Uncorrected Visual Impairment Research Articles

Towards better estimates of uncorrected presbyopia.

Normal vision depends upon the ability of the ocular lens to change shape, ensuring that light is focused on the most sensitive part of the retina. Anyone living beyond middle age is inevitably affected by presbyopia, an inability to focus on near objects, due to the loss of flexibility of the ocular lens. It is estimated that over half of the one billion people affected globally cannot afford the spectacles needed to correct their eyesight. Most of the people with uncorrected visual impairment live in low- and middle-income countries.1,2

Association of vision loss and work status in the United States.

Working is critical to personal health and well-being. We examine the association of vision measured objectively with work status using a nationally representative sample of working-age Americans. A total of 19 849 participants from the 1999-2008 National Health and Nutrition Examination Survey completed a vision examination and employment/demographic questionnaires. Employment rates for men with visual impairment, uncorrected refractive error, and normal vision were 58.7%, 66.5%, and 76.2%, respectively; employment rates for women with visual impairment, uncorrected refractive error, and normal vision were 24.5%, 56.0%, and 62.9%, respectively. In multivariable models adjusting for age, sex, race/ethnicity, and chronic disease status, both uncorrected refractive error (odds ratio [OR], 1.36; 95% CI, 1.15-1.60) and visual impairment (OR, 3.04; 95% CI, 1.93-4.79) were associated with a higher likelihood of not working. Subgroups in which visual impairment was associated with even higher odds of not working included women (OR, 4.9; 95% CI, 2.5-9.6), participants younger than 55 years (OR, 4.3; 95% CI, 2.9-6.5), and diabetic individuals (OR, 14.8; 95% CI, 5.8-37.3). Decreased vision is associated with a significantly higher likelihood of not working. Visually impaired diabetic individuals, women, and those younger than 55 years have a particularly high risk of not working. Further investigation is warranted to understand barriers for employment in individuals with decreased vision.

Observer-rated depression in long-term care: Frequency and risk factors

The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months. We measured demographic, medical, and functional factors at baseline and monthly intervals, using data from research assessments, nurse interviews, and chart reviews.274 residents were recruited and completed baseline depression assessments. The prevalence of depression (CSDD score of 6+) was 19.0%. The incidence of depression among those without prevalent depression was 73.3 per 100 person-years. A delirium diagnosis, pain, and diabetes were independently associated with prevalent depression. CSDD score at baseline and development of severe cognitive impairment at follow-up were independent risk factors for incident depression. A diagnosis of delirium and uncorrected visual impairment at follow-up occurred concurrently with incident depression. The results of this study have implications for the detection and prevention of depression in LTC. Delirium diagnosis, pain and diabetes at baseline were associated with prevalent depression; depression symptoms at baseline and development of severe cognitive impairment at follow-up were risk factors for incident depression.

A Call for Vision Screening in Adolescents

Researchers have estimated that 9% of U.S. adolescents age 12 to 19 years have uncorrected distance visual impairment (UDVI; JAMA 2006; 296:2158) and

Uncorrected Distance Visual Impairment Among Adolescents in the United States

To describe uncorrected distance visual impairment (VI). We conducted an analysis of the 3,555 adolescents aged 12 through 21 years who participated in the 2005-2008 National Health and Nutrition Examination Survey. Distance VI was defined as 20/40 or worse in the better-seeing eye. Data were weighted to represent the civilian noninstitutionalized population. Overall, 12.3% (95% confidence interval [CI]: 10.7%-14.1%) had distance VI, which was correctable to 20/30 or better in both eyes in 86.1% (95% CI: 83.6%-89.5%). The prevalence was higher among those who reported not having corrective lenses available (44.3%) compared with those who reported that they did not need them (8.5%) or who had them available (5.2%; p < .001). After adjusting for potential confounders, those who were 12 or 13 years of age had 2.27 (95% CI: 1.32-3.90) greater odds of distance VI than older adolescents, and the odds of distance VI were greater among non-Hispanic blacks (1.66 [95% CI: 1.11-2.48]), Hispanics (1.96 [95% CI: 1.35-2.84]), or other race/ethnicities (2.06 [95% CI: 1.19-3.57]) than among non-Hispanic whites. More than 1 in 10 adolescents had uncorrected distance VI. To address this, interventions should address case detection, access to eye care, and adherence with corrective lenses.

