Showing papers in "Ophthalmic Epidemiology in 2010"
TL;DR: The projected increases in the prevalence of visual impairment over time reflect the demographic changes of a declining and aging Japanese population and highlight that the burden of disease due to visual impairment and imposed on society is likely to increase.
Abstract: Purpose: To present a comprehensive estimate of the total number of people with visual impairment in the adult Japanese population by age, gender, severity and cause, and to estimate future prevalence based on population projections and expected demographic changes.Methods: Definitions of visual impairment used in this study were based on the United States criteria. Total visual impairment was calculated as the sum of low vision and blindness. The prevalence estimates were based on input from a number of Japanese epidemiological surveys, census material and official population projections.Results: There were an estimated 1.64 million people with visual impairment in 2007 in Japan. Of these, 187,800 were estimated to be blind. The prevalence of visual impairment in Japan increased with age and half of the people with visual impairment were aged 70 years or older. The leading causes of visual impairment in Japan were glaucoma (24.3%), diabetic retinopathy (20.6%), degenerative myopia (12.2%), age-related ma...
146 citations
TL;DR: The baseline characteristics of a large international cohort of patients with macular telangiectasia type 2 (MacTel Type 2) are described in anticipation of a longitudinal natural history study to evaluate structural and functional changes, identify potential risk factors and related outcomes and highlight the limitation of using visual acuity measurements as a measure of function and as an outcome measure in potential clinical trials.
Abstract: Purpose: To describe the baseline characteristics of a large international cohort of patients with macular telangiectasia type 2 (MacTel Type 2) in anticipation of a longitudinal natural history study to evaluate structural and functional changes, identify potential risk factors and related outcomes.Methods: Images including fundus photographs, fluorescein angiograms, optical coherence tomography and fundus autofluorescence were collected. A grading system for MacTel type 2 was developed by the central reading center to evaluate lesion characteristics. Relationships between lesion characteristics and visual acuity were evaluated.Results: A total of 310 participants have been enrolled in the study. The mean time since diagnosis was 3 years (range 0 to 25 years). The mean age at the baseline examination was 61 ± 9 years. The mean visual acuity in the better eye was approximately 20/32 Snellen equivalents and approximately 20/50 in the worse eye. The visual acuity in the better eye of half of the participant...
128 citations
TL;DR: Dry eye signs were significantly associated with dry eye symptoms and independent risk factors included increased age, age-related cataract and pterygium.
Abstract: Purpose: To estimate the prevalence of dry eye disease, analyze the associations between dry eye symptoms and signs, and identify the risk factors in an elderly Mongolian population at high altitude in China.Methods: A population-based survey was conducted in 2006. A total of 2,486 Mongolians age 40 and older were selected. Symptoms of dry eye were assessed using a 6-item validated questionnaire. Dry eye disease was defined if participants reported one or more symptoms often or all the time. Positive signs included a tear-film breakup time of ≤10 seconds, a Schirmer test score of ≤ 5mm, or a fluorescein staining score ≥ 1 in one or both eyes. Presence of dry eye symptoms and positive signs were analyzed. Correlations between symptoms and signs, and risk factors were evaluated in a multivariate model.Results: Of the 1,816 participants, 50.1% (95% confidence interval, 47.8–52.4) were symptomatic. Tear-film breakup time of ≤ 10 seconds was 37.7% (95% confidence interval, 35.5–39.9). A Schirmer test score of ...
123 citations
TL;DR: Prevalence and risk factors for microangiopathy are similar to other studies, and the important finding is that the TC/HDL ratio was significant for DME.
