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Jie Jin Wang - One of the best experts on this subject based on the ideXlab platform.
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prevalence and causes of Visual Impairment and blindness in an urban indian population the singapore indian eye study
Ophthalmology, 2011Co-Authors: Yingfeng Zheng, Jie Jin Wang, Paul Mitchell, Raghavan Lavanya, Renyi Wu, Wanling Wong, Ning Cheung, Howard Cajucomuy, Ecosse L LamoureuxAbstract:Purpose To describe the prevalence and causes of Visual Impairment and blindness in an urban Indian population. Design Population-based study. Participants Ethnic Indians aged more than 40 years living in Singapore. Methods Participants underwent standardized ophthalmic assessments for Visual Impairment and blindness, defined using best-corrected Visual acuity (BCVA) and presenting Visual acuity (PVA), according to US and modified World Health Organization (WHO) definitions. Main Outcome Measures Unilateral Visual Impairment or blindness was defined on the basis of the worse eye, and bilateral Visual Impairment or blindness was defined on the basis of the better eye. Primary causes of Visual Impairment were determined. Results A total of 3400 eligible individuals (75.6% response rate) participated. On the basis of US definitions, the age-standardized prevalence was 0.4% for bilateral blindness (≤20/200, better eye) and 3.4% for bilateral Visual Impairment ( 20/200, better eye). Another 0.3% of bilateral blindness and 13.4% of bilateral Visual Impairment were correctable with refraction. Cataract was the principal cause of best-corrected bilateral blindness (60.0%) and bilateral Visual Impairment (65.7%). Other major causes of blindness and Visual Impairment included diabetic retinopathy, age-related macular degeneration, glaucoma, corneal opacity, and myopic maculopathy. Conclusions The prevalence of bilateral blindness and Visual Impairment in Indians living in Singapore is lower than estimates from populations living in India, but similar to estimates obtained from Singapore Malay and Chinese populations. Cataract is the leading cause of blindness and Visual Impairment. One in 20 cases of bilateral blindness and 1 in 10 cases of bilateral Visual Impairment are attributable to diabetic retinopathy. These data may have relevance to many ethnic Indian persons living outside India. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Visual Impairment causes of vision loss and falls the singapore malay eye study
Investigative Ophthalmology & Visual Science, 2008Co-Authors: Ecosse L Lamoreux, Jie Jin Wang, Paul Mitchell, Elaine W Chong, Tin Aung, Tien Yin WongAbstract:PURPOSE: To report associations of Visual Impairment and the main causes of vision loss with falls in an older Asian population. METHODS: The population-based Singapore Malay Eye Study examined 3280 (78.7% response rate) Malay adults 40 to 80 years of age. Details about any fall in the previous 12 months and personal and sociodemographic information were collected. Presenting Visual acuity (PVA) was measured. Mild or moderate Visual Impairment (0.3/= 1.0), and the primary causes of Visual Impairment were determined by ophthalmologists at examination. RESULTS: Of the 3280 participants, 3266 (99.6%) provided information about falls. Of these, 14.7% (n = 480) reported having fallen in the past 12 months. After adjustment for gender, age, body mass index, history of angina, heart attack, stroke, hypertension, diabetes, and self-rated health, the results showed that severe Visual Impairment in the worse eye significantly increased the risk of falling (60%; OR = 1.6; 95% CI 1.1 to 2.3). Severe Visual Impairment in one eye and mild or moderate Visual Impairment in the other also doubled the risk of falls (OR = 2.1; 95% CI 1.4-3.1). Having glaucoma (n = 21) increased the risk of falling by more than fourfold (OR = 4.2; 95% CI 1.2-12.3) after adjustment for Visual acuity. Although mild or moderate Visual Impairment was not significantly associated with falls, odds ratios tended toward the direction of risk. CONCLUSIONS: Findings from this Asian population provide further evidence in support of the association between severe Visual Impairment and falls in older persons. Language: en
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impact of bilateral Visual Impairment on health related quality of life the blue mountains eye study
Investigative Ophthalmology & Visual Science, 2004Co-Authors: Eemunn Chia, Jie Jin Wang, Wayne Smith, Elena Rochtchina, Robert R Cumming, Paul MitchellAbstract:PURPOSE: To assess the impact of Visual Impairment on health-related quality of life (HRQOL) in an older population and compare it with the impact of major medical conditions. METHODS: Participants of the second cross-sectional Blue Mountains Eye Study (BMES; n = 3509; mean age, 66.7 years; 57% female) were asked to complete the self-administered 36-item Short-Form health survey (SF-36), a comprehensive interview, and an eye examination. Visual Impairment was defined as Visual acuity less than 20/40 (better eye). RESULTS: Of 3154 (89.9%) participants with complete data, 172 (5.5%) had Visual Impairment due to refractive errors (correctable Visual Impairment) and 66 (2.1%) due to eye conditions (noncorrectable Visual Impairment; 49 mild, 9 moderate, 8 severe). After adjustment for demographic and medical confounders, there was a trend toward lower SF-36 scores in participants with noncorrectable Impairment than in those with correctable Impairment (physical component score [PCS] Ptrend = 0.01 and mental component score [MCS] Ptrend = 0.02). Increasingly severe noncorrectable Visual Impairment was associated with significantly poorer SF-36 scores in all but two dimensions. The impact of noncorrectable Visual Impairment was comparable to that from major medical conditions (e.g., stroke) and had a greater impact on mental than physical domains (mean MCS = 46.2, PCS = 41). No significant differences in HRQOL were demonstrated between Visual Impairment cases caused by age-related maculopathy and cataract, after adjusting for severity of Visual Impairment. CONCLUSIONS: Noncorrectable Visual Impairment was associated with reduced functional status and well-being, with a magnitude comparable to major medical conditions. These data have implications for disability weights such as those developed by the Global Burden of Disease study.