Visual impairment and blindness: an overview of prevalence and causes in Brazil

Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from two cross-sectional population-based studies - the São Paulo Eye Study and the Refractive Error in School Children Study is presented. 3678 older adults and 2441 school children were examined between July 2004 and December 2005. Prevalence of blindness in older adults using presenting visual acuity was 1.51% decreasing to 1. 07% with refractive correction. The most common causes of blindness in older adults were retinal disorders, followed by cataract and glaucoma. In school children, the prevalence of uncorrected visual impairment was 4.82% decreasing to 0.41% with refractive correction. The most common cause of visual impairment in school children was uncorrected refractive error. Visual impairment and blindness in Brazil is an important public health problem. It is a significant problem in older Brazilians, reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling. In school-children cost-effective strategies are needed to address a readily treatable cause of vision impairment - prescription and provision of glasses.

Prevalence and Causes of Visual Impairment in African-American and Hispanic Preschool Children: The Multi-Ethnic Pediatric Eye Disease Study

To determine the prevalence and causes of decreased visual acuity (VA) in a population-based study of minority preschool children. Population-based, cross-sectional study. Children 30 to 72 months of age in 44 census tracts in Los Angeles County. A population-based sample of children underwent comprehensive ophthalmic evaluation including monocular VA testing, cover testing, cycloplegic autorefraction, anterior segment and fundus evaluation, and VA retesting with refractive correction. The prevalence and etiology of decreased VA were determined, for both presenting and best-measured VA, and better eye and worse eye. Prevalence of decreased presenting and best-measured VA with an identifiable ophthalmic etiology. Presenting VA was assessed in 3207 children and best-measured VA in 3364 children. Although nearly one third of cases of worse-eye decreased presenting VA were without an identifiable ophthalmic etiology, this proportion decreased with increasing age. Decreased presenting VA that resolved with retesting and was associated with uncorrected refractive error was present in the worse eye of 4.3% of African-American children and 5.3% of Hispanic children, and in the better eye of 1.9% of African-American children and 1.7% of Hispanic children. Decreased best-measured VA that was not immediately correctable with spectacles and that was because of ocular disease, unilateral or bilateral amblyopia, or probable bilateral ametropic amblyopia, was seen in the worse eye of 1.5% of African-American and 1.9% of Hispanic children, and in the better eye of 0.8% of African-American and 0.6% of Hispanic children. Amblyopia related to refractive error was the most common cause. More than 5% of African-American and Hispanic preschool children in Los Angeles County have either correctable visual impairment from uncorrected refractive error or visual impairment from amblyopia related to refractive error.

The Prevalence and Causes of Visual Impairment in Central Sri Lanka: The Kandy Eye Study

To determine the prevalence and causes of uncorrectable visual impairment in the Kandy District of central Sri Lanka. Population-based, cross-sectional study. Inhabitants >or=40 years of age from villages in the Kandy District were selected by randomized cluster sampling; 1721 eligible participants were identified and 1375 participated in the study. The ophthalmic examination included best-corrected logarithm of the minimum angle of resolution visual acuity (VA), slit-lamp examination of the anterior segment, and dilated stereoscopic fundus examination. The principal cause of visual impairment after best correction was recorded. Visual impairment (better eye <6/18) and blindness (better eye <3/60) after best correction. Comprehensive examinations, including VA, were performed on 1375 subjects (79.9% participation rate). The prevalence of blindness was 1.1% (95% confidence interval [CI], 0.002-0.020; 15 participants). The prevalence of visual impairment was 5.9% (95% CI, 0.043-0.075; 81 subjects). Cataract and age-related macular degeneration were the main causes of visual impairment. Visual impairment remains a major public health problem in central Sri Lanka. Specific programs directed at reducing the cataract burden need to be implemented. The authors have no proprietary or commercial interest in any materials discussed in this article.

