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Nathan Congdon - One of the best experts on this subject based on the ideXlab platform.
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effect of chinese eye exercises on change in visual acuity and eyeglasses wear among school aged children in rural china a propensity score matched cohort study
BMC Complementary Medicine and Therapies, 2020Co-Authors: Huan Wang, Nathan Congdon, Matthew Boswell, Yiwei Qian, Scott RozelleAbstract:Daily “eye exercises,” massaging of periocular acupuncture pressure points, have been part of China’s national Vision Care policy in schools for some 50 years. However, the effect of eye exercises on myopia progression and eyeglasses wear has not been definitively investigated. This study evaluates the effectiveness of eye exercises on visual acuity and the propensity of rural children to wear eyeglasses. Cohort study in 252 randomly-selected rural schools with baseline in September 2012 and follow up surveys 9 and 21 months later. Outcomes were assessed using propensity-score matching (PSM), multivariate linear regression and logistic regression to adjust for differences between children performing and not performing eye exercises. Among 19,934 children randomly selected for screening, 2374 myopic (spherical equivalent refractive error ≤ − 0.5 diopters in either eye) children (11.9%, mean age 10.5 [Standard Error 1.08] years, 48.5% boys) had VA in either eye ≤6/12 without eyeglasses correctable to > 6/12 with eyeglasses. Among these who completed the 21-month follow up, 1217 (58.2%) children reported practicing eye exercises on school days and 874 (41.8%) did not. After propensity-score matching, 1652 (79%) children were matched: 826 (50%) in the Eye Exercises group and 826 (50%) in the No Exercise group. Performing eye exercises was not associated with change in LogMAR uncorrected visual acuity and wear of eyeglasses, using either logistic regression or PSM at 9 or 21 months. We found no evidence for an effect of eye exercises on change in Vision or eyeglasses wear. The original trial (Registration site: http://isrctn.org. Registration number: ISRCTN03252665) was retrospectively registered 25/09/2012.
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impact of a local Vision Care center on glasses ownership and wearing behavior in northwestern rural china a cluster randomized controlled trial
International Journal of Environmental Research and Public Health, 2018Co-Authors: Yujuan Gao, Yaojiang Shi, Yue Wang, Jiangchao Jing, Hongyu Guan, Nathan CongdonAbstract:Visual impairment is common among rural Chinese children, but fewer than a quarter of children who need glasses actually own and use them. To study the effect of rural county hospital Vision centers (VC) on self-reported glasses ownership and wearing behavior (primary outcome) among rural children in China, we conducted a cluster-randomized controlled trial at a VC in the government hospital of Qinan County, a nationally-designated poor county. All rural primary schools (n = 164) in the county were invited to participate. Schools were randomly assigned to either the treatment group to receive free Vision Care and eyeglasses, if needed, or control group, who received glasses only at the end of the study. Among 2806 eligible children with visiual impairment (visual acuity ≤ 6/12 in either eye), 93 (3.31%) were lost to follow-up, leaving 2713 students (45.0% boys). Among these, glasses ownership at the end of the school year was 68.6% among 1252 treatment group students (82 schools), and 26.4% (p < 0.01) among 1461 controls (82 schools). The rate of wearing glasses was 55.2% in the treatment group and 23.4% (p < 0.01) among the control group. In logistic regression models, treatment group membership was significantly associated with spectacle ownership (Odds Ratio [OR] = 11.9, p < 0.001) and wearing behavior (OR = 7.2, p < 0.001). County hospital-based Vision centers appear effective in delivering childrens’ glasses in rural China.