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Visual Impairment age related cataract and mortality
Archives of Ophthalmology, 2001Co-Authors: Jie Jin Wang, Paul Mitchell, Judy M Simpson, Robert G Cumming, Wayne SmithAbstract:Objective To explore associations between Visual Impairment, cataract, and mortality in older persons after adjusting for other factors associated with mortality. Methods A population cohort of 3654 persons aged 49 years or older (82.4% of eligible residents in the Blue Mountains region, west of Sydney, Australia), were examined at the Blue Mountains Eye Study baseline period (1992-1994) and followed up 5 years later (1997-1999). Australian National Death Index data were used to confirm persons who had died since baseline. Associations between mortality and presence of Visual Impairment and cataract at baseline were assessed using the Cox proportional hazards regression model, controlling for age, sex, demographic and socioeconomic status, medical history, and health risk behaviors. Results By June 30, 1999, 604 participants (16.5%) had died. The age- and sex-standardized 7-year cumulative mortality rate was 26% among persons with any Visual Impairment and 16% in persons without Visual Impairment. After adjusting for factors found significantly associated with mortality, including age, male sex, low self-rated health, low socioeconomic status, systemic medical conditions, and negative health risk behaviors, the presence at baseline of any Visual Impairment was independently associated with increased mortality risk (risk ratio [RR], 1.7; 95% confidence interval, 1.2-2.3). The presence of age-related cataract, either nuclear (RR, 1.5), cortical (RR, 1.3), or posterior subcapsular cataract (RR, 1.5), was also significantly associated with increased mortality risk. These associations remained statistically significant when Visual Impairment and each type of cataract were included simultaneously in the multivariate Cox model. Conclusion Visual Impairment and age-related cataract may be independent risk factors for increased mortality in older persons.
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age specific prevalence and causes of bilateral and unilateral Visual Impairment in older australians the blue mountains eye study
Clinical and Experimental Ophthalmology, 2000Co-Authors: Jie Jin Wang, Suriya Foran, Paul MitchellAbstract:Purpose: To report age-specific prevalence and causes of bilateral and unilateral Visual Impairment in a representative older Australian population. Methods: Participants in the Blue Mountains Eye Study (n = 3654) underwent a detailed eye examination. Any Visual Impairment was defined as best-corrected Visual acuity (VA) of 6/12 or worse, moderate Impairment as VA 6/24–6/60 and severe Impairment as VA worse than 6/60 (the Australian definition for legal blindness). Bilateral Visual Impairment was defined from the better eye and unilateral Impairment from the worse eye. Proportional causes for Visual loss were determined by the examining ophthalmologist. Results: Prevalence of bilateral and unilateral Visual Impairment was strongly age related. Corresponding bilateral and unilateral Visual Impairment prevalence rates were, respectively, 0.6% and 3.6% for persons aged 49–59 years, 1.1% and 8.2% for ages 60–69, 5.4% and 20.1% for ages 70–79, and 26.3% and 52.2% for persons aged 80+ years. Overwhelmingly, age-related maculopathy (ARM) was the predominant cause of bilateral blindness (13/17) and of moderate to severe bilateral Visual Impairment in persons aged 70+ years. However, cataract was the most frequent cause of mild bilateral Visual Impairment among persons aged 60+ years. Amblyopia was the most frequent cause of mild or worse unilateral Visual Impairment in persons aged 49–59 years. Cataract was the most common cause of mild unilateral Visual Impairment in people aged 60+ years, while ARM and cataract were jointly the most frequent causes of moderate to severe unilateral Visual Impairment in people aged 70+ years. Conclusions: These findings indicate that around half of Visually impaired persons aged 60 years or over had cataract, a cause amenable to treatment.
Paul Mitchell - One of the best experts on this subject based on the ideXlab platform.