Diabetes Mellitus and Visual Impairment

To examine the prevalence and correlates of visual impairment (VI) among US adults with and without diabetes mellitus. Using National Health and Nutrition Examination Surveys conducted during 1999-2004, we estimated the prevalence of presenting (correctable or uncorrectable), correctable, and uncorrectable VI among Americans 20 years or older with and without diabetes. Data were weighted to make estimates representative of the US civilian noninstitutionalized population. We used multivariate logistic regression to calculate odds ratios and corresponding 95% confidence intervals. Approximately 11.0% of US adults with diabetes had some form of VI (3.8% uncorrectable and 7.2% correctable). Among those without diabetes, 5.9% had some form of VI (1.4% uncorrectable and 4.5% correctable). People with diabetes were more likely to have uncorrectable VI than those without diabetes, even after controlling for selected other factors (P < .05). Our findings also suggest a strong association between VI (correctable and uncorrectable) and older age, member of racial/ethnic minorities, lower income, and lack of health insurance, all independent of diabetes status (P < .05). Vision loss is more common in people with diabetes than in people without diabetes. Diverse public health strategies are needed to reduce the burden of both correctable and uncorrectable VI.

The Prevalence of Visual Impairment in School Children of Upper-Middle Socioeconomic Status in Kathmandu

Purpose: Assess visual impairment in school children of upper-middle socioeconomic status in Kathmandu for comparison with rural Jhapa District. Methods: Random selection of classes from secondary private schools in Kathmandu was used to identify the study sample. Children in 130 classes at 43 schools were enumerated using school records and examined between January–May 2006. Examinations included visual acuity testing, ocular motility evaluation, cycloplegic refraction, and examination of the external eye, anterior segment, media, and fundus. The principal cause was determined for eyes with uncorrected visual acuity ≤ 20/40. Results: A total of 4,501 children in grades 5–9 were enumerated; 4282 (95.1%) were examined. The prevalence of uncorrected, presenting, and best-corrected visual impairment (≤ 20/40) in the better eye was 18.6%, 9.1%, and 0.86%, respectively. Refractive error was a cause in 93.3% of children with uncorrected visual impairment, amblyopia 1.8%, retinal disorders 1.3%, other causes 0.3%, and unexplained causes 4.4%. Among children correctable in at least one eye, 46.3% presented without the necessary spectacles. Visual impairment with myopia (−0.50 diopters) ranged from 10.9% in 10 year-olds to 27.3% in 15 year-olds, compared to 0.5%–3.0% in rural Jhapa District. Myopic visual impairment was associated with grade level, female gender, parental education, parental spectacle usage, and Mongol ethnicity. Conclusions: Visual impairment with myopia among upper-middle socioeconomic school children in Kathmandu is higher than that in rural Nepal, and a public health problem because nearly half are without corrective spectacles. Effective strategies are needed to eliminate this easily treatable cause of visual impairment.

Visual functions of commercial drivers in relation to road accidents in Nigeria.

Objective:To determine the effects of the visual functions on the occurrence of road traffic accidents (RTA) amongst commercial drivers in Ife central local government area (LGA) of Osun state of Nigeria.Design:A cross-sectional study.Settings:Four major motor parks located at Ife Central LGA.Materials and Methods:Of the estimated 270 commercial drivers in the four major parks of the LGA, 215 consecutive drivers were interviewed and had their eyes examined. Structured questionnaires were administered by an ophthalmologist.Results:The prevalence of visual impairment (visual acuity < 6/18) in the better eye without correction was 3.3% ± 2.4 and there was a significant association between uncorrected visual acuity impairment in the better eye and RTA (P = 0.0152). Refractive error was seen in 8.4% of the drivers, but none of these wear corrective glasses. Visual field defect, abnormal stereopsis and color vision impairment did not have any significant association with RTA.Conclusion:Poor visual acuity is strongly associated with RTA amongst Nigerian commercial drivers as opposed to visual field defect, abnormal color vision and stereopsis. A significant proportion of visual impairment was due to uncorrected refractive errors.

Refractive Error and Patterns of Spectacle Use in 12-Year-Old Australian Children