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effect of a local Vision Care center on eyeglasses use and school performance in rural china a cluster randomized clinical trial
JAMA Ophthalmology, 2018Co-Authors: Nathan Congdon, Yaojiang Shi, Matthew Boswell, Scott Rozelle, Ruth E Hogg, Alexis Medina, Mony IyerAbstract:Importance Visual impairment is common among children in rural China, but fewer than one-third of children with poor Vision own and wear eyeglasses. Objective To study the effect of hospital-based Vision centers on academic performance, ownership of eyeglasses, and eyeglasses-wearing behavior in rural Chinese children. Design, Setting, and Participants Cluster randomized, investigator-masked, clinical trial from September 2014 through June 2015. A Vision center capable of providing refractive services was established in the Hospital of Yongshou County, a nationally designated poor county in rural Shaanxi Province, western China. All 31 rural primary schools in Yongshou County participated; participants were all children in grades 4 through 6 (aged approximately 10-12 years) with uncorrected visual acuity of Snellen 6/12 or worse in either eye (2613 children). Data analysis was conducted March through May 2016, and data were analyzed by the intention-to-treat principle. Interventions After teacher-led Vision screening early in the school year (September-October 2014), schools were randomly assigned to either early referral (December 2014-February 2015) to the Vision center for refraction and free eyeglasses if needed or late referral (March-June 2015) for the identical intervention. Main Outcomes and Measures The primary outcome was score on a study-administered mathematics test (June 2015) adjusted for baseline score. Secondary outcomes were self-reported eyeglasses ownership and wear at final examination (June 2015). Results All 2613 children evaluated were of Han Chinese race/ethnicity, and 1209 (46.3%) were female. Twelve hundred children (45.9%) met the Vision criteria. Among these, 543 (45.3%) were randomized to early screening and 657 (54.7%) to late screening; 433 (79.7%) of the early screening group and 516 (78.5%) of the late screening group completed the study. Of eligible children, 120 (27.7%) owned eyeglasses at baseline. The adjusted effect on test scores comparing early and late groups was 0.25 SD (95% CI, 0.01-0.48; 1-sided P = .04), with the point estimate equivalent to half a semester of additional learning. At the end of the study, 347 of the 433 participants in the early group (80%) reported owning eyeglasses and 326 (75%) reported wearing eyeglasses; among the 516 participants in the late group, 371 (61%) reported owning and 286 (55%) reported wearing eyeglasses. Conclusions and Relevance In this study, early proVision of free eyeglasses was seen to improve children’s academic performance and wearing of spectacles. These findings suggest that a county hospital–based Vision center may be an effective way to improve children’s educational opportunities in rural China. Trial Registration isrctn.org Identifier:ISRCTN03252665
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AN INVESTIGATION OF Vision PROBLEMS AND THE Vision Care SYSTEM IN RURAL CHINA.
The Southeast Asian journal of tropical medicine and public health, 2014Co-Authors: Yunli Bai, Nathan Congdon, Linxiu Zhang, Yaojiang Shi, Zhongqiang Zhou, Matthew Boswell, Scott RozelleAbstract:This paper examines the prevalence of Vision problems and the accessibility to and quality of Vision Care in rural China. We obtained data from 4 sources: 1) the National Rural Vision Care Survey; 2) the Private Optometrists Survey; 3) the County Hospital Eye Care Survey; and 4) the Rural School Vision Care Survey. The data from each of the surveys were collected by the authors during 2012. Thirty-three percent of the rural population surveyed self-reported Vision problems. Twenty-two percent of subjects surveyed had ever had a Vision exam. Among those who self-reported having Vision problems, 34% did not wear eyeglasses. Fifty-four percent of those with Vision problems who had eyeglasses did not have a Vision exam prior to receiving glasses. However, having a Vision exam did not always guarantee access to quality Vision Care. Four channels of Vision Care service were assessed. The school Vision examination program did not increase the usage rate of eyeglasses. Each county-hospital was staffed with three eye-doctors having one year of education beyond high school, serving more than 400,000 residents. Private optometrists often had low levels of education and professional certification. In conclusion, our findings shows that the Vision Care system in rural China is inadequate and ineffective in meeting the needs of the rural population sampled.