Abstract: Purpose: To determine the prevalence of microangiopathy, and its risk factors in a population-based study of diabetes mellitus patients in the north-eastern area of Spain.Methods: A population-based transversal study of 8,187 type 2 (83.37% of the diagnosed patients) and 488 type 1 (85.76% of the diagnosed patients) underwent a detailed medical history that included: diagnoses of diabetic retinopathy, macular edema, microalbuminuria or overt nephropathy. A study of its risk factors, and the relationship between diabetic retinopathy and renal lesion was performed.Results: In type 1 diabetes patients we observed a prevalence of 36.47% of diabetic retinopathy and 5.73% with macular edema; in type 2 diabetes patients the prevalence of diabetic retinopathy was 26.11% and 6.44% with macular edema. Microalbuminuria prevalence was 25.61% in type 1 and 17.78% in type 2 patients, and overt nephropathy prevalence was 8.60% in type 1 and 6.74% in type 2 diabetic patients. The risk factors for diabetic retinopathy wer...
108 citations
TL;DR: Outdoor activities might be an important protecting factor for myopia in rural school children in Taiwan, and it is suggested that outdoor activity showed significance and was inversely associated with myopia.
Abstract: Purpose: The aim was to identify the prevalence and risk factors of myopia among elementary school students in a rural area of Taiwan.Methods: A cross-sectional study was conducted. Elementary school students aged 7–12 years were recruited from the two schools located on Chimei Island. Data were obtained by means of a parent questionnaire and ocular evaluations that included axial length and cycloplegic autorefraction.Results: One hundred and forty five students were recruited for this study. Myopia prevalence was 31%. In univariate analysis, myopia was significantly associated with school year, myopic parent, and watching television (TV) (P < .0001, = 0.007 and = 0.029, respectively). Multiple logistic regression analysis revealed that myopia was significantly associated with school year and myopic parent. However, the effect of watching TV was not statistically significant (P = 0.059). Outdoor activity showed significance and was inversely associated with myopia (Odds Ratio [OR] = 0.3, 95% Confidence In...
107 citations
TL;DR: ADREV provides valid estimates of how visual loss due to glaucoma affects the ability to perform activities of daily living and how patients rated their own visual ability with how they performed when objectively tested.
Abstract: Purpose: To determine the relationships among three methods of assessing visual loss caused by glaucoma: (1) standard clinical tests of vision, (2) self-reported quality of life, and (3) the ability to perform activities of daily living.Methods: One hundred and ninety two glaucoma patients with a full range of glaucomatous visual loss were selected from the Glaucoma Service of Wills Eye Institute. Subjects were evaluated clinically by visual acuity, contrast sensitivity, visual field, stereopsis, the Disc Damage Likelihood Scale, and intraocular pressure. Subjects were evaluated subjectively by the 25-item National Eye Institute’s Visual Functioning Questionnaire (NEI-VFQ-25) and objectively by a performance-based measure of visual function, the Assessment of Disability Related to Vision (ADREV). Statistical analysis, including Spearman coefficients, was performed on the data from the clinical measures, NEI-VFQ-25, and ADREV.Results: The clinical tests had higher correlations with ADREV than with the NEI-...
83 citations
TL;DR: Investigation of the prevalence and causes of vision impairment/blindness among older adults in a high CSR area in Gujarat found cataract remains the predominant cause of blindness.
Abstract: Background: The cataract surgical rate (CSR) in Gujarat, India is reported to be above 10,000 per million population. This study was conducted to investigate the prevalence and causes of vision impairment/blindness among older adults in a high CSR area.Methods: Geographically defined cluster sampling was used in randomly selecting persons ≥ 50 years of age in Navsari district. Subjects in 35 study clusters were enumerated and invited for measurement of presenting and best-corrected visual acuity and an ocular examination. The principal cause was identified for eyes with presenting visual acuity < 20/32.Results: A total of 5158 eligible persons were enumerated and 4738 (91.9%) examined. Prevalence of presenting visual impairment < 20/63 to 20/200 in the better eye was 29.3% (95% confidence interval [CI]: 27.5–31.2) and 13.5% (95% CI: 12.0–14.9) with best correction. The prevalence of presenting bilateral blindness (< 20/200) was 6.9% (95% CI: 5.7–8.1), and 3.1% (95% CI: 2.5–3.7) with best correction. Prese...
