survey (NHMS) 2018.

Introduction Disability has adverse effects on health, wellbeing, and life quality. Vision disorder is one of the top-ranked causes of disability in the elderly population. This study aims to determine the prevalence and factors associated with vision disability among the elderly in Malaysia. Methodology. Data collection from National Health and Morbidity Survey (NHMS) 2018 was obtained. This survey focused on elderly health by using two-stage stratified cluster sampling design. The Washington Group Extended Question Set on Functioning (WG ES-F) was used to determine the vision disability. The data were analyzed using SPSS version 21.0 utilizing a complex sample design with multivariable logistic regression analysis to determine the prevalence and associated factors to vision disability. Results A total of 3,977 elderly completed the vision disability questionnaire. The overall prevalence of vision disability among those who were 60 years old and above was 4.5%. Multiple logistic regression revealed that no formal education (AOR: 6.69, 95% CI: 1.52, 29.49), only primary education (AOR: 4.26, 95% CI: 1.01, 18.03), unemployed/retiree or homemaker (AOR: 3.25, 95% CI: 1.79, 5.89), hypertension (AOR: 1.45, 95% CI: 1.00, 2.09), and malnourished elderly (AOR: 2.84, 95% CI: 1.76, 461) had higher odds for having vision disability. Conclusion The findings suggest that a low education level, unemployment, hypertension, and malnourishment are significant risk factors for VD among Malaysia's elderly. Strengthening awareness campaigns to increase VD awareness and provide high-quality rehabilitation services must target specific groups, such as the elderly with a low level of education and the unemployed. Empower primary healthcare providers with the knowledge and skills necessary to improve the quality of eye care delivery and expand eye screening in settling VD issues nationally.

Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1

BackgroundPsychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1).MethodsData was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress.ResultsThe analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4).ConclusionsPersons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.

Self-Reported Vision Impairment and Psychological Distress in U.S. Adults

ABSTRACT Purpose Examine the relationship between vision impairment and psychological distress in adults ≥18 years. Methods Using the 2016–2017 cross-sectional, U.S. National Health Interview Survey, we analyzed self-reported data (n = 57,644) on: Kessler psychological distress scores; general vision impairment (GVI), defined as difficulty seeing even when wearing glasses or contacts; and visual function impairment (VFI), measured using six visual function questions. Multinomial logistic regression was used to estimate adjusted odds ratios (aOR) for mild/moderate and serious psychological distress, by GVI and VFI status, and identify predictors of psychological distress among those with GVI or VFI. Results Among adults, 10.6% (95% CI: 10.2, 11.0) had GVI; 11.6% (CI: 11.1, 12.0) had VFI. One in four adults with GVI had psychological distress (14.9% [CI: 13.8, 16.0] reported mild/moderate and 11.2% [CI: 10.2, 12.3] reported serious). Individuals with GVI, versus those without, had higher odds of mild/moderate (aOR = 2.24; CI: 2.00, 2.52) and serious (aOR = 3.41; CI: 2.96, 3.93) psychological distress; VFI had similar findings. Among adults with GVI, odds of serious psychological distress were higher for those aged 18–39 (aOR = 4.46; CI: 2.89, 6.90) or 40–64 (aOR = 6.09; CI: 4.33, 8.57) versus ≥65 years; smokers (aOR = 2.45; CI: 1.88, 3.18) versus non-smokers; physically inactive (aOR = 1.61; CI: 1.22, 2.11) versus active; and with arthritis (aOR = 2.18; CI: 1.66, 2.87) or chronic obstructive pulmonary disease (aOR = 1.65; CI: 1.15, 2.37) versus without. Conclusion Adults with self-reported vision impairment had higher odds of psychological distress. These findings may inform screening interventions to address psychological distress, particularly among younger working-age adults vision impairment.