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quality of life and near Vision impairment due to functional presbyopia among rural chinese adults
Investigative Ophthalmology & Visual Science, 2011Co-Authors: Qing Lu, Amy Yang, Nathan Congdon, Xiangdong He, G V S Murthy, Wei HeAbstract:PURPOSE: To evaluate the impact of near-Vision impairment on visual functioning and quality of life in a rural adult population in Shenyang, northern China. METHODS: A population-based, cross-sectional study was conducted among persons aged 40+ years, during which functional presbyopia (correctable presenting near Vision < 20/50 [N8] at 40 cm) was assessed. Near-Vision-related quality of life and spectacle usage questionnaires were administered by trained interviewers to determine the degree of self-rated difficulty with near tasks. RESULTS: A total of 1008 respondents (91.5% of 1102 eligible persons) were examined, and 776 (78%) of completed the questionnaires (mean age, 57.0 ± 10.2 years; 63.3% women). Near-Vision spectacle wearers obtained their spectacles primarily from markets (74.5%) and optical shops (21.7%), and only 1.14% from eye clinics. Among 538 (69.3%) persons with functional presbyopia, self-rated overall (distance and near) Vision was worse (P < 0.001) and difficulty with activities of daily living greater (P < 0.001) than among nonpresbyopes. Odds of reporting any difficulty with daily tasks remained higher (OR = 2.32; P < 0.001) for presbyopes after adjustment for age, sex, education and distance Vision. Compared to persons without presbyopia, presbyopic persons were more likely to report diminished accomplishment due to Vision (P = 0.01, adjusted for age, sex, education, and distance Vision.) CONCLUSIONS: Difficulties with activities of daily living and resulting social impediments are common due to presbyopia in this setting. Most spectacle wearers with presbyopia in rural China obtain near correction from sources that do not provide comprehensive Vision Care.
Kyle V Marra - One of the best experts on this subject based on the ideXlab platform.
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Care of older adults role of primary Care physicians in the treatment of cataracts and macular degeneration
Journal of the American Geriatrics Society, 2016Co-Authors: Kyle V Marra, Sushant Wagley, Mark C Kuperwaser, Rafael Campo, Jorge G ArroyoAbstract:This article aims to facilitate optimal management of cataracts and age-related macular degeneration (AMD) by providing information on indications, risk factors, referral guidelines, and treatments and to describe techniques to maximize quality of life (QOL) for people with irreversible Vision loss. A review of PubMed and other online databases was performed for peer-reviewed English-language articles from 1980 through August 2012 on visual impairment in elderly adults. Search terms included Vision loss, visual impairment, blind, low Vision, QOL combined with age-related, elderly, and aging. Articles were selected that discussed Vision loss in elderly adults, effects of Vision impairment on QOL, and Care strategies to manage Vision loss in older adults. The ability of primary Care physicians (PCPs) to identify early signs of cataracts and AMD in individuals at risk of Vision loss is critical to early diagnosis and management of these common age-related eye diseases. PCPs can help preserve Vision by issuing aptly timed referrals and encouraging behavioral modifications that reduce risk factors. With knowledge of referral guidelines for soliciting low-Vision rehabilitation services, visual aids, and community support resources, PCPs can considerably increase the QOL of individuals with uncorrectable Vision loss. By offering appropriately timed referrals, promoting behavioral modifications, and allocating low-Vision Care resources, PCPs may play a critical role in preserving visual health and enhancing the QOL for the elderly population.
Rohit Varma - One of the best experts on this subject based on the ideXlab platform.