77 citations
TL;DR: The prevalence of blindness in this population in Kilimanjaro Region was low, reflecting high cataract surgical coverage from an outreach program, and an emphasis on quality is needed.
Abstract: Purpose: To estimate the prevalence and causes of avoidable blindness and visual impairment in persons 50 years of age and older, and to assess the impact of cataract surgical services.Methods: In this cross-sectional population-based survey, 72 clusters of 50 people 50 years and older were selected by probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Participants underwent an ophthalmic examination in their homes, including measurement of visual acuity (VA) with a tumbling-E chart and diagnosis of the principal cause of visual impairment. Patients who had been operated on were questioned about details of their cataract surgery.Results: Three thousand six hundred eligible subjects were selected, of whom 3,436 (95.5%) were examined. The prevalence of bilateral blindness (presenting VA < 3/60) was 2.4% (95% confidence interval [CI], 1.9%–2.9%); prevalence of severe visual impairment was 0.99% (95% CI, 0.98%–0.99%); and prevalence of visual...
65 citations
TL;DR: The ZAP trial will determine if laser iridotomy (LI) is safe and effective at preventing pathological angle closure in asymptomatic eyes with narrow angle configurations on gonioscopy and provide data on what happens to untreated eyes in PACSs.
Abstract: Purpose: To summarize the design and methodology of a large-scale trial in southern China, the Zhongshan Angle Closure Prevention (ZAP) trial. This trial will determine if laser iridotomy (LI) is superior to no treatment for managing Chinese people who are Primary Angle Closure Suspects (PACS). In this trial, PACS was defined as having 6 or more clock hours of angle circumference in which the pigmented trabecular meshwork was not visible under static gonioscopy in both eyes without elevated intraocular pressure, peripheral anterior synechiae or glaucomatous neuropathy.Methods: Subjects were recruited from an urban district in Guangzhou. The target sample size was 870. Persons 50 years of age and older with 20/40 or better vision in both eyes identified as having 6 or more clock hours of angle circumference in which the pigmented trabecular meshwork was not visible under static gonioscopy in both eyes were enrolled. Each subject was randomized to undergo LI in one eye with the fellow eye left untreated. Fo...
63 citations
TL;DR: Given a higher ratio of female residents relative to female faculty, it is probable that graduating female residents are choosing not to pursue academic medicine, shrinking the potential pool of female candidates for positions of departmental leadership.
Abstract: Purpose: To determine if there is any association in ophthalmology between the gender of the chairperson and residency program director and the gender of faculty and residents.Methods: An anonymous electronic survey was sent to 121 ophthalmology residency program directors. Demographic information pertaining to size, location, academic or community affiliation, and gender distribution of the faculty, residents, residency program directors and chairs was obtained.Results: The response rate was 45.45% with 55 residency program directors responding to the survey. Academic programs comprised 53 (96%) of the programs studied. Male department chairs led all 53 (96%) programs. In terms of the residency program director gender, 37 (67%) were male, whereas 18 (34%) were female. Female faculty and residents comprised 313 (28%) and 270 (45%), respectively. Compared to departments with male chairs, departments with a female chair had a higher crude proportion of female faculty (35% vs. 28%; P = 0.300) and female resi...
56 citations
TL;DR: Although progress is being made in the region, it is clear that substantial proportions of bilaterally blind persons are still not receiving surgery and a good correlation between cataract surgery rate and gross national income per capita was found.
Abstract: Purpose: To collect cataract surgery rates data in 19 Latin American countries over a 4-year period as data published to date have been limited.Methods: Cataract surgery rates were obtained from Na...
TL;DR: Couching is still widely practiced in Nigeria and visual outcomes are very poor, and services for high quality, affordable cataract surgery need to be expanded, particularly in rural areas and in the north of the country.
