Seven-year incidence of uncorrected refractive error among an elderly Chinese population in Shihpai, Taiwan: The Shihpai Eye Study.
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ABSTRACT: Purpose
To report the 7-year incidence of uncorrected refractive error in a metropolitan Chinese elderly population.Methods
The Shihpai Eye Study 2006 included 460/824 (55.8%) subjects (age range 72-94 years old) of 1361 participants in the 1999 baseline survey for a follow-up eye examination. Visual acuity was assessed using a Snellen chart, uncorrected refractive error was defined as presenting visual acuity (naked eye if without spectacles and with distance spectacles if worn) in the better eye of <6/12 that improved to no impairment (≥6/12) after refractive correction.Results
The 7-year incidence of uncorrected refractive error was 10.5% (95% confidence interval (CI): 7.6-13.4%). 92.7% of participants with uncorrection and 77.8% with undercorrection were able to improve at least two lines of visual acuity by refractive correction. In multivariate analysis controlling for covariates, uncorrected refractive error was significantly related to myopia (relative risk (RR): 3.15; 95% CI: 1.31-7.58) and living alone (RR: 2.94; 95% CI 1.14-7.53), whereas distance spectacles worn during examination was protective (RR: 0.35; 95% CI: 0.14-0.88).Conclusion
Our study indicated that the incidence of uncorrected refractive error was high (10.5%) in this elderly Chinese population. Living alone and myopia are predisposing factors, whereas wearing distance spectacles at examination is protective.
SUBMITTER: Kuang TM
PROVIDER: S-EPMC5108537 | biostudies-literature | 2016 Apr
REPOSITORIES: biostudies-literature
Publications
Seven-year incidence of uncorrected refractive error among an elderly Chinese population in Shihpai, Taiwan: The Shihpai Eye Study.
Kuang T-M TM Tsai S-Y SY Liu C J-L CJ Ko Y-C YC Lee S-M SM Chou P P
Eye (London, England) 20160122 4
<h4>Purpose</h4>To report the 7-year incidence of uncorrected refractive error in a metropolitan Chinese elderly population.<h4>Methods</h4>The Shihpai Eye Study 2006 included 460/824 (55.8%) subjects (age range 72-94 years old) of 1361 participants in the 1999 baseline survey for a follow-up eye examination. Visual acuity was assessed using a Snellen chart, uncorrected refractive error was defined as presenting visual acuity (naked eye if without spectacles and with distance spectacles if worn) ...[more]
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Project description:Objectives To investigate the prevalence and risk factors of uncorrected refractive error (URE) in an elderly urban Chinese population in China. Design A population-based cross-sectional study. Methods The study was conducted using a cluster random sample of residents aged 50 years or older living in the Jiangning Road subdistrict, Shanghai, China. All participants underwent a standardised interview and eye examinations, including presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) between November 2012 and February 2013. URE was defined as an improvement of two lines or more in the BCVA compared with the PVA in the better eye of <20/40. Results A total of 1999 subjects (an 82.5% response rate) completed both the questionnaire and ophthalmic examination. The prevalence of URE was 20.1% (95% CI 18.0% to 22.2%) in the study sample. After age standardisation, the prevalence of URE in Chinese people aged 50 years or older was 18.7% (95% CI 17.0% to 20.4%). Under multiple logistic regression analysis, older age (per 1-year increase, OR 1.04, 95% CI 1.03 to 1.05) and a lower level of education (OR 1.34, 95% CI 1.07 to 1.69) were significantly related to URE. A history of ocular diseases (OR 0.71, 95% CI 0.55 to 0.92) was a protective factor for URE. Conclusions URE is highly prevalent among the elderly urban Chinese population, which should raise awareness of the URE burden in China to meet the Vision 2020 goal to eliminate preventable blindness.