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color Vision deficiency in preschool children the multi ethnic pediatric eye disease study
Ophthalmology, 2014Co-Authors: Rohit Varma, J Xie, Kristina Tarczyhornoch, Jesse Lin, Susan A Cotter, Mina TorresAbstract:Purpose To determine the sex- and ethnicity-specific prevalence of color Vision deficiency (CVD) in black, Asian, Hispanic, and non-Hispanic white preschool children. Design Population-based, cross-sectional study. Participants The Multi-Ethnic Pediatric Eye Disease Study is a population-based evaluation of the prevalence of Vision disorders in children in Southern California. A total of 5960 subjects 30 to 72 months of age were recruited for the study, of whom 4177 were able to complete color Vision testing (1265 black, 812 Asian, 1280 Hispanic, and 820 non-Hispanic white). Methods Color Vision testing was performed using Color Vision Testing Made Easy color plates (Home Vision Care, Gulf Breeze, FL), and diagnostic confirmatory testing was performed using the Waggoner HRR Diagnostic Test color plates (Home Vision Care). Main Outcome Measures Testability of color Vision in preschool children between 30 and 72 months of age and prevalence of CVD stratified by age, sex, and ethnicity. Results Testability was 17% in children younger than 37 months of age, increasing to 57% in children 37 to 48 months of age, 89% in children 49 to 60 months of age, and 98% in children 61 to 72 months of age. The prevalence of CVD among boys was 1.4% for black, 3.1% for Asian, 2.6% for Hispanic, and 5.6% for non-Hispanic white children; the prevalence in girls was 0.0% to 0.5% for all ethnicities. The ethnic difference in CVD was statistically significant between black and non-Hispanic white children ( P = 0.0003) and between Hispanic and non-Hispanic white children ( P = 0.02). In boys, most CVD cases were either deutan (51%) or protan (34%); 32% were classified as mild, 15% as moderate, and 41% as severe. Conclusions Testability for CVD in preschool children is high by 4 years of age. The prevalence of CVD in preschool boys varies by ethnicity, with the highest prevalence in non-Hispanic white and lowest in black children.
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noncompliance with Vision Care guidelines in latinos with type 2 diabetes mellitus the los angeles latino eye study
Ophthalmology, 2006Co-Authors: Sylvia H Paz, Rohit Varma, Ronald Klein, Stanley P AzenAbstract:Objective To determine the prevalence of and personal factors associated with noncompliance with American Diabetes Association (ADA) guidelines for Vision Care in a population-based sample of adult Latinos with type 2 diabetes mellitus (T2DM). Design Population-based cross-sectional study. Participants Eight hundred twenty-one Los Angeles Latino Eye Study (LALES) participants with a history of T2DM and a history of treatment for T2DM. Methods Detailed interviews, physical examinations, and dilated eye examinations were performed on all participants. Interviews assessed sociodemographic factors, history of diabetes and eye disease, and utilization of health and eye Care services. All participants with a self-reported history and treatment of diabetes were asked about health and Vision Care utilization and diabetes self-Care. Main Outcome Measure Compliance with ADA guidelines for Vision Care. Noncompliance was defined as having had no dilated eye examination in the previous 12 months. Logistic regression analyses were used to identify personal factors associated with noncompliance. Results Of 821 individuals who self-reported having T2DM and being on treatment for T2DM, 535 (65%) had not complied with ADA Vision guidelines for persons with T2DM. When compared with those with T2DM who complied with ADA guidelines, noncompliers were more likely to be less educated (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1–2.2), to lack health insurance (OR, 2.5; 95% CI, 1.7–3.7), to have had no routine physical examination in the 12 months before the LALES examination (OR, 1.8; 95% CI, 1.3–2.5), and to have a glycosylated hemoglobin level ≥ 9.0% (OR, 1.7; 95% CI, 1.1–2.6). Conclusions Because timely and appropriate Vision Care can delay the onset of ocular morbidity, visual impairment, and blindness associated with diabetic retinopathy, our data suggest the need to evaluate intervention programs aimed at a targeted group of Latinos with T2DM—those who have less than a high school education, lack health insurance, have had no routine physical examination in the previous year, and have poorly controlled T2DM.
Mark W Swanson - One of the best experts on this subject based on the ideXlab platform.
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Vision Care among school aged children with autism spectrum disorder in north america findings from the autism treatment network registry call back study
Autism, 2020Co-Authors: Olivia J Lindly, Mark W Swanson, James Chan, Rachel M Fenning, Justin G Farmer, Ann M Neumeyer, Paul P Wang, Robert A ParkerAbstract:Children with autism spectrum disorder have a high risk of Vision problems yet little is known about their Vision Care. This cross-sectional survey study, therefore, examined Vision Care among 351 ...