Abstract: Purpose: Couching is an ancient treatment for cataract which is still practiced in some of the poorer developing countries, particularly in sub-Saharan Africa. The purpose of this study is to describe risk factors for couching and visual acuity outcomes in a nationally representative sample of adults aged 40 years and above in Nigeria.Methods: Probability in proportion size methods were used to identify a representative sample. Of the 15,375 adults enumerated, 13,582 were interviewed and examined. Examination included logMar acuities, slit lamp examination and dilated fundoscopy with digital fundus imaging.Results: Almost half of the 583 eyes undergoing a procedure for cataract had been couched (249 eyes, 42.7%). Individuals living in rural areas (P = 0.033) and in the two underserved northern administrative zones (P = 0.33; P = 0.002) were more likely to have been couched. Visual outcomes were poor according to World Health Organization categories, with 55.8% of people and 73.1% of eyes having a presenti...
TL;DR: The first estimate of the prevalence of GCD2 in Korea is presented, and it is estimated that the prevalence is greater than anticipated and could potentially be applied to estimating the prevalence in other rare diseases.
Abstract: Purpose: This study investigates the prevalence of granular corneal dystrophy type 2 (GCD2; Avellino corneal dystrophy) in the Korean populationMethods: GCD2 homozygotes were identified through a collaboration of Korean referral centers for corneal disease The genetic status of the patients and their immediate families were verified by DNA analysis A lower bound for the gene prevalence was calculated using a model based on the Hardy-Weinberg principle A second population-based model was developed to correct for known underestimation in the primary model The corrected model used population data from the 2005 Korean census and fertility rates from historical Korean census dataResults: We identified 21 individuals homozygous for GCD2 (R124H mutation) from 16 Korean families From this, we estimate that the overall prevalence (combining heterozygotes and homozygotes) is at least 825 affected persons/10,000 persons Our corrected estimate for overall prevalence is 115 affected persons/10,000 personsCo
TL;DR: Older adults with blindness face significant health disparities that can diminish their quality of life without timely, disability-sensitive interventions to address serious psychological distress and physical inactivity.
Abstract: Purpose: To develop a health risk profile for adults age 65 years or older with blindness, using the International Classification of Functioning, Disability and Health (ICF) as our conceptual framework.Methods: We combined and analyzed data from the 2000–2006 National Health Interview Survey after backcoding questions to the ICF. We compared older adults with blindness (n = 477) and older adults with vision loss but not blindness (n = 6,721) with older adults who reported no vision loss (n = 33,497) for the following outcome measures: demographics, functional limitations (self-care, social participation, and mobility limitations), level of psychological distress, physical health status, selected chronic conditions and health risk behaviors (smoking, alcohol use, obesity, and physical inactivity).Results: Older adults with blindness were more likely to be poorer, older, and less educated than older adults without vision loss. They were also more likely to have fair to poor health; to have difficulty walkin...
TL;DR: In the sample of Singaporean children without ocular disease, distance VA did not play a significant role in predicting academic school performance.
Abstract: Purpose: To determine whether presenting distance visual acuity is related to subsequent academic school performance in Singaporean children between 9 to 10 years of age.Methods: Singapore children (n = 1143 children) were examined during their visits at ages 9 to 10 years (grades 3 to 4) as part of the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) longitudinal study. Each child underwent an annual comprehensive eye examination, including the assessment of presenting logarithm of the minimum angle of resolution (LogMAR) distance visual acuity (VA). The individual marks of a nation-wide standard examination in grade 4 were used as the outcome measure for academic school performance. Children with any known eye disease, (such as media opacities) were excluded from the analysis.Results: The mean presenting distance VA of the better eye was 0.10 and 0.08 when the children were in grades 3 and 4, respectively. There was a statistically significant difference for mean presenting VA with 9 and 10...
TL;DR: This study among adults undergoing cataract surgery in 3 different low-income settings found evidence of improved VRQoL and generic HRQo L to approximately equal that of controls with normal vision.