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prevalence and causes of Visual Impairment and blindness in an urban indian population the singapore indian eye study
Ophthalmology, 2011Co-Authors: Yingfeng Zheng, Jie Jin Wang, Paul Mitchell, Raghavan Lavanya, Renyi Wu, Wanling Wong, Ning Cheung, Howard Cajucomuy, Ecosse L LamoureuxAbstract:Purpose To describe the prevalence and causes of Visual Impairment and blindness in an urban Indian population. Design Population-based study. Participants Ethnic Indians aged more than 40 years living in Singapore. Methods Participants underwent standardized ophthalmic assessments for Visual Impairment and blindness, defined using best-corrected Visual acuity (BCVA) and presenting Visual acuity (PVA), according to US and modified World Health Organization (WHO) definitions. Main Outcome Measures Unilateral Visual Impairment or blindness was defined on the basis of the worse eye, and bilateral Visual Impairment or blindness was defined on the basis of the better eye. Primary causes of Visual Impairment were determined. Results A total of 3400 eligible individuals (75.6% response rate) participated. On the basis of US definitions, the age-standardized prevalence was 0.4% for bilateral blindness (≤20/200, better eye) and 3.4% for bilateral Visual Impairment ( 20/200, better eye). Another 0.3% of bilateral blindness and 13.4% of bilateral Visual Impairment were correctable with refraction. Cataract was the principal cause of best-corrected bilateral blindness (60.0%) and bilateral Visual Impairment (65.7%). Other major causes of blindness and Visual Impairment included diabetic retinopathy, age-related macular degeneration, glaucoma, corneal opacity, and myopic maculopathy. Conclusions The prevalence of bilateral blindness and Visual Impairment in Indians living in Singapore is lower than estimates from populations living in India, but similar to estimates obtained from Singapore Malay and Chinese populations. Cataract is the leading cause of blindness and Visual Impairment. One in 20 cases of bilateral blindness and 1 in 10 cases of bilateral Visual Impairment are attributable to diabetic retinopathy. These data may have relevance to many ethnic Indian persons living outside India. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Visual Impairment causes of vision loss and falls the singapore malay eye study
Investigative Ophthalmology & Visual Science, 2008Co-Authors: Ecosse L Lamoreux, Jie Jin Wang, Paul Mitchell, Elaine W Chong, Tin Aung, Tien Yin WongAbstract:PURPOSE: To report associations of Visual Impairment and the main causes of vision loss with falls in an older Asian population. METHODS: The population-based Singapore Malay Eye Study examined 3280 (78.7% response rate) Malay adults 40 to 80 years of age. Details about any fall in the previous 12 months and personal and sociodemographic information were collected. Presenting Visual acuity (PVA) was measured. Mild or moderate Visual Impairment (0.3/= 1.0), and the primary causes of Visual Impairment were determined by ophthalmologists at examination. RESULTS: Of the 3280 participants, 3266 (99.6%) provided information about falls. Of these, 14.7% (n = 480) reported having fallen in the past 12 months. After adjustment for gender, age, body mass index, history of angina, heart attack, stroke, hypertension, diabetes, and self-rated health, the results showed that severe Visual Impairment in the worse eye significantly increased the risk of falling (60%; OR = 1.6; 95% CI 1.1 to 2.3). Severe Visual Impairment in one eye and mild or moderate Visual Impairment in the other also doubled the risk of falls (OR = 2.1; 95% CI 1.4-3.1). Having glaucoma (n = 21) increased the risk of falling by more than fourfold (OR = 4.2; 95% CI 1.2-12.3) after adjustment for Visual acuity. Although mild or moderate Visual Impairment was not significantly associated with falls, odds ratios tended toward the direction of risk. CONCLUSIONS: Findings from this Asian population provide further evidence in support of the association between severe Visual Impairment and falls in older persons. Language: en
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impact of bilateral Visual Impairment on health related quality of life the blue mountains eye study
Investigative Ophthalmology & Visual Science, 2004Co-Authors: Eemunn Chia, Jie Jin Wang, Wayne Smith, Elena Rochtchina, Robert R Cumming, Paul MitchellAbstract:PURPOSE: To assess the impact of Visual Impairment on health-related quality of life (HRQOL) in an older population and compare it with the impact of major medical conditions. METHODS: Participants of the second cross-sectional Blue Mountains Eye Study (BMES; n = 3509; mean age, 66.7 years; 57% female) were asked to complete the self-administered 36-item Short-Form health survey (SF-36), a comprehensive interview, and an eye examination. Visual Impairment was defined as Visual acuity less than 20/40 (better eye). RESULTS: Of 3154 (89.9%) participants with complete data, 172 (5.5%) had Visual Impairment due to refractive errors (correctable Visual Impairment) and 66 (2.1%) due to eye conditions (noncorrectable Visual Impairment; 49 mild, 9 moderate, 8 severe). After adjustment for demographic and medical confounders, there was a trend toward lower SF-36 scores in participants with noncorrectable Impairment than in those with correctable Impairment (physical component score [PCS] Ptrend = 0.01 and mental component score [MCS] Ptrend = 0.02). Increasingly severe noncorrectable Visual Impairment was associated with significantly poorer SF-36 scores in all but two dimensions. The impact of noncorrectable Visual Impairment was comparable to that from major medical conditions (e.g., stroke) and had a greater impact on mental than physical domains (mean MCS = 46.2, PCS = 41). No significant differences in HRQOL were demonstrated between Visual Impairment cases caused by age-related maculopathy and cataract, after adjusting for severity of Visual Impairment. CONCLUSIONS: Noncorrectable Visual Impairment was associated with reduced functional status and well-being, with a magnitude comparable to major medical conditions. These data have implications for disability weights such as those developed by the Global Burden of Disease study.