To document the prevalence of visual impairment resulting from refractive error and to describe patterns of spectacle use in a representative sample of 12-year-old Australian school children. Population-based cross-sectional study. Two thousand three hundred fifty-three predominantly 12-year-old children examined from 2004 through 2005. Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was measured unaided and with spectacles if worn. Subjective refraction, cycloplegic autorefraction (with cyclopentolate), and detailed dilated fundus examination were performed. Myopia was defined as spherical equivalent (SE) refraction < or =-0.50 diopters (D), hyperopia as SE refraction > or =2.0 D, and astigmatism as cylinder > or =1.0 D. Uncorrected visual impairment was defined using unaided VA, and presenting visual impairment was defined using spectacle-corrected VA, if worn. Visual impairment was defined as VA <20/40 (<40 logMAR letters) for both better and worse eyes. Spectacle need was defined as uncorrected visual impairment in the better eye, improving by at least 2 lines with refraction, and undercorrection as presenting impairment in the better eye, improving by at least 2 lines with refraction. Uncorrected and presenting visual impairment in at least 1 eye because of refractive error was found in 10.4% and 3.7%, respectively. Spectacle use was reported by 448 children (19.0%); 204 (46.3%) had myopia, 48 (10.9%) had hyperopia, and 96 (21.8%) had astigmatism in at least 1 eye; 38.3% had no significant refractive error in either eye. Eight children were in need of spectacles and 37 children (8.3% of spectacle users) were undercorrected. Nonrefractive spectacle users were more likely to report eyestrain and headache or to have had learning difficulty at school (P<0.0001). This study documents a relatively low prevalence of undercorrected refractive error in a population of Australian children. Nonrefractive prescription of spectacles is common.

Patterns of Spectacle Use in Young Australian School Children: Findings from a Population-Based Study

To describe the patterns of spectacle use in a population-based sample of Australian Year 1 school children (mostly aged 6 years). Logarithm of the minimum angle of resolution (logMAR) visual acuity was measured in both eyes before and after pinhole correction, and using spectacles if worn. Cycloplegic autorefraction (cyclopentolate) and detailed dilated fundus examination were performed. Visual impairment was defined as visual acuity <40 logMAR letters (ie, <20/40 Snellen equivalent). Myopia was defined as spherical equivalent (SE) refraction < or = -0.50 diopters (D), and hyperopia as SE refraction > or = +2.0D, deemed significant when > or = +3.0D. Astigmatism was defined as cylinder > or =1.0D and anisometropia as SE refraction difference between the two eyes at least 1.0D. One thousand seven hundred forty predominantly 6-year-old school children were examined during 2003 to 2004. Spectacle use was documented in 77 children (4.4% of sample). Uncorrected visual impairment was found in the worse eye of 71 children (4.1%) and refractive error accounted for the majority (69.0%). Astigmatism was the most common refractive error causing visual impairment, accounting for 46.5%. Hyperopia, with or without astigmatism, was the most frequent reason for spectacle use, documented in 40.3%. Spectacle use in the absence of significant refractive error, amblyogenic risk factors, or visual impairment was noted in 26 children (33.8% of spectacle wearers). The prescription of spectacles could have benefited a further 26 children (1.5% of sample), mostly for correction of astigmatism. This study documents a significant disparity between spectacle use and need. Astigmatism was the most common cause of visual impairment due to refractive error.

Visual Acuity and the Causes of Visual Loss in a Population-Based Sample of 6-Year-Old Australian Children

To describe the distribution of visual acuity and causes of visual loss in a representative sample of Australian schoolchildren. Population-based cross-sectional study. One thousand seven hundred thirty-eight predominantly 6-year old children examined during 2003 to 2004. Logarithm of the minimum angle of resolution (logMAR) visual acuity was measured in both eyes before and after pinhole correction and with spectacles if worn. Cycloplegic autorefraction (cyclopentolate) and detailed dilated fundus examination were performed. Visual impairment was defined as any (visual acuity <20/40; <40 letters) or severe (visual acuity < or =20/200; 0-5 letters) for both better and worse eyes. Myopia was defined as spherical equivalent (SE) refraction < or =-0.50 diopters (D), and hyperopia as SE refraction > or =+2.0 D, deemed significant when > or =+3.0 D. Astigmatism was defined as cylinder > or =1.0 D and anisometropia as SE refraction difference between eyes at least 1.0 D. Amblyopia was defined as corrected visual acuity <0.3 logMAR units (<20/40; <40 letters) in the affected eye not attributable to any underlying structural abnormality of the eye or visual pathway, together with a 2-logMAR line difference between the eyes and presence of an amblyogenic risk factor. The mean visual acuity of this sample was 20/25 (49.3 letters). Uncorrected visual impairment was found in the better eye of 23 children (1.3%) and in the worse eye of 71 children (4.1%). The prevalence was higher in girls than boys and among children of lower socioeconomic status. Refractive error was the most frequent cause, accounting for 69.0%, followed by amblyopia (22.5%). Astigmatism was the principle refractive error causing visual impairment and was frequently uncorrected. Presenting visual impairment (using current glasses if worn) was found in the better and worse eyes of 15 children (0.9%) and 54 children (2.8%), respectively. This was mainly due to under corrected or uncorrected refractive error. This study has documented a relatively low prevalence of visual impairment in a population of Australian children. Uncorrected astigmatism and amblyopia were the most frequent causes.