Abstract: ABStrA ct Purpose: To assess the impact of cataract surgery on vision related quality of life (VRQoL) and generic health related quality of life (HRQoL) in Kenya, Bangladesh and the Philippines. Methods: A multi-center intervention study was conducted. At baseline 651 cases aged ≥50 years with visually impairing cataract (corrected visual acuity (VA) 6/18) were interviewed about VRQoL (using the World Health Organization/ Prevention of Blindness and Deafness 20-item Visual Functioning Questionnaire [WHO/PBD VF20]) and generic HRQoL (EuroQol). Cases were offered free/subsidized cataract surgery. Approximately 1 year later participants were re-interviewed. Results: Response rate at follow up was 84% for operated cases and 80% for controls. At baseline, cases had significantly poorer VRQoL scores, were more likely to report problems with the EuroQol 5D five descriptive (EQ−SD) domains (mobility, daily activities, self-care, pain, depression/anxiety) and had significantly poorer self-rated health compared to controls. At follow up VRQoL scores of operated cases improved significantly to approximately equal those of controls. Effect sizes were large (> 0.8) regardless of pre-operative VA. Poor outcome from surgery (VA < 6/60) was associated with smaller VRQoL gains. Among operated cases frequency of reported problems with all the EQ-5D reduced significantly compared to baseline in Kenya and the Philippines, and in mobility, daily activities and self-care in Bangladesh. Self-rated health scores increased significantly in each country. HRQoL of controls remained stable from baseline to follow up.
TL;DR: PXF is common among older individuals in north-western Spain and has a significantly higher prevalence of glaucoma than subjects without, and an abnormal ocular surface detected by rose bengal staining is highly prevalent among subjects with pseudoexfoliation.
Abstract: Purpose: To estimate the prevalence of Pseudoexfoliation syndrome (PXF) and to investigate its relationship with systemic and ocular diseases and lifestyle factors in a general adult population in north-western Spain.Methods: An age-stratified random sample of 1155 subjects was drawn from the population aged 40 years and over of O Salnes (Spain). From 937 eligible subjects, 619 (66.1%) participated (mean age (Standard Deviation [SD]): 63.4 (14.5) years, range: 40–96, 37.0% males). An interview to collect past history of ocular and systemic diseases and lifestyle details, and a comprehensive ophthalmic evaluation were performed. Study subjects with typical pseudoexfoliative material on the anterior capsule or in the pupil margin were labelled as having PXF. A design based analysis was performed and all calculations were weighted to give unbiased estimates.Results: The prevalence of PXF was 6.5% (95% confidence interval [CI]:4.9–8.1). PXF rates increased significantly with age (P = 0.000). No cases of PXF w...
TL;DR: A moderate prevalence of childhood blindness in the Lorestan province of Iran is suggested, a high proportion of which may be avoidable, given improved access to ophthalmic and genetic counselling services in rural areas.
Abstract: Purpose: To estimate the prevalence and causes of severe visual impairment and blindness among children in Lorestan province of Iran, and to assess the feasibility of the Key Informant Method in this setting.Methods: Potential cases were identified using the Key Informant Method, in 3 counties of Lorestan province during June through August 2008, and referred for examination. Causes of severe visual impairment/blindness were determined and categorized using standard World Health Organization methods.Results: Of 123 children referred for examination, 27 children were confirmed to have severe visual impairment/blindness or blindness. The median age was11 years (interquartile range 6–13), and 59% were girls. After adjusting for non-attenders, the estimated prevalence of severe visual impairment/blindness was 0.04% (0.03–0.05). The main site of abnormality was retina (44%), followed by disorders of the whole eye (33%). The majority of causes had a hereditary etiology (70%), which was associated with a family ...
TL;DR: The study supports the use of the WHO/PBD VF20 in a Philippine population and highlights the worsening VRQoL associated with cataract vision loss, which indicates an impact of visual impairment on perceived health and well-being, beyond vision-specific experience.