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Visual Impairment age related cataract and mortality
Archives of Ophthalmology, 2001Co-Authors: Jie Jin Wang, Paul Mitchell, Judy M Simpson, Robert G Cumming, Wayne SmithAbstract:Objective To explore associations between Visual Impairment, cataract, and mortality in older persons after adjusting for other factors associated with mortality. Methods A population cohort of 3654 persons aged 49 years or older (82.4% of eligible residents in the Blue Mountains region, west of Sydney, Australia), were examined at the Blue Mountains Eye Study baseline period (1992-1994) and followed up 5 years later (1997-1999). Australian National Death Index data were used to confirm persons who had died since baseline. Associations between mortality and presence of Visual Impairment and cataract at baseline were assessed using the Cox proportional hazards regression model, controlling for age, sex, demographic and socioeconomic status, medical history, and health risk behaviors. Results By June 30, 1999, 604 participants (16.5%) had died. The age- and sex-standardized 7-year cumulative mortality rate was 26% among persons with any Visual Impairment and 16% in persons without Visual Impairment. After adjusting for factors found significantly associated with mortality, including age, male sex, low self-rated health, low socioeconomic status, systemic medical conditions, and negative health risk behaviors, the presence at baseline of any Visual Impairment was independently associated with increased mortality risk (risk ratio [RR], 1.7; 95% confidence interval, 1.2-2.3). The presence of age-related cataract, either nuclear (RR, 1.5), cortical (RR, 1.3), or posterior subcapsular cataract (RR, 1.5), was also significantly associated with increased mortality risk. These associations remained statistically significant when Visual Impairment and each type of cataract were included simultaneously in the multivariate Cox model. Conclusion Visual Impairment and age-related cataract may be independent risk factors for increased mortality in older persons.
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age specific prevalence and causes of bilateral and unilateral Visual Impairment in older australians the blue mountains eye study
Clinical and Experimental Ophthalmology, 2000Co-Authors: Jie Jin Wang, Suriya Foran, Paul MitchellAbstract:Purpose: To report age-specific prevalence and causes of bilateral and unilateral Visual Impairment in a representative older Australian population. Methods: Participants in the Blue Mountains Eye Study (n = 3654) underwent a detailed eye examination. Any Visual Impairment was defined as best-corrected Visual acuity (VA) of 6/12 or worse, moderate Impairment as VA 6/24–6/60 and severe Impairment as VA worse than 6/60 (the Australian definition for legal blindness). Bilateral Visual Impairment was defined from the better eye and unilateral Impairment from the worse eye. Proportional causes for Visual loss were determined by the examining ophthalmologist. Results: Prevalence of bilateral and unilateral Visual Impairment was strongly age related. Corresponding bilateral and unilateral Visual Impairment prevalence rates were, respectively, 0.6% and 3.6% for persons aged 49–59 years, 1.1% and 8.2% for ages 60–69, 5.4% and 20.1% for ages 70–79, and 26.3% and 52.2% for persons aged 80+ years. Overwhelmingly, age-related maculopathy (ARM) was the predominant cause of bilateral blindness (13/17) and of moderate to severe bilateral Visual Impairment in persons aged 70+ years. However, cataract was the most frequent cause of mild bilateral Visual Impairment among persons aged 60+ years. Amblyopia was the most frequent cause of mild or worse unilateral Visual Impairment in persons aged 49–59 years. Cataract was the most common cause of mild unilateral Visual Impairment in people aged 60+ years, while ARM and cataract were jointly the most frequent causes of moderate to severe unilateral Visual Impairment in people aged 70+ years. Conclusions: These findings indicate that around half of Visually impaired persons aged 60 years or over had cataract, a cause amenable to treatment.
Catherine A. Mccarty - One of the best experts on this subject based on the ideXlab platform.
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Five-year incidence of bilateral cause-specific Visual Impairment in the Melbourne Visual Impairment Project.
Investigative Ophthalmology & Visual Science, 2003Co-Authors: Peter N. Dimitrov, Catherine A. Mccarty, Bickol N. Mukesh, Hugh R. TaylorAbstract:PURPOSE. To describe the age-, gender-, and cause-specific 5-year incidence of bilateral Visual Impairment in participants in the Melbourne Visual Impairment Project, Victoria, Australia. METHODS. Participants aged 40 years and older were recruited from Melbourne, Victoria, Australia, by random cluster sampling. The mean age of the 3271 (83% of the eligible) participants was 59 12 (SD) years. Of the participants, 54% were female. The initial baseline study (1992‐1994) was followed by a 5-year incidence study (1997‐1999). At both time points of the study, participants underwent a standardized testing procedure. Distance and near vision was tested using logarithm of the minimum angle of resolution (logMAR) charts, followed by refraction if needed. Visual fields were assessed by the 24-2 Humphrey field test (FastPac, Humphrey Field Analyzer; Carl Zeiss Meditec, Dublin, CA). Also, intraocular pressure, ocular motility, dilated ophthalmoscopy, and photography of the lens and the fundus were conducted. Furthermore, an interview included demographic characteristics, history of eye disease, medical history, and medication use. For classification of Visual Impairment, both Visual acuity (VA) and Visual fields (VF) examination results were used. Four levels of bilateral presenting Visual Impairment were defined: mild (VA, 20/40 ‐20/60, and/or VF, homonymous hemianopia), moderate (VA, 20/ 60 ‐20/200, and/or VF, constriction 20° to 10° from fixation), severe (VA, 20/200 ‐10/200, and/or VF, constriction 10° to 5° from fixation), and profound (VA, 10/200, and/or VF, constriction 5° from fixation). For all participants found to be Visually impaired, the major cause was identified. RESULTS. Of the 3040 people eligible to attend follow-up 2594 (85%) participated. Data were available for 2530 (98%) participants. In 105 participants (4.22%; 95% confidence limit 2.58 ‐ 5.85) some degree of Visual Impairment developed. The main causes were undercorrected refractive error (59%), age-related macular degeneration, cataract and neuro-ophthalmic disorders (7% each), glaucoma (3%), and diabetic retinopathy (1%). The main cause of severe and profound Visual Impairment was age-related macular degeneration (37%). CONCLUSIONS. Undercorrected refractive error was the primary cause of new cases of Visual Impairment in this population. Further research is needed to understand the origin of this and to develop appropriate prevention measures. Age-related macular degeneration is the primary cause of severe or profound vision loss in Australia. This disease requires further investigation for effective cure and preventive strategies. (Invest Ophthalmol Vis Sci. 2003;44:5075‐5081) DOI:10.1167/iovs.020457