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Project description:BackgroundUncorrected refractive error (URE) is one of the main causes of visual impairments. URE may reduce interaction and learning in the classroom, leading to social isolation, irreversible amblyopia, lack of external knowledge, and restrictions on education and employment opportunities. Our aim was to investigate the prevalence and related factors of URE in adolescents using epidemiological surveys and questionnaire surveys related to lifestyle habits.MethodsA cross-sectional school-based study was conducted in Nantong, China, including adolescents 12-19 years of age from 16 schools. URE was defined as presenting visual acuity worse than 6/12 and improving to ≥ 1 lines after correction in either eye. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between URE and related lifestyle parameters. Non-cycloplegic autorefraction was assessed for each adolescent.ResultsA total of 2,910 adolescents were analyzed, of which 50.3% (n = 1,465) were male, and 49.7% (n = 1,445) were female. The mean age was 15.23 ± 1.77 years. The overall prevalence of URE was 23.7%. The total prevalence of REC and eREC was 85.1% and 71.7%, respectively, and both of them showed an increasing trend with age (Ptrend = 0.018 and Ptrend = 0.019, respectively). A higher prevalence of URE was related to myopia, anisometropia, and increased daily use of electronic products. Timely visual examination by medical institutions, more extracurricular homework, and older age were protective factors for URE. Among the 689 adolescents with URE, 362 (52.5%) did not receive any refractive correction, and 327 (47.5%) used corrected glasses.ConclusionURE was highly prevalent among adolescents in China. Myopia was the most important risk factor for URE. The impact of anisometropia and increased daily use of electronic devices on URE was significant. Timely visual examinations by medical institutions served as an effective protective factor against URE. Further research on adjusting intervention strategies is therefore needed to eliminate preventable visual impairments.
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Project description:Purpose: Uncorrected refractive error (URE) is the leading cause of impaired vision in older adults and has been associated with adverse health outcomes. Here, we investigate the association between URE and frailty in older adults.Methods: This is a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) participants ≥60 years (1999-2006 cycles). URE was defined as visual acuity worse than 6/12 that can be improved with correction, and prefrailty and frailty were defined as meeting 1-2 and ≥3 of 4 components of a modified physical frailty phenotype. The 5-item phenotype (including slowness) was analyzed in a subset of participants with available data. Propensity score adjustment was used to address the imbalance of potential confounders (including age) between URE groups.Results: In this sample (n = 5,265), 6% of participants had URE (n = 373). In fully adjusted propensity score-based models, individuals with URE were more likely to be prefrail (OR = 1.4; 95% CI: 1.0-2.0) and frail (OR = 3.2; 95% CI: 1.3-7.4) than those without URE using the 4-item phenotype. For the 2,486 participants with 5-item phenotype data, individuals with URE were more likely to be frail (OR = 3.0; 95% CI: 1.2-7.5); however, the association with prefrailty was not statistically significant (OR = 1.8; 95% CI: 0.9-3.6).Conclusion: In this population-based sample, older adults with URE were more likely to be frail than those without URE, even after rigorous control for confounders, including age.
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Project description:PurposeTo assess the rate of visual impairment (VI) from uncorrected refractive error (URE) and associations with demographic and socioeconomic factors among low-income patients presenting to the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program.DesignCross-sectional study.ParticipantsAdults ≥ 18 years without acute ocular symptoms.MethodsMI-SIGHT program participants received a telemedicine-based eye disease screening and ordered glasses through an online optical store. Participants were categorized based on refractive error (RE) status: VI from URE (presenting visual acuity [PVA], ≤ 20/50; best-corrected visual acuity [BCVA], ≥ 20/40), URE without VI (PVA, ≥ 20/40; ≥ 2-line improvement to BCVA), and no or adequately corrected RE (PVA, ≥ 20/40; < 2-line improvement to BCVA). Patient demographics, self-reported visual function, and satisfaction with glasses obtained through the program were compared among groups using analysis of variance, Kruskal-Wallis, chi-square, and Fisher exact testing.Main outcome measuresPVA, BCVA, and presence of VI (defined as PVA ≤ 20/50).ResultsOf 1171 participants enrolled in the MI-SIGHT program during the first year, average age was 55.1 years (SD = 14.5), 37.7% were male, 54.1% identified as Black, and 1166 (99.6%) had both PVA and BCVA measured. VI was observed in 120 participants (10.3%); 96 had VI from URE (8.2%), 168 participants (14.4%) had URE without VI, and 878 (75.3%) had no or adequately corrected RE. A smaller percentage of participants with VI resulting from URE reported having a college degree, and a larger percentage