Abstract: Purpose: To evaluate a vision related quality of life (VRQoL) scale, the World Health Organization Prevention of Blindness and Deafness Visual Function-20 (WHO/ PBD VF20) and describe the relationship between visual impairment from cataract and vision related and generic Health Related Quality of Life (HRQoL) in a case-control study of adults aged ≥ 50 years in the Philippines.Methods: Two hundred and thirty eight population based persons visually impaired from cataract and 163 age- gender- matched controls with normal vision were interviewed using the WHO/PBD VF20 and European Quality of Life (EuroQol) questionnaire (an HRQoL). The WHO/PBD VF20 was evaluated using standard psychometric tests.Results: The WHO/PBD VF20 had good item acceptability and validity. Cases had significantly poorer VRQoL than controls and worsening Visual Acuity (VA) was associated with worsening VRQoL. The general functioning subscale had good internal consistency. The psychosocial sub-scale had a Cronbach’s alpha of 0.61, just b...
TL;DR: Although eye injury in elderly occurred more commonly on the farm during farm related activities, gender related differences are present with injury occurring more commonly in the home and during assaults/disputes.
Abstract: Purpose: To study the epidemiology of ocular trauma among the elderly in a developing country.Method: This is a multi-center retrospective clinical study of patients aged 65 years and above managed for ocular trauma between 2001 and 2007 at 4 hospitals in southwestern Nigeria. Age, sex, occupation, residential address, location at time of injury, activity preceding injury, agent of injury, treatment modalities offered and presenting visual acuity were recorded in a predesigned form. Type of injury was classified according to Birmingham Eye Trauma Terminology. Data were recorded and analyzed with descriptive statistics and Chi square using SPSS 11 (SPSS Inc., Chicago, IL) and statistical significance accepted at P < 0.05.Results: 78 patients with overall mean age of 70.1 ± 5.5 years and male to female ratio of 1.9: 1 (P = 0.007) were studied. Mean age for males was 70.0 ± 5.4 years and 70.1 ± 5.7 years for females. Eye injury occurred most commonly on the farm (37.2%), during farm related activities (35.9%...
TL;DR: FDT is a feasible, fast, and reliable method for visual field loss screening in a population-based U.S. study, with an 86.2% response rate, median exam time ~9 minutes, and nearly 95% of examined participants having complete, reliable results in 1 or both eyes.
Abstract: Purpose: To describe the frequency doubling technology (FDT) methodology to measure visual field loss in the National Health and Nutrition Examination Survey and to evaluate data reliability.Methods: Participants aged 40 years and older were eligible (n = 2,529) for 2 visual field tests per eye performed with the Humphrey Matrix N-30-5 screening test. Visual field loss was determined using a 2-2-1 algorithm requiring 2 complete tests per eye, with at least 2 abnormal field results in each test, and 1 common abnormal field.Results: Response rate was 86.2%. Time constraints were the main reason for no exam (55.6%). Median times were: single test, 37 seconds; entire exam, 9.1 minutes. When defining reliability based on ≤ 1/3 blind spots, ≤ 1/3 false positive tests, and technician noted proper fixation, 80.1% of examined adults had 2 reliable tests for both eyes; an additional 13.4% had 2 reliable tests for 1 eye. Increasing age, decreasing visual acuity, and the presence of self-reported glaucoma resulted in...
TL;DR: The AHEI score may be a useful instrument for assessing AMD risk due to diet, and it could potentially be improved by incorporating more specific information regarding micronutrient intake.
Abstract: Purpose: To examine overall diet quality in relation to advanced age-related macular degeneration (AMD).Methods: This case-control study identified 437 advanced AMD patients and 259 unrelated controls using stereoscopic color fundus photographs. Participants were predominantly non-Hispanic White men and women from North Carolina and Tennessee. A 97-item Block food frequency questionnaire was used to gather diet information, and overall diet quality was measured using the Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI).Results: Participants in the highest quartile of diet quality had significantly reduced odds of AMD according to the AHEI score (0.54, 95% confidence interval 0.30–0.99) and non-significantly reduced odds of AMD according to the HEI (0.75, 0.41–1.38). Odds of AMD were also 51% lower in the highest quartile of fish intake compared to the lowest quartile (odds ratio = 0.49, 0.26–0.90).Conclusions: We found that advanced AMD was significantly related to overall diet quality...