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Visual Impairment and eye diseases in elderly institutionalized australians
Ophthalmology, 2000Co-Authors: Mylan R Vannewkirk, Jill E. Keeffe, Catherine A. Mccarty, Le Ann Weih, Y L Stanislavsky, Hugh R. TaylorAbstract:Abstract Objective To study the prevalence and distribution of Visual Impairment and eye diseases by age and gender in an urban institutionalized population. Design Cross-sectional study. Participants Four hundred three residents of nursing homes and hostels. Methods Fourteen nursing homes were randomly selected from 104 nursing homes and hostels located within a 5-km radius of each of nine clusters studied in the Visual Impairment Project (VIP) urban cohort. Participants completed a standardized orthoptic and dilated ophthalmic examination, including measurement of Visual acuity and Visual fields. The major cause of vision loss was identified for participants with Visual Impairment. Main outcome measures Presenting Visual acuity and ophthalmic diagnoses. Results The participants' mean age was 82 years (standard deviation, 9.24), with an age range of 46 years to 101 years. Women outnumbered men by 318 to 85. Seventy-one (22%) of 318 women had bilateral profound Visual Impairment (blindness), defined as best-corrected Visual acuity Conclusions Underestimation of Visual Impairment may occur in residential population-based studies that exclude institutional or residential nursing homes and hostels for the aged citizens. Expanded methods are required for Visual assessment in institutional populations.
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Unilateral Visual Impairment in an urban population in southern India.
Indian Journal of Ophthalmology, 2000Co-Authors: Lalit Dandona, Rakhi Dandona, Marmamula Srinivas, Partha Mandal, Catherine A. MccartyAbstract:This study assessed the prevalence and causes of unilateral Visual Impairment in the urban population of Hyderabad city as part of the Andhra Pradesh Eye Disease Study. Stratified, random, cluster, systematic sampling was used to select 2,954 subjects from 24 clusters representative of the population of Hyderabad. Eligible subjects underwent detailed eye examination including logMAR Visual acuity, refraction, slitlamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic evaluation of fundus. Automated threshold Visual fields and slitlamp and fundus photography were done when indicated by standardised criteria. Unilateral Visual Impairment was defined as presenting distance Visual acuity A total of 2,522 subjects (85.4% of eligible), including 1,399 ≥30 years old, participated in the study. In addition to the 1% blindness and 7.2% moderate Visual Impairment (based on bilateral Visual Impairment criteria) reported earlier in this sample, 139 subjects had unilateral Visual Impairment, an age-gender-adjusted prevalence of 3.8% (95% confidence interval 2.7-4.9%). The major causes of this Visual Impairment 39.9% were refractive error (42.9%), cataract (14.4%), corneal disease (11.5%), and retinal disease (11.2%). Of this unilateral Visual Impairment was blindness. The major causes of unilateral blindness were corneal disease (23.2%), cataract (22.5%), retinal disease (18%), and optic atrophy (12.9%). On the other hand, the predominant cause of unilateral moderate Visual Impairment was refractive error (67%) followed by cataract (9%). Of the total unilateral Visual Impairment, 34.3% was present in those Unilateral Visual Impairment afflicts approximately 1 in 25 persons in this urban population. A large proportion of this unilateral Visual Impairment is present in younger age groups. The causes of unilateral Visual Impairment, like those of bilateral Visual Impairment in this population, are varied, suggesting therefore, that in addition to the current focus of eye care in India predominantly on cataract, other causes of Visual Impairment need to be addressed as well.
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age specific causes of bilateral Visual Impairment
Archives of Ophthalmology, 2000Co-Authors: Le Ann Weih, Catherine A. Mccarty, Mylan R Vannewkirk, Hugh R. TaylorAbstract:Objectives To describe the age-specific prevalence of common eye diseases causing bilateral Visual Impairment and estimate the total number of Australians with cause-specific Visual Impairment. Methods Cluster-stratified random sample of 5147 residents aged 40 years and older from urban and rural areas and aged-care facilities. Participants completed a standardized interview and eye examination. Four levels of bilateral Visual Impairment were defined: less than 20/40 to 20/60 and/or homonymous hemianopia (mild), less than 20/60 to 20/200 or better and/or less than 20° to 10° radius field (moderate), less than 20/200 to 10/200 and/or less than 10° to 5° radius field (severe), and less than 10/200 and/or less than 5° radius field (profound). The major cause of vision loss was identified for all participants found to be Visually impaired. Results Uncorrected refractive error was the most common cause of bilateral Visual Impairment across all decades of life, rising from 0.5% in 40- to 49-year-olds to 13% among those aged 80 years and older. Prevalence of Visual Impairment due to diabetic retinopathy was 0.7% in 50- to 59-year-olds and 0.8% in those older than 80 years. Visual Impairment due to glaucoma had a prevalence of 0.7% among 60-year-olds and rose to 4% of those older than 90 years. The prevalence of Visual Impairment due to cataract (only present in those aged 70 years or older) rose from 0.6% to 11% in those older than 90 years, and the prevalence of Visual Impairment due to age-related macular degeneration rose from 0.8% to 16% in those older than 90 years. Conclusions The predominant causes of Visual Impairment change with age. Recognition of these patterns is fundamental for early diagnosis and treatment of eye disease and, where appropriate, referral for rehabilitation.