Refractive Error and Visual Impairment in School-Age Children in Gombak District, Malaysia

To assess the prevalence of refractive error and visual impairment in school-age children in Gombak District, a suburban area near Kuala Lumpur city. Population-based, cross-sectional survey. Four thousand six hundred thirty-four children 7 to 15 years of age living in 3004 households. Random selection of geographically defined clusters was used to identify the study sample. Children in 34 clusters were enumerated through a door-to-door survey and examined in 140 schools between March and July 2003. The examination included visual acuity measurements; ocular motility evaluation; retinoscopy and autorefraction under cycloplegia; and examination of the external eye, anterior segment, media, and fundus. Distance visual acuity and cycloplegic refraction. The examined population was 70.3% Malay, 16.5% Chinese, 8.9% Indian, and 4.3% of other ethnicity. The prevalence of uncorrected (unaided), presenting, and best-corrected visual impairment (visual acuity < or =20/40 in the better eye) was 17.1%, 10.1%, and 1.4%, respectively. More than half of those in need of corrective spectacles were without them. In eyes with reduced vision, refractive error was the cause in 87.0%, amblyopia in 2.0%, other causes in 0.6%, and unexplained causes in 10.4%, mainly suspected amblyopia. Myopia (spherical equivalent of at least -0.50 diopter [D] in either eye) measured with retinoscopy was present in 9.8% of children 7 years of age, increasing to 34.4% in 15-year-olds; and in 10.0% and 32.5%, respectively, with autorefraction. Myopia was associated with older age, female gender, higher parental education, and Chinese ethnicity. Hyperopia (> or =2.00 D) with retinoscopy varied from 3.8% in 7-year-olds, 5.0% with autorefraction, to less than 1% by age 15, with either measurement method. Hyperopia was associated with younger age and "other" ethnicity. Astigmatism (> or =0.75 D) was present in 15.7% of children with retinoscopy and in 21.3% with autorefraction. Visual impairment in school-age children in urban Gombak District is overwhelmingly caused by myopia, with a particularly high prevalence among children of Chinese ethnicity. Eye health education and screening may help address the unmet need for refractive correction.

Persecutory symptoms and perceptual disturbance in a community sample of older people: the Islington study.

While there are extensive studies of paranoid symptoms and perceptual disturbance (PPD) in younger adults, relatively little is known about older adults with similar symptoms. This study took place in Islington, an inner London borough. Enumeration Districts were randomised to provide a sampling frame. Residents aged 65 or over were interviewed at home. The Short-CARE was used to elicit psychiatric symptoms and diagnosis. Sociodemographic particulars were elicited using the Client Sociodemographic and Service Receipt Inventory. Questions were asked regarding sight and hearing. We used subsections of the geriatric mental scale to identify people who had PPD symptoms. Medications taken were recorded. We asked 'Do you have any health problems?' as a screening question for subjective health problems. We interviewed 720 people. Twenty-eight (3.9%) participants scored positively on the PPD sub-scales of the GMS. A forward logistic regression analysis for independent predictors of PPD found the significant independent predictors were dementia (p = 0.0000; odds ratio 6.8), drinking alcohol in last 6 months (p < 0.03; odds ratio 0.3), drinking alcohol to help sleep (p < 0.005; odds ratio 9.6), subjective memory loss (p < 0.007; odds ratio 3.3) and uncorrected visual impairment (p < 0.02; odds ratio 2.8). There is a relatively high prevalence of PPD in older people living in the community. This is not associated with higher use of services despite the increased needs. Further studies should consider interventions to meet this unmet need.