reported income < $10 000 compared with participants with no or adequately corrected RE (3.2% vs. 14.2% [P = 0.02]; 45.5% vs. 21.6% [P < 0.0001], respectively). Visual function was lowest among participants with VI from URE, followed by those with URE without VI, and then those with no or adequately corrected RE (9-item National Eye Institute Visual Function Questionnaire composite score, 67.3 ± 19.6 vs. 77.0 ± 14.4 vs. 82.2 ± 13.3, respectively; P < 0.0001). In total, 71.2% (n = 830) ordered glasses for an average cost of $36.80 ± $32.60; 97.7% were satisfied with their glasses.ConclusionsURE was the main cause of VI at 2 clinics serving low-income communities and was associated with reduced vision-related quality of life. An online optical store with lower prices made eyeglasses accessible to low-income patients.Financial disclosure(s)Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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| S-EPMC10801974 | biostudies-literature
Project description:BackgroundDeveloping countries such as Kenya still experience challenges around human resource to deliver refractive error services. However, given the burden of uncorrected refractive error, adoption of innovative and cost effective approaches is desirable. Hence this study intended to develop a task shifting framework integrated with telemedicine to potentially scale refractive error services.MethodsThis was an exploratory study conducted in four phases as follows: a scoping review of the scope of practice for ophthalmic workers in Kenya, an interview with key opinion leaders on the need for integration of public health approaches such as the vision corridors within the eye health ecosystem in Kenya and their knowledge on task shifting, and finally development and validation of a proposed task shifting framework through a Delphi technique. Purposive sampling was used to recruit key opinion leaders and data was collected via telephonic interviews. The qualitative data was analyzed thematically using NVivo Software, Version 11.ResultsThe scoping review showed that only optometrists, ophthalmologists and ophthalmic clinical officers are allowed to undertake refraction in Kenya. All of the key opinion leaders (100%) were aware of task shifting and agreed that it is suitable for adoption within the eye health ecosystem in Kenya. All of the key opinion leaders (100%) agreed that skills development for healthcare workers without prior training on eye health supervised by optometrists through telemedicine is desirable. Notwithstanding, all of the key opinion leaders (100%) agreed that integration of public health approaches such as the vision corridors across all levels of healthcare delivery channels and development of a self-assessment visual acuity tool is desirable. Finally all of the key opinion leaders (100%) agreed that task shifting is relevant for adoption within the eye health ecosystem in Kenya. The developed framework prioritized partnership, advocacy, skills development, establishment and equipping of refraction points. The proposed framework advocated for a telemedicine between professionals with conventional training and those with skills development.ConclusionTask shifting integrated with telemedicine could cost effectively scale refractive error service delivery. However, internal and external factors may hinder the success warranting the need for a multi-faceted interventions and a connection between planning and training to scale the uptake.
| S-EPMC10801974 | biostudies-literature
Project description:BackgroundTraditional Chinese eye exercises of acupoints involve acupoint self-massage. These have been advocated as a compulsory measure to reduce ocular fatigue, as well as to retard the development of myopia, among Chinese school children. This study evaluated the impact of these eye exercises among Chinese urban children.Methods409 children (195 males, 47.7%), aged 11.1?±?3.2 (range 6-17) years, from the Beijing Myopia Progression Study (BMPS) were recruited. All had completed the eye exercise questionnaire, the convergence insufficiency symptom survey (CISS), and a cycloplegic autorefraction. Among these, 395 (96.6%) performed the eye exercises of acupoints. Multiple logistic regressions for myopia and multiple linear regressions for the CISS score (after adjusting for age, gender, average parental refractive error, and time spent doing near work and outdoor activity) for the different items of the eye exercises questionnaire were performed.ResultsOnly the univariate odds ratio (95% confidence interval) for "seriousness of attitude" towards performing the eye exercises of acupoints (0.51, 0.33-0.78) showed a protective effect towards myopia. However, none of the odds ratios were significant after adjusting for the confounding factors. The univariate and multiple ? coefficients for the CISS score were -2.47 (p?=?0.002) and -1.65 (p?=?0.039), -3.57 (p?=?0.002) and -2.35 (p?=?0.042), and -2.40 (p?=?0.003) and -2.29 (p?=?0.004), for attitude, speed of exercise, and acquaintance with acupoints, respectively, which were all significant.ConclusionsThe traditional Chinese eye exercises of acupoints appeared to have a modest effect on relieving near vision symptoms among Chinese urban children aged 6 to 17 years. However, no remarkable effect on reducing myopia was observed.