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burden of moderate Visual Impairment in an urban population in southern india
Ophthalmology, 1999Co-Authors: Lalit Dandona, Catherine A. Mccarty, Rakhi Dandona, Marmamula Srinivas, Partha Mandal, Thomas Naduvilath, Ashok NandaAbstract:Abstract Objective To assess the prevalence and causes of moderate Visual Impairment in an urban population in southern India. Design Population-based, cross-sectional study. Participants A total of 2522 (85.4% of the eligible) persons of all ages, including 1399 persons 30 years of age or older, from 24 clusters representative of the population of Hyderabad city. Testing The eligible subjects underwent a detailed ocular evaluation, including logarithm of the minimum angle of resolution (logMAR) Visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, cataract grading, and stereoscopic dilated fundus evaluation. Automated threshold Visual fields and slit-lamp and fundus photography were done when indicated by standardized criteria. Main outcome measure Moderate Visual Impairment was defined as presenting distance Visual acuity less than 20/40 to 20/200 or Visual field loss by predefined standardized conservative criteria in the better eye. Results In addition to the 1% prevalence of blindness in this sample reported earlier, moderate Visual Impairment was present in 303 subjects, an age-gender-adjusted prevalence of 7.2% (95% confidence interval [CI], 4.5%–9.9%; design effect, 2.7). The major cause of moderate Visual Impairment was refractive error (59.4%, 95% CI, 52.3%–66.5%) followed by cataract (25.3%, 95% CI, 19%–31.6%). Multivariate analysis showed that the prevalence of moderate Visual Impairment was significantly higher in those 40 years of age or older (odds ratio, 10.9; 95% CI, 8–15) and females (odds ratio, 1.89; 95% CI, 1.41–2.53) and lower in those belonging to the highest socioeconomic status (odds ratio, 0.27; 95% CI, 0.14–0.51). However, because of the pyramidal age distribution of the population, 38.1% of the total moderate Visual Impairment was present in those younger than 40 years of age. The proportion of moderate Visual Impairment caused by refractive error was higher in the younger than in the older age groups ( P Conclusions Projecting the results to the 26.5% urban population of India, there would be 18.4 million (95% CI, 11.5–25.2 million) persons with moderate Visual Impairment in urban India alone. Refractive error was the major cause of moderate Visual Impairment in the population studied. The absolute proportion of moderate Visual Impairment in those younger than 40 years of age was considerable. The eyecare policy of India, apart from dealing with blindness, should address the issue of the relatively easily treatable uncorrected refractive error as the cause of moderate Visual Impairment in an estimated 10.9 million persons in urban India.
Tien Yin Wong - One of the best experts on this subject based on the ideXlab platform.
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Visual Impairment age related eye diseases and cognitive function the singapore malay eye study
Archives of Ophthalmology, 2012Co-Authors: Carol Y Cheung, Ecosse L Lamoureux, Xiang Li, Kamran M Ikram, Jie Ding, Chingyu Cheng, Benjamin Haaland, Narayanaswamy Venketasubramanian, Christopher P L Chen, Tien Yin WongAbstract:Objective To describe the associations of Visual Impairment and major age-related eye diseases with cognitive function in an older Asian population. Methods A population-based, cross-sectional study of 1179 participants aged 60 to 80 years from the Singapore Malay Eye study was conducted. Visual acuity was measured using the logMAR vision chart. Cataract and age-related macular degeneration were graded using the Wisconsin Cataract Grading System and the Wisconsin Age-Related Maculopathy Grading System, respectively. Glaucoma was diagnosed using the International Society Geographical and Epidemiological Ophthalmology criteria. Diabetic retinopathy was graded using the modified Airlie House classification system. Cognitive dysfunction was defined as a locally validated Abbreviated Mental Test using education-based cutoff scores. Results After adjusting for age, sex, education level, income, and type of housing, persons with Visual Impairment before refractive correction (odds ratio [OR] = 2.59; 95% CI, 1.89-3.56) or after refractive correction (OR = 1.96; 95% CI, 1.27-3.02) and those with Visual Impairment due to cataract (OR = 2.75; 95% CI, 1.35-5.63) were more likely to have cognitive dysfunction. Only moderate to severe diabetic retinopathy was independently associated with cognitive dysfunction (OR = 5.57; 95% CI, 1.56-19.91) after controlling for concurrent age-related eye diseases. No significant independent associations were observed between cataract, age-related macular degeneration, or glaucoma and cognitive dysfunction. Conclusions Older persons with Visual Impairment, particularly those with Visual Impairment due to cataract, were more likely to have cognitive dysfunction. Furthermore, among the major age-related eye diseases, only diabetic retinopathy was associated with cognitive dysfunction.