TL;DR: The findings suggest that despite 9 years of hospital and community eye care services the prevalence of blindness in this area is still challengingly high and the cataract surgical coverage unacceptably low and community outreach awareness programs and accessibility for the Nepali cataracts blind to the hospital need to be upgraded.
Abstract: Purpose: The Gaur Eye Hospital, which provides eye care services to the people in Rautahat and adjacent districts, completed 9 years of operation in 2006. Over 14,000 cataract surgeries were performed during this period. This study aimed to ascertain the impact of the hospital services by estimating the prevalence of blindness, visual impairment and cataract surgical coverage among the older adult population of the Rautahat district.Methods: People aged 50 years and older were enrolled in this study that used a stratified cluster design. Subjects in 32 randomly selected clusters were identified through door-to-door visits, presenting and corrected visual acuities measurement, and clinical examination by ophthalmologists were conducted at a centrally located site.Results: Of the 5,533 identified subjects, 85.3% were examined. Blindness was defined as presenting with visual acuity < 6/60 in both eyes. Blindness was found in 17.4% (95% Confidence Interval: 15.1 to 19.7); however, 55.6% of individuals examine...
TL;DR: Surgery for cataracts with delayed presentation helps to regain functional vision, which can be used for navigation and low vision aids.
Abstract: Purpose: Childhood cataract is an important cause of avoidable blindness in children. The study aimed to investigate the outcome of surgery in cataracts with delayed presentation which had been operated upon as new pediatric ophthalmology centers were set up in India.Methods: This was a retrospective interventional case series from a community eye care center in Western India. Demographic, surgical, pre-operative and post-operative details were obtained from the patients records and entered into Microsoft excel and statistical analysis conducted using SPSS-11 software (SPSS, Chicago, IL). Vision was tested 6 weeks after surgery. The predictors of good vision (≥6/18) were identified by regression analysis. If the interval between detection of cataract in children and their presentation for surgery was more than 18 months for developmental and 6 months for congenital the cataract was defined having a delayed presentation.Results: Five hundred and twenty nine eyes of 437 children aged 2 months to 16 years we...
TL;DR: The D-AI offers a way of systematically assessing and measuring functional limitations and disabilities, and provides detailed information about activities that are needed to perform a certain goal.
Abstract: Purpose: To develop a valid and reliable instrument to systematically investigate visual rehabilitation needs of visually impaired older adults, which is compatible with the “International Classification of Functioning, Disability and Health” (ICF) structure: a new Dutch ICF version of the Activity Inventory (D-AI).Methods: The original AI was translated, adjusted and expanded. After studying literature and investigating patient records, focus group discussions were conducted until the input was just confirmatory. Six (n = 41) and seven (n = 50) discussions with patients and professionals respectively contributed to the first draft of the D-AI, which was further improved by professionals.Results: The D-AI now consists of 10 domains, 68 goals and 813 tasks. Goals are organized into the “Activities and Participation” domains of the ICF. The original routing was maintained; only tasks organized under important (0 [not important] to 3 [very important]) and difficult (0 [not difficult] to 4 [impossible]) goals...
TL;DR: Primary and secondary eye care systems should be strengthened to improve the care of blinding eye diseases in Qatar and to reduce avoidable blindness, un-operated cataract should be addressed.
Abstract: Background: Rapid Assessment for the Avoidable Blindness (RAAB) was conducted in Qatar during 2009 We present the prevalence and determinants of visual disabilities and status of cataract among citizens aged 50 years and olderMethods: Residents of randomly selected houses and clusters participated in the survey Opticians noted the presenting and the best corrected vision of participants from 49 clusters Ophthalmologists examined participants with additional instruments like bio-microscope, digital camera, auto-perimeter and auto-refractor in a mobile van World Health Organization recommended principal cause of blindness (Visual acuity [VA] < 3/60 in better eye), Severe visual impairment (SVI) (<6/60), low vision (VA < 6/18) and unilateral blindness (VA < 3/60) were designated Persons with VA < 6/18 and cataract were interviewed to calculate coverage and barriers for cataract surgeries Age sex adjusted prevalence of visual disabilities and their 95% Confidence Intervals (CI) were estimatedResults:
TL;DR: Low GA, low BW, phototherapy, ARDS, and blood transfusion were the main risk factors for development of ROP.