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Project description:ImportanceThere is substantial socioeconomic and individual burden from uncorrected refractive error (URE) and chronic ocular disease. Understanding the association of visual acuity (VA) reduction with URE and the adults most likely to benefit from refraction may help support clinical decision-making in ophthalmologic care and maximize patient outcomes.ObjectivesTo assess the magnitude of VA improvement associated with URE among adults under ophthalmic care who obtain low vision rehabilitation (LVR) services and identify the characteristics of the patients who are most likely to experience improvement.Design, setting, and participantsThis retrospective case series assessed patients 20 years or older who were new to the LVR clinics from August 1, 2013, to December 31, 2015, and who had habitual VA between 20/40 and counting fingers (not including) and underwent refraction. Data analysis was performed from April 4, 2018, to December 20, 2019.ExposuresPatient demographics and clinical data, including habitual and refraction VA, refraction, and disease diagnosis. Habitual VA was categorized as mild (VA worse than 20/40 and at least 20/60), moderate (VA worse than 20/60 and better than 20/200), severe (VA 20/200 or worse and better than 20/500), and profound (VA 20/500 or worse) vision impairment (VI).Main outcomes and measuresAt least 2-line VA improvement and any VA improvement (≥1-line) by refraction.ResultsAmong the 2923 patients new to LVR clinics, 1773 (mean [SD] age, 70 [18.2] years; 1069 [60.3%] female) were included in these analyses. The mean habitual VA was 20/100 (mean [SD], 0.67 [0.36] logMAR). At least 2-line improvement was observed in 493 patients (27.8%), and any VA improvement was seen in 1023 patients (57.7%). At least 2-line improvement was observed in 54 patients (34.8%) with corneal disorders and was more likely seen among patients aged 40 to <65 years compared with those aged 20 to <40 years (odds ratio [OR], 1.57; 95% CI, 1.02-2.41), African American patients compared with white patients (OR, 1.41; 95% CI, 1.08-1.85), or patients with moderate VI compared with mild VI (OR, 1.36; 95% CI, 1.07-1.72).Conclusions and relevanceThe findings suggest that URE is prevalent among patients with ocular disease and accessing LVR and that refractive evaluation should be considered for patients with ocular disease and reduced VA, especially working-age adults aged 40 to <65 years, African American patients, and those with moderate VI.
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Project description:PurposeTo report calculated crystalline lens power and describe the distribution of ocular biometry and its association with refractive error in older Chinese adults.MethodsRandom clustering sampling was used to identify adults aged 50 years and above in Xuhui and Baoshan districts of Shanghai. Refraction was determined by subjective refraction that achieved the best corrected vision based on monocular measurement. Ocular biometry was measured by IOL Master. The crystalline lens power of right eyes was calculated using modified Bennett-Rabbetts formula.ResultsWe analyzed 6099 normal phakic right eyes. The mean crystalline lens power was 20.34 ± 2.24D (range: 13.40-36.08). Lens power, spherical equivalent, and anterior chamber depth changed linearly with age; however, axial length, corneal power and AL/CR ratio did not vary with age. The overall prevalence of hyperopia, myopia, and high myopia was 48.48% (95% CI: 47.23%-49.74%), 22.82% (95% CI: 21.77%-23.88%), and 4.57% (95% CI: 4.05-5.10), respectively. The prevalence of hyperopia increased linearly with age while lens power decreased with age. In multivariate models, refractive error was strongly correlated with axial length, lens power, corneal power, and anterior chamber depth; refractive error was slightly correlated with best corrected visual acuity, age and sex.ConclusionLens power, hyperopia, and spherical equivalent changed linearly with age; Moreover, the continuous loss of lens power produced hyperopic shifts in refraction in subjects aged more than 50 years.
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