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Visual Impairment causes of vision loss and falls the singapore malay eye study
Investigative Ophthalmology & Visual Science, 2008Co-Authors: Ecosse L Lamoreux, Jie Jin Wang, Paul Mitchell, Elaine W Chong, Tin Aung, Tien Yin WongAbstract:PURPOSE: To report associations of Visual Impairment and the main causes of vision loss with falls in an older Asian population. METHODS: The population-based Singapore Malay Eye Study examined 3280 (78.7% response rate) Malay adults 40 to 80 years of age. Details about any fall in the previous 12 months and personal and sociodemographic information were collected. Presenting Visual acuity (PVA) was measured. Mild or moderate Visual Impairment (0.3/= 1.0), and the primary causes of Visual Impairment were determined by ophthalmologists at examination. RESULTS: Of the 3280 participants, 3266 (99.6%) provided information about falls. Of these, 14.7% (n = 480) reported having fallen in the past 12 months. After adjustment for gender, age, body mass index, history of angina, heart attack, stroke, hypertension, diabetes, and self-rated health, the results showed that severe Visual Impairment in the worse eye significantly increased the risk of falling (60%; OR = 1.6; 95% CI 1.1 to 2.3). Severe Visual Impairment in one eye and mild or moderate Visual Impairment in the other also doubled the risk of falls (OR = 2.1; 95% CI 1.4-3.1). Having glaucoma (n = 21) increased the risk of falling by more than fourfold (OR = 4.2; 95% CI 1.2-12.3) after adjustment for Visual acuity. Although mild or moderate Visual Impairment was not significantly associated with falls, odds ratios tended toward the direction of risk. CONCLUSIONS: Findings from this Asian population provide further evidence in support of the association between severe Visual Impairment and falls in older persons. Language: en
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estimation of global Visual Impairment due to uncorrected refractive error
Bulletin of The World Health Organization, 2008Co-Authors: Lalit Dandona, Rakhi DandonaAbstract:The paper by Resnikoff et al.1 on the global magnitude of Visual Impairment caused by uncorrected refractive error published in the Bulletin of the World Health Organization in January 2008 does not refer to our previous publication2 on the same topic in BMC Medicine that precedes their paper by about two years and is readily available in the public domain. The reason for this is unclear as our paper clearly shows up in a PubMed® search for both “blindness” and “Visual Impairment”. In addition, the global estimates of blindness and Visual Impairment due to uncorrected refractive error made in our paper are know to the blindness community as they were presented at the World Ophthalmology Congress at Sao Paulo in February 2006. It is therefore surprising that Resnikoff et al. did not follow the usual norm of referring to previously published relevant literature. While there are differences in the inclusion criteria for studies in our paper and that of Resnikoff et al., with our paper using stricter criteria leading to fewer qualifying studies, and there were differences in the estimates of blindness and Visual Impairment due to uncorrected refractive error in the two papers, these should not be reasons for not referring to previously published work.
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revision of Visual Impairment definitions in the international statistical classification of diseases
BMC Medicine, 2006Co-Authors: Lalit Dandona, Rakhi DandonaAbstract:The existing definitions of Visual Impairment in the International Statistical Classification of Diseases are based on recommendations made over 30 years ago. New data and knowledge related to Visual Impairment that have accumulated over this period suggest that these definitions need to be revised. Three major issues need to be addressed in the revision of these definitions. First, the existing definitions are based on best-corrected Visual acuity, which exclude uncorrected refractive error as a cause of Visual Impairment, leading to substantial underestimation of the total Visual Impairment burden by about 38%. Second, the cut-off level of Visual Impairment to define blindness in the International Statistical Classification of Diseases is Visual acuity less than 3/60 in the better eye, but with increasing human development the Visual acuity requirements are also increasing, suggesting that a level less than 6/60 be used to define blindness. Third, the International Statistical Classification of Diseases uses the term 'low vision' for Visual Impairment level less than blindness, which causes confusion with the common use of this term for uncorrectable vision requiring aids or rehabilitation, suggesting that alternative terms such as moderate and mild Visual Impairment would be more appropriate for Visual Impairment less severe than blindness. We propose a revision of the definitions of Visual Impairment in the International Statistical Classification of Diseases that addresses these three issues. According to these revised definitions, the number of blind persons in the world defined as presenting Visual acuity less than 6/60 in the better eye would be about 57 million as compared with the World Health Organization estimate of 37 million using the existing International Statistical Classification of Diseases definition of best-corrected Visual acuity less than 3/60 in the better eye, and the number of persons in the world with moderate Visual Impairment defined as presenting Visual acuity less than 6/18 to 6/60 in the better eye would be about 202 million as compared with the World Health Organization estimate of 124 million persons with low vision defined as best-corrected Visual acuity less than 6/18 to 3/60 in the better eye. Our suggested revision of the Visual Impairment definitions in the International Statistical Classification of Diseases takes into account advances in the understanding of Visual Impairment. This revised classification seems more appropriate for estimating and tracking Visual Impairment in the countries and regions of the world than the existing classification in the International Statistical Classification of Diseases.