Abstract: Purpose: To determine the incidence and risk factors for the development of retinopathy of prematurity (ROP) among premature infants.Methods: New born infants with gestational age 2000 gr. Blood transfusion (Odds Ratio [OR] = 2.45, P = 0.031), phototherapy (OR = 2.405, P...
TL;DR: There is significant delay in accessing appropriate specialist care following eye injury in Tanzania, much of which occurs after first visiting a health facility, and a new model of delay is presented that may help guide interventions to reduce this delay.
Abstract: Purpose: To determine the extent and reasons for delay in accessing specialist eye care following a significant eye injury.Methods: Mixed methods study involving 93 consecutive admissions to Kilimanjaro Christian Medical Center, Tanzania (KCMC). Semi-structured interviews were conducted and supplemented by a review of medical notes. A statistical analysis of delay and predictor variables was conducted. Framework analysis of interviews was conducted.Results: Ninety of 93 patients took part. Significant visual loss was determined in 95.5% of affected eyes on arrival. The mean delay for treatment was 6.8 days. Of participants, 61.1% visited some health facility within 24 hours, and 82.2% within 48 hours. Injury on a weekend, using topical drops and visiting other health facilities before KCMC were independently associated with delay greater than 24 hours and greater than 48 hours, female gender with was associated with delay greater than 24 hours. Patient journeys involved key milestones and processes. Journ...
TL;DR: The prevalence of POAG in the population aged ≥40 years in central Sri Lanka was 2.3%, andPOAG in this population was independently associated with increasing age, IOP and axial length.
Abstract: Purpose: To report the prevalence and risk factors associated with primary open-angle glaucoma (POAG) in the Kandy district of central Sri Lanka.Methods: A cross-sectional, population-based ophthalmic survey of the inhabitants ≥ 40 years of age from villages in the Kandy District, Sri Lanka was conducted. Selection was randomized using a cluster sampling process; 1721 eligible participants were identified, 1375 participated in the study and sufficient examination data to diagnose glaucoma in at least one eye was obtained in 1244 participants. A detailed ophthalmic history and examination including ocular biometry was made of each participant. Primary open-angle glaucoma was classified into three levels according to diagnostic evidence.Results: The overall prevalence of POAG was 2.3% (95% CI 1.5–3.2). In the univariate analyses, increasing age (P = 0.001), intraocular pressure (IOP) (P < 0.001), myopia (P < 0.001) and axial length (P = 0.003) were significantly associated with POAG. In the multivariate ana...
TL;DR: The Glausat questionnaire has proven to be reliable and structurally valid and may be used to assess patients’ satisfaction with glaucoma treatment.
Abstract: Objective: Patient satisfaction with glaucoma therapy is one of the aspects that affects adequate adherence to treatment; therefore, it would be interesting to measure the satisfaction properly. We present the development process and psychometric properties of a new instrument for measuring patient satisfaction with glaucoma treatment.Material and methods: After collection and discussion of contents, a 38-item questionnaire was proposed and arranged into seven theoretical domains. The questionnaire was applied to a sample of 194 patients and its length was reduced using an exploratory factor analysis. Psychometric properties were assessed under classic theory.Results: The final questionnaire is formed by 22 items grouped into seven dimensions: expectations and beliefs about treatment, ease of use, efficacy, undesired effects, impact on health-related quality of life, medical care, and general satisfaction with treatment. Some dimensions correlated slightly. The reliability of the dimensions ranged from 0....