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rehabilitation referral for patients with irreversible Vision impairment seen in a public safety net eye clinic
JAMA Ophthalmology, 2018Co-Authors: Austin M Coker, Carrie Huisingh, Gerald Mcgwin, Russell W Read, Mark W Swanson, Laura E Dreer, Dawn K Decarlo, Lindsay Gregg, Cynthia OwsleyAbstract:Importance The prevalence of irreversible Vision impairment in the United States is expected to increase by 2050. Vision rehabilitation is the primary treatment option. Clinical trials have established its efficacy in improving quality of life. Yet studies indicate that patients experience many barriers to accessing low-Vision Care. Objectives To examine the rate of referral for low-Vision rehabilitation services by resident and attending ophthalmologists for adults with irreversible Vision impairment and to assess the knowledge, attitudes, and beliefs of patients about Vision rehabilitation. Design, Setting, and Participants Cross-sectional study with enrollment from June 20, 2016, to January 31, 2017, of 143 adults 18 years or older seen in a publicly funded, comprehensive eye clinic in Jefferson County, Alabama, and having 1 or both eyes with irreversible Vision impairment (visual acuity was defined as 20/60 or worse) per the electronic health record. Exposures Demographic characteristics; patient questionnaire on knowledge, attitudes, and beliefs about Vision rehabilitation; general cognitive status (Short Orientation-Memory-Concentration test); depressive symptoms (Patient Health Questionnaire-9); health literacy (Rapid Estimate of Adult Literacy in Medicine, Revised [REALM-R]); and self-reported difficulty in everyday activities. Main Outcomes and Measures Proportion of patients with irreversible Vision impairment who were referred by ophthalmologists to low-Vision rehabilitation services per the electronic health record. Results Of 143 patients enrolled with irreversible Vision impairment in 1 or both eyes, the mean (SD) age was 55.4 (11.1) years and 68 (47.6%) were women. Most patients were African American (123 [86.0%]), uninsured (88 [61.5%]), and unemployed (92 [64.3%]); on average, they had normal cognitive status, minor depressive symptoms, and limited health literacy. As noted in the electronic health record, the rate of referral for low-Vision rehabilitation services was 11.4% for patients with irreversible bilateral Vision impairment (4 of 35 patients) and 1.9% for those with unilateral impairment (2 of 108). Most patients with bilateral (31 of 34 [91.2%]) and unilateral (90 of 97 [92.8%]) impairment indicated that they were bothered by their Vision impairment, and most reported difficulty with reading (33 of 34 patients [97.1%] who were bilaterally impaired vs 85 of 104 [81.7%] who were unilaterally impaired). Conclusions and Relevance Results of this study suggest a need to better educate ophthalmologists and residents in ophthalmology about referrals to low-Vision rehabilitation services for patients with irreversible Vision impairment.
Sushant Wagley - One of the best experts on this subject based on the ideXlab platform.
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Care of older adults role of primary Care physicians in the treatment of cataracts and macular degeneration
Journal of the American Geriatrics Society, 2016Co-Authors: Kyle V Marra, Sushant Wagley, Mark C Kuperwaser, Rafael Campo, Jorge G ArroyoAbstract:This article aims to facilitate optimal management of cataracts and age-related macular degeneration (AMD) by providing information on indications, risk factors, referral guidelines, and treatments and to describe techniques to maximize quality of life (QOL) for people with irreversible Vision loss. A review of PubMed and other online databases was performed for peer-reviewed English-language articles from 1980 through August 2012 on visual impairment in elderly adults. Search terms included Vision loss, visual impairment, blind, low Vision, QOL combined with age-related, elderly, and aging. Articles were selected that discussed Vision loss in elderly adults, effects of Vision impairment on QOL, and Care strategies to manage Vision loss in older adults. The ability of primary Care physicians (PCPs) to identify early signs of cataracts and AMD in individuals at risk of Vision loss is critical to early diagnosis and management of these common age-related eye diseases. PCPs can help preserve Vision by issuing aptly timed referrals and encouraging behavioral modifications that reduce risk factors. With knowledge of referral guidelines for soliciting low-Vision rehabilitation services, visual aids, and community support resources, PCPs can considerably increase the QOL of individuals with uncorrectable Vision loss. By offering appropriately timed referrals, promoting behavioral modifications, and allocating low-Vision Care resources, PCPs may play a critical role in preserving visual health and enhancing the QOL for the elderly population.