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what is the global burden of Visual Impairment
BMC Medicine, 2006Co-Authors: Lalit Dandona, Rakhi DandonaAbstract:Background A recent estimate by the World Health Organization (WHO) suggests that 161 million persons worldwide have Visual Impairment, including 37 million blind (best-corrected Visual acuity less than 3/60 in the better eye) and 124 million with Visual Impairment less severe than blindness (best-corrected acuity less than 6/18 to 3/60 in the better eye). This estimate is quoted widely, but because it is based on definitions using best-corrected Visual acuity, uncorrected refractive error as a cause of Visual Impairment is excluded.
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Unilateral Visual Impairment in an urban population in southern India.
Indian Journal of Ophthalmology, 2000Co-Authors: Lalit Dandona, Rakhi Dandona, Marmamula Srinivas, Partha Mandal, Catherine A. MccartyAbstract:This study assessed the prevalence and causes of unilateral Visual Impairment in the urban population of Hyderabad city as part of the Andhra Pradesh Eye Disease Study. Stratified, random, cluster, systematic sampling was used to select 2,954 subjects from 24 clusters representative of the population of Hyderabad. Eligible subjects underwent detailed eye examination including logMAR Visual acuity, refraction, slitlamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic evaluation of fundus. Automated threshold Visual fields and slitlamp and fundus photography were done when indicated by standardised criteria. Unilateral Visual Impairment was defined as presenting distance Visual acuity A total of 2,522 subjects (85.4% of eligible), including 1,399 ≥30 years old, participated in the study. In addition to the 1% blindness and 7.2% moderate Visual Impairment (based on bilateral Visual Impairment criteria) reported earlier in this sample, 139 subjects had unilateral Visual Impairment, an age-gender-adjusted prevalence of 3.8% (95% confidence interval 2.7-4.9%). The major causes of this Visual Impairment 39.9% were refractive error (42.9%), cataract (14.4%), corneal disease (11.5%), and retinal disease (11.2%). Of this unilateral Visual Impairment was blindness. The major causes of unilateral blindness were corneal disease (23.2%), cataract (22.5%), retinal disease (18%), and optic atrophy (12.9%). On the other hand, the predominant cause of unilateral moderate Visual Impairment was refractive error (67%) followed by cataract (9%). Of the total unilateral Visual Impairment, 34.3% was present in those Unilateral Visual Impairment afflicts approximately 1 in 25 persons in this urban population. A large proportion of this unilateral Visual Impairment is present in younger age groups. The causes of unilateral Visual Impairment, like those of bilateral Visual Impairment in this population, are varied, suggesting therefore, that in addition to the current focus of eye care in India predominantly on cataract, other causes of Visual Impairment need to be addressed as well.
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burden of moderate Visual Impairment in an urban population in southern india
Ophthalmology, 1999Co-Authors: Lalit Dandona, Catherine A. Mccarty, Rakhi Dandona, Marmamula Srinivas, Partha Mandal, Thomas Naduvilath, Ashok NandaAbstract:Abstract Objective To assess the prevalence and causes of moderate Visual Impairment in an urban population in southern India. Design Population-based, cross-sectional study. Participants A total of 2522 (85.4% of the eligible) persons of all ages, including 1399 persons 30 years of age or older, from 24 clusters representative of the population of Hyderabad city. Testing The eligible subjects underwent a detailed ocular evaluation, including logarithm of the minimum angle of resolution (logMAR) Visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, cataract grading, and stereoscopic dilated fundus evaluation. Automated threshold Visual fields and slit-lamp and fundus photography were done when indicated by standardized criteria. Main outcome measure Moderate Visual Impairment was defined as presenting distance Visual acuity less than 20/40 to 20/200 or Visual field loss by predefined standardized conservative criteria in the better eye. Results In addition to the 1% prevalence of blindness in this sample reported earlier, moderate Visual Impairment was present in 303 subjects, an age-gender-adjusted prevalence of 7.2% (95% confidence interval [CI], 4.5%–9.9%; design effect, 2.7). The major cause of moderate Visual Impairment was refractive error (59.4%, 95% CI, 52.3%–66.5%) followed by cataract (25.3%, 95% CI, 19%–31.6%). Multivariate analysis showed that the prevalence of moderate Visual Impairment was significantly higher in those 40 years of age or older (odds ratio, 10.9; 95% CI, 8–15) and females (odds ratio, 1.89; 95% CI, 1.41–2.53) and lower in those belonging to the highest socioeconomic status (odds ratio, 0.27; 95% CI, 0.14–0.51). However, because of the pyramidal age distribution of the population, 38.1% of the total moderate Visual Impairment was present in those younger than 40 years of age. The proportion of moderate Visual Impairment caused by refractive error was higher in the younger than in the older age groups ( P Conclusions Projecting the results to the 26.5% urban population of India, there would be 18.4 million (95% CI, 11.5–25.2 million) persons with moderate Visual Impairment in urban India alone. Refractive error was the major cause of moderate Visual Impairment in the population studied. The absolute proportion of moderate Visual Impairment in those younger than 40 years of age was considerable. The eyecare policy of India, apart from dealing with blindness, should address the issue of the relatively easily treatable uncorrected refractive error as the cause of moderate Visual Impairment in an estimated 10.9 million persons in urban India.