Uncorrected binocular distance visual impairment in U.S. Hispanic children and adolescents

PURPOSE: To assess and compare uncorrected binocular distance visual impairment rates in U.S. Hispanic children and adolescents. METHODS: Data from the Hispanic Health and Nutrition Examination Survey, 1982–1984, were analyzed for 6–19 year-old Cuban-Americans (n = 317), Mexican-Americans (n = 2519), and Puerto Ricans (n = 988). Visual acuity was assessed using Sloan Letters or Landolt Rings. RESULTS: Prevalence rates of uncorrected binocular distance visual impairment (20/30 or worse) were 15.5%, 14.9%, and 23.6% for Cuban-Americans, Mexican-Americans, and Puerto Ricans, respectively. After adjusting for age and gender, the differences between Puerto Ricans and both Cuban-Americans and Mexican-Americans were significant (p < 0.05). Children 6–12 years of age had lower visual impairment rates than 13–19 year-old adolescents. Girls had higher age-adjusted visual impairment rates than boys; these gender differences were statistically significant among Mexican-Americans (OR = 1.6, 95% CI = 1.1, 2.2) and Puerto Ricans (OR = 1.7, 95% CI = 1.2, 2.4). CONCLUSIONS: Among Hispanics, Puerto Rican children and adolescents have the highest prevalence rate of uncorrected binocular distance visual impairment; older age and female gender are associated with higher rates of uncorrected visual impairment.

Older adults, diabetes mellitus and visual acuity: a community-based case-control study.

to screen for impaired distance visual acuity in older adults living at home, both with and without diabetes mellitus to determine whether diabetes increases the likelihood of visual impairment and to identify associated factors. case-control study. three districts of Wales: North Clwyd, Powys and South Glamorgan, with assessments in subjects' homes. 385 with diabetes mellitus and 385 age- and sex-matched controls. visual acuity measures, short form (SF)-36 quality of life scores we observed impairment of visual acuity in 40% of those with diabetes mellitus and 31% of controls. Diabetes was associated with an increased risk of visual impairment [odds ratio 1.50 (95% confidence interval 1.09-2.05), P = 0.013]. The pinhole test identified uncorrected refractive error in 11% of the 63 patients with diabetes and 12% of the 49 controls who wore glasses, and in 51% of the 91 patients and 84% of the 69 controls who did not wear glasses (P < 0.001). Increasing age (P < 0.001) and female sex (P = 0.014) were significantly associated with visual impairment in both groups, whilst history of foot ulceration (P = 0.001), duration of diabetes (P = 0.018) and treatment with insulin (P < 0.001) were significantly associated with visual impairment in subjects with diabetes. We observed a significant association between impaired visual acuity and five domains of the SF-36 (physical and social functioning, mental health, vitality, and health perceptions; P < 0.01 in each case). older adults living at home have a high prevalence of uncorrected visual impairment. Diabetes mellitus is associated with significantly increased risk of visual loss. This impairment is associated with detriments in health-related quality of life. We recommend earlier use of optometry services and assessment of visual acuity by clinicians.

Prevalence and correction of near vision impairment at Kaski, Nepal

Presbyopia is an important cause of avoidable visual disability. To estimate the prevalence of near vision impairment and spectacle coverage among middle and older-aged adults in rural Nepal. The surveys was carried out among the people of age 35 and over in randomly-selected cluster samples in rural settings of Kaski district of western Nepal, Near visual acuity, with and without presenting near correction, was measured at 40 cm using a LogMAR near vision tumbling E chart under ambient indoor lighting. Subjects with uncorrected binocular distance vision of 20/40 or worse were refracted and those with near vision of 20/40 or worse tested with plus sphere to obtain the best-corrected binocular near visual acuity. A total of 2,360 persons aged 35 years and over were enumerated and 2,156 (91.3%) were examined. The age- and gender-standardized prevalence of uncorrected near visual impairment (vision of 20/40 or worse) in study population was found to be 66.1 %. Near vision could not be corrected (>20/40) even after distance and near vision correction in 6.4 % . Using the multiple logistic regression models, uncorrected visual impairment was associated with an older age (odds ratio [OR] = 1.13, P less than 0.001) and a lower educational level (OR = 1.11, P = 0.01) was less associated with female gender (OR = 0.72, P = 0.038). Over 90 % of people with near visual impairment did not have spectacles. The prevalence of presbyopia appears to be higher with an earlier onset and over 90 % of people in need of near correction do not have spectacles in